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Attention Enrollees in the IVIG Demonstration

September 30, 2017

On Thursday, September 28, Congress passed legislation which extended the Medicare IVIG Demonstration through December 31, 2020. Without this new legislation, the demonstration had been scheduled to end September 30, 2017. All beneficiaries enrolled in the demonstration as of September 30, 2017, will automatically be re-enrolled in the demonstration and do not need to take any action. Suppliers can continue to provide and be paid for demonstration services to these beneficiaries on or after October 1, 2017.

CMS is now accepting new enrollees for this demonstration in accordance with the provisions of the original authorizing legislation (the "Medicare IVIG Access and Strengthening Medicare and Repaying Taxpayers Act of 2012"). Please go to the Information for Beneficiaries page on this website to find the application forms.

Information for Beneficiaries

Applications for participation in the IVIG Demonstration will continue to be accepted on a rolling basis until Medicare reaches or projects it will reach the statutory limit on funding and/or enrollment (4,000 beneficiaries). At this time, applications are still being received.

Please note that in order to be enrolled in the IVIG Demonstration, a beneficiary must:

  • Be covered under Medicare Fee-For-Service and enrolled in Part B,
  • Have a diagnosis of Primary Immune Deficiency Disease (PIDD), and
  • Not be currently covered under a home health episode of care.

IVIG Demonstration Enrollment Application

All beneficiaries must complete and submit a signed application in order to be considered for this demonstration. The blank application may be printed and completed manually or filled in online and printed before signing. Once completed and signed by the beneficiary, the application must also be signed by the beneficiary's treating physician:

Your version of Adobe Acrobat may offer a feature to "digitally sign" the application document. Users should not use this feature as it does not properly qualify as a signature. Once completed, the application must be printed and signed with an ink pen.

IVIG Demonstration Enrollment Application Guide 

These guides provide complete instructions for completing the IVIG Demonstration Enrollment Application.

Submitting the Application

By Fax - Completed IVIG Demonstration applications can be faxed to: 701-277-2428.

By Mail - Completed IVIG Demonstration applications can be mailed to:
Noridian Healthcare Solutions
PO Box 6788
Fargo  ND 58108-6788

Overnight Mailing
Noridian Healthcare Solutions
900 42nd St S
Fargo ND 58103

Notification Process

All IVIG Demonstration applicants will be notified within ten business days of receipt of a complete application of their status and the effective date of their coverage under the demonstration.

Effective Dates for Enrollment

Completed applications received by the 15th of the month, if eligible, will have coverage effective the first of the next month.

Completed applications received after the 15th of the month, if eligible, will have coverage effective the first date of the month following the next month. For example, if an application is received on September 15th, coverage will be effective October 1. If an application is received on September 20th, coverage will be effective November 1.

Last Updated Jun 07, 2016