H.R. 1458 would amend title XVIII of the Social Security Act to provide continued entitlement to coverage for immunosuppressive drugs furnished to beneficiaries under the Medicare Program that have received a kidney transplant and whose entitlement to coverage would otherwise expire.
Detailed Summary
Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2009 - Amends SSA title II (Old Age, Survivors and Disability Insurance) (OASDI) to: (1) continue entitlement to prescription drugs used in immunosuppressive therapy furnished to an individual who receives a kidney transplant for which payment is made under Medicare; and (2) extend Medicare secondary payer requirements for end stage renal disease (ESRD) beneficiaries.
Amends title XVIII (Medicare ) of SSA to apply special rules to kidney transplant recipients receiving additional coverage for immunosuppressive drugs. Deems such individual to be enrolled under Medicare part B. Makes him or her responsible for the full amount of the applicable premiums. Applies deductible and coinsurance requirements to the provision of such drugs.
Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code to set forth requirements for group health plans to provide coverage of immunosuppressive drugs for kidney transplant patients.
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Status of the Legislation
Latest Major Action: 4/29/2009: Referred to House subcommittee. Status: Referred to the Subcommittee on Health, Employment, Labor, and Pensions.
Points in Favor
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Points Against
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Visitor Comments
Ken Bradshaw
March 21, 2009, 10:48am (report abuse)HR 1458 sounds like a plan we the people need and should be passed for all good reasons. And especially for those who are in need of momotery relief of the situation brought on by the sickness. We have the ability to help nations stay afloat and we have the ability to help our own.
Tom Wilson
March 27, 2009, 6:34am (report abuse)Considering the investment in the transplanted organ from the procedure, the procurement through Public service announcements to the actual operation, plus the all the other resources that are required to make a successful transplant, By NOT supporting the patients need for the anti-rejection medications is a BAD IDEA. The medications are extremely expensive and most every transplant recipient cannot afford even One months supply let alone the cost of the anti-rejection medications for the remainder of their life. The medications is a SMALL investment vs allowing the transplant to become rejected which requires Dialysis, which in turn puts the patient back on Medicare and on the transplant list again for another extremely expensive dialysis treatments and then another transplant. Maintaining the first transplant is FAR less expensive.
Using an automotive analogy. Its cheaper to change the oil regularly then to disregard such maintenance and replacing the engine every 2 years or so.
Duane G
April 7, 2009, 5:48pm (report abuse)I am a heart transplant patient, disabled before I was 50 years old.
I am faced with exorbinant cost for my immunosuppresant medications, out of pocket annual is approx $5900.OO. This bill should include all transplant patients as the post transplant expense is Huge.
Kim Collins
April 9, 2009, 8:39pm (report abuse)This bill is an important step to bridge those time(s) in which a transplant recipient might not have the insurance coverage or funding to be able to buy the life saving immunosuppressents to keep their transplant alive and well. It just doesn't make sense for Medicare to pay upwards of $100k for a transplant just to loose that transplant down if you are not able to pay for the very drugs that you have to take for the rest of your life. Life throws all kinds of curves, loss of job these days is a biggie. Loss of job usually means loss of insurance too. When it comes to making the choice of feeding the kids or buying your medication, WOW! Bottom line, we take care of our kids and pray that Uncle Sam will continue to take care of us.
paul stuart
April 12, 2009, 3:39pm (report abuse)As a future renal transplant patient,i am considering not having the surgery because of the future cost of the immune surpressent drugs. We have gone through all the test that were needed ,found that we were a match only to be disillusioned by the cost of the drugs. Please save the American people taxpayer money.
Ronada St Marie
May 5, 2009, 8:29pm (report abuse)This bill is a great idea. However, Duane G is right. It should include all transplant patients. I had a heart transplant 15 years ago. I have worked full-time for all of those 15 years. I have had several jobs and all covered my transplant needs including medications. I now work for local county government and the insurance will not cover anything to do with transplants. So I pay out of pocket for all my medications. I can barely afford to get all my medications. One medication "Cellcept" cost me over $750 a month. The transplant center has been helping me with this cost and now the foundation that helps support patients like me is running out of money due to the economy. So what will happen if I don't get my most important medication. You guessed it, rejection and hospitalization which my insurance will not pay for. Legislation needs to be passed to mandate that all companies including government entities must cover transplant costs.
Craig
May 9, 2009, 2:12pm (report abuse)I received my kidney transplant last year, at age 35, and have been struggling to pay the $350 per month cost of my anti-rejection meds (which in 2 years when my medicare expires will be more like $2k per month!)!!!! If the U.S. has money to help greedy CEOs and banks;they should be willing to help the sick. simple math really; help with the costs of meds or pay way more for lifetime of dialysis!
Ursula Green/70811
May 14, 2009, 10:44pm (report abuse)I'm not a kidney patient, but I was affected by my husband kidney rejecting. You can't begin to imagine what a person goes through having a spouse on dialysis. And to marry someone that's not at the best of health, but he's a little satsified with his present life as is. And then get up one day and you can't urinate at all.
Then you go to the hospital and the doctor tells your spouse you're going back on dialysis. That's huge pill to swallow. Try putting yourself in that situation. One day you are perfectly alright and the next day it's like someone has came into your house and robbed you of lifes functions. This a bill that need to be pass. You dont know the seriousness of this bill until you are wearing the shoes.
Robin Hiersche
May 27, 2009, 1:52am (report abuse)Please write to your congresspeople and put your support for this legislation in writing.
chuck sidener
July 7, 2009, 6:58pm (report abuse)i agree that all organ transplant recipients should have access to insurance coverage whether it be commercial or s.s. currently my wifes employer covers most of the costs-like 95%. what happens when she retires and we are both on social security? baby boomers have donated more than any other generation to social security and it looks like we could be the first ones to get screwed. write to your congressman and have your children or anybody else you can think of to let their congressman know that this is important stuff! estimates of 17 thousand dollars a year for immunosuppresent drugs is not an exagerration. as a bi-lateral lung transplant recipient i have to take 3 immunosupressent drugs. all 3 are 700 to 850 dollars per month if i had to pay. plus there are other drugs needed to keep your body from collapsing from all of those drugs. good luck everybody-we'll need it. CS
Kim Wurdeman
November 18, 2009, 2:32pm (report abuse)If any of the senators family members were facing this the bill would be passed and this would be the end of it. I am expected to recieve a kidney transplant within the next 12 months. I have 2 insurance plans to cover exp and meds. How long will they last, who knows. I am trusting God, but our money says this as well. Trust in God, Our elected officals need to get this don't. Please pray for change!!!!!