Literature Review

Controversial conversations: Key takeaways from The Jeffrey Fudin Debates on pain and palliative care practices Pharmacy Times; Interview with Lee Kral, PharmD, FASHP, NBC-HWC, CPMC, CPE; 6/5/24In an interview with the Pharmacy Times®, Lee Kral, PharmD, FASHP, NBC-HWC, CPMC, CPE, clinical pharmacy specialist of pain management at the University of Iowa Hospitals and Clinics, shares her insights into pain management in palliative care for patients with cancer-related chronic pain. She highlights the crucial role of pharmacists in managing patient treatment regimens, including administration of opioids, the role of off-label prescribing, and the potential of deprescribing to improve patients’ quality of life. 

Reap what you sowFraud of the Day; by Larry Benson; 6/4/24Newly released Federal Trade Commission data show that consumers reported losing more than $10 billion to fraud in 2023, marking the first time that fraud losses have reached that benchmark. This marks a 14% increase over reported losses in 2022. The short of this report is that there is more opportunity in fraud than ever before. And fraudsters don’t care who they are scheming from. Including the dying. Shiva Akula owned and oversaw the day-to-day operations of Canon Healthcare, LLC, a hospice facility with offices in Louisiana and Mississippi. ... Between January 2013 and December 2019, Akula billed Medicare approximately $84 million in fraudulent claims. He was paid approximately $42 million relating to these fraudulent claims. And leaving the dying to just do that. Die without the extra care he profited from. ... [Akula was sentenced to serve 20 years in prison and to repay $42 million in fraudulent Medicare billing claims.]

Palliative care significantly improves discussion and documentation of end-of-life care preferences among patients with AML and MDS Oncology Learning Network; transcribed interview featuring Areej El-Jawahri, MD; 6/1/24 Areej El-Jawahri, MD, Massachusetts General Hospital, Boston, Massachusetts, discusses results from a clinical trial comparing a collaborative palliative and oncology care model vs usual care for adult patients with acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS). The study showed that palliative care significantly improved the rates of discussion and documentation of end-of-life (EOL) care preferences, reduced hospitalization at the EOL, and improved the quality of life in patients. 

Should all healthcare workers take the Hippocratic Oath? Becker's Hospital Review; Madeline Ashley; 5/29/24 As private equity expands across the healthcare industry and proper patient care is brought into question, Don Berwick, MD, a Harvard Medical School health policy lecturer in Boston and former CMS administrator during the Obama administration, called for an extended Hippocratic Oath for all who work in healthcare. During an April 3 senate hearing in Boston, titled, "When Health Care Becomes Wealth Care: How Corporate Greed Puts Patient Care and Health Workers at Risk," Dr. Berwick spoke passionately about how patient needs have been put on the backburner, but should be the No. 1 priority in healthcare.

National aging framework outlines governmentwide initiatives promoting home-based careMcKnight's Home Care; by Adam Healy; 6/3/24The Department of Health and Human Services released a new framework for its National Plan on Aging on Thursday. The framework aims to guide a multifaceted, governmentwide approach to help caregivers and home- and community-based service providers enable older adults to age comfortably in place.

LeadingAge: CMS on right track with high-acuity hospice RFIHospice News; by Jim Parker; 5/31/24 The senior care advocacy group LeadingAge has praised the U.S. Centers for Medicare & Medicaid Services (CMS) inquiries into high-acuity palliative care, but expressed concern over reimbursement and staffing issues. The agency’s 2025 proposed hospice rule featured a series of requests for information (RFI) on issues like health equity, social determinants of health and future quality measures. The RFIs contain further questions about the utilization of higher-cost palliative treatments under the Medicare Hospice Benefit. The agency posed similar queries in its proposed rule for 2024. The new proposal seeks greater clarity on the financial risks and costs that providers say represent barriers to providing those services, such as palliative chemotherapy, radiation blood transfusions or dialysis, among others.

