Literature Review

Part D Plans cover a larger share of Medicare Beneficiaries in rural counties Managed Healthcare Executive; by Denise Myshko; 4/25/25 Medicare beneficiaries living in more rural counties are enrolled in traditional Medicare and rely on stand-alone prescription drug plans (PDPs), according to recent analysis from KFF.In fact, in 27 states, at least half of Medicare Part D enrollees living in the most rural areas are enrolled in stand-alone prescription drug plans. This includes 8 states with 75% or more of Part D enrollees in the most rural areas in prescription drug plans (Nevada, Alaska, Massachusetts, California, Kansas, Wyoming, Nebraska, and South Dakota). Nationwide, 58% of beneficiaries living in rural areas are enrolled in stand-alone prescription drug plans in 2025. The remainder (42%) are enrolled in Medicare Advantage drug plans (MA-PDs).

CMS releases HOPE Guidance Manual (V. 1.01) and TablesCenters for Medicare and Medicaid Services (CMS); by CMS; 4/22/25On April 22, 2025, CMS released the HOPE Guidance Manual (V. 1.01) and connected tables. Providers can use v1.01 for HOPE planning, as this is considered final before HOPE implementation. Also note that earlier this month, the final HOPE data specs have also been released, helping software developers to finalize their HOPE software for testing in the coming months.

HMN 2025: What are the obstacles to opiod accessibility for severely ailing sufferers Health Medicine Network; by The Mount Sinai Hospital; 4/22/25 In a research published in NEJM Catalyst, researchers on the Icahn School of Medicine at Mount Sinai describe how measures to curb opioid overdoses within the normal inhabitants have compromised a crucial cornerstone of palliative care. ...  “The opioid disaster of overdose deaths stays omnipresent; nonetheless, a brand new menace has emerged amongst susceptible populations who want these medicines as first-line remedy for his or her ache, which will be extreme,” says lead writer Rebecca Rodin, MD, Assistant Professor of Geriatrics and Palliative Medicine, Icahn Mount School of Medicine at Mount Sinai, who makes a speciality of palliative drugs. “We hope our findings will lay the muse for deeper dialog to revive stability between opioid extra and entry.”

Florida lawmakers unanimously approve bill to make medical marijuana cards free for military veterans Marijuana Moments; by Ben Adlin; 4/15/25 A Florida House panel on Tuesday unanimously approved a bill that would exempt military veterans from state registration fees for medical marijuana cards, allowing them to obtain the certifications for free. ... If HB 555 becomes law, the changes would take effect July 1.

Medicare and Medicaid officials finalize rule to clarify that medical marijuana isn’t covered by federal health programsMarijuana Moment; by Kyle Jaeger; 4/8/25 The federal Centers for Medicare & Medicaid Services (CMS) has finalized a rule to clarify that marijuana products are not eligible for coverage under certain health plans for chronically ill patients because “they are illegal substances under Federal law.” In a notice set to be published in the Federal Register next week, CMS said that a series of policy and technical changes for its Medicare Advantage (MA) program and other services, including rulemaking related to cannabis products, will now take effect on June 3.[Continue reading ...]

Harmonizing federal and Florida laws on prescribing controlled substances through telehealth JD Supra; by Jeremy Burnette, Martin Dix, and John Hood; 3/24/25 Practitioners who want to prescribe controlled substances via telehealth to patients in Florida must meet the requirements of both federal and state law. The federal Drug Enforcement Administration (DEA) and the Florida legislature have recently amended the applicable federal regulations and state laws, respectively, to allow the prescribing of controlled substances via telehealth[*] without conducting an in-person evaluation under certain circumstances. There are key differences between federal and state law, so practitioners prescribing controlled substances via telehealth to patients in Florida should be aware of the particular requirements of each. [Continue reading ...]

Bringing palliative care to every patient with cancer: A conversation with Janet L. Abrahm, MD, FACP, FAAHPM, FASCO The ASCO Post, in partnership with the American Society of Clinical Oncology; by Jo Cavallo; 3/25/25 Janet L. Abrahm, MD, FACP, FAAHPM, FASCO, ... has become a widely recognized leader in the field of supportive care and palliative medicine, serving for nearly a decade on the leadership team of the American Academy of Hospice and Palliative Medicine and helping to craft the first Hospice and Palliative Medicine certifying examination offered by the American Board of Internal Medicine. ... In a wide-ranging interview with The ASCO Post, Dr. Abrahm discussed the importance of providing every patient with cancer access to palliative medicine throughout survivorship, how oncologists can become more effective communicators, and strategies to alleviate patients’ suffering at the end of life.

RFK Jr. continues pioid Crisis PHE into its eighth year Inside Health Policy; by Dorothy Mills-Gregg; 3/19/25 HHS Secretary Robert F. Kennedy Jr. recently renewed the department’s longest ongoing public health emergency (PHE) first declared under the first Trump administration: the opioid abuse crisis. While the Centers for Disease Control and Prevention found a 25.5% decrease in overdose deaths in 2024 compared to the previous year, HHS says the opioid PHE needs to be renewed for another 90 days so federal coordination efforts can continue and key flexibilities for HHS will be preserved.Editor's note: How recently have you reviewed your Policies & Procedures for destroying drugs in the patient's home, upon death--in accordance with state laws? For staff education and accountability? For communicating this with family? For assessing possible drug diversion of opioids, with appropriate follow-up actions? Additionally, numerous hospice bereavement programs have been flooded with grief needs of bereaved family members from opioid deaths. Click here for the U.S. Department of Justice's Drug Enforcement Administration - Diversion Control Divsion; more focused, scroll down to their "Home Disposal Methods."

