A bipartisan solution to ensure seniors’ access to bone marrow transplants
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Americans who need – or those who have ever received – an organ or blood transplant are keenly aware that despite remarkable advances in science and technology, there are still innumerable variables that can make or break a successful transplant.  

For solid organs, like the heart and lungs, patients must wait until the organs of a deceased donor become available. But patients in need of bone marrow, cord blood or stem cells face a different reality. They must hope that a family member, or anonymous donor with a close enough match, even exists. Then, among countless other considerations, doctors need to determine if blood and tissue types are compatible, and whether the recipient is stable enough to undergo a transplant. According to the United Network for Organ Sharing (UNOS), approximately 20 people die each day while waiting for a transplant.

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There is one variable, however, that should never be an obstacle: the availability of health care providers willing and able to perform this lifesaving care.

Unfortunately, that’s exactly the crisis facing Medicare beneficiaries nationwide, as hospitals and health networks question their ability to provide bone marrow and cord blood transplants for patients 65 and older due to a technical difference in how Medicare reimburses for non-solid organ transplants. Medicare policy simply hasn’t kept pace with technological advances; and tragically, this disparity is threatening the lives of older Americans with blood cancers – and strips them of hope for a cure.

For decades now, Medicare has adequately reimbursed hospitals that perform solid organ transplants by paying a reasonable amount for both the cost of acquiring the organ and for the related inpatient care. The same can’t be said for hospitals performing cellular transplants. Under current payment policy, Medicare reimburses hospitals a single amount, which includes both the 20- to 30-day hospital stay and the cost of cell acquisition.

In layman’s terms, the outdated policy means hospitals that perform bone marrow and cord blood transplants lose tens of thousands of dollars on every Medicare patient they treat. The going reimbursement rate simply isn’t enough to cover the costs of cell acquisition as well as management of the intricacies of the transplant process from start to finish, including a lengthy hospital stay.

For older Americans with blood cancers – like leukemia, lymphoma, and Myelodysplastic Syndromes (MDS) – this news about their limited treatment options is devastating.

Whereas physicians once had very few options to treat these patients, today, blood transplants offer a cure. The number of Medicare beneficiaries requiring this type of care is relatively small – approximately 1,200 patients age 65 and over could benefit from a transplant – but the individual impact is tremendous. It can be the difference between life and death, and it can prevent the crushing medical debt that occurs when patients are forced to completely finance their own care.

It’s time to ensure that older Americans with blood cancers can access the same lifesaving care they would receive if they were to need a solid organ transplant. That’s why we are proud to champion H.R. 4215, The Patient Access to Cellular Transplant (PACT) Act, which would update Medicare policy to reimburse hospitals for the cost of acquiring bone marrow, stem cell, and cord blood cells the same way solid organ acquisition costs are paid.

Congress must act to ensure that Medicare patients who might otherwise die from their disease have access to necessary treatment. The PACT Act – long overdue – will get us there.

Paulsen, Kind, Matsui and Bilirakis are lead sponsors of The Patient Access to Cellular Transplant (PACT) Act.