Medicare tests paying for hospice transfusions separately—raising end-of-life care stakes
S. 1936 — Improving Access to Transfusion Care for Hospice Patients Act of 2025 · Filed by Jacky Rosen (D-NV) · 2 cosponsors · Introduced Jun 3, 2025 · Referred to committee
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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.
The full analysis lists 4 implications of this text.
Who stands to gain
hospice providers and chains; blood product manufacturers and distributors; dialysis and infusion service providers