S. 1936: Improving Access to Transfusion Care for Hospice Patients Act of 2025

This bill, titled the "Improving Access to Transfusion Care for Hospice Patients Act of 2025," aims to change how Medicare handles payments for blood transfusions for patients receiving hospice care. Currently, hospice patients receive a bundled payment that covers a wide range of services, but blood transfusions are not separately billed. This legislation proposes that blood transfusions be paid for separately from the hospice all-inclusive payment.

Key Provisions of the Bill

• The Centers for Medicare and Medicaid Innovation (CMI) must develop and implement a new payment model within one year of the bill's enactment.
• This new model will allow for blood transfusions provided to hospice patients to be billed individually, based on the standard Medicare payment rate for such procedures outside of hospice care.
• In evaluating this payment model, the CMI is required to compare outcomes of hospice patients receiving transfusions to similar patients who do not receive hospice care.

Evaluation Metrics

When assessing the effectiveness of the new payment model, the CMI will analyze several metrics, including:

• The number of chemotherapy services used in the last 14 days of life.
• Hospital utilization during the last 30 days of life, including emergency department visits and lengths of hospital stays.
• The duration of hospice care received before death.
• The number of patients in hospice care who receive transfusions compared to those with similar conditions who do not receive hospice care.
• The frequency of transfusions among hospice patients versus non-hospice patients.
• The overall number of transfusions administered to hospice patients compared to non-hospice patients.
• Any other relevant areas determined by the CMI.

In summary, this bill is focused on ensuring that patients in hospice care have access to necessary blood transfusions without the financial constraints currently imposed by the bundled payment system. It aims to provide better care options for hospice patients by allowing specific treatments to be funded appropriately.

Relevant Companies

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