Literature Review

While claiming transparency, CMS quietly drops health equity elements of EOM American Journal of Managed Care (AJMC); by Mary Caffrey; 4/22/25 Key Takeaways:

Federal court strikes down minimum staffing rule: The details you might not know behind the decisionMcKnights Long-Term Care News; by Neville M. Bilimoria; 4/21/25On April 7, 2025, the US District Court for the Northern District of Texas struck down the federal minimum staffing Final Rule issued by the Department of Health and Human Services and the Centers for Medicare & Medicaid Services. This was incredibly good news for nursing homes across the country for a variety of reasons ... The opinion from District Court Judge Matthew Kacsmaryk outlined the many laws and regulations America’s nursing homes are subject to in the healthcare arena, but it also recounted some deep history behind minimum staffing efforts that were previously unsuccessful, both by HHS and Congress.  ...

Regulatory leaked HHS budget signals $40B in cuts, assumes ACA subsidies expire Fierce Healthcare; by Noah Tong; 4/17/25 Department of Health and Human Services (HHS) reorganization plans appear to have been revealed through a leaked Office of Management and Budget (OMB) document. The 64-page PDF with HHS’ plans were first reported by Inside Medicine and later reported by The Washington Post and other news publications. In an update, Inside Medicine said the entire document was authenticated by The Washington Post. ... While the restructuring was broadly announced, and individual offices have been reportedly axed in recent weeks, the leak provides greater insight into how the reorganization, firings, reductions in force and office eliminations and consolidations will fundamentally alter the agency.

CMS clarifies physician referral authority, tightens attestation requirements in proposed hospice ruleInside Health Policy; by Jalen Brown; 4/11/25... The proposed rule would explicitly allow the physician member of the hospice interdisciplinary group (IDG) to recommend patients for hospice care, addressing a gap in current regulations over which physicians have that authority. While CMS already lets IDG physicians certify that a patient is terminally ill and eligible for hospice, the existing admission rules only name the hospice medical director or physician designee as authorized to recommend admission. CMS also wants to strengthen documentation requirements for hospice recertification, ... Starting at day 180 and every 60 days thereafter, Medicare requires a hospice physician or nurse practitioner (NP) to conduct a face-to-face visit with the patient before recertifying eligibility. After the visit, the clinician must provide a written attestation confirming that the visit occurred and was used to assess whether the patient still qualifies for hospice care. Under CMS' proposal, that attestation would also need to include the clinician's signature and the date signed, submitted as a clearly labeled section or addendum to the recertification form. 

HHS restructures duals, PACE offices amid department overhaul Modern Healthcare; by Bridget Early; 4/3/25 The Health and Human Services Department is reorganizing a handful of key programs for dually eligible enrollees and older adults, including laying off numerous staffers. HHS is shuffling how it manages care coordination for people dually eligible for Medicare and Medicaid under the Medicare-Medicaid Coordination Office and the Program of All-Inclusive Care for the Elderly. PACE, which had been poised for growth, offers home and center-based care mostly to dual-eligible Medicare and Medicaid enrollees who qualify for skilled nursing but can still live in their communities. A spokesperson for HHS said the department has “planned productivity enhancements for the PACE management department.” HHS did not elaborate on what management changes for the PACE program might look like.

Kennedy slashing 10,000 jobs in health department overhaul USA Today, Washington, DC; by Joey Garrison; 3/27/25 Health and Human Secretary Robert F. Kennedy Jr. said Thursday he will cut about 10,000 full-time jobs from the Cabinet department in a dramatic reduction that includes closing half its regional offices as part of a wider Trump administration overhaul of the federal government. Combined with HHS employees who previously accepted buyouts and others who were already fired, the agency's workforce will be sliced by one-quarter from 82,000 full-time employees to 62,000 since President Donald Trump returned to the White House. The Department of Health and Human Services ‒ which oversees the Centers for Disease Control and Prevention and Centers for Medicare and Medicaid Services ‒ will consolidate the agency's 28 divisions into 15 new divisions in Kennedy's shakeup. ... Among the cuts in key divisions:

Oz does not rule out Medicaid cuts during Senate confirmation hearing McKnights Home Care; by Adam Healy; 3/14/25 Mehmet Oz, MD, President Donald Trump’s pick to lead the Centers for Medicare & Medicaid Services, did not give a direct answer when asked whether he was for or against Medicaid cuts Friday during a Senate Finance Committee hearing. “I cherish Medicaid and I’ve worked within the Medicaid environment quite extensively practicing at Columbia University,” Oz said when asked by Sen. Ron Wyden (D-OR) if he would oppose cuts to Medicaid. “I want to make sure that patients today and in the future have resources to protect them if they get ill. The way you protect Medicaid is by making sure it’s viable at every level, which includes having enough practitioners to afford the services, paying them enough to do what you request of them, and making sure that patients are able to actually use Medicaid.”

