Literature Review

Trump freezes HHS communications: report Modern Healthcare Alert; by Bridget Early; 1/22/25 The Health and Human Services Department and its agencies are going silent for now, according to the Washington Post. On Tuesday, the day after President Donald Trump's inauguration, HHS received an order to halt all outbound communications, including health advisories, weekly reports, research, website updates and social media posts, the newspaper reported. The Washington Post reports that the pause has no definitive end date and that the decree does not specify whether exceptions will be made for disease outbreaks or other urgent situations. The directive applies to agencies such as the Centers for Medicare and Medicaid Services, the Food and Drug Administration, the Health Resources and Services Administration, the Centers for Disease Control and Prevention, the National Institutes of Health and the Substance Abuse and Mental Health Services Administration.

CMS announces updated Medicaid eligibility standards for 2025 McKnights Senior Living; by Lois A. Bowers; 1/17/25 The Centers for Medicare & Medicaid Services on Friday released an informational bulletin with updated federal poverty level standards applied to eligibility criteria for Medicaid. The 2025 guidelines reflect a 2.9% price increase between calendar years 2023 and 2024, the agency said. For 2025, the poverty guideline in all states except Alaska and Hawaii is $15,650 for a one-person family/household and $21,150 for a two-person family/household. The 2025 standards for individuals dually eligible for Medicare and Medicaid: [Click on the title's link to continue reading.]

CMS Health Equity Data Book U.S. Centers for Medicare and Medicaid Services - Office of Minority Health; by CMS Office of Minority Health; published December 2024, email notifications 1/15/25 One of the six pillars of the Centers for Medicare & Medicaid Services (CMS) 2023 Strategic Plan is to, “Advance health equity by addressing the health disparities that underlie our health system.” The CMS Office of Minority Health (OMH) aims to advance health equity by providing broader access to data about the state of health equity across CMS’ programs. This Data Book presents summary information on disparities within CMS programs as demonstrated by data related to prevalence. ... This Data Book is intended for use as a readily-available information source on health disparities within the Medicare, Medicaid, and the Health Insurance Marketplace populations. This Data Book is organized into five key sections – CMS at a Glance, Demographics, Chronic Conditions, Behavioral Health, and Social Determinants of Health – so that Data Book users can jump to the section most relevant to their data needs. Within each section, data are presented by each population type.

Special Bulletin – CA Wildfires Public Health EmergencyCommunity Health Accreditation Partner (CHAP); Special Bulletin; 1/14/2025 HHS Declares Public Health Emergency for California to Aid Health Care Response to Wildfires. The declaration follows President Biden’s major disaster declaration and gives the Centers for Medicare & Medicaid Services’ (CMS) health care providers and suppliers greater flexibility in meeting the emergency health needs of Medicare and Medicaid beneficiaries. HHS has waived sanctions and penalties for violations of certain provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule against hospitals in the emergency area. [Click on the title's link to continue reading]

Increasing Medicaid rates: A critical step to support home-based care Association Press, North Salt Lake, UT; by Business Wire; 1/14/25To address the growing challenges facing the healthcare system, the Homecare and Hospice Association of Utah (HHAU) calls for an urgent increase in Medicaid reimbursement rates for Home and Community-Based Services (HCBS) waivers, Private Duty Nursing (PDN), and Home Health. These critical services form the backbone of home-based care, enabling individuals to receive the medical attention and support they need in their homes, while saving tax dollars and alleviating strain on hospitals and long-term care facilities.

Kōkua Mau, Hawaii, Medicaid Palliative Care Services BenefitHawaiʻi is the first state to comprehensively cover palliative care services for its Medicaid beneficiaries, by adding community palliative care as a preventive service in its Medicaid state plan. Since the memo has been published we are now moving into the implementation phase. This novel SPA (State Plan Amendment) is the result of multi-stakeholder collaboration over many years. It serves as a road map for other states exploring new ways to pay for interdisciplinary, community-based palliative care.

Winter snow storm slams into over a dozen states in the East, Midwest USA Today; by Julia Gomez; 1/6/25 The Central Plains and Midwest are getting slammed by a winter storm , according to officials, and it's leaving over a dozen inches of snow in some places. Here's a look at what the storm is leaving behind. Over 60 million people in the Central Plains, Midwest and along the East Coast are being bombarded by heavy snowfall because of the "disruptive" winter storm moving through the area, according to the National Weather Service. Some areas could see snowfall anywhere between 8 to 14 inches. The storm is also expected to impact travel in Kansas City, St. Louis, Indianapolis and Cincinnati and bring the cities to a standstill.Editor's note: Are you ready for emergencies in your service areas? Click here for the CMS.gov Emergency Preparedness Rule. Click here for Wisconsin's CMS Emergency Preparedness Rule Toolkit: Hospices.

