Medicare test could boost transfusions in final days—and hospice profits
H.R. 9703 — Improving Access to Transfusion Care for Hospice Patients Act of 2026 · Filed by Debbie Dingell (D-MI) · Introduced Jul 15, 2026 · Referred to committee
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What it does
This bill directs Medicare to test a new payment model allowing blood transfusions given to hospice patients to be paid separately from hospice's standard flat daily fee, rather than bundled into it. Currently, hospice providers receive a fixed per-diem payment that covers all care, including transfusions; this test would let them bill Medicare separately for transfusions at the standard non-hospice rate, potentially increasing reimbursement. The Centers for Medicare & Medicaid Innovation must launch the test within one year and measure outcomes including transfusion frequency, hospital use, and end-of-life care patterns.
Why we flagged it
The bill's core function is to change how Medicare pays for a specific service (blood transfusions) within hospice care—moving from bundled to unbundled reimbursement. This is a payment-model test, not a clinical mandate or access guarantee.
What the text implies
- Unbundling transfusions may create financial incentives for hospice providers to increase transfusion frequency in final days of life, where clinical benefit is often unclear and may conflict with palliative-care principles.
- The bill requires CMI to measure transfusion frequency and hospital utilization but does not mandate comparison of patient outcomes (survival, symptom relief, quality of life), potentially obscuring whether increased transfusions improve or harm end-of-life experience.
The full analysis lists 4 implications of this text.
Who stands to gain
hospice providers and chains; blood product manufacturers and distributors; clinical laboratory and transfusion services