Literature Review

ACA's future in Trump's 2nd term: 17 things to know Becker's Hospital Review; by Laura Dyrda; 11/8/24 The Affordable Care Act has been through many iterations since being signed into law in 2010. Donald Trump's second presidential term could bring about more changes. The New York Times gathered perspective from experts across the political spectrum to outline what could happen next based on limited information from the campaign trail and Mr. Trump's historical view of the ACA. Here are 17 key points. 

Nebraska voters approve legalization of medical marijuana. Here's what to know USA Today; by Greta Cross; 11/6/2 Medical marijuana is now legal in the state of Nebraska, approved by voters on Tuesday. Two ballot measures dealing with medical marijuana were on the Nebraska ballot. A total of 70.7% of voters approved Initiative Measure 437 and 66.9% of voters approved Initiative Measure 438. Initiative Measure 437 establishes a new statute that will allow the use, possession and acquisition of up to 5 ounces of cannabis for medical purposes by a qualified patient with a written recommendation from a health care practitioner. The statue will also allow for a caregiver to assist a qualified patient with these activities. Initiative Measure 438 establishes a new statute that makes penalties inapplicable under state law for the possession, manufacture, distribution, delivery and dispensing of cannabis for medical purposes by registered private entities. The statute will also establish a Nebraska Medical Cannabis Commission to regulate such activities.

Pennsylvania signs home care, hospice efficiency bills into law McKnights Home Care; by Adam Healy; 11/5/24 Pennsylvania Gov. Josh Shapiro (D) signed into law two bills that will reduce operational challenges and improve recruitment efforts for home care and hospice agencies. House Bill 155 allows healthcare providers, including home care and hospice agencies, to use remote video technology for interviews with direct care workers. Meanwhile, Senate Bill 1080 allows licensed practical nurses (LPNs) to pronounce death in home-based hospice settings. These two new laws will make direct care worker recruiting processes more accessible and efficient, while improving end-of-life care for both patients and providers, according to the Pennsylvania Homecare Association. “The signing into law of HB 155 and SB 1080 helps create efficiencies in how we deliver home-based care,” Mia Haney, chief executive officer of PHA, said Friday in a statement. “With a growing demand for these services, efforts such as these allow providers to use their time effectively and focus on what’s most important — quality of care.”

Governor proclaims Home Care, Hospice, Palliative Care Month 2024Governor.nc.gov - an official website of the State of North Carolina; by Governor Roy Cooper; 11/1/24A PROCLAMATIONWHEREAS, the State of North Carolina recognizes the importance and value of home care, home health, hospice, and palliative care in enhancing the well-being and quality of life for individuals and their families; andWHEREAS, home care, home health, hospice, and palliative care providers offer essential services and support to individuals of all ages, ensuring their ability to receive necessary care in the comfort and familiarity of their own homes; andWHEREAS, being able to receive care and support in the comfort of one's own home allows individuals to maintain a sense of dignity, independence, and quality of life; andWHEREAS, the dedicated professionals of the home care, home health, hospice, and palliative care industry work tirelessly to improve the lives of North Carolina residents, providing compassionate care, emotional support, and necessary medical assistance; and ...WHEREAS, North Carolina's home care, home health, hospice, and palliative care providers play a crucial role in promoting patient independence, reducing hospital readmissions, and minimizing the burden on our healthcare system; NOW, THEREFORE, I, ROY COOPER, Governor of the State of North Carolina, do hereby proclaim November, 2024, as “HOME CARE, HOSPICE, PALLIATIVE CARE MONTH” in North Carolina, and commend its observance to all citizens. [Click here to read the full proclamation.]

Bill introduced to increase access to advanced wheelchairs HomeCare, Nashville, TN; 10/24/24 U.S. Senators Marsha Blackburn (R-Tenn) and Tammy Duckworth (D-Ill.) introduced the Choices for Increased Mobility Act (S 5154) to increase access to wheelchairs made with advanced materials by allowing Medicare beneficiaries to upgrade to lighter, more functional wheelchairs without bearing the entire upfront cost. These manual wheelchairs help prevent shoulder injuries, enhance maneuverability and reduce overall pain and fatigue for users. ... When the Medicare billing code for ultra-lightweight manual wheelchairs was established in 1993, materials like titanium and carbon fiber were not considered, as they were not yet in use for wheelchairs. As a result, ... providers have struggled to supply wheelchairs with these advanced materials at the fee schedule amounts set by Medicare.

AAHPM Board President: Telehealth access ‘critical’ for hospice patientsHospice News; by Jim Parker; 10/17/24 The forthcoming expiration of telehealth flexibilities implemented during the pandemic could have a devastating impact on vulnerable populations, including those receiving hospice or palliative care. This is according to Dr. Holly Yang, board president of the American Academy of Hospice and Palliative Medicine (AAHPM). Currently, temporary federal rules allowing for greater access to telehealth are set to expire on Dec. 31. While legislation is in play to extend them, the outcome is uncertain, and the end of the year is approaching. Hospice News sat down with Yang to discuss the importance of these flexibilities and how their impending departure could impact patients and families, particularly those in rural areas or with limited mobility, poor health equity or social determinants of health needs.

