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ASH President Applauds Introduction of Legislation for Palliative Blood Transfusions

New bill introduced today to enhance access for patients with blood cancers to necessary transfusions in hospice setting

(WASHINGTON, July 30, 2021) — Today, Senators Jacky Rosen (D-NV), John Barrasso (R-WY), and Tammy Baldwin (D-WI) introduced a bipartisan bill to increase access to palliative blood transfusions for patients receiving end-of-life care through the Medicare hospice benefit.

The bill seeks to address a serious problem many patients with blood cancers on Medicare currently face by establishing a demonstration program that would provide a separate payment model to promote the provision of palliative blood transfusions in hospice, with the goal of ensuring that patients with blood cancers and other hematologic diseases and conditions receive high-quality end-of-life care.

The Medicare hospice benefit was established to provide terminally ill Medicare beneficiaries with access to high-quality end-of-life care, and to that end it covers services for pain and symptom management. Blood transfusions can address palliative needs related to breathlessness, bleeding, and profound fatigue. However, in practice, many patients do not have access to transfusions in hospice. There are three main reasons why this occurs, including costs, misconceptions about this therapy, and lack of referrals. In fact, many hospices are forced to choose not to provide treatments such as palliative blood transfusions because of their cost, relative to the daily reimbursement rate for hospice care services.

For several years, the American Society of Hematology (ASH) has worked with members of Congress to educate them about the issue of lack of access to blood transfusions in hospice care, as well as to advocate for innovative Medicare payment models such as the one introduced in the new bill.

In response to the introduction of the legislation, ASH President Martin S. Tallman, MD, of Memorial Sloan Kettering Cancer Center issued the following statement:

“We applaud Senators Rosen, Barrasso, and Baldwin for acknowledging and addressing the problem of lack of access to palliative blood transfusions in hospice and we encourage other members of Congress to join them in this important legislation.

As hematologists, we have seen our patients with blood cancers have to make the very difficult decision between receiving transfusions, which can improve their quality of life but often require a hospital admittance, and hospice care, which would allow them to spend their end of life in the comfort of their own homes. Unfortunately, this means that patients with hematologic malignancies who need blood transfusions to control their symptoms are less likely to use hospice services than patients with other cancers. Lack of hospice care is known to not only increase health care costs but also raise the risk of adverse events, such as emergency room visits and hospital admissions, at end of life.

This new bill is a vital first step in ensuring that blood cancer patients are not forced to choose between blood transfusions and hospice care in their final days and can instead focus on spending time with loved ones. We look forward to continuing to work closely with Senators Rosen, Barrasso, and Baldwin and other members of Congress to ensure that all our patients with blood disorders get the care they need.”

The American Society of Hematology (ASH) (www.hematology.org) is the world’s largest professional society of hematologists dedicated to furthering the understanding, diagnosis, treatment, and prevention of disorders affecting the blood. For more than 60 years, the Society has led the development of hematology as a discipline by promoting research, patient care, education, training, and advocacy in hematology. ASH publishes Blood (www.bloodjournal.org), the most cited peer-reviewed publication in the field, and Blood Advances (www.bloodadvances.org), an online, peer-reviewed open-access journal.

Leah Enser, American Society of Hematology
[email protected], 202-552-4927