Medicare test could boost transfusions in final days—and hospice profits

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.
• If the test shows higher transfusion rates under separate payment, Medicare may face pressure to expand the model permanently, locking in higher spending without evidence of clinical benefit.
• Hospice providers (including for-profit chains) stand to increase revenue if transfusions are unbundled and reimbursed at higher rates, creating a structural conflict of interest in how aggressively transfusions are offered.

Who it affects

Hospice patients may gain access to transfusions if cost barriers currently discourage providers from offering them, improving end-of-life care quality. However, unbundling transfusions from the flat fee could incentivize overuse of transfusions in the final days of life—a medically questionable practice—and increase Medicare spending without clear evidence of benefit, shifting costs to taxpayers and potentially diverting resources from other end-of-life care.

Who stands to gain

• hospice providers and chains
• blood product manufacturers and distributors
• clinical laboratory and transfusion services

Named in the bill

Centers for Medicare & Medicaid Innovation (CMI), Medicare, Social Security Act Section 1115A, hospice care providers, blood transfusion services, Bristol Myers Squibb (BMY), Grifols (GH), Pfizer (PFE), DaVita (DVA), Johnson & Johnson (JNJ)

Where it stands

1 cosponsor: 1 Democrats.

• Jul 15, 2026 — Introduced · Congress.gov: “Introduced in House”
• Jul 15, 2026 — Referred to House Committee on Ways and Means · Congress.gov: “Referred to the House Committee on Ways and Means”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.