[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9778 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 9778
To amend title XVIII of the Social Security Act to include penicillin
allergy verification and evaluation as part of the initial preventive
physical examination under the Medicare program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 24, 2024
Mr. Bucshon (for himself, Mr. Bera, Mr. Griffith, Mr. Peters, Mr.
Murphy, Ms. Schrier, Mr. Kelly of Pennsylvania, Ms. DelBene, Mrs.
Miller-Meeks, and Ms. Underwood) introduced the following bill; which
was referred to the Committee on Energy and Commerce, and in addition
to the Committee on Ways and Means, 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
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to include penicillin
allergy verification and evaluation as part of the initial preventive
physical examination under the Medicare program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Penicillin Allergy Verification and
Evaluation Act'' or the ``PAVE Act''.
SEC. 2. FINDINGS.
Congress makes the following:
(1) On September 28, 1928, Alexander Fleming, a Scottish
bacteriologist, discovered penicillin, forever changing
healthcare by identifying an effective way to treat a wide
range of infections which opened the doctor for numerous
successful medical treatments.
(2) Millions of patients believe they are allergic to
penicillin, but information cited by the Centers for Disease
Control and Prevention and recent medical journal articles in
the Journal of the American Medical Association and the Journal
of Allergy and Clinical Immunology, shows that more than 90
percent of patients who have a self-reported penicillin allergy
in their electronic medical record can safely take penicillin
after verification testing.
(3) A 2020 medical research review found, penicillin
allergy is estimated to affect approximately 10 percent of the
population, and 15 percent of hospitalized patients are labeled
with a penicillin allergy.
(4) Penicillin allergy label is associated with poor
patient outcomes including increased hospital length of stay,
increased perioperative infections, and overall increased
mortality according to the New England Journal of Medicine.
(5) A 2018 paper in the Journal of Allergy and Clinical
Immunology indicates that penicillin allergy evaluation by any
means has been shown to be a cost-saving intervention.
(6) Delabeling penicillin allergy is an important component
of antibiotic stewardship and is endorsed by many professional
organizations and public health bodies, including the American
Academy of Allergy, Asthma & Immunology.
(7) A 2023 study of adults 65 and older with a penicillin
allergy label published in the Annals of Allergy, Asthma &
Immunology found that 97 percent were disproved after
verification testing.
SEC. 3. PENICILLIN ALLERGY VERIFICATION AND EVALUATION FOR SENIORS.
(a) Initial Preventive Physical Examination.--Section 1861(ww) of
the Social Security Act (42 U.S.C. 1395x(ww)) is amended--
(1) In paragraph (1)--
(A) by inserting ``penicillin allergy verification
and evaluation (as defined in paragraph (5)),'' after
``(as defined in paragraph (4)),''; and
(2) in paragraph (2)--
(A) by redesignating subparagraph (O) as
subparagraph (P); and
(B) by inserting after subparagraph (N) the
following new subparagraph:
``(O) Penicillin allergy verification and
evaluation.''; and
(3) by adding at the end the following new paragraph:
``(5) For purposes of paragraph (1), the term `penicillin
allergy verification and evaluation' means--
``(A) identification of individuals reporting a
history of penicillin allergy;
``(B) consideration of whether the reported
reaction history is consistent with an allergy or
hypersensitivity reaction or can be reevaluated;
``(C) the provision of information on the adverse
individual and public health impact of a penicillin
allergy label; and
``(D) a referral to an allergy or immunology
specialist, as appropriate.''.
(b) Annual Wellness Visit.--Section 1861(hhh)(2) of the Social
Security Act (42 U.S.C. 1395x(hhh)(2)) is amended--
(1) by redesignating subparagraph (I) as subparagraph (J);
and
(2) by inserting after subparagraph (H) the following new
subparagraph:
``(I) Penicillin allergy verification and
evaluation (as defined in subsection (ww)(5)).''.
(c) Rule of Construction.--Nothing in the amendments made by
subsection (a) or (b) shall be construed to prohibit separate payment
for structured penicillin allergy validation and evaluation services
furnished to an individual on the same day as an initial preventive
physical examination or an annual wellness visit.
(d) Effective Date.--The amendments made by this section shall
apply to examinations and visits furnished on or after January 1, 2025.
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