,,ii  #aahth ,,congress  #ast ,session  
,s4 #bahf  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #bb1     
#bjbc,ms4 ,rosen 7for herself1 ,mr4     
,barrasso1 and ,ms4 ,baldwin7 introduced
 the following bill2 which was read     
twice and referred to the ,committee on 
,finance  ,a ,,bill  ,to require the    
,center for ,medicare and ,medicaid     
,innovation to test allowing blood      
transfusions to be paid separately from 
the ,medicare hospice all-inclusive per 
diem payment4  #a4 ,short title ,this   
,act may be cited as the ,improving     
,access to ,transfusion ,care for       
,hospice ,patients ,act of #bjbc4  #b4  
,center for ,medicare and ,medicaid     
,innovation testing of allowing blood   
transfusions to be paid separately from 
the ,medicare hospice all-inclusive per 
diem payment ,section #aaae;,a of the   
,social ,security ,act 7#db ,u4,s4,c4   
#acae;a7 is amended-- 7#a7 in subsection
 7b77#b77;,a71 by adding at the end the 
following new sentence3 8,the models    

selected under this subparagraph shall  
include the testing of the model        
described in subsection 7h7402 and  7#b7
 by adding at the end the following new 
subsection3  7h7 ,testing of allowing   
blood transfusions ,to be paid          
separately from the ,medicare hospice   
all-,inclusive per diem payment  7#a7   
,in general ,not later than #a year     
after the date of enactment of this     
subsection1 the ,,cmi shall establish   
and implement a model under which blood 
transfusions furnished to an individual 
receiving hospice care are paid         
separately from the hospice             
all-inclusive per diem payment under    
section #ahad7;i74 ,the separate payment
 amount for such blood transfusion shall
 be the amount that would otherwise     
apply under title ,,xviii if the        
transfusion was not furnished as part of
 hospice care4  7#b7 ,requirements for  
evaluation ,in conducting any evaluation
 of the model described in paragraph    
7#a7 pursuant to subsection 7b77#d71 the

 ,,cmi shall ensure it compares         
participants under the model with       
similar patients outside of the model   
with respect to the following metrics3  
7,a7 ,the number of chemotherapy        
services furnished in the last #ad days 
of life4  7,b7 ,hospital utilization in 
the last #cj days of life1 including    
emergency department visits1 in-patient 
and observation status stays 7including 
the length of the stays71 and intensive 
care unit 7,,icu7 days4  7,c7 ,how many 
days receiving hospice care before the  
end of life4  7,d7 ,the number of       
patients receiving hospice care who     
received a transfusion compared to      
patients with similar diagnoses not     
receiving hospice care4  7,e7 ,the      
average frequency of transfusion for    
patients receiving hospice care compared
 to patients not receiving hospice care4
  7,f7 ,the number of transfusions for  
patients receiving hospice care compared
 to patients not receiving hospice care4
  7,g7 ,other areas determined          

appropriate by the ,,cmi4  4