Literature Review

This was the year advanced practice nurses thought they’d get full practice authority in NC. They were wrong.NC Health News - NC Board of Nursing; by TwumasiD-Mensah; 8/29/24 Every so often, Megan Conner, a nurse anesthetist in Greenville said she sees a patient who’s driven for hours to come for a screening colonoscopy but who instead has to be sent to the emergency department. ... It frustrates Conner that so many patients, who have to travel sometimes hours for care in eastern North Carolina, end up not getting it because of common ailments they can’t get treated closer to home.That’s why Conner is a big believer in the Safe, Accessible, Value-directed and Excellent Health Care Act (SAVE Act), which would give advanced practice registered nurses (APRNs) like her full practice authority. She argues the data show that more nurse practitioners would provide primary care in rural North Carolina if the state would give them autonomy to practice, bringing care to small burgs that often go without. And now, the demands for care are being driven by hundreds of thousands of patients newly eligible for care because of Medicaid expansion. Along with a growing number of lawmakers who believe the legislation is overdue, advanced practice nurses thought this would be the year that the SAVE Act finally passed. They were wrong. [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.”

Doctors could opt out of assisted dying for religious reasons, says peer behind proposed law The Telegraph, United Kingdom; by Kamal Ahmed and Camilla Tominey; 7/26/24 Lord Falconer is launching a bill to make assisted dying legal but which includes a 'conscience clause' to factor in people's faiths. Doctors will be able to opt out of supporting assisted dying in England and Wales if they believe it clashes with their religious beliefs under a new attempt to legalise terminally ill people being able to end their lives.

New proposed federal legislation takes aim at concerns regarding perceived “looting” of health care systems by private equity investors JDSupra - Epstein Becker Green; by Melissa Jampol, Enrique Miranda, Kathleen Premo; 7/26/24On June 11, 2024, U.S. Senators Ed Markey and Elizabeth Warren from Massachusetts, introduced proposed legislation titled The Corporate Crimes Against Health Care Act (“CCAHCA”), aimed at addressing a perceived “looting” of health care systems by for profit private equity investors. According to Sen. Warren, the bill was introduced to “root out corporate greed and private equity abuse in the health care system,” “prevent exploitative private equity practices,” and to specifically ensure that actions such as “looting” do not happen again by addressing trigger events and targeting real estate investment trusts. ... Finally, the CCAHCA would require health care entities, including, but not limited to:  ... a hospice program, a home health agency, ... to publicly report to the Secretary of Health and Human Services on an annual basis: (i) transactions entered into ... [Click on the title's link to continue reading.]

[NJ] Governor Murphy signs "Louisa Carman Medical Debt Relief Act” Official Site of the State of New Jersey; 7/22/24 Governor Phil Murphy today signed the Louisa Carman Medical Debt Relief Act which will help New Jersey families avoid falling into medical debt and protect individuals from predatory medical debt collectors. The Louisa Carman Medical Debt Relief Act is named in honor of a member of the Governor’s Office who helped craft the proposal before tragically passing away in a car accident on New Year’s Day at the age of 25. Joined by Louisa’s family and advocates, the Governor signed the bill, advancing his Administration’s efforts to make New Jersey’s health care system more accessible and more affordable for more people.

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.”

NAHC re-files lawsuit against HHS, CMS over home health cuts Home Health Care News; by Joyce Famakinwa; 6/28/24 The National Association for Home Care & Hospice (NAHC) hasn’t given up on efforts to push back on Medicare home health payment calculations. NAHC has re-filled its lawsuit against the U.S. Department of Health and Human Services (HHS). The lawsuit focuses on the home health PDGM budget neutrality adjustment, which imposed both permanent and temporary calculations with a methodology that NAHC believes is noncompliant with the law. The original lawsuit was filed last summer, and in April the case was dismissed by a federal court in Washington D.C. The case was dismissed on the basis that NAHC did not fully exhaust administrative appeal remedies. ... There are a number of factors that made NAHC decide to re-file the lawsuit, according to [NAHC President, William A.] Dombi. “No. 1, it will be faster,” he said. “No. 2, we are highly likely to get the same judge, as there’s a related litigation standard in an assignment of cases,” he said. One of the biggest factors that heavily contributed to NAHC’s decision was the Supreme Court ruling, which upended the Chevron Doctrine.

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.”