The PI Post Acute Access Act would create a dedicated payment within Medicare for Skilled Nursing Facilities (SNF) to provide intravenous immunoglobulin (IVIG) treatments onsite.
Expand Medicare beneficiaries' access to IVIG treatment in skilled nursing facilities by creating a dedicated Medicare payment for onsite administration.
Occurrences
Evidence
This bipartisan legislation would create a dedicated payment within Medicare for Skilled Nursing Facilities (SNF) to provide intravenous immunoglobulin (IVIG) treatments onsite... Congresswoman Doris Matsui (D-CA-07) and Congressman Adrian Smith (R-NE-03) introduced the PI Post Acute Access Act.
This bill allows for separate payment under Medicare to skilled nursing facilities for items and services that are needed to administer intravenous immune globin (IVIG) to patients with primary immune deficiency diseases... Latest Action: House - 12/17/2024 Referred to the Subcommittee on Health.
A hospital, critical access hospital, or skilled nursing facility isn’t an eligible institutional home setting.
This bipartisan legislation would create a dedicated payment within Medicare for Skilled Nursing Facilities (SNF) to provide IVIG treatments onsite.
Assessments
Matsui materially pursued this policy but did not deliver it. In the 118th Congress, her PI Post Acute Access Act (H.R. 3017) was introduced on April 28, 2023 and stalled in subcommittee without becoming law. On April 27, 2026, she and Rep. Adrian Smith reintroduced the proposal to create a dedicated Medicare payment for skilled nursing facilities to administer IVIG onsite, which shows a serious same-term legislative effort. But CMS guidance published in February 2026 still stated that skilled nursing facilities were not eligible institutional home settings under the existing IVIG payment framework, so the promised Medicare payment expansion was not in place as of June 21, 2026. Under the scoring rule, a serious attempt that fails to achieve the promised outcome is 'never' with an effort badge.
The promise matches a specific federal policy proposal: creating a dedicated Medicare payment so skilled nursing facilities can administer IVIG onsite. Evidence shows Rep. Matsui materially advanced this by introducing the bipartisan PI Post Acute Access Act, including an earlier version in the 118th Congress and a reintroduction in April 2026. However, the record provided does not show enactment, CMS adoption, or any other completed policy change. CMS guidance from February 2026 indicates the requested SNF payment policy is not already in place. Because she has clearly made a serious legislative effort but there is no evidence yet of final delivery and she remains in office, the best judgment is unresolved rather than delivered or partial.