CMS Seeks Input on Provision of Palliative Transfusion Under Medicare Hospice Benefit

The Centers for Medicare and Medicaid Services (CMS) is seeking feedback on palliative blood transfusion as part of the Fiscal Year (FY) 2025 Hospice Wage Index and Payment Rate Update Proposed Rule, which is scheduled for publication Thursday.

In an unpublished March 28 Federal Register notice, CMS said that anecdotes from beneficiaries and families suggest they have been informed that palliative therapies such as dialysis, chemotherapy, radiation and blood transfusions are not options upon election of the hospice benefit.

CMS clarified that while these types of treatments are not intended to cure the patient’s terminal illness, some practitioners may determine that, for some patients, these therapies may be beneficial for symptom control. In such instances, these palliative treatments would be covered under the hospice benefit.

As CMS continues its focus on improved access and value within the hospice benefit, the agency is soliciting public comment on the following questions:

• What strategies could mitigate financial risks associated with providing complex palliative treatments and higher intensity hospice care?
• What are the specific financial barriers preventing hospices from offering higher-cost palliative treatments, such as equipment or treatment expenses?
• Should there be guidelines on when palliative treatments qualify for alternative payment types, considering the level of care required?
• Should CMS define palliative services in the context of high-cost treatments, without altering the current definition of palliative care?
• Is documentation necessary to ensure all other palliative options have been explored before billing for higher-cost treatments, and would this pose a barrier for hospices?
• Should there be separate payments for various types of higher-cost palliative treatments, or should there be a single standard payment for high-cost treatments that exceed the per-diem rate?

CMS is accepting comments on the proposed rule through May 28.