IDF Survey Helps Persuade
CMS to Temporarily Stop Reductions for IVIG Medicare Payments
The Immune Deficiency Foundation (IDF) patient survey helped
persuade the Centers for Medicare and Medicaid Services (CMS) to issue final
rules that grant a critical reprieve for patients with primary immune
deficiency diseases (PIDD). On November
1, CMS issued a ruling that will continue the temporary
“preadministration-related services” add-on for IVIG in 2007 for both physician
services and hospital outpatient department (OPD) reimbursements for IVIG. CMS
had established this additional payment for IVIG in 2006 to compensate
physicians and hospital OPDs for extra resources needed for locating and
obtaining appropriate IVIG products. It
was also used for scheduling patient infusions during a period “where there may
be temporary instability.” CMS also
withdrew another separate proposal to reduce Medicare’s payment for IVIG in the
hospital OPD setting.
In its final rules, CMS cited the IDF patient survey as
offering evidence of the hardships that many PIDD patients have had to deal
with because of reductions in Medicare payments for IVIG. Some of the findings from the survey include
patients reporting that they have had to change the site of their infusions,
postpone infusions, increase intervals between infusions, and reduce dosage of
IVIG as the result of changes in Medicare reimbursement methodology for
IVIG.
IDF wishes to thank the over one thousand PIDD patients who
took the time to respond to our survey this year. We believe that the survey’s results made the difference in providing
hard, empirical data that CMS needed to withdraw its proposed reductions.
IDF also acknowledges the hundreds of patients and family
members from the PIDD community who have contacted their Members of Congress
about this critical issue through our online advocacy program, Action
Alert. These personal contacts and our
patient survey demonstrate that an individual’s input can make a difference on
policymaking in Washington.
While this reprieve from reductions is vital to patients
with PIDD, IDF does not believe that it goes far enough to bring stability for
Medicare beneficiaries. We are taking
the same patient survey findings to Congressional Committees and Members of
Congress to show them the kinds of dislocations Medicare IVIG users are
experiencing as a result of changes in reimbursement policies enacted in
2003. We believe that a permanent
adjustment needs to be made in the way Medicare pays for IVIG to assure access
to care and choice of provider. Congress may need to take legislative action to
make sure this happens.
We celebrate this temporary reprieve for the PIDD community,
but recognize that it is not a time to become complacent. IDF urges all of you
to again visit our Web site and make your voice heard. Log on to IDF Action Alert at
www.primaryimmune.org to contact your
Members of Congress and let them know how important access to IVIG is to your
health.