John W. Walsh Alpha-1 Home Infusion Act of 2025 · Introduced in House (2025-03-25)

SEC. 2. Medicare coverage of Alpha-1 Antitrypsin Disorder treatment

(a) In general

Section 1861 of the Social Security Act () is amended— 42 U.S.C. 1395x
- in subsection (s)(2)—
  - by striking and at the end of subparagraph (II);
  - by inserting at the end of subparagraph (JJ); and
    - Alpha-1 Antitrypsin Deficiency Disorder treatment (as defined in subsection (nnn));
  - by inserting at the end the following new subparagraph:
  - (nnn) Alpha-1 Antitrypsin Deficiency Disorder treatment
    - The term means augmentation therapy (as defined in paragraph (2)(C)) furnished by qualified home infusion therapy suppliers (as defined in paragraph (2)(D)) which are furnished in the individual’s home (as defined in paragraph (2)(B)) to an individual— Alpha-1 Antitrypsin Deficiency Disorder treatment
      - who is under the care of an applicable provider;
      - who is enrolled under both parts A and B of this title, and is not enrolled in an MA plan under part C of such title; and
      - who requires augmentation therapy (as defined in paragraph (2)(C)).
    - For purposes of this subsection:
      - The term means— applicable provider
        
        (i) a physician;
        
        (ii) a nurse practitioner; and
        
        (iii) a physician assistant.
      - The term means a place of residence used as the home of an individual (as defined for purposes of subsection (n)).
      - The term means an Alpha-1 Proteinase Inhibitor indicated for chronic augmentation and maintenance therapy in adults with clinical evidence of emphysema due to severe hereditary deficiency of Alpha-1 Antitrypsin. augmentation therapy
      - The term has the meaning given such term in subsection (iii)(3)(D)(i). qualified home infusion therapy supplier
- by adding at the end the following new subsection:

(b) Payment for intravenous administration kits and nursing services for Alpha-1 Antitrypsin Deficiency Disorder treatment

Section 1834 of the Social Security Act () is amended by adding at the end the following new subsection: 42 U.S.C. 1395m
- (aa) Payment for intravenous administration kits and nursing services for Alpha-1 Antitrypsin Deficiency Disorder treatment
  - The Secretary shall implement a payment system under which payment is made under this title to a qualified home infusion therapy supplier (as defined in section 1861(nnn)(3)(D)) for intravenous administration kits and nursing services for up to 2 hours of care by a qualified home infusion therapy supplier in coordination with the furnishing of augmentation therapy (as defined in section 1861(nnn)(2)(C)).

(1) Payment reference
- Section 1833(a)(1) of the Social Security Act () is amended— 42 U.S.C. 1395l(a)(1)
  - by striking before ; and
  - by inserting before the semicolon at the end the following: .
(2) Direct payment
- The first sentence of section 1842(b)(6) of the Social Security Act () is amended— 42 U.S.C. 1395u(b)(6)
  - by striking before ; and
  - by inserting before the period at the end the following: .
(3) Exclusion from home health services
- Section 1861(m) of the Social Security Act () is amended, in the first sentence, by inserting the following before the period at the end: . 42 U.S.C. 1395x(m)

(d) Effective date

The amendments made by this section shall apply to items and services furnished on or after January 1, 2027.

H.R. 2343

Table of contents

SEC. 1. Short title

SEC. 2. Medicare coverage of Alpha-1 Antitrypsin Disorder treatment