Literature Review

Medical Aid in Dying and the “slippery slope” argument Psychiatric Times; by Doublas W. Heinrichs, MD; 7/1/24 Commentary: A mainstay for opponents of medical aid in dying (MAID) for the terminally ill has long been the slippery slope argument. Rather than argue directly against MAID for the terminally ill, which puts them at odds with the majority of US citizens and physicians, they argue that MAID should be rejected because it will inevitably lead to unacceptable expansions to other populations. They say it will expand from the terminally medically ill, to non-terminal medically ill patients with intractable pain and suffering, to advanced directives for dementia, to psychiatric patients with intractable mental pain and suffering, or to anyone who simply finds life unbearable. It is best, they argue, to stop this by opposing the first step. Editor's Note: We do not provide this article to promote this author's conclusions, but rather to raise awareness of key issues that are being examined by individuals, by healthcare professionals, and legislators in many US states and numerous international countries.

How the Supreme Court’s Chevron Decision could help stop home health cuts Home Health Care News; by Andrew Donlan; 6/28/24 On Friday, the U.S. Supreme Court upended the Chevron doctrine precedent. For home health industry purposes, that means a potentially weakened Centers for Medicare & Medicaid Services (CMS) moving forward. The news comes just two days after the home health proposed payment rule was released, which included significant cuts for the third straight year. Broadly, moving away from the Chevron precedent – usually known as the Chevron doctrine – will mean less regulatory power for government agencies. Government agencies often take their own interpretations of certain laws and statutes, and then act upon those interpretations. ... The National Association for Home Care & Hospice (NAHC) already filed a lawsuit against the U.S. Department of Health & Human Services (HHS) and CMS over rate cuts in 2023. “In our own analysis, we believe that providers of home health have been underpaid as it relates to budget neutrality,” NAHC President William A. Dombi said when the lawsuit was filed. “At minimum, we would expect to see the rate cuts from 2023, that were permanent readjustments to the base rate, and the one proposed for 2024, along with the temporary adjustments … to go away. The end product of that is that we would have a stable system to deliver home health services to Medicare beneficiaries.”

Medical aid-in-dying bill stalls in Delaware Senate Bay to Bay News, Dover, Delaware; by Joseph Edelen; 6/24/24 An act that would allow physician-assisted suicide stalled in the state Senate on Thursday. House Bill 140, if enacted as written, permits a terminally ill individual who is an adult resident of Delaware to request and self-administer medication to end their life in a humane and dignified way. ... The bill, brought by Rep. Paul S. Baumbach, D-Newark, narrowly passed the House of Representatives in April, with a vote of 21-16. On Thursday in the Senate, the measure logged 10 yes votes and nine no votes, with Sen. Kyra Hoffner, D-Dover, not voting. But Senate sponsor Bryan Townsend, D-Newark, then changed his yes vote to no. The alteration meant that the initiative stalled in the Senate but could be brought back to its floor for another vote by Sunday, the last day of this year’s legislative session. Many senators seemed emotional while speaking about the measure Thursday. ...

ASTHO and NAMD call on Congress to fully fund Medicaid and CHIP in U.S. territories ASTHO - Association of State and Territorial Health Officials; by Jane Esworthy and Stephanie Rhodes; 6/20/24 In a joint letter to Congress, the Association of State and Territorial Health Officials (ASTHO) and the National Association of Medicaid Directors (NAMD) urged Congress to fully fund Medicaid and Children's Health Insurance Programs (CHIP) in the U.S. territories. ASTHO and NAMD request that Congress lift the annual Section 1108(g) allotment cap for all territories and authorize a permanent 83% Federal Medical Assistance Percentage (FMAP) for Puerto Rico. ... “ASTHO recognizes the importance of permanent, sustainable, and equitable Medicaid financing for all U.S. territories,” says Joseph Kanter, MD, MPH, ASTHO CEO. ... “Unlike the states, the U.S. territories face an annual cap on their Medicaid funding,” says Kate McEvoy, Executive Director of NAMD. “This has impaired the territories’ capacity to provide needed health care to Medicaid-eligible U.S. citizens and nationals. It has also held the territories back from making the structural investments in care delivery and value-based payment reform, workforce, IT systems, and program integrity that are crucial to high performing and innovative Medicaid programs.”

