WASHINGTON, D.C. – Today, U.S. Senators Jacky Rosen (D-NV) John Barrasso (R-WY), Tammy Baldwin (D-WI), and Deb Fischer (R-NE) – co-chairs and co-founders of the Senate Comprehensive Care Caucus – announced the introduction of the bipartisan Expanding Access to Palliative Care Act. Senators Rosen, Barrasso, and Baldwin also announced the introduction of their bipartisan Improving Access to Transfusion Care for Hospice Patients Act of 2021.

“As someone who stepped away from my career to care for my parents and in-laws as they aged, and as a co-founder of the Senate’s Comprehensive Care Caucus, I have an insight into the challenges that seniors and families face when dealing with palliative or hospice care,” said Senator Rosen. “I’m proud to join my colleagues in introducing this bipartisan legislative package that would allow patients to seek palliative care earlier, and receive comprehensive support throughout the entire course of their illness or injury. This package would also reduce barriers to hospice care for seriously ill patients who rely on blood transfusions to maintain quality of life. These important steps will help to increase the quality and capacity of care that we are providing, making a real difference in the lives of countless Americans.”

“Like many Americans, my family has personally experienced the benefits of hospice and palliative care,” said Senator Barrasso. “As a leader of the Senate Comprehensive Care Caucus, I support giving more families the option to use these services. This is just one way we can modernize Medicare and make it work better for seniors.”

“As someone who spent time as a primary caregiver to a close family member, I know firsthand the difference good palliative and hospice care can make in someone’s life,” said Senator Baldwin. “I’m proud to once again work across party lines with my Comprehensive Care Caucus colleagues to enhance access to palliative care services and improve the quality of life for the millions of Americans managing serious illnesses.”

Endorsements of the Expanding Access to Palliative Care Act:

“NHPCO thanks Senators Jacky Rosen, John Barrasso, Tammy Baldwin, and Deb Fischer for introducing Expanding Access to Palliative Care Act, which directs the implementation of a demonstration model for community-based palliative care,” said Edo Banach, President and CEO of the National Hospice and Palliative Care Organization. “COVID-19 has highlighted the critical need for additional support for patients and their families across the nation and we appreciate our champions for leading the charge.”

“The Coalition to Transform Advanced Care (C-TAC) is pleased to support the introduction of the Expanding Access to Palliative Care Act. We greatly appreciate the leadership that Senator Rosen continues to provide as we work to ensure that all individuals with serious illness and their families receive care and supports that reflect their needs, values, and care preferences,” said Jon Broyles, Executive Director of C-TAC. “We are gratified that this legislation also addresses a number of the core principles we believe all payment models should address, including support for care coordination, a team-based approach, access to palliative care, community-based services and supports, and a focus on care in the home. C-TAC looks forward to working with Senator Rosen, the bipartisan Comprehensive Care Caucus, the Finance Committee leaders and others who support this important issue.”

“The National Association for Home Care & Hospice (NAHC) applauds Senators Rosen, Barrasso, Baldwin, and Fischer for their introduction of the Expanding Access to Palliative Care Act,” said Bill Dombi, President of the National Association for Home and Hospice Care. “This legislation is an important step forward in the broader effort to more fully integrate palliative services into home and community-based settings. By testing a more sustainable method of payment, this demonstration model would help ensure that providers across the care continuum, including hospices and home health agencies, have the support they need to increase access to high-quality palliative care for the patients and families they serve.”

“The Oncology Nursing Society (ONS) applauds Senators Rosen, Barrasso, Baldwin, and Fischer for their leadership related to palliative care, which continues to be a critical service for oncology patients,” said Nancy Houlihan, MA, RN, AOCN; National President of the Oncology Nursing Society. “Medicare beneficiaries suffering from cancer and other serious illness will benefit from the proposed model in the bill, with the ability to receive team-based, high quality palliative care within the community setting.”

“Interdisciplinary, community-based palliative care is a critical component of aging services,” said Katie Smith Sloan, President and CEO of LeadingAge, the association of nonprofit providers of aging services. “We thank Senators Rosen, Barrasso, Baldwin, and Fischer for their leadership in ensuring access to community-based palliative care by testing a value-based payment model that addresses the needs of seriously ill older adults--wherever they call home--and fills the existing gap in available services and payment.”

Endorsements of the Improving Access to Transfusion Care for Hospice Patients Act of 2021:

“The American Red Cross supports Senator Rosen, Barrasso, and Baldwin’s bill, the Improving Access to Transfusion Care for Hospice Patients Act of 2021,” said J. Chris Hrouda, President of the American Red Cross Biomedical Services. “Our organization believes that the provision of blood products and services in a timely, streamlined manner to all Americans is in the best interests of the people and that this is a worthy initiative to explore meeting this objective.”

“We commend Senator Rosen for introducing legislation to establish the demonstration program, which would offer a payment model for blood transfusions for hospice patients on Medicare,” said American Society of Hematology (ASH) President Martin S. Tallman, MD, of Memorial Sloan Kettering Cancer Center. “ASH has long recognized that transfusions for patients with blood cancers can address palliative needs including breathlessness, bleeding, and profound fatigue. While the Medicare hospice benefit covers services for pain and symptom management, in practice, many patients do not have access to the palliative transfusions they need in hospice, so we have advocated for unique payment models to ensure access. Introducing this legislation to establish the demonstration program is a vital first step, and we look forward to continuing to work closely with Senator Rosen and other members of Congress to ensure that all patients with blood cancers get the care they need.”

“Blood transfusions are a demonstrated palliative measure to improve quality of life for many patients with a life limiting illness,” said Kate Fry, CEO America’s Blood Centers. “This important bill ensures patients can receive transfusions while also benefiting from the holistic care afforded under the Medicare hospice benefit.”

About 70% of all patients suffering from Myelodysplastic Syndromes (MDS) develop a regular blood transfusion dependence in the course of their disease,” said Audrey Hassan, Patient Liaison at the Myelodysplastic Syndromes (MDS) Foundation, Inc. “Since their anemia is refractory, they are in need of blood transfusions. The benefits of blood transfusions for MDS patients undergoing palliative care are significant and can improve their quality of life.”

BACKGROUND: The Expanding Access to Palliative Care Act would create a demonstration project in Medicare to allow palliative care to be covered concurrently with curative treatments for patients with serious illness or injury. Currently, patients on Medicare can only access palliative care through hospice. This legislation would provide comprehensive palliative care services much earlier in the course of illness, improving quality of life for the patient and their family and often also improving outcomes.

The Improving Access to Transfusion Care for Hospice Patients Act of 2021 would carve out payment for transfusion services within the hospice Medicare benefit, billing Medicare for transfusion separately. Patients needing this care would be able to continue to receive it outside of the hospice bundle, while still receiving full hospice benefits. Currently, many patients needing transfusions to maintain quality of life (due to conditions such as leukemia, lymphoma, or myeloma) often wait much longer to opt into hospice because they can lose access to transfusion care when they do so, given that such care currently is paid for out of a capped hospice benefit amount. Hospices are allowed to cover transfusions, but it is very costly, so few patients can afford to do so on a regular basis when in hospice care.  

Last Congress, Senator Rosen launched the bipartisan Comprehensive Care Caucus, with co-chairs Senators John Barrasso (R-WY), Tammy Baldwin (D-WI), and Deb Fischer (R-NE). The purpose of the Comprehensive Care Caucus is to raise the public’s awareness and promote the availability and benefits of palliative care, while also finding bipartisan solutions to expand access to palliative care services, improve coordinated care, and address issues impacting caregivers.

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