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.

Bill: 115-hr-4215
Sponsor: full_name: Rep. Paulsen, Erik [R-MN-3]
Introduced: 2017-11-01
Policy area: Health
Subjects: Blood and blood diseases

Cancer

Cell biology and embryology

Hospital care

Immunology and vaccination

Medicare

Organ and tissue donation and transplantation
Latest action: action_date: 2017-11-01
text: Referred to the House Committee on Ways and Means.

Summaries:
action_date: 2017-11-01
action_desc: Introduced in House
text: <p>This bill requires the Centers for Medicare &amp; 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.</p> <p>"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.</p>

tv_txt: I 115th CONGRESS 1st Session H. R. 4215 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.

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. .