CMS deletes Medicare Advantage vision statement, signaling another shift from health equity Fierce Healthcare - Regulatory; by Noah Tong; 3/10/25 The Centers for Medicare & Medicaid Services (CMS) wiped away the agency’s stated intentions for the future of Medicare Advantage (MA), underlining new uncertainty for the future of health-related social needs, CMS Innovation Center models and the federal health program. ... A frequently asked questions page gave further explanation, as did an executive summary of a report to be released in early 2025. The page included a section with the question, “What is CMS’ vision for the future of the MA program?” as of Feb. 22, archived versions of the web page shows. But that question and answer was quietly deleted, and the page was last modified Feb. 26. It previously described how the VBID model helped health plans address health-related social needs and stressed health equity as an important cornerstone of its mission. ... The CMS did not immediately respond to a request for comment.

UnitedHealth drops dismissal bid in US suit over Amedisys deal Bloomberg Law; by Justin Wise; 2/6/25 (additional subscription may be required)UnitedHealth Group Inc. is withdrawing its motion to dismiss the Justice Department’s lawsuit seeking to block its $3.3 billion acquisition of home-health and hospice services provider Amedisys Inc. and planning to fight the case at trial. In a Wednesday [2/5/25] filing in the US District Court for the District of Maryland, UnitedHealth and Amedisys said that new information provided by the Justice Department eliminated the basis for its request to toss the case at a preliminary stage. The firms previously argued the DOJ was withholding key geographic market information integral to its claim that the tie-up would stifle competition ...

Immigration policies’ ‘chilling effect’ on the hospice workforce Hospice News; by Holly Vossel; 2/5/24 The White House recently issued several executive orders that have ramped up the nation’s immigration enforcement policies. The health care sector may be facing a host of staffing and operational challenges as the regulatory moves unfold, according to Hannah Liu, manager of immigration advocacy at Asian Americans Advancing Justice (AAJC). A tightening of immigration policies has come with “concern, panic and confusion” across diverse communities nationwide, Liu stated. “As the effects of these hostile immigration policies play out, patients may also face the life-or-death situations that arise from interruptions in care caused by staffing shortages,” Liu told Hospice News in an email. “Immigrants in the health care industry may fear the possibility of arrest and detention, including in workplaces like hospitals, palliative care facilities and clinics.” 

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.

Agency Information Collection Activities: Proposed collection; Comment request Federal Register - United States Government; A Notice by the Centers for Medicare & Medicaid Services, Health  and Human Services; 12/16/24 The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information (including each proposed extension or reinstatement of an existing collection of information) and to allow 60 days for public comment on the proposed action. Interested persons are invited to send comments regarding our burden estimates or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated burden, ways to enhance the quality, utility, and clarity of the information to be collected, and the use of automated collection techniques or other forms of information technology to minimize the information collection burden.

Killing of UnitedHealthcare CEO brings resentment of the health care system to the fore STAT Business, Boston, MA; by Bob Herman and Tara Bell; 12/6/24 The targeted killing of UnitedHealthcare CEO Brian Thompson has become a defining moment in the zeitgeist of American health care. The attack was a tragedy that adds to the country’s grim tally of gun deaths. But instead of eliciting sympathy, it opened the floodgates for an outpouring of rage, captured across social media and online forums, over the health care system — one that charges people the highest prices in the world, erects financial and bureaucratic barriers to getting care, and has plunged millions of people into debt. Social media posts have ranged from mournful to apathetic to joyful, including morbid celebrations of Thompson’s death. That deluge has forced people across the country to grapple with two heavy subjects at once: the callousness of a slaying, and an undercurrent of deep-seated anger at a health care industry that makes a lot of money by exploiting Americans. ... [Click on the title's link to continue reading.]