Senators Propose Bills to Expand Hospice Training, Ensure Access to Transfusions

Sens. Jacky Rosen (D-Nev.) and Lisa Murkowski (R-Alaska) recently re-introduced legislation designed to expand the palliative care workforce.

The two lawmakers, along with others, also brought forth a second bill designed to ensure that hospice patients who need blood transfusions can receive them.

The bipartisan-supported Provider Training in Palliative Care Act aims to increase the number of clinicians trained in palliative care as long-standing labor shortages continue to hinder access.


“This bipartisan effort will help to address workforce shortages in palliative care and will ensure that people living with serious illnesses receive the comprehensive care they deserve,” Murkowski said in a statement. “I’m glad to join Senator Rosen on this bill that would remove barriers to expand training opportunities and increase access to this critical care in underserved areas.”

Engaging medical students

If enacted, the legislation would allow medical students in the National Health Service Corps’ (NHSC) to defer clinical service requirements for up to one year to pursue additional training in palliative care. They also would provide primary care during their time of service with NHSC.

If enacted, the legislature would help increase awareness and education around palliative care to a broader base of diverse medical professionals, according to Ben Marcantonio, COO and Interim CEO at the National Hospice and Palliative Care Organization (NHPCO). Many medical professionals lack exposure to palliative care in their training, he indicated.


“The Provider Training in Palliative Care Act would allow for more health care professionals to receive training in the field of palliative medicine which is critical for the future success and longevity of the hospice community,” Marcantonio said in a statement.

Established in 1972, NHSC is part of the U.S. Department of Health & Human Services (HHS) and supports more than 20,000 medical organizations that serve upwards of 21 million patients annually. NHSC’s member organizations provide primary, dental and behavioral health care, among other services.

NHSC also provides scholarships and loan programs to primary care providers in eligible disciplines. The Health Resources and Services Administration (HRSA) manages the initiative.

This is not the bill’s first iteration. Rosen and Murkowski, initially tried to pass the palliative care training bill in 2019, and then again 2021. Both senators are members of the Senate Committee on Health, Education, Labor and Pensions.

Stakeholders that have endorsed the legislation include NHPCO, AARP, the American Academy of Hospice and Palliative Medicine (AAHPM), the Coalition to Transform Advanced Care (C-TAC), the National Association for Home Care & Hospice (NAHC) and the National Partnership for Hospice Innovation (NPHI), among others.

The legislation would help to shore up the nation’s supply of palliative care specialists in the face of rising demand for serious illness care – especially in underserved regions, according to AAHPM President Dr. Holly Yang.

“Given the critical shortage of health professionals with expert knowledge and skills in palliative care, AAHPM offers its strong support for the Provider Training in Palliative Care Act, which would provide an important update to the National Health Service Corps program,” Yang said. “Allowing eligible individuals to postpone their service obligation to seek post-graduate training in palliative care will not only help ensure that we build a health care workforce more closely aligned with America’s evolving health care needs, but build on a program which is vital to increasing access to care in rural and underserved areas.”

Improving access to transfusions

The training legislation comes alongside another bipartisan bill introduced by Rosen, Baldwin and Sen.John Barrasso (R-Wy.) intended to improve quality and access to blood transfusion care for hospice patients.

The Improving Access to Transfusion Care for Hospice Patients Act would create a payment model for blood transfusion services within the Medicare Hospice Benefit. This would allow hospice providers to bill Medicare separately for transfusion services

“As a doctor and as a son, I have seen the benefits of hospice and palliative care firsthand. In these circumstances, personalized medical services can drastically improve the quality of life for hospice patients and their families,” Barrasso said in a statement. “That is why I have supported legislation that will allow more patients access to the highest quality of end-of-life care.”

Access to blood transfusion services is an important option for many patients with life-limiting and serious illnesses, according to Kate Fry, CEO of America’s Blood Centers.

Fear of losing theses services can be a deterrent for these patients when considering their end-of-life care options, Fry stated.

“Blood transfusions are a crucial palliative measure to improve the quality of life for patients with life-limiting illnesses,” Fry said. “It is imperative that patients have access to blood transfusions, while also being able to benefit from the comprehensive care provided under the Medicare hospice benefit. We thank Senators Rosen, Barasso and Baldwin for introducing this important legislation to take a major step toward ensuring that all patients receive the best possible care.”

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