Revamped tool can reliably assess pain symptoms in dementia patients: researchers McKnights Long-Term Care News; by Zee Johnson; 3/17/25 ... A team of researchers reconstructed the End-of-Life Dementia-Comfort Assessment in Dying, or EOLD-CAD, after a multifacility study showed that caregivers could adequately and reliably address a host of pain symptoms seen in end-of-life dementia patients. ... When clinicians working in the SNFs that were part of the trials used the EOLD-CAD, they were able to detect patterns in more than 600 residents that fell into four categories: physical distress, symptoms of dying, emotional distress, and well-being. Common symptoms observed across these categories were restlessness, shortness of breath, choking, gurgling, difficulty in swallowing, fear and anxiety. ...

Hospice Insights Podcast - Psychedelics and end of life care: Understanding the legal landscape Hospice Insight - The Law and Beyond; by Husch Blackwell LLP; 3/12/25 There has been a lot of buzz around psychedelics, and particularly their potential usefulness in treating existential suffering at the end of life. Husch Blackwell was the first law firm in the country to establish a Psychedelics & Emerging Therapies practice group devoted to helping clinicians, researchers, and investors navigate the complex and difficult legal and regulatory issues involved in developing new therapies in this space. In this episode, host Meg Pekarske is joined by the leaders of Husch Blackwell’s Psychedelics & Emerging Therapies practice group, Kimberly Chew, Karen Luong, and Natasha Sumner, who provide an overview of what psychedelics are, their legal status under federal and state laws, and liability considerations for clinicians.

Walgreens sells to private equity firm Sycamore Partners Healthcare Brew - Pharma; by Nicole Ortiz; 3/11/25 Since December, rumors have floated around that Walgreens was going to be acquired by private equity (PE) firm Sycamore Partners. And while analysts told Healthcare Brew at the time that it was unlikely to happen, the tides appear to have turned in the PE company’s favor. On March 6, Walgreens Boots Alliance announced in a press release that it had signed a definitive purchase agreement with Sycamore for up to $23.7 billion. However, when Walgreens’s debts and assets to be potentially divested are taken out, the total sale price is actually closer to around $10 billion, per the ll Street Journal, turning the retailer into a private entity after nearly a century as a public company.

Hallucinogens may elevate death risk by more than twofold Medscape; by Liz Scherer; 3/5/25 Hallucinogens are associated with a 2.6-fold increased risk for premature death in some individuals seeking emergency care, according to a recent study. The risks are especially substantial in vulnerable patients who are suicidal, who are susceptible to severe mental illness, or have comorbid conditions such as respiratory disease or cancer. The findings come at a time of renewed interest in the therapeutic potential of substances like psilocybin, lysergic acid diethylamide, methylenedioxymethamphetamine (MDMA), and ketamine for mood and substance use disorders. In 2023, the Canadian Institutes of Health Research allocated roughly $3 million to three clinical trials examining psilocybin-assisted psychotherapy in the treatment of alcohol use disorder, treatment-resistant depression, and end-of-life psychological distress in patients with advanced cancer.

Charges dismissed against chef accused of trying to kill his Monterey county mother KSBW Action News-8, Monterey, CA; by Felix Cortez; 2/28/25 A popular San Francisco area chef who was arrested along with his sister and charged with trying to kill their mother more than two years ago has had attempted murder charges dismissed against him. “In over 30 years of practice, this was one of the saddest cases I have ever seen and one of the most incompetent investigations by the Monterey County Sheriff’s Department that I have ever seen,” said Juliet Peck, the attorney for James Stolich. ... The mother was terminally ill and lived on a ranch off Highway 68 outside Salinas. “James’ mother’s only wish was to die at home without pain, surrounded by her daughter, son, and pets,” Peck said. But that never happened; Tinker died about a week later in a hospice facility, never to see her children again, because an emergency protective order obtained by the sheriff’s office prevented the children from visiting their dying mother. ... According to court documents, the daughter, Whitney, was the “agent designated to make all health care decisions for her mother,” which included administering medication to help alleviate her mother’s pain. ...The original criminal complaint alleging attempted murder charges said Whitney or a co-conspirator “crushed up pills with a mallet.” A close friend of Tinker was willing to testify that Whitney had no intent to kill her mother but was simply following her mother’s “directive to provide effective and sufficient palliative care even if it hastened her death.”Editor's note: This case raises numerous issues, including but not limited to community education (including law enforcement), Advance Directives, patient and caregiver education and support, MAiD (Medical Aid in Dying) or the End Of Life Option Act (EOLOA) in California, ethics, and the dying process (note that "the mother died about a week later in a hospice facility).