Improving Access to Transfusion Care for Hospice Patients Act of 2026
- Sponsor
- Rep. Dingell, Debbie [D-MI-6]
- Committees
- Ways and Means Committee (primary)
- Last action
- Jul 15, 2026
Bottom line
The bill requires Medicare to test a new payment model that would allow blood transfusions for hospice patients to be paid for separately, aiming to improve access to this care.
What it actually does
This bill mandates the Center for Medicare and Medicaid Innovation (CMI) to establish a new model within one year of enactment. This model will test paying for blood transfusions furnished to individuals receiving hospice care separately from the existing Medicare hospice all-inclusive per diem payment. The separate payment amount would be equivalent to what Medicare would pay if the transfusion was not part of hospice care. The CMI is also required to evaluate this model against specific metrics related to patient care and utilization.
Proponents argue
Supporters argue that the current all-inclusive hospice payment model can create a disincentive for hospice providers to offer blood transfusions, even when they could significantly improve a patient's quality of life. By allowing separate payment, this bill would remove a financial barrier, ensuring hospice patients can receive necessary supportive care without having to disenroll from hospice or seek care in more expensive settings like emergency departments or hospitals. This could lead to better patient outcomes and a more holistic approach to end-of-life care.
Opponents contend
Critics might express concerns that carving out specific services from the all-inclusive hospice payment could increase overall Medicare costs if not carefully managed, potentially leading to overutilization of transfusions. They may also argue that such carve-outs could complicate the administrative structure of hospice benefits and potentially undermine the foundational principle of comprehensive, bundled care that defines hospice.
The bill is very short and clear, making it highly accessible for a quick review.
Section 2(1)
Mandatory CMI Model Testing
This provision amends the Social Security Act to explicitly require the Center for Medicare and Medicaid Innovation (CMI) to include the testing of the model described in the bill. This means the CMI cannot choose whether or not to implement this particular payment model test; it is a mandatory directive from Congress.
Supporters argue
Proponents argue that making this model test mandatory ensures that the CMI will address a critical gap in hospice care, rather than leaving it to their discretion. This guarantees that the issue of blood transfusion access for hospice patients will be thoroughly examined.
Critics contend
No specific opposition is typically raised against mandating CMI to test a model, as its purpose is innovation and evaluation. However, some might argue against specific mandates that limit the CMI's flexibility to prioritize models based on its own research and strategic goals.
Tradeoffs
This provision trades CMI's discretion for a congressional mandate, ensuring a specific policy area is explored. The tension lies between CMI's autonomy in model selection and Congress's desire to address specific perceived needs.
Section 2(2) adding subsection (h)(1)
Separate Payment for Blood Transfusions in Hospice
This section requires the CMI to establish a model within one year where blood transfusions for hospice patients are paid for separately from the standard all-inclusive daily payment. The payment for these transfusions will be the same amount that Medicare would typically pay if the patient were not receiving hospice care, effectively carving out this service from the bundled payment.
Section 2(2) adding subsection (h)(2)
Evaluation Requirements for the CMI Model
This provision outlines specific metrics that the CMI must use when evaluating the new payment model for blood transfusions. These metrics include comparing hospice patients in the model to similar non-hospice patients on factors like chemotherapy use near end-of-life, hospital utilization (emergency department, inpatient, ICU stays), duration of hospice care, and the frequency and number of transfusions received.