Literature Review

ACA's future in Trump's 2nd term: 17 things to know Becker's Hospital Review; by Laura Dyrda; 11/8/24 The Affordable Care Act has been through many iterations since being signed into law in 2010. Donald Trump's second presidential term could bring about more changes. The New York Times gathered perspective from experts across the political spectrum to outline what could happen next based on limited information from the campaign trail and Mr. Trump's historical view of the ACA. Here are 17 key points. 

Nebraska voters approve legalization of medical marijuana. Here's what to know USA Today; by Greta Cross; 11/6/2 Medical marijuana is now legal in the state of Nebraska, approved by voters on Tuesday. Two ballot measures dealing with medical marijuana were on the Nebraska ballot. A total of 70.7% of voters approved Initiative Measure 437 and 66.9% of voters approved Initiative Measure 438. Initiative Measure 437 establishes a new statute that will allow the use, possession and acquisition of up to 5 ounces of cannabis for medical purposes by a qualified patient with a written recommendation from a health care practitioner. The statue will also allow for a caregiver to assist a qualified patient with these activities. Initiative Measure 438 establishes a new statute that makes penalties inapplicable under state law for the possession, manufacture, distribution, delivery and dispensing of cannabis for medical purposes by registered private entities. The statute will also establish a Nebraska Medical Cannabis Commission to regulate such activities.

Pennsylvania signs home care, hospice efficiency bills into law McKnights Home Care; by Adam Healy; 11/5/24 Pennsylvania Gov. Josh Shapiro (D) signed into law two bills that will reduce operational challenges and improve recruitment efforts for home care and hospice agencies. House Bill 155 allows healthcare providers, including home care and hospice agencies, to use remote video technology for interviews with direct care workers. Meanwhile, Senate Bill 1080 allows licensed practical nurses (LPNs) to pronounce death in home-based hospice settings. These two new laws will make direct care worker recruiting processes more accessible and efficient, while improving end-of-life care for both patients and providers, according to the Pennsylvania Homecare Association. “The signing into law of HB 155 and SB 1080 helps create efficiencies in how we deliver home-based care,” Mia Haney, chief executive officer of PHA, said Friday in a statement. “With a growing demand for these services, efforts such as these allow providers to use their time effectively and focus on what’s most important — quality of care.”

Terminally ill patients from other states can’t come to N.J. to end their lives, court rules NJ.com; by Chris Sheldon; 10/29/24 A federal judge ruled Wednesday that the residency requirement in New Jersey’s medical aid in dying law does not violate the U.S. Constitution, meaning the state can continue to keep its right to die law exclusively for residents. The ruling was in response to a lawsuit filed in August 2023 by Compassion & Choices on behalf of terminally-ill cancer patients in Delaware and Pennsylvania and two New Jersey doctors, according to a statement from the non-profit, which works to expand choice for the end of life.

Anxiety grows over telemedicine flexibility extension The Hill; by Joseph Choi; 10/24/24 Lawmakers and physicians are growing anxious for COVID-era telemedicine flexibility measures to be extended for a third time, as federal regulators signal a potential tightening of the rules ahead of a deadline at the end of the year. Since 2020, the Department of Health and Human Services and the Drug Enforcement Administration (DEA) have allowed physicians to prescribe schedule II to V controlled substances without in-person medical evaluations. ... Last year, the two agencies extended these flexibility measures through the end of 2024. With December fast approaching, a bipartisan group of lawmakers in both the House and Senate want another round of extensions secured. 

Court rules False Claims Act Provisions unconstitutional, with implications for hospice cases Hospice News; by Jim Parker; 10/7/24 A federal judge has struck down the whistleblower provisions of the False Claims Act, with broad implications for hospice and other health care enforcement actions. The ruling centers on the law’s qui tam clauses, which the court found unconstitutional. In a qui tam action, a whistleblower, called a “relator” by the courts, files a False Claims Act suit on behalf of the government and possibly receives a portion of any funds recovered by the government via the lawsuit, typically ranging from 15% to 25%. The overwhelming majority of False Claims Act cases involve qui tam whistleblowers. In Fiscal Year 2023, for example, these cases recovered $2.3 billion of the total $2.68 billion recouped by the government in FCA settlements and judgements, according to a report from the law firm Polsinelli. ... FCA cases have been rampant in the hospice space during the last several years. Many of the major cases and settlements that have occurred during that time have been qui tam actions, including two major actions this year. ...

