Medicare tests paying for hospice transfusions separately—raising end-of-life care stakes

What it does

This bill directs Medicare to test whether blood transfusions given to hospice patients should be paid separately from the fixed daily hospice payment, rather than bundled into it. Currently, hospice providers receive a flat per-diem rate that covers all care; the bill would allow transfusions to be billed separately at standard Medicare rates, potentially increasing reimbursement for hospice providers and making transfusions more financially attractive to offer at end of life.

Why we flagged it

The bill's core function is to authorize a Centers for Medicare & Medicaid Innovation (CMI) pilot test of a payment model change. It is a narrow, technical amendment to the Social Security Act establishing a specific reimbursement experiment, not a broad policy mandate.

What the text implies

• Separating transfusion payment from the hospice per diem removes a financial disincentive to transfuse, potentially increasing transfusion frequency in the final weeks of life—a shift that may conflict with hospice's palliative care mission and increase end-of-life spending.
• The bill's evaluation metrics (chemotherapy in last 14 days, hospital utilization, transfusion frequency) suggest policymakers anticipate the risk of increased aggressive interventions; if the pilot shows higher transfusion rates, it may normalize end-of-life transfusions as standard practice.
• Hospice providers (including for-profit chains) stand to increase revenue if transfusions are billed separately; this creates a financial incentive structure that may influence clinical decision-making independent of patient benefit.
• The pilot is time-limited and evaluation-driven, but if successful, could lead to permanent policy change affecting Medicare spending and end-of-life care patterns across the hospice industry.

Who it affects

Hospice patients may gain access to transfusions that providers currently avoid due to bundled-payment disincentives, improving end-of-life care options. However, the separate-payment model may incentivize overuse of transfusions in the final weeks of life, raising costs and potentially conflicting with hospice's palliative philosophy; the bill's evaluation metrics suggest concern about this exact risk.

Who stands to gain

• hospice providers and chains
• blood product manufacturers and distributors
• dialysis and infusion service providers

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

2 cosponsors: 1 Democrats, 1 Republicans.

• Jun 3, 2025 — Introduced · Congress.gov: “Introduced in Senate”
• Jun 3, 2025 — Referred to Senate Committee on Finance · Congress.gov: “Read twice and referred to the Committee on Finance”

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

Money around this bill

2 lobbying clients named this bill on 3 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $720,000 in lobbying spend. A filing names 11 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 41% of bills with at least one filing.

Jacky Rosen, the sponsor, reported $207,550 in PAC receipts in the 2026 cycle.

• Blood Cancer United (fka the Leukemia & Lymphoma Society) — $590,000 on 1 filing
• American Society of Hematology — $130,000 on 2 filings

Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.