Literature Review

County Commissioners question providing nonprofits with funding Times Union Online, Kosciusko County, IN; by David L. Slone; 7/16/24 The future of Kosciusko County government providing funding to local nonprofit organizations is uncertain. Tuesday, after some discussion on the appropriateness of the county giving taxpayer dollars to nonprofits, the Kosciusko County Commissioners approved recommending to the County Council that seven nonprofits receive the same amount of funds in 2025 as they did in 2024. [Among the organizations listed is] Stillwater Hospice, $50,000. ... [Commissioner Cary] Groninger said the county council would have the final say on the nonprofit funding. ... [Commissioner Brad] Jackson said the decision was a tough one and they didn’t just want to stop providing funding without giving the nonprofits notice. 

Hospice CARES Act would update medical reviews, seek to reduce audits Hospice News; by Jim Parker; 7/12/24 The forthcoming Hospice Care Accountability, Reform and Enforcement (Hospice CARE) Act from U.S. Rep. Earl Blumenaur (D-Oregon), if enacted, would implement a number of changes to medical review processes. ... Though the bill language is still in development, it will likely contain proposed updates to payment mechanisms for high-acuity palliative services, changes to the per-diem payment process and actions to improve quality and combat fraud. The bill would also implement a temporary, national moratorium on the enrollment of new hospices into Medicare, to help stem the tide of fraudulent activities among recently established providers concentrated primarily in California, Arizona, Texas and Nevada. ... Among the anticipated provisions of the bill would be an item requiring the U.S. Centers for Medicare & Medicaid Services (CMS) to use documentation in a patient’s medical record as supporting material. The documentation would include the reasons that an attending physician certified a patient for hospice and establish a six-month terminal prognosis.

Lawmakers say CMS should ban Medicare Advantage’s use of AI to deny care McKnights Long-Term Care News; by Josh Henreckson; 6/26/24 The Centers for Medicare & Medicaid Services should consider banning artificial intelligence from being used to deny Medicare Advantage coverage pending a “systematic review,” a group of 49 congressional leaders is urging. ...  Skilled nursing providers have been sounding the alarm for years on Medicare Advantage coverage access, especially when informed by AI and other algorithms. Sector leaders have frequently noted that these methods can deny or prematurely end coverage for patients who need it to afford necessary long-term care. Providers and consumer advocates both spoke out in favor of the lawmakers’ letter this week. “LeadingAge’s nonprofit and mission driven members … have firsthand experience of Medicare Advantage (MA) plans’ inappropriate use of prior authorization to deny, shorten and limit MA enrollees’ access to medically necessary Medicare benefits,” wrote Katie Smith Sloan, president and CEO of LeadingAge. ... “Implementation by [the] Centers for Medicare and Medicaid Services (CMS), which we fully support, would ensure MA plans fulfill their obligation to provide enrollees equitable access to Medicare services.”

How the Supreme Court’s Chevron Decision could help stop home health cuts Home Health Care News; by Andrew Donlan; 6/28/24 On Friday, the U.S. Supreme Court upended the Chevron doctrine precedent. For home health industry purposes, that means a potentially weakened Centers for Medicare & Medicaid Services (CMS) moving forward. The news comes just two days after the home health proposed payment rule was released, which included significant cuts for the third straight year. Broadly, moving away from the Chevron precedent – usually known as the Chevron doctrine – will mean less regulatory power for government agencies. Government agencies often take their own interpretations of certain laws and statutes, and then act upon those interpretations. ... The National Association for Home Care & Hospice (NAHC) already filed a lawsuit against the U.S. Department of Health & Human Services (HHS) and CMS over rate cuts in 2023. “In our own analysis, we believe that providers of home health have been underpaid as it relates to budget neutrality,” NAHC President William A. Dombi said when the lawsuit was filed. “At minimum, we would expect to see the rate cuts from 2023, that were permanent readjustments to the base rate, and the one proposed for 2024, along with the temporary adjustments … to go away. The end product of that is that we would have a stable system to deliver home health services to Medicare beneficiaries.”

Delaware legislature passes Medical-Aid-in-Dying law CBS WBOC, DOver, DE; by Sean Curtis; 6/25/24 The Delaware State Senate is sending House Bill 140, or the End-of-Life Options Law, to Governor John Carney’s desk after passing it Tuesday [6/25/24]. ... Medical aid in dying would only be available to adult Delawareans diagnosed with an incurable disease or illness who have been given a prognosis of six months or less to live. The prognosis must come from at least two medical professionals, according to lawmakers. Advanced age, disability, mental illness, or chronic health conditions would not qualify a person, under the law. Those seeking medical aid in dying under HB 140 would need to demonstrate an ability to understand and grasp the consequences of their decision, as determined by a licensed psychiatrist or psychologist. ... It will now head to the Governor’s Office for Carney’s signature before becoming law, unless Carney chooses to veto the legislation. 

