Literature Review

Telehealth bill for Medicare approved by House Panel Retirement Daily; by Retirement Daily; 9/21/24 House Ways and Means Committee on Sept. 18, 2024, passed the Preserving Telehealth, Hospital, and Ambulance Access Act by a vote of 41-0 after lawmakers raised concerns about the need for more guardrails and hospice recertification. The move sets up the legislation for passage by the full House later this year. The markup included objections by Democrats and Republicans to the high cost durable medical equipment and clinical diagnostics guardrails proposed in the bill, saying the provisions merely restate existing authorities of the Center for Medicare and Medicaid Services. The bill requires reports on DME and clinical diagnostics fraud which some lawmakers think have already been established and don’t need further study. Many lawmakers likewise expressed concern about the extension of hospice recertification via telehealth. Some lawmakers raised concern about fraud in the hospice program, which they say the telehealth requirement could let fester.

Family caregivers need greater support from Medicare, advocates say McKnights Home Care; by Adam Healy; 9/20/24 Though federal agencies have made substantial progress on initiatives supporting family caregivers, more can be done to assist people providing unpaid care for older loved ones, according to the National Alliance for Caregiving. “While we’ve made strides, the urgent needs of family caregivers demand more ambitious action,” Jason Resendez, president and chief executive officer of NAC, said Thursday in a statement. “The time for bold action is now.” NAC specifically urged Congress to boost federal funding for national and state-level grants that support family caregivers, and recommended policies that help caregivers access paid family and medical leave, tax credits and Medicare- and Medicaid-sponsored support programs.

Frailty in Medicare Advantage beneficiaries and Traditional Medicare beneficiariesJAMA Network Open; Sandra M. Shi, MD, MPH; Brianne Olivieri-Mui, PhD, MPH; Chan Mi Park, MD, MPH; Stephanie Sison, MD, MBA; Ellen P. McCarthy, PhD, MPH; Dae H. Kim, MD, ScD; 8/24In this nationally representative cohort study of 7063 community-dwelling individuals aged 65 years and older, compared with traditional fee-for-service Medicare beneficiaries, Medicare Advantage beneficiaries had higher levels of frailty at baseline but similar levels of frailty change over 1 year. These findings suggest that enrollment in Medicare Advantage plans is not associated with altered frailty trajectories compared with Traditional Medicare, and more work is needed to better understand the health services needs of older adults with frailty.

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.]

Hospice CARE Act would create reimbursement for high-acuity hospice services Hospice News; by Holly Vossel; 8/19/24 If enacted, the Hospice Care Accountability, Reform and Enforcement (Hospice CARE) Act could open up reimbursement pathways for high-acuity palliative services during a time when demand and costs are rising. Developed by U.S. Rep. Earl Blumenaur (D-Oregon) and announced in June at the Hospice News Elevate conference, the bill proposed massive reimbursement and regulatory changes to the Medicare Hospice Benefit. Currently in a discussion draft phase, the bill includes ways for hospice providers to have clearer definitions and improved payment for more intensive forms of palliation, such as radiation therapy, blood transfusions or dialysis, among others.

Top PBM executives grilled in contentious congressional hearingModern Healthcare; by Michael McAuliff; 7/23/24Lawmakers and executives from three major pharmacy benefit managers presented diametrically opposing views at a heated Capitol Hill hearing Tuesday, as major bills aimed at reining in the organizations remain stalled in Congress. Members of the House Committee on Oversight and Accountability blamed the highly concentrated PBM industry for raising drug prices and running independent pharmacies out of business, while leaders from CVS Caremark, Express Scripts and Optum Rx all countered that the sector in fact lowers prices and supports local pharmacies.