Integration of palliative care in the management of multiple chronic conditions: An expert consensus paper with policy implications George Washington University; by Kim Kuebler, DNP, ANP-BC, FAAN, Todd Monroe, PhD, RN, FAAN, Richard Ricciardi, PhD, CRNP, FAAN, Cheryl Westlake, PhD, ACNS-BC, FAAN, Matthew Sorenson, PhD, ANP-C, FAAN, Jane Pederson, MD, MS, Michael Neft, PhD, CRNA, FAAN, Sandra A. Mitchell, PhD, CRNP, FAAN, Kathryn Daniel, PhD, AGNP, FAAN, Susan De Santo-Madeya, PhD, APRN-CNS, FAAN, Susan Renda, DNP, ANP-BC, FAAN, Elizabeth Henneman, PhD, RN, FAAN, Eduardo Bruera, MD; 10/10/24 This paper was jointly developed from members of the American Academy of Nursing Expert Panels on Palliative and End of Life Care, Primary Care, Aging, Acute and Critical Care, and two expert physicians. Purpose: The overarching goal is to promote the integration of palliative care as symptom management into the primary care setting to transform care for patients living with multiple chronic conditions. ... Discussion: Earlier palliative interventions reduce disease exacerbation, prevent hospitalization, maintain physical functioning, and support health-related quality of life. Conclusion: This is a needed paradigm shift as the nation’s aging population escalates, Americans are living longer, and the healthcare costs for the nation are unprecedented. [Click on the title's link for this full description; then scroll down to "Download PDF" for the actual paper.]

National PACE Association to Congress: End the PACE Part D Penalty before this session concludes PR Newswire; by National PACE Association; 9/23/24 The National PACE Association (NPA) is calling on Congress to end the costly financial penalty incurred by the Program of All-Inclusive Care for the Elderly (PACE) participants eligible for Medicare who must enroll in the PACE Medicare Part D drug benefit. Every other original Medicare enrollee may comparison shop for an affordable Part D plan from among numerous options in their county. Medicare-enrolled PACE program participants face exponentially higher premiums for prescription drugs—22 times higher, on average—than other people enrolled in Medicare Part D who may select from numerous Part D plans available in their county. The PACE Part D penalty, which can total $11,000 annually, prevents people enrolled in Medicare with complex care needs from participating in the PACE program, which provides affordable, high-quality, highly coordinated services to people directly in their homes and communities.

CMS submits 75,000 pages to federal court to justify nursing home staffing mandate McKnights Long-Term Care News; by Kimberly Marselas; 9/15/24 The Department of Health and Human Services filed more than 75,000 pages of rule-making records with a federal court Friday, beginning its formal defense of its controversial nursing home staffing mandate. The submission of the administrative record is the first significant advance in the case since the American Health Care Association brought its challenge to the minimum staffing standard in late May. The Texas Health Care Association, three Texas providers and LeadingAge are also part of the case. In another development, District Court for the Northern District of Texas Judge Matthew Kacsmaryk on Sept. 10 agreed to fold in a separate federal challenge against the staffing mandate filed by the state of Texas. He noted that the two cases “share common questions of law or fact, consist of similar parties, the same claims, and [have] the same relief sought.”

Telehealth groups urge feds to extend virtual prescribing flexibilities  Healthcare IT News; by Mike Miliard; 9/11/24 With just four months to go until the scheduled expiration of Drug Enforcement Administration flexibilities on virtual prescribing of controlled substances, a long list of hundreds of healthcare stakeholders is calling on Congress and the White House to extend them before "countless patients [are] abandoned, left without lifesaving clinically appropriate care." Led by the American Telemedicine Association and its ATA Action arm, more than 330 disparate organizations have signed on to an effort urging federal officials to extend pandemic-era allowances for virtual prescribing that "have been a lifeline for countless individuals across the country, ensuring uninterrupted access to essential mental health care, substance use treatment, end-of-life care, and many other crucial treatments during a time when in-person visits were impossible or unsafe."

Hospice care standards are important. Congress must be careful tinkering with them. NorthJersey.com, Special to the USA TODAY Network; by Patrick Maron; 8/28/24... As hospice care grows, real attention needs to be paid to the differences between nonprofit and for-profit centers.  [A] staggering  73%  of hospice programs today are for-profit and are driven by financial motives, ... Rep. Earl Blumenauer, D-Oregon, is drafting legislation that, if enacted, would represent the most significant reforms to date for hospice payment and oversight. Though Blumenauer’s bill, the Hospice Care Accountability, Reform, and Enforcement — or Hospice CARE — Act, is still in development, key provisions will likely include a new payment mechanism 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 ... However, there are significant challenges for nonprofit freestanding inpatient hospice facilities like Villa Marie Claire in Saddle River. Most important, the proposed five-year moratorium on enrolling new hospice programs into Medicare could limit our ability to expand services, straining resources of the Villa ... What’s more, the legislation mandates more frequent inspections and enhanced oversight, which could lead to operational stress and higher costs. [Click on the title's link to continue reading.]

Blumenthal & Barragán introduce bicameral legislation to improve end-of-life carePress release; 8/1/24U.S. Senator Richard Blumenthal (D-CT) and U.S. Representative Nanette Barragán (D-CA) today introduced the Compassionate Care Act, legislation to promote advance care planning and end-of-life care. Many Americans do not have plans in place in the event they experience severe illness. In order to help patients access the care they need and that is right for them, the Compassionate Care Act provides critical resources to educate patients and providers, develop core end-of-life quality measures, and expand access to advance care planning via telehealth.

How the Hospice CARE Act could change respite services Hospice News; by Jim Parker; 8/1/24 The Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act, if enacted, would make changes to the ways hospices provide respite care. Rep. Earl Blumenauer (D-Oregon) is in the process of drafting the bill that would represent the most significant reforms to date for hospice payment and oversight. The legislation is currently in a discussion draft phase, which has been circulated among the nation’s major industry trade associations and their members for feedback. ... “There’s evidence that people who take advantage of hospice care delivered properly, actually have a higher quality of life. Oftentimes, they live longer,” Blumenauer said at Elevate. “This is an opportunity to do something in this Congress that is concrete, specific, that will save money and improve the quality of care for some of our most vulnerable people.”