PAVE Act

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5736 Introduced in House (IH)]

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119th CONGRESS
  1st Session
                                H. R. 5736

 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

                            October 10, 2025

 Mr. Griffith (for himself, Mr. Bera, Mrs. Miller-Meeks, Ms. Schrier,
 Ms. DelBene, Mr. Onder, and Mr. Auchincloss) 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 door 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)),'';
            (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, 2027.
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