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 1115A of the Social Security Act (42 U.S.C. 1315a) is amended— (1) in subsection (b)(2)(A), by adding at the end the following new sentence: “The models selected under this subparagraph shall include the testing of the model described in subsection (h).”; and (2) by adding at the end the following new subsection: (h) Testing of allowing blood transfusions To be paid separately from the Medicare hospice all-Inclusive per diem payment (1) In general Not later than 1 year after the date of enactment of this subsection, 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 1814(i). 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 care. (2) Requirements for evaluation In conducting any evaluation of the model described in paragraph (1) pursuant to subsection (b)(4), the CMI shall ensure it compares participants under the model with similar patients outside of the model with respect to the following metrics: (A) The number of chemotherapy services furnished in the last 14 days of life. (B) Hospital utilization in the last 30 days of life, including emergency department visits, in-patient and observation status stays (including the length of the stays), and intensive care unit (ICU) days. (C) How many days receiving hospice care before the end of life. (D) The number of patients receiving hospice care who received a transfusion compared to patients with similar diagnoses not receiving hospice care. (E) The average frequency of transfusion for patients receiving hospice care compared to patients not receiving hospice care. (F) The number of transfusions for patients receiving hospice care compared to patients not receiving hospice care. (G) Other areas determined appropriate by the CMI..