Literature Review

New DOJ rules for online healthcare content make sure seniors aren’t taken offline McKnights Senior Living, by Aaron Dorman; 4/11/24The Department of Justice took steps earlier this week to help make sure old adults have appropriate access to valuable web content they need for understanding important healthcare and coverage decisions. State and government agencies, such as the Centers for Medicare & Medicaid Services, must abide by new technical standards, according to a new DOJ rule signed Monday [4/1/24]. “Just as stairs can exclude people who use wheelchairs from accessing government buildings,” the official rule states, “inaccessible web content and mobile apps can exclude people with a range of disabilities from accessing government services.” The technical requirements of the rule are extensive — the updated document is almost 300 pages long — but the overall purpose is to instruct agencies on their obligations to account for possible disabilities.

Medicaid expansion and palliative care for advanced-stage liver cancer Journal of Gastrointestinal Surgery; by Henrique A Lima, Parit Mavani, Muhammad Musaab Munir, Yutaka Endo, Selamawit Woldesenbet, Muhammad Muntazir Mehdi Khan, Karol Rawicz-Pruszyński, Usama Waqar, Erryk Katayama, Vivian Resende, Mujtaba Khalil, Timothy M Pawlik; dated 4/24/28 (for print) Conclusion: The implementation of ME [Medicaid expansion] contributed to increased rates of palliative treatment for patients residing in ME states after expansion. However, racial disparities persist even after ME, resulting in inequitable access to palliative care. 

Medicare, Medicaid made $100B in improper payments in 2023 Becker's Hospital Review - Legal & Regulatory Issues, by Andrew Cass; 3/27/24 The federal government reported an estimated $235.8 billion in improper payments in fiscal year 2023, with more than $100 billion coming from Medicare and Medicaid, according to a March 26 report from the U.S. Government Accountability Office. The $235.8 billion in improper payments reported by 14 agencies across 71 programs is a decrease from the $247 billion reported in 2022, but the figure remains higher than pre-pandemic levels, according to the report. 

Regulatory reference links for home health care, hospice and durable medical equipment National Association for Home Care & Hospice; per email 3/25/24 Includes reference descriptions and links to the following:

A $400M incentive drives hospitals to meet health equity goalsModern Healthcare, by Kara Hartnett; 3/21/24 Hospitals across Massachusetts are building infrastructure to examine health disparities and address social needs, driven by new incentives within the state's Medicaid program. The program is authorized to pay out $400 million annually to private acute-care hospitals, divided among those that comply with an evolving set of operational and quality standards related to health equity. Eventually, healthcare organizations will receive distributions based on their ability to close gaps in care.

Dual eligibles, PACE expansion bill draws bipartisan support, industry endorsements McKnights Home Care, by Adam Healy; 3/18/24A bipartisan group of senators introduced legislation that would improve care coordination for dual-eligible beneficiaries and expand the Program of All-Inclusive Care for the Elderly to a larger share of people. The legislation’s primary function would be to require every state to develop a comprehensive, integrated health plan for dual-eligible beneficiaries, according to a summary. The bill also would require every state to allow PACE programs to be established, open up enrollment to any time in a given month, and extend PACE coverage to people under 55 years of age. 

When Medicaid comes after the family home The New York Times, by Paula Span; 3/16/24Federal law requires states to seek reimbursement from the assets, usally home, of people who died after receiving benefits for long-term care. ... The letter came from the state department of human services ... It expressed condolences for the loss of the recipient's mother, who had died a few weeks earlier at 88. ... Medicaid estate recovery means surviving family members may have to sell the home of a loved one to repay Medicaid, or the state may seize the property. Editor's Note: Please share this article with your hospice bereavement counselors. (Access might be limited, per NYT subscriptions.)

A fond farewell: Musings on the end of the Medicare Advantage Hospice Carve-In Demonstration Husch Blackwell, podcast with Meg Pekarske and Chris Comeaux; 3/14/24It came as a surprise to our team when we learned that the Centers for Medicare & Medicaid Services (CMS) was ending the hospice component of Value-Based Insurance Design (VBID) on December 31, 2024. Upon learning this, Husch Blackwell’s Meg Pekarske contacted Chris Comeaux, the president and CEO of Teleios Collaborative Network, to see if he wanted to share his thoughts on this unexpected turn of events and what may be on the horizon. This is a forward-looking conversation where we explore how the lessons learned can galvanize new advocacy on the best ways to care for patients with advanced illnesses.

False Claims Act - 2023 Year in ReviewJD Supra; by William Athanas, A. Lee Bentley III, Gene Besen, Ryan Dean, Jonathan Ferry, Daniel Fortune, Giovanni Giarratana, Ty Howard, Elisha Kobre, Anna Lashley, Gregory Marshall, Lyndsay Medlin, Stephen Moulton, Ocasha Musah, Scarlett Singleton Nokes, Cara Rice, Brad Robertson, Tara Sarosiek, Jack Selden, Erin Sullivan, Courtlyn Ward, Virginia Wright; 2/28/24As we do every year, this issue revisits the key cases and other developments from the year gone by. And by most metrics, 2023 was a notable year for the False Claims Act (FCA).

Planning Ahead: Medicare, Medicaid or Hospice for at-home careThe Mercury, by Janet Colliton; 2/21/24If you are seeking at-home care assistance for a family member that is paid either in full or in part by the government, you can find that the system is complicated and, unless your loved one fits within one of the designated categories, you may be limited to paying from your family member’s asset or your own. Here are some of the differences and criteria.Editor's Note: This concise, user-friendly article by a Certified Elder Law Attorney provides simple descriptions of this all-important information. What Hospice Medicare information does your staff need to know and use? What clarity do you provide to the public / community you serve?

Centers for Medicare & Medicaid Services corrects rule involving 2024 home health prospective payment system rate updateCMS Federal Register; 2/21/24This document corrects technical errors in the final rule that appeared in the November 13, 2023 Federal Register titled “Medicare Program; Calendar Year (CY) 2024 Home Health (HH) Prospective Payment System Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin Items and Services; Hospice Informal Dispute Resolution and Special Focus Program Requirements, Certain Requirements for Durable Medical Equipment Prosthetics and Orthotics Supplies; and Provider and Supplier Enrollment Requirements” (referred to hereafter as the “CY 2024 HH PPS final rule”).

Reduced federal share may force state Medicaid programs to cut services, HCBS expert saysMcKnights Home Care, by Adam Healy; 2/15/24The Congressional Budget Office this month released its “Budget and Economic Outlook” report for the coming decade. In its report, CBO predicted a roughly $58 billion drop in federal Medicaid outlays for 2024 compared to 2023 — a 9% decrease in federal Medicaid spending, due in part to fewer beneficiaries on states’ Medicaid rolls. Reduced Medicaid outlays ... has placed an even greater strain on states to pay for these Medicaid programs, according to Damon Terzaghi, director of Medicaid HCBS for the National Association for Home Care & Hospice.