Literature Review

New telehealth rules: 5 takeaways on temporary flexibilities for 2025 Becker's ASC Review; in collaboration with Coronis Health; 1/21/25 With the passage of the American Relief Act, 2025, certain telehealth flexibilities initially introduced during the public health emergency (PHE) era have been extended. These provisions, however, are only authorized through March 31, 2025. A Jan. 9 blog post by Coronis Health breaks down what the extensions mean for telehealth providers and patients, what services and features were left out and why certain changes could become permanent in 2025. Five takeaways:

California system, nonprofits pause lawsuit alleging $1B in misuse Becker's Hospital Review; by Kristin Kuchno; 1/6/25 The lawsuit alleging Fresno, Calif.-based Community Health System misused $1 billion in tax dollars has been paused until June while the health system and the nonprofit plaintiffs negotiate privately, Fresnoland reported Jan. 6. Community Health System, Cultiva La Salud and Fresno Building Healthy Communities jointly filed a stipulation on Dec. 23 requesting the court to stay the case, which Fresno County Superior Court Judge Kristi Culver Kapetan approved Dec. 30, according to Fresnoland. The stay halts legal proceedings. The two nonprofit organizations filed the lawsuit in August, alleging the health system misused $1 billion in tax dollars intended to serve low-income patients.

4 new healthcare laws in 2025 Becker's Hospital Review; by Kristin Kuchno; 1/3/25 Through recently passed ballot initiatives and legislation, states across the U.S. are implementing healthcare and workforce-related changes in 2025.

Congress finalizes sweeping bill to help veteran caregivers Military Times; by Leo Shane III; 12/16/24 House lawmakers on Monday finalized a sweeping veterans bill to expand caregiver benefits for elderly and infirm veterans and update medical options for veterans outside the department’s health care system, sending the legislative package to the White House to become law. The legislation was originally passed by the chamber last month but had to be reapproved this week after technical changes were added by the Senate last week. 

Beshear unveils paid leave plan for state workers with new child or serious illness Spectrum News 1, Frankfort, KY; by Associated Press; 12/12/24 Kentucky plans to provide state employees with paid time off so they can bond with a new child or deal with a serious medical situation, Gov. Andy Beshear, D-Ky., said Thursday. The added benefit will give state executive branch workers up to six weeks of paid leave, available in three intervals during an employee's career, the governor said. New hires will immediately become eligible for six weeks of paid time off, he said. Another six weeks of paid leave will be offered two more times: once employees reach 10 years of service and again at 20 years. 

[KY] Attorney General Russell Coleman files lawsuit against Optum Rx for role in opioid epidemic Northern Kentucky Tribune - Kentucky Center for Public Service Journalism; 12/1/24 The Kentucky Attorney General’s Office has announced its latest lawsuit against a corporation behind the worst man-made epidemic in modern medical history. Attorney General Russell Coleman added Optum Rx and its affiliates to the list of those responsible for the opioid crisis. ... According to the Attorney General’s lawsuit, Optum Rx played a central role in the reckless promotion, dispensing, and oversupply of opioids. ... “Defendants have hidden their conduct through non-transparent business practices and by requiring each entity with whom they conduct business, such as opioid manufacturers, to enter into confidentiality agreements or otherwise keep their agreements confidential,” said the lawsuit. “No state has been harder hit by the drug crisis than Kentucky. Last year alone, nearly 2,000 Kentuckians died of a drug overdose,” Attorney General Coleman said. “These groups pushed a profit-fueled agenda at the expense of Kentucky families, who are left with empty seats at the dinner table. Our Office will continue to hold those behind the drug crisis accountable for their devastating actions.”

Dole Act could give veterans greater access to hospice, palliative care Hospice News; by Jim Parker; 11/26/24 The Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, currently winding its way through Congress, would likely increase access to hospice and palliative care for veterans, if enacted. The omnibus veterans’ benefits reform bill contains two provisions in particular that could influence hospice and palliative care utilization. First, it contains language from Gerald’s Law, as well as clauses that would allow veterans to use their benefits to enter PACE programs. The bill recently passed the U.S. House of Representatives and now will go to the Senate. A reasonable chance exists that the bill will be approved by both chambers this year, according to Madison Summers, manager of public affairs for the National Alliance for Care at Home. 

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.”

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 LPNs will now be able to make death pronouncements Tri-State Alert; 11/4/24 A bill sponsored by Sen. Lynda Schlegel Culver (R-27) was signed into law this week to enable licensed practical nurses (LPNs) working in a hospice setting to make death pronouncements. “I am grateful for the governor’s support of this important legislation,” Culver said. “LPNs are with patients and their families until the moment of death, providing essential care during emotional times. Allowing LPNs to make death pronouncements, which was previously only a function of doctors, RNs, physician assistants, and coroners, can alleviate wait times that grieving families often experience.” The bill was amended in the House of Representatives to also provide needed clarification on the waiver of birth and death certificate fees for members of the armed services, veterans, and their families. The law now outlines specifically whose documents qualify for the waiver, as well as applicants and scenarios for which the fee may be waived. 

Bill introduced to increase access to advanced wheelchairs HomeCare, Nashville, TN; 10/24/24 U.S. Senators Marsha Blackburn (R-Tenn) and Tammy Duckworth (D-Ill.) introduced the Choices for Increased Mobility Act (S 5154) to increase access to wheelchairs made with advanced materials by allowing Medicare beneficiaries to upgrade to lighter, more functional wheelchairs without bearing the entire upfront cost. These manual wheelchairs help prevent shoulder injuries, enhance maneuverability and reduce overall pain and fatigue for users. ... When the Medicare billing code for ultra-lightweight manual wheelchairs was established in 1993, materials like titanium and carbon fiber were not considered, as they were not yet in use for wheelchairs. As a result, ... providers have struggled to supply wheelchairs with these advanced materials at the fee schedule amounts set by Medicare.

AAHPM Board President: Telehealth access ‘critical’ for hospice patientsHospice News; by Jim Parker; 10/17/24 The forthcoming expiration of telehealth flexibilities implemented during the pandemic could have a devastating impact on vulnerable populations, including those receiving hospice or palliative care. This is according to Dr. Holly Yang, board president of the American Academy of Hospice and Palliative Medicine (AAHPM). Currently, temporary federal rules allowing for greater access to telehealth are set to expire on Dec. 31. While legislation is in play to extend them, the outcome is uncertain, and the end of the year is approaching. Hospice News sat down with Yang to discuss the importance of these flexibilities and how their impending departure could impact patients and families, particularly those in rural areas or with limited mobility, poor health equity or social determinants of health needs.

Hospice policy mandating two-week enrollment prior to ingesting aid-in-dying medicationAcademy of Aid-in-Dying Medicine; by Constance Holden, Jeanne Kerwin, Paula Goodman-Crews, Margaret Pabst Battin; 10/2/24[A white paper from the ACAMAID Ethics Consultation Service.] An aid-in-dying-prescribing physician is concerned about a policy that several local hospices have implemented prohibiting patients from ingesting their aid-in-dying medication during the first two weeks of enrollment. The requesting provider is concerned that this policy requires patients who have made aid-in-dying requests to wait well beyond the 48 hours mandated by law. This potentially results in undue added suffering for the patient. It is also a potentially discriminatory practice, as it leads to unequal access to care.