Sponsor
Debbie Dingell
Representative · D-MI
Requires CMI to implement and evaluate a Medicare demonstration that pays separately for blood transfusions furnished to hospice patients within one year of enactment.
Representative · D-MI
The bill increases access to transfusions for hospice-enrolled Medicare beneficiaries and reduces provider payment barriers, but it raises Medicare spending and could change end-of-life care patterns while imposing implementation and evaluation burdens on CMS.
Medicare beneficiaries enrolled in hospice will be able to receive blood transfusions billed separately from the hospice per diem, increasing access to transfusions without forcing beneficiaries to leave hospice.
Hospices and hospitals will be reimbursed for transfusions at standard Medicare rates, reducing financial disincentives for providers to offer transfusions in hospice settings.
The model requires CMS to evaluate utilization and end-of-life care metrics, generating evidence that could inform better hospice care practices and more efficient resource use.
Medicare beneficiaries and taxpayers could face higher Medicare spending (with possible downstream effects on premiums or federal budgets) because transfusions would be paid separately.
Medicare beneficiaries in hospice may experience shifts in end-of-life care if hospices increase transfusion use in response to new payments, potentially altering care patterns or goals-of-care discussions.
CMS and implementing agencies could face administrative and evaluative strain from standing up and assessing a new payment model within one year, which may limit the scope or rigor of the evaluation and divert staff resources.
Based on analysis of 2 sections of legislative text.
Official title: 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.
Introduced July 15, 2026 by Debbie Dingell · Last progress July 15, 2026
Directs the Medicare Innovation Center to create and run a payment model that allows blood transfusions for hospice patients to be paid separately from the hospice per diem. The Center for Medicare & Medicaid Innovation (CMI) must implement the transfusion payment model within one year of enactment and evaluate its effects on care patterns and utilization using specified quality and utilization metrics. The bill requires CMI to compare participating providers to similar non-participants on measures such as chemotherapy received in the last 14 days of life, emergency department and inpatient use in the last 30 days, days in hospice before death, and transfusion frequency, plus other measures CMI chooses, and to evaluate the model under its standard statutory evaluation rules.