II 

117TH CONGRESS 

1ST SESSION S. 2566 

To require the Center for Medicare and Medicaid Innovation to test allowing 

blood transfusions to be paid separately from the Medicare hospice allinclusive per diem payment 

IN THE SENATE OF THE UNITED STATES 

JULY 29, 2021 

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 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Improving Access to 

5 Transfusion Care for Hospice Patients Act of 2021’’. 


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1 SEC. 2. CENTER FOR MEDICARE AND MEDICAID INNOVA2 TION TESTING OF ALLOWING BLOOD TRANS3 FUSIONS TO BE PAID SEPARATELY FROM 

4 THE MEDICARE HOSPICE ALL-INCLUSIVE 

5 PER DIEM PAYMENT. 

6 Section 1115A of the Social Security Act (42 U.S.C. 

7 1315a) is amended— 

8 (1) in subsection (b)(2)(A), by adding at the 

9 end the following new sentence: ‘‘The models se10 lected under this subparagraph shall include the 

11 testing of the model described in subsection (h).’’; 

12 and 

13 (2) by adding at the end the following new sub14 section: 

15 ‘‘(h) TESTING OF ALLOWING BLOOD TRANSFUSIONS

16 TO BE PAID SEPARATELY FROM THE MEDICARE HOS17 PICE ALL-INCLUSIVE PER DIEM PAYMENT.— 

18 ‘‘(1) IN GENERAL.—Not later than 1 year after 

19 the date of enactment of this subsection, the CMI 

20 shall establish and implement a model under which 

21 blood transfusions furnished to an individual receiv22 ing hospice care are paid separately from the hospice 

23 all-inclusive per diem payment under section 

24 1814(i). The separate payment amount for such 

25 blood transfusion shall be the amount that would 


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1 otherwise apply under title XVIII if the transfusion 

2 was not furnished as part of hospice care. 

3 ‘‘(2) REQUIREMENTS FOR EVALUATION.—In 

4 conducting any evaluation of the model described in 

5 paragraph (1) pursuant to subsection (b)(4), the 

6 CMI shall ensure it compares participants under the 

7 model with similar patients outside of the model 

8 with respect to the following metrics: 

9 ‘‘(A) The number of chemotherapy services 

10 furnished in the last 14 days of life. 

11 ‘‘(B) Hospital utilization in the last 30 

12 days of life, including emergency department 

13 visits, in-patient and observation status stays 

14 (including the length of the stays), and inten15 sive care unit (ICU) days. 

16 ‘‘(C) How many days receiving hospice 

17 care before the end of life. 

18 ‘‘(D) The number of patients receiving 

19 hospice care who received a transfusion com20 pared to patients with similar diagnoses not re21 ceiving hospice care. 

22 ‘‘(E) The average frequency of transfusion 

23 for patients receiving hospice care compared pa24 tients not receiving hospice care. 


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1 ‘‘(F) The number of transfusions for pa2 tients receiving hospice care compared to pa3 tients not receiving hospice care. 

4 ‘‘(G) Other areas determined appropriate 

5 by the CMI.’’. 

Æ 


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