Hawaiʻi is the first state to provide palliative care coverage EIN Presswire; by Governor JOsh Green, MD; 4/4/24 Governor Josh Green, M.D., and the Department of Human Services (DHS) Med-QUEST Division are pleased to announce that the Centers for Medicare and Medicaid Services (CMS) approved a new State Plan Amendment (SPA) to cover community palliative care services through Medicaid, making Hawaiʻi the first state in the nation to do so.  ... “After several years of hard work and collaboration with many community members and experts in the field, I am proud to announce that Med-QUEST is the first Medicaid program in the country to get this benefit approved,” said Governor Green. “This will greatly improve the quality of life and health outcomes for thousands of people who face serious medical conditions in our state. Hawaiʻi continues to lead the nation in innovations in health and health care.”  

Empathetic AI: How Genai virtual agents will be leveraged Informa; by Josh Streets; 6/3/24 Imagine you're shopping online or in a store and have a question about a product. But you don’t want to find a store employee or call into their contact center to speak with a salesperson while you wait for answers. With a simple snapshot of a QR/UPC code on the product or a tap on your mobile device within an application, you're instantly connected to a virtual agent via video chat. This AI assistant not only understands your questions but can also pick up on your facial expressions and body language via your video discussion, to respond with empathy and some level of emotional intelligence. "I can see you're a bit frustrated," the virtual agent says with a warm, reassuring tone. "Let me walk you through the product details and address any concerns you might have."Editor's Note: This AI solution might be great for shopping, but is it ethical for hospice care, especially when the person calling might be elderly and assumes they are talking with a person? How would you feel, especially if you're calling when your loved is actively dying, or has just died moments before? 

Hospice Certifying Physician edit in effectAAPC - American Academy of Professional Coders; by Rebecca Johnson; 6/3/24 The Centers for Medicare & Medicaid Services (CMS) and its Home Health and Hospice (HHH) Medicare Administrative Contractors (MACs) are all systems go for the new — and potentially troublesome — claims system edit. The edit went into effect June 3. ... In the 2024 Hospice Payment Rate Update final rule, CMS adopted a requirement that two categories of physicians must be enrolled in or validly opted out of Medicare for hospice services to be paid: the hospice medical director or the physician member of the hospice interdisciplinary group; and the attending physician that certifies the patient for hospice. CMS did at least grant hospices’ requests for an implementation delay at that time, moving the deadline from the proposed Oct. 1, 2023, to May 1, 2024. Then, on the eve of that start date, CMS bumped the edit for one more month. ...

Telehealth delivers early palliative care as effectively as in-person careAJMC, American Society of Clinical Oncology; by Laura Joszt, MA; 6/2/24 Early palliative care can be delivered via telehealth with equivalent quality-of-life effects as palliative care delivered in person to patients with advanced non–small cell lung cancer (NSCLC), according to late-breaking results presented during [a] plenary session at the 2024 American Society of Clinical Oncology (ASCO) annual meeting. Whether the palliative care was delivered in person or via telehealth, the most common topics discussed during the visit were similar and included building and establishing rapport to create a relationship with the patient and their family, identifying symptoms and grading symptom management, and coping with serious illness, explained Joseph Greer, PhD, codirector of the Cancer Outcomes Research & Education Program at Massachusetts General Hospital Cancer Center and associate professor of psychology in the Department of Psychiatry at Harvard Medical School ...

Great things are not done by impulse, but by a series of small things brought together. - George Eliot

EPCSO, Hospice of El Paso make dream come true for teen facing terminal illnessABC KVIA; by Tyaun Marshburn; 5/29/24Evan Molina was sworn in Wednesday by El Paso County Sheriff Richard Wiles to be honorary Sheriff of El Paso for the day. Molina is a pediatric patient at Hospice of El Paso. He said he has always wanted to be a sheriff, and today the El Paso County Sheriff's Office and Hospice of El Paso made that wish come true.

Reminders for the new Hospice Certifying Physician Claim Edit: Effective June 3, 2024