Improving Access to Transfusion Care for Hospice Patients Act of 2025

Improving Access to Transfusion Care for Hospice Patients Act of 2025

This bill requires the Center for Medicare and Medicaid Innovation (CMMI) to test a model under which blood transfusions furnished to an individual receiving hospice care are paid separately from the hospice all-inclusive per diem payment under Medicare. The CMMI must evaluate the model by comparing patients participating in the model with those outside of the model in relation to specified metrics, such as hospital utilization and days of hospice care before the end of life.

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1936 Introduced in Senate (IS)]

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119th CONGRESS
  1st Session
                                S. 1936

  To require the Center for Medicare and Medicaid Innovation to test 
  allowing blood transfusions to be paid separately from the Medicare 
                hospice all-inclusive per diem payment.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              June 3, 2025

 Ms. Rosen (for herself, Mr. Barrasso, and Ms. Baldwin) introduced the 
 following bill; which was read twice and referred to the Committee on 
                                Finance

_______________________________________________________________________

                                 A BILL


 
  To require the Center for Medicare and Medicaid Innovation to test 
  allowing blood transfusions to be paid separately from the Medicare 
                hospice all-inclusive per diem payment.

    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 ``Improving Access to Transfusion Care 
for Hospice Patients Act of 2025''.

SEC. 2. CENTER FOR MEDICARE AND MEDICAID INNOVATION TESTING OF ALLOWING 
              BLOOD TRANSFUSIONS TO BE PAID SEPARATELY FROM THE 
              MEDICARE HOSPICE ALL-INCLUSIVE PER DIEM PAYMENT.

    Section 1115A of the Social Security Act (42 U.S.C. 1315a) is 
amended--
            (1) in subsection (b)(2)(A), by adding at the end the 
        following new sentence: ``The models selected under this 
        subparagraph shall include the testing of the model described 
        in subsection (h).''; and
            (2) by adding at the end the following new subsection:
    ``(h) Testing of Allowing Blood Transfusions To Be Paid Separately 
From the Medicare Hospice All-Inclusive Per Diem Payment.--
            ``(1) In general.--Not later than 1 year after the date of 
        enactment of this subsection, the CMI shall establish and 
        implement a model under which blood transfusions furnished to 
        an individual receiving hospice care are paid separately from 
        the hospice all-inclusive per diem payment under section 
        1814(i). The separate payment amount for such blood transfusion 
        shall be the amount that would otherwise apply under title 
        XVIII if the transfusion was not furnished as part of hospice 
        care.
            ``(2) Requirements for evaluation.--In conducting any 
        evaluation of the model described in paragraph (1) pursuant to 
        subsection (b)(4), the CMI shall ensure it compares 
        participants under the model with similar patients outside of 
        the model with respect to the following metrics:
                    ``(A) The number of chemotherapy services furnished 
                in the last 14 days of life.
                    ``(B) Hospital utilization in the last 30 days of 
                life, including emergency department visits, in-patient 
                and observation status stays (including the length of 
                the stays), and intensive care unit (ICU) days.
                    ``(C) How many days receiving hospice care before 
                the end of life.
                    ``(D) The number of patients receiving hospice care 
                who received a transfusion compared to patients with 
                similar diagnoses not receiving hospice care.
                    ``(E) The average frequency of transfusion for 
                patients receiving hospice care compared to patients 
                not receiving hospice care.
                    ``(F) The number of transfusions for patients 
                receiving hospice care compared to patients not 
                receiving hospice care.
                    ``(G) Other areas determined appropriate by the 
                CMI.''.
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