A reimbursement bill for palliative blood transfusion has been reintroduced in the Senate that would require the “Center for Medicare and Medicaid Innovation (CMMI) to test allowing blood transfusions to be paid separately from the Medicare hospice all-inclusive per diem payment.” Senate Bill 2186, or the “Improving Access to Transfusion Care for Hospice Patients Act of 2023,” was brought forward on June 22nd by Sens. Jacky Rosen (D-Nev.), John Barrasso (R-W.Y.), and Tammy Baldwin (D-Wis.).
Ensuring patient access by expanding the availability of blood in hospice is one of the priorities of the 2023 America’s Blood Centers (ABC) Advocacy Agenda and was addressed during ABC’s Blood Advocacy Week 2023. ABC continues to ask CMMI to create a demonstration program to allow reimbursement for palliative blood transfusion outside of the hospice benefit.
The Senate bill states “[n]ot later than one year after the date of enactment of this subsection, the C[M]MI 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.” Specifically, the bill instructs the agency to “ensure it compares participants under the model with similar patients outside of the model with respect to the following metrics:
- [t]he number of chemotherapy services furnished in the last 14 days of life.
- 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.
- How many days receiving hospice care before the end of life.
- The number of patients receiving hospice care who received a transfusion compared to patients with similar diagnoses not receiving hospice care.
- The average frequency of transfusion for patients receiving hospice care compared to patients not receiving hospice care.
- The number of transfusions for patients receiving hospice care compared to patients not receiving hospice care.
- Other areas determined appropriate by the CM[M]I.’’
Earlier this month, ABC, the Association for the Advancement of Blood & Biotherapies (AABB), and the American Red Cross also submitted joint comments regarding reimbursement for palliative blood transfusion to the Centers for Medicare and Medicaid Services (CMS) in response to the proposed rule titled “Medicare Program; FY 2024 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice Quality Reporting Program Requirements, and Hospice Certifying Physician Provider Enrollment Requirements” (CMS-1787-P). ABC will continue to provide updates on both our advocacy efforts and the legislation as they become available.