Title: 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.
Policy area: Health

Summary:
This bill requires the Centers for Medicare & Medicaid Services to pay, to a provider that furnishes a hematopoietic stem cell transplant, an adjusted Medicare payment consistent with the Medicare payment methodology for kidney-acquisition costs outlined in regulation. Under the applicable regulation, kidney-acquisition costs are treated apart from the prospective payment rate for inpatient operating costs, and payment is adjusted to compensate the hospital for certain reasonable expenses.
"Hematopoietic stem cell transplant" means the infusion of allogeneic hematopoietic cells (including bone marrow, peripheral blood stem cells, and cord-blood units, but excluding embryonic stem cells) that are: (1) not more than minimally manipulated; and (2) intended to reestablish hematopoietic function in an individual whose blood marrow or immune system is damaged, defective, or adversely affective by a congenital disorder.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4215 Introduced in House (IH)]

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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) 
 introduced 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 Representatives of the 
United States of America in Congress assembled,

SECTION 1. HEMATOPOETIC STEM CELL ACQUISITION PAYMENTS.

    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:
    ``(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 payment for such provider consistent with the 
payment methodology 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 acquisition include costs associated with 
the following:
            ``(I) Tissue typing, including in the case that such typing 
        is furnished by an independent laboratory.
            ``(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 (including donor and 
        recipient tissue typing and related services furnished prior to 
        admission).
            ``(IX) Items or services related to such collection that 
        are furnished by residents and interns not in approved teaching 
        programs.
            ``(X) All pre-admission physicians' services applicable 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 
reestablish hematopoetic function in such individual whose bone marrow 
or immune system is damaged or defective, or adversely affected by a 
congenital disorder.''.
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