Medicare bill would pay for immune disorder drug separately at nursing facilities

What does this do?

HR 8528 removes intravenous immune globulin, known as IVIG, from the bundled daily payment Medicare uses for skilled nursing facilities when the drug is needed to treat primary immunodeficiency disease. Instead of receiving one flat daily rate that must cover IVIG, a facility would receive a separate Medicare payment for the drug on top of that rate. The change would take effect October 1, 2026.

Who does it affect?

Medicare patients with primary immunodeficiency disease, a group of rare conditions where the immune system cannot fight infections without IVIG, are the patients directly affected. Skilled nursing facilities that treat these patients would also be affected under the new reimbursement structure.

Why does it matter?

Because IVIG is expensive and currently folded into a flat daily rate, some skilled nursing facilities decline to admit patients who need the drug, since the cost can exceed what Medicare pays. Separating the payment means facilities would receive additional reimbursement for the drug rather than absorbing the cost, which may affect patient access to post-hospital care at these facilities.

What does it cost, and who pays?

• IVIG paid separately from daily rate
• No dollar amount specified
• Medicare bears the additional cost