Reps. Ami Bera, Larry Bucshon Introduce Bipartisan Penicillin Allergy Verification and Evaluation Act

U.S. Representative Ami Bera, M.D. (D-CA-06), along with U.S. Representative Larry Bucshon, M.D. (R-IN-08) and eight additional bipartisan colleagues, recently introduced the Penicillin Allergy Verification and Evaluation (PAVE) Act. This legislation would add a penicillin allergy verification component to the "Welcome to Medicare" preventive visit and annual wellness visits.

"Evidence shows that millions of seniors have either outgrew or mistakenly believe they have a penicillin allergy, yet have never been retested. As a doctor, I understand firsthand how crucial it is to have accurate, up-to-date health information," said Representative Ami Bera. "An outdated or incorrect penicillin allergy in someone's medical record can restrict treatment options, increase healthcare costs, and contribute to the spread of antimicrobial resistance. The PAVE Act offers a common-sense solution to this problem. By including penicillin allergy verification in Medicare's initial and annual wellness visits, we can help ensure that seniors receive the most effective and appropriate treatments available."

"As a physician, I know just how important it is to have a full picture of a patient's health and wellness. Without accurate health information, patients and their health care providers can't make informed health decisions," said Dr. Bucshon. "It has become apparent that millions of patient records contain inaccurate information about a penicillin allergy-maybe because of a misdiagnosis, or because the individual outgrew the allergy later in life. This legislation will provide our seniors with better access to penicillin allergy verification testing, ensuring that they can receive treatments most appropriate for their situation."

The PAVE Act is supported by a wide variety of clinician and patient stakeholder groups, including the American Academy of Allergy, Asthma & Immunology, which provided feedback in drafting the bill.

"The American Academy of Allergy, Asthma & Immunology (AAAAI) enthusiastically applauds Representatives Bucshon, Bera, Griffith, Peters, Murphy, Schrier, Kelly, DelBene, Miller-Meeks, and Underwood for their leadership in introducing the PAVE Act", said Dr. Paul Williams, President, AAAAI. "Millions of patients believe they are allergic to penicillin, but evidence shows that 95% of patients with a self-reported penicillin allergy in their electronic medical record can safely take penicillin. The PAVE Act would add penicillin allergy verification and evaluation for Medicare beneficiaries, which will improve healthcare outcomes for these patients, while also reducing healthcare costs and help fight antimicrobial resistance. As we approach National Penicillin Allergy Day on September 28, the AAAAI looks forward to working with the bill champions to educate the public on penicillin allergy testing and advance this important legislation."

Additional Supporting Organizations:

American Academy of Allergy, Asthma & Immunology (AAAAI)

American Academy of Otolaryngic Allergy (AAOA)

American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS)

American College of Allergy, Asthma & Immunology(ACAAI)

American College of Physicians (ACP)

American Gastroenterological Association (AGA)

American Geriatrics Society (AGS)

Allergy and Asthma Network (AAN)

American Medical Association (AMA)

Asthma and Allergy Foundation of America (AAFA)

Food Allergy & Anaphylaxis Connection Team (FAACT)

Food Allergy Research & Education (FARE)

Infectious Diseases Society of America (IDSA)

International Food Protein Induced Enterocolitis Syndrome Association (I-FPIES)

The Mast Cell Disease Society, Inc. (TMS)

Peggy Lillis Foundation (PLF)

BACKGROUND: Millions of patients believe they are allergic to penicillin, but evidence shows that the vast majority of patients with a self-reported allergy can safely take penicillin after verification testing and evaluation. Removing an incorrect penicillin allergy label from a patient's electronic medical record is a relatively easy, low cost and important public health intervention that can improve patient outcomes, reduce healthcare costs, and advance the fight against antimicrobial resistance (AMR). Addressing inaccurate reports of penicillin allergy is particularly crucial for older adults, who face heightened vulnerability to severe infections and adverse drug reactions.

BILL SUMMARY: To improve antibiotic stewardship and combat AMR, the PAVE Act seeks to identify and de-label Medicare patients who have been previously labeled with a penicillin allergy. The legislation adds "penicillin allergy verification and evaluation" as part of Medicare's Initial Preventative Physical Exam (IPPE) and Annual Wellness Visit (AWV). IPPEs are covered for new Medicare Part B enrollees within the 12 months and AWVs are covered annually.

The bill defines "penicillin allergy verification and evaluation" as:

• identification of individuals reporting a history of penicillin allergy;

• consideration of whether the reported reaction history is consistent with an allergy/hypersensitivity reaction or can be re-evaluated;

• provision of information on the adverse individual and public health impact of a penicillin allergy label; and

• referral to an allergy/immunology specialist, as appropriate.

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