Pharmacy Question for the Week of April 29, 2019

Pharmacy Compliance Question of the Week

Question:

What are criteria points for coverage regarding intravenous immune globulin (IVIG) under the Medicare Prescription Drug, Improvement, and Modernization Act?

Answer:

IVIG is covered under this benefit when the patient is diagnosed with a primary immune deficiency disease, it is administered in the home of a patient with a diagnosed primary immune deficiency disease, and the physician determines that home administration of the derivative is medically appropriate. The benefit does not include coverage for items or services related to the administration of the derivative.

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