Lawmakers remain committed to passing hospice workforce bill Hospice News; by Jim Parker; 6/24/24 Federal legislators plan to continue to work on passing a bill designed to bolster the hospice and palliative care workforce. The Palliative Care and Hospice Education Training Act (PCHETA) has come before Congress several times but has not yet been passed. The bill’s most recent development occurred in July 2023, when it was reintroduced by Sens. Tammy Baldwin (D-Wisc.) and Shelley Moore Capito (R-W.Va.). Capito has indicated that the senators are not giving up on the legislation as they seek to ensure that hospice and palliative care providers are able to meet growing demand. ... The legislation would establish fellowships through new palliative care and hospice education centers to provide short-term, intensive training, as well as incentivized award programs across all the relevant disciplines. It also would support programs to develop career paths within the field.

Advocates rally in DC for the future of hospice: NHPCO and HAN amplify provider voices on Capitol Hill NHPCO; Press Release; 6/13/24 More than 100 hospice and palliative care advocates from across the country met with over 150 congressional offices this week to discuss key legislative and regulatory priorities for ensuring and expanding access to hospice and palliative care. The meetings were part of Hospice Action Week, hosted in Washington, DC by the National Hospice and Palliative Care Organization (NHPCO) and its advocacy affiliate, the Hospice Action Network (HAN). “The cornerstone of effective advocacy is storytelling. It’s about sharing why hospice holds personal significance and why serious illness and end-of-life care policy should resonate with our lawmakers,” said Logan Hoover, NHPCO’s VP of Policy & Government Relations. “From Hawaii to Rhode Island, advocates from 35 diverse states came to DC this year. The relationships they’re building with Members of Congress hold the potential to shape the future of the healthcare landscape.” 

H.R.8278 - Hospice Recertification Flexibility Act: Introduced to Congress Congress.gov; introduced by Rep. Carol Miller [R-WV-1] on 5/7/24; text released 6/10/24To amend title XVIII of the Social Security Act to extend certain telehealth flexibilities with respect to hospice care under the Medicare program, and to establish a modifier for recertifications of hospice care eligibility conducted through telehealth.

Hospital staffing shortages draws hundreds to California rally AFSCME, American Federation of State, County & Municipal Employees; by UNANC/UHCP and AFSCME International Staff; 5/21/24 SACRAMENTO, Calif. – More than 400 health care union members went to the California state Capitol during National Nurses Week this month to appeal to the state’s elected leaders to fix the nursing education backlog and hospital staffing issues that affect patient care. ... Rally participants pressed lawmakers to make health care education and training programs more accessible so students remain in their California communities for their health care careers. They also appealed to lawmakers to empower health care professionals to enforce safe staffing standards in the state’s hospitals.Editor's Note: Pair this article with others in today's issue, in our "Education" section.

Spread of assisted dying shines spotlight on difficult decisions Financial Times; by Charlotte Middlehurst; 5/22/24 The right to control your death is a principle that societies have debated for centuries. But, as more countries prepare to legalise medically-assisted dying, the reality of allowing the practice is sparking fresh ethical arguments. Some form of assisted dying is now legal in 9 countries, as well as in 11 US states and parts of Australia. [Click on the title's link for data and discussion regarding international policies; concerns about increased "unassisted suicide"; rapid legislative/medical decisions; inducing death; devaluing the lives of disabled persons; ethical choices based on economic factors; doctors' choices; and more.] 

Medical aid in dying bill didn’t cross finish line this MN Legislature session Twin Cities Pioneer Press; by Dene K. Dryden; 5/22/24 Despite advancing through several House committees, Minnesota’s End-of-Life Option Act did not receive a floor vote in the House or Senate during the 2024 legislative session, which ended earlier this week. The legislation, co-authored by Rep. Andy Smith, DFL-Rochester, and Sen. Liz Boldon, DFL-Rochester, would have permitted medical aid in dying, also known as physician-assisted suicide. The measure would have allowed terminally ill adults to request a prescription for life-ending medication, which they would have to self-administer. 

Senate ramps up push to reform doctors' Medicare pay Modern Healthcare; by Michael Mcauliff; 5/20/24Declining doctors' pay in Medicare is getting its most serious look in nearly a decade in the Senate, with a bipartisan push launched Friday by the Senate Finance Committee. Doctors have grown especially vocal in recent years about falling Medicare reimbursement. Groups including the American Medical Association have estimated doctors were effectively getting paid 26% less in 2023 than in 2001 because the physician fee schedule set by the Centers for Medicare and Medicaid Services is not adjusted for inflation. Physicians have also called for more flexibility within the pay system.