U.S. health care spending reaches $4.9 trillion Hospice News; by Jim Parker; 12/20/24 The nation’s total health expenditures rose 7.5% to $4.9 trillion in 2023, a new analysis by the U.S. Centers for Medicare & Medicaid Services (CMS) found. This growth took place at a faster pace in 2023 than prior years. In 2022, health care spending rose at a rate of 4.6%. Total Medicare hospice spending accounted for $25.7 billion last year, according to a separate report from the Medicare Payment Advisory Commission (MedPAC). ... About 21% of U.S. health care spending in 2023 was via Medicare, with private insurance representing a 30% share. Medicaid accounted for 21%, and the remaining 10% were out-of-pocket costs. “Hospital care, physician and clinical services, and nursing care facilities and continuing care retirement communities, which collectively accounted for 33% of all out-of-pocket spending in 2023, were the main contributors to the faster growth in 2023,” CMS indicated.

How the downfall of the ‘Chevron Doctrine’ could affect hospices in the courts Hospice News; by Holly Vossel; 12/16/24 Recent court rulings have the potential to make significant differences in the landscape of hospice regulatory oversight in coming years, particularly when it comes to audits and the forthcoming Special Focus Program (SFP). In June the U.S. Supreme Court overturned a ruling that in 1984 established the “Chevron Doctrine,” which instructed lower courts to defer to executive branch agencies to resolve ambiguities in laws passed by Congress. The decision marked the end of the practice known as “Chevron deference,” which required that courts must defer to regulatory agencies’ interpretations of “ambiguous” statutes within federal legislation as long as the enforcement activity is deemed “reasonable.” Hospices could potentially see a vastly different outlook in regulatory enforcement activity during a time of tremendous changes already taking place in the industry, [Bryan Nowicki, partner at the law firm Husch Blackwell] said.

What's new for Medicare in 2025? Fidelity; by Kate Ashford, Nerdwallet; 11/25/24, updated 12/11/24Each year, Medicare comes with a new set of prices, new plan ratings and sometimes new regulations. What you’ll pay may be different from last year, and your network and prescription drug coverage may change, depending on your plan. Here’s how Medicare looks in 2025. ...

What is compliance risk? TechTarget; by Katie Terrell Hanna and Francesca Sales; 11/26/24 Compliance risk is an organization's potential exposure to legal penalties, financial forfeiture and material loss, resulting from its failure to act in accordance with industry laws and regulations, internal policies or prescribed best practices. Compliance risk is also known as integrity risk. Organizations of all types and sizes are exposed to compliance risk, whether they are public or private entities, for-profit or nonprofit, state or federal. An organization's failure to comply with applicable laws and regulations can affect its revenue, which can lead to loss of reputation, business opportunities and valuation. Types of compliance risk ... An organization might be implicated in the following types of compliance risks:

CMS Innovation Center reimagines rural health care approaches Center for Medicare and Medicaid Innovation; 11/12/24 Re-Imagining Rural Health: Themes, Concepts, and Next steps from the CMS Innovation Center "Hackathon" Series. ... Over sixty million Americans currently live in areas identified as rural, Tribal, frontier, and geographically isolated areas, including the U.S. Territories. Compared to people living in urban areas, rural Americans are more likely to experience poverty, be older, be uninsured, and have a disability. At the same time, rural communities face unique barriers to accessing care due to more limited availability of health care providers, including primary care, specialty care and home and community-based services, and residents often have to travel long distances to obtain health care. [Click on the title's link to continue reading (and distribute) this important 20 page whitepaper.]

Palliative care, ACO collaborations fuel ‘historical savings’ in MSSP Program Hospice News; by Holly Vossel; 11/11/24 Palliative care providers that form collaborative partnerships with Accountable Care Organizations (ACOs) may be lending to a landmark downward trend in health care spending in the value-based payment landscape. The U.S. Centers for Medicare & Medicaid Services (CMS) recently announced that its Medicare Shared Savings Program (MSSP) yielded more than $2.1 billion net savings in 2023 — the largest amount in the program’s inception more than a decade ago, according to the agency. ACOs participating in MSSP earned an estimated $3.1 billion in shared savings payments during the program’s 2022 to 2023 performance year, the highest dollar amount thus far, CMS reported. [Click on the title's link to continue reading.]