Providers, patients would benefit from hospice telehealth extension, doc offers McKnights Senior Living; by Rachael Zimlich; 7/31/24 The COVID-19 pandemic triggered many changes in healthcare, and not all were bad. In the years since the coronavirus forced worldwide lockdowns and limited access to care, the healthcare industry increasingly has embraced measures such as remote care and telehealth. One surprising area that has benefitted from those changes is hospice care. Hospice care by telehealth provides an obvious convenience for patients, but [Sean Oser, MD, MPH] shared his surprise at how much the increased frequency and ease of visits — plus better insight into the patient’s home environment —could improve his own experience as the provider. ... The latest extension of rules to allow hospice provided via telehealth to be paid through Medicare will end in December. ... Representatives called out the need to extend the hospital-at-home waiver, which is set to expire at the end of 2024.

Senators introduce bipartisan bill to expand zccess to senior care program [PACE] FCFreePress.com; by News Desk - Health News; 7/25/24 [Thursday, 7/25/24,] U.S. Senators Bob Casey (D-PA) and Mike Braun (R-IN), leaders of the U.S. Senate Special Committee on Aging, introduced the bipartisan PACE Anytime Act. This legislative move seeks to broaden the accessibility of the Program of All-Inclusive Care for the Elderly (PACE) which serves thousands of lower-income seniors and individuals with disabilities by offering comprehensive, integrated care. ... Under current regulations, eligible individuals can only enroll in PACE programs at the beginning of each month. The PACE Anytime Act proposes to remove this restriction, allowing for enrollment at any time during the month, thereby making the program more accessible. 

Keeping for-profits out of hospices in New York State: A moral imperative Mid Hudson News, Albany, NY; 7/28/24 In recent years, the debate surrounding the role of for-profit entities in healthcare has intensified, particularly concerning the hospice sector. New York State, known for its robust healthcare infrastructure and progressive policies, now faces a critical decision: whether to allow for-profit companies to operate hospices. The implications of this decision are profound, as it touches on the very essence of what hospice care represents—compassion, dignity, and support at the end of life. The New York State Assembly is taking action by introducing Assembly Bill 6032, aimed at restricting the expansion of for-profit hospices across the state and preventing existing providers from increasing their capacity.

Alpharetta City Council considering fee for lifting assistance calls Appen Media, Alpharetta & Roswell, GA; by Jon Wilcox; 7/16/24 The Alpharetta City Council is considering a fee for residents and assisted living homes who make multiple calls a month for emergency responders to help people who have fallen. Director of Public Safety John Robison told the council July 15 that calls for lifting assistance come at significant cost and tie up responders who may be needed for other emergencies. Last year, Robison said, 328 calls for lift assistance cost the city $78,844, almost double the cost from the previous year, which saw 190 calls at a cost of $32,275.30. ... A proposed ordinance suggests a schedule of fees for calls asking responders to assess people who have fallen and may be injured. ... Hospice patients would be exempt from the fees. 

NAHC-NHPCO Alliance comments on Hospice CARE Act HomeCare; 7/16/24 The NAHC-NHPCO Alliance submitted a comment letter to the office of Rep. Earl Blumenauer (OR-3) on the discussion draft of the Hospice Care Accountability, Reform, and Enforcement Act (Hospice CARE Act), along with an overview and section-by-section summary. The Hospice CARE Act focuses on hospice payment reform and program integrity. The two trade organizations said they have worked closely with Blumenauer for years on these issues and are committed to continuing the dialogue to secure optimal outcomes for hospice providers and the continued delivery of quality care for patients and their families.

Arkansas group proposing more access to medical marijuana qualifies for ballot in Nov. election ABC KTBC-3, Texarkana, AR; by Tracy Gladney; 7/6/24 The ballot committee in Arkansas that proposed more access to medical marijuana received enough signatures from around the state to qualify for a ballot in the November election.  90,704 signatures were required for a ballot, and boxes were turned in to the state capitol with 111,402 signatures, well exceeding the number needed. ... The amendment would allow patients to grow their own marijuana at home, end annual renewal requirements for medical certification and expand which medical professionals could approve medical marijuana cards to include pharmacists, physicians’ assistants and nurse practitioners. The state legalized medical cannabis in 2016, and this is the first proposed amendment to this law in eight years. 

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.”