PI Post Acute Access Act
- Bill Number
- H.R. 8528
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-04-27: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-06-03T08:08:04Z
AI-Generated Summary
H.R. 8528: PI Post Acute Access Act
Purpose
To improve Medicare coverage for skilled nursing facility (SNF) services—short-term care in nursing homes after a hospital stay—for patients with primary immunodeficiency (PI) diseases, which weaken the immune system.
Key Provisions
- Amendment to Social Security Act: Adds a new provision (subclause VII) to Section 1888(e)(2)(A)(iii), which adjusts Medicare payments to SNFs based on patient needs.
- Coverage Expansion: Includes intravenous immune globulin (IVIG)—a treatment infused into veins to boost immunity for PI diseases—specified by Healthcare Common Procedure Coding System (HCPCS) codes (J1561, J1569, J1576, J1568, J1459, J1554, J1557, J1566, as updated by the Secretary of Health and Human Services). Also covers related items and services.
- Effective Date: Applies to services provided on or after October 1, 2026.
Significant Changes to Existing Law
- Expands the list of high-cost services that trigger higher Medicare payment adjustments under the SNF prospective payment system (a formula for reimbursing nursing homes).
- Previously, IVIG for PI was not explicitly listed, potentially limiting SNF access or payments for these patients.
Potential Impacts
- Citizens: Better access to post-hospital SNF care for Medicare beneficiaries with PI, reducing barriers to IVIG treatment outside hospitals.
- Government Agencies: Centers for Medicare & Medicaid Services (CMS) must update payment systems and HCPCS codes, with modest administrative costs.
- No international relations impact.
Main Stakeholders
- Patients: Medicare enrollees with primary immunodeficiency diseases.
- Healthcare Providers: Skilled nursing facilities and staff administering IVIG.
- Payers: Medicare program and taxpayers funding expanded reimbursements.
Notable Legal, Constitutional, or Political Implications
- Legal: Narrow, technical update to Medicare rules; no broad regulatory changes or challenges anticipated.
- Constitutional: None identified; aligns with Congress's authority over federal spending programs like Medicare.
- Political: Bipartisan sponsorship (Rep. Smith of Nebraska and Rep. Matsui); targets niche health issue without major fiscal controversy. Referred to House Committees on Ways and Means and Energy and Commerce.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (3)
Rep. Matsui, Doris O. [D-CA-7], Rep. Moore, Tim [R-NC-14], Rep. Gottheimer, Josh [D-NJ-5]
Recent Actions
- 2026-04-27: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2026-04-27: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2026-04-27: Introduced in House
- 2026-04-27: Introduced in House
Bill Versions
- PI Post Acute Access Act — issued 2026-04-27 — PDF (2 pages)