US Federal Senate Bill SB1936

US Federal 2025-2026 Regular Session

• Introduced: 6/3/25
• Refer: 6/3/25

Caption

Improving Access to Transfusion Care for Hospice Patients Act of 2025

Summary

SB 1936, the Improving Access to Transfusion Care for Hospice Patients Act of 2025, would direct the Center for Medicare and Medicaid Innovation (CMMI) to create and test a Medicare payment model that allows blood transfusions furnished to hospice patients to be paid separately from the hospice all-inclusive per diem payment. Under current hospice payment rules, transfusions are generally bundled into the daily hospice rate; this bill would instead pay transfusions at the amount that would otherwise apply under Medicare Part A if the service were not provided as part of hospice care. The bill also requires CMMI to evaluate the model using specified measures, including chemotherapy use in the last 14 days of life, hospital and emergency department utilization in the last 30 days of life, ICU days, length of hospice enrollment before death, and transfusion use among hospice and non-hospice patients with similar diagnoses. The model must be established and implemented within one year after enactment, and the bill amends Section 1115A of the Social Security Act to ensure this model is among those tested by CMMI.

Impact

If enacted, the bill would amend Section 1115A of the Social Security Act and affect Medicare hospice payment policy by creating a demonstration model for separate reimbursement of blood transfusions. It would not immediately change all hospice billing nationwide, but it would require CMMI to test whether separate payment improves access to transfusion care for hospice patients and to measure effects on utilization and end-of-life care patterns. The primary affected parties would be Medicare hospice beneficiaries, hospice providers, transfusion providers, and CMS/CMMI administrators.

Sentiment

Based on the bill text and sponsorship, the measure appears to have a generally supportive and bipartisan framing, with introduction by Senators Rosen, Barrasso, and Baldwin. The bill’s purpose is narrowly targeted and patient-focused, suggesting an intent to improve access to needed supportive care for hospice patients rather than to broadly expand Medicare spending. No committee debate or recorded votes are provided, so the available context shows support at introduction but no documented opposition in the supplied materials.

Contention

The main policy issue is whether blood transfusions should be carved out from the hospice per diem payment or remain bundled within it. Supporters are likely to argue that separate payment would improve access for hospice patients who may otherwise forgo transfusions because of hospice financing constraints. Potential concerns, though not documented in the provided transcripts, would center on Medicare costs, whether separate payment could alter hospice utilization patterns, and whether the model might affect end-of-life care decisions, including hospital use and chemotherapy near the end of life. The bill anticipates these concerns by requiring evaluation of utilization and patient-comparison metrics.