Governor vetoes private equity bill that would have affected healthcare transactionsMcKnight's Senior Living; by Kathleen Steele Gaivin; 10/1/24California Gov. Gavin Newsom (D) on Saturday vetoed a bill that would have required private equity firms and hedge fund organizations in the state to provide advance notice to the state’s attorney general of acquisitions or changes in control. The bill would have given the attorney general authority to grant, deny or impose conditions on a proposed transaction, after determining the likelihood of anticompetitive effects, “including a substantial risk of lessening competition or of tending to create a monopoly, or may create a significant effect on the access or availability of healthcare services to the affected community.” The governor’s veto “was a surprise to many in the healthcare industry,” Arent Fox Schiff attorneys wrote for the National Law Review.

NY home care agency pays $400K in racial prejudice lawsuit A home care agency in Brooklyn, NY, was ordered to pay $400,000 to settle a race and national origin discrimination lawsuit filed by the US Equal Employment Opportunity Commission. ACARE HHC Inc., doing business as Four Seasons Licensed Home Health Care Agency, routinely assigned home health aides based on clients’ racial preferences, according to a consent order filed with the US District Court for the Eastern District of New York. These workers, which included Black and Hispanic aides, would either be transferred to new client assignments based on clients’ wishes or lose their employment entirely, EEOC found. These practices were a violation of the Civil Rights Act, which prohibits employers from making job assignments based on workers’ race or national origin. Four Seasons will pay $400,000 in monetary relief for the home health aides affected, according to the consent order. It will also update its internal policies and training processes related to Civil Rights Act requirements, cease making home health aide assignments based on clients’ race or nationality preferences, and provide semi-annual reports to the EEOC regarding any reports or complaints surrounding race discrimination.

National PACE Association to Congress: End the PACE Part D Penalty before this session concludes PR Newswire; by National PACE Association; 9/23/24 The National PACE Association (NPA) is calling on Congress to end the costly financial penalty incurred by the Program of All-Inclusive Care for the Elderly (PACE) participants eligible for Medicare who must enroll in the PACE Medicare Part D drug benefit. Every other original Medicare enrollee may comparison shop for an affordable Part D plan from among numerous options in their county. Medicare-enrolled PACE program participants face exponentially higher premiums for prescription drugs—22 times higher, on average—than other people enrolled in Medicare Part D who may select from numerous Part D plans available in their county. The PACE Part D penalty, which can total $11,000 annually, prevents people enrolled in Medicare with complex care needs from participating in the PACE program, which provides affordable, high-quality, highly coordinated services to people directly in their homes and communities.

Delaware Governor John Carney vetoed HB #140 AAB HA #1 (9/20/24) – An act to amend Title 16 of the Delaware Code related to end of life optionsPress release; 9/20/24

Is medical assistance in dying part of palliative care?JAMA Network; by Harvey Max Chochinov, Joseph J. Fins; 9/11/24Whatever one’s view on medical assistance in dying (MAID), an underlying question is whether it should be considered part of palliative care. The Canadian Hospice Palliative Care Association takes the stance that MAID “definitionally fall(s) outside of the scope of palliative care.” 1 This is a historical perspective dating to Hippocratic injunctions against a fatal draft. But with the advent of euthanasia and assisted suicide as legal life-ending options in various jurisdictions, the insistence on separation between palliative care and MAID has been questioned.

Hospice care standards are important. Congress must be careful tinkering with them. NorthJersey.com, Special to the USA TODAY Network; by Patrick Maron; 8/28/24... As hospice care grows, real attention needs to be paid to the differences between nonprofit and for-profit centers.  [A] staggering  73%  of hospice programs today are for-profit and are driven by financial motives, ... Rep. Earl Blumenauer, D-Oregon, is drafting legislation that, if enacted, would represent the most significant reforms to date for hospice payment and oversight. Though Blumenauer’s bill, the Hospice Care Accountability, Reform, and Enforcement — or Hospice CARE — Act, is still in development, key provisions will likely include a new payment mechanism 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 ... However, there are significant challenges for nonprofit freestanding inpatient hospice facilities like Villa Marie Claire in Saddle River. Most important, the proposed five-year moratorium on enrolling new hospice programs into Medicare could limit our ability to expand services, straining resources of the Villa ... What’s more, the legislation mandates more frequent inspections and enhanced oversight, which could lead to operational stress and higher costs. [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.