I 
115TH CONGRESS 
1ST SESSION H. R. 4215 
To amend title XVIII of the Social Security Act to ensure that providers 
of services receive adequate payments for the acquisition of hematopoietic 
stem cells under the Medicare program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 1, 2017 
Mr. PAULSEN (for himself, Mr. KIND, Ms. MATSUI, and Mr. BILIRAKIS) intro-
duced the following bill; which was referred to the Committee on Ways 
and Means 
A BILL 
To amend title XVIII of the Social Security Act to ensure 
that providers of services receive adequate payments for 
the acquisition of hematopoietic stem cells under the 
Medicare program, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. HEMATOPOETIC STEM CELL ACQUISITION PAY-
MENTS. 
Section 1886(d)(5) of the Social Security Act (42 
U.S.C. 1395ww(d)(5)) is amended by adding at the end 
the following new subparagraph: 
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‘‘(M)(i) For cost reporting periods beginning on or 
after October 1, 2018, in the case of a provider of services 
that furnishes a hematopoetic stem cell transplant during 
such a period, the Secretary shall provide a separate pay-
ment for such provider consistent with the payment meth-
odology for kidney acquisition costs under section 412.100 
of title 42 of the Code of the Federal Register in lieu of 
taking into account such costs in any other payment made 
under this section. Such costs associated with such acqui-
sition include costs associated with the following: 
‘‘(I) Tissue typing, including in the case that 
such typing is furnished by an independent labora-
tory. 
‘‘(II) Donor evaluation. 
‘‘(III) The collection of such cells. 
‘‘(IV) Furnishing the donor items or services 
relating to such collection. 
‘‘(V) Preservation and perfusion. 
‘‘(VI) Transportation of such cells. 
‘‘(VII) Using the services of the transplantation 
program described in section 379 of the Public 
Health Service Act. 
‘‘(VIII) Costs applicable to such collection that 
would otherwise be considered outpatient costs (in-
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cluding donor and recipient tissue typing and related 
services furnished prior to admission). 
‘‘(IX) Items or services related to such collec-
tion that are furnished by residents and interns not 
in approved teaching programs. 
‘‘(X) All pre-admission physicians’ services ap-
plicable to such collection. 
‘‘(XI) Other costs determined appropriated by 
the Secretary. 
‘‘(ii) In this subparagraph, the term ‘hematopoetic 
stem cell transplant’ means, with respect to an individual, 
the infusion of allogenic hematopoetic cells (including bone 
marrow, peripheral blood stem cells, and cord blood units, 
but not including embryonic stem cells) that are not more 
than minimally manipulated and are intended to reestab-
lish hematopoetic function in such individual whose bone 
marrow or immune system is damaged or defective, or ad-
versely affected by a congenital disorder.’’. 
Æ 
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