New Law Requires Doctors to Check Penicillin Allergies for Seniors Starting 2027: Could Cut Costs and Improve Care

The Penicillin Allergy Verification and Evaluation Act, or the PAVE Act, is basically a massive cleanup effort aimed at correcting millions of inaccurate medical labels. Starting January 1, 2027, this bill requires doctors to add a specific review of reported penicillin allergies during a senior’s initial “Welcome to Medicare” physical exam and their annual wellness visits.

The Allergy Label Problem: Worse Than You Think

If you have “penicillin allergy” listed in your medical chart, chances are high—over 90% high, according to studies cited in the bill—that you aren't actually allergic. This isn't just a minor administrative error; it has serious real-world consequences. When doctors can’t use penicillin (a cheap, highly effective antibiotic), they have to switch to second-line drugs. The bill points out that this switch often leads to longer hospital stays, higher infection rates after surgery, and generally worse health outcomes. For seniors (age 65+), the problem is even more pronounced: one study found 97% of those labeled allergic were actually safe to take the drug.

What the Doctor Has to Do Now

Under Section 3 of the PAVE Act, the required “verification and evaluation” process is structured into four parts during that routine check-up. First, the doctor must identify who reports the allergy. Second, they need to reassess the history of the reaction—was it a true allergic reaction, or just a side effect like an upset stomach? Third, they have to educate the patient on why carrying a false allergy label is bad for them and for public health (it contributes to antibiotic resistance). Finally, if the history is murky or concerning, the doctor must refer the patient to a specialist, like an allergist, for definitive testing.

The Money and Time Factor

This is where the bill gets practical for both patients and providers. For seniors, getting this review done during an existing annual visit means they don't have to schedule a separate, potentially costly appointment just to clear up an old medical record mistake. For the doctors, the bill clarifies that they can bill separately for this structured allergy validation service even though it’s being performed on the same day as the main physical. This is important because it ensures doctors are compensated for the extra time and detailed review this process requires, making it more likely they’ll do a thorough job instead of just ticking a box.

Real-World Impact: Safer Care, Lower Costs

Think of a 70-year-old construction worker, Bob, needing a hip replacement. If Bob’s chart says he’s allergic to penicillin from a childhood rash, the surgeon must use a more expensive, less effective antibiotic for preventing infection. If his doctor uses the PAVE Act review to clear that allergy label, Bob can receive the optimal, standard-of-care antibiotic, which lowers his risk of post-op infection and potentially shortens his hospital stay. This shift is a win-win: better patient safety and significant cost savings for the healthcare system, as noted in the bill’s findings. While the criteria for when a referral to a specialist is deemed “necessary” remains subjective, the mandate ensures that the conversation about clearing up this common medical error finally happens on a national scale.