H.R.8278 - Hospice Recertification Flexibility Act: Introduced to Congress Congress.gov; introduced by Rep. Carol Miller [R-WV-1] on 5/7/24; text released 6/10/24To amend title XVIII of the Social Security Act to extend certain telehealth flexibilities with respect to hospice care under the Medicare program, and to establish a modifier for recertifications of hospice care eligibility conducted through telehealth.

Experts urge Legislature to pass bill preventing for-profit and private equity hospice in New York Spectrum News 1; by Susan Arbetter; 5/21/24The FBI has issued public warnings about hospice fraud in four states — Texas, Arizona, Nevada and California. The bureau is alerting consumers to a wide-spread scam in which patients are enrolled in hospice without their knowledge by recruiters who “sell” hospice care to people who aren’t actually eligible. ...  One reason fraudsters have yet to gain a foothold in New York is that new hospices here go through a “Certificate of Need” process (CON) which reviews applications, provides for public comment and ensures that hospice operators don’t have a history of fraud or abuse. But according to Jeanne Chirico, president and CEO of the Hospice & Palliative Care Association of NYS (HPCANYS), and Kara Travis, president and CEO of Mountain Valley Hospice & Palliative Care, and a trustee of HPCANYS, there’s more that New York can do to protect consumers. They are urging lawmakers to pass a bill carried by state Sen. Liz Krueger and Assemblymember Amy Paulin that would prohibit the establishment of new for-profit hospices in the state (A6032 - Paulin / S6460 – Krueger).

Hospital staffing shortages draws hundreds to California rally AFSCME, American Federation of State, County & Municipal Employees; by UNANC/UHCP and AFSCME International Staff; 5/21/24 SACRAMENTO, Calif. – More than 400 health care union members went to the California state Capitol during National Nurses Week this month to appeal to the state’s elected leaders to fix the nursing education backlog and hospital staffing issues that affect patient care. ... Rally participants pressed lawmakers to make health care education and training programs more accessible so students remain in their California communities for their health care careers. They also appealed to lawmakers to empower health care professionals to enforce safe staffing standards in the state’s hospitals.Editor's Note: Pair this article with others in today's issue, in our "Education" section.

Senate ramps up push to reform doctors' Medicare pay Modern Healthcare; by Michael Mcauliff; 5/20/24Declining doctors' pay in Medicare is getting its most serious look in nearly a decade in the Senate, with a bipartisan push launched Friday by the Senate Finance Committee. Doctors have grown especially vocal in recent years about falling Medicare reimbursement. Groups including the American Medical Association have estimated doctors were effectively getting paid 26% less in 2023 than in 2001 because the physician fee schedule set by the Centers for Medicare and Medicaid Services is not adjusted for inflation. Physicians have also called for more flexibility within the pay system.

Senate kills bill allowing medical aid in dyingConcord Monitor; by Sruthi Gopalakrishnan; 5/16/24After months of intense public debate, with Granite Staters on both sides of the legislation that would allow medical aid in dying, packing the room at every public hearing, the Senate voted on Thursday to kill the bill.

House Committee vote gives hope to extending telehealth, hospital at home waivers Health Leaders; by Eric Wicklund; 5/9/24 The House Ways and Means Committee has voted to advance the Preserving Telehealth, Hospital and Ambulance Access Act (HR 8261), which would, among other things,  continue pandemic-era Medicare waivers enacted by the Centers for Medicare and Medicaid Services (CMS) for telehealth access and coverage through 2026 and extend the CMS Acute Hospital Care at Home waiver for an additional five years, to the end of 2029.

Wide-ranging health care bill gets final approval from CT House CT Mirror - Connecticut's Nonprofit Journalism; by Jenna Carlesso; 5/6/24The House gave final passage Monday to a wide-ranging health care bill that would add protections for home care workers, boost preparedness for cyberattacks at medical facilities and establish new regulations for the state’s health information exchange, among other reforms. ... The sections on additional protections for home care workers were prompted by the murder of visiting nurse Joyce Grayson, who was killed in October while working at a halfway house in Willimantic. ... The bill requires home health aide agencies to collect certain client information upon intake and make it available to any employee assigned to the client. Information includes a history of violence against health care workers, domestic abuse, substance use, psychiatric history, any listing on a sex offender registry, the crime rate of the municipality the person lives in, and whether there are any weapons or safety hazards in the home. [Click on the title's link for more important information about this bill's safety measures.]

Physician-Assisted Suicide Bill recommended by second committee in Massachusetts legislature New Boston Post; 5/1/24 A bill that would legalize physician-assisted suicide has gotten a favorable vote from a second legislative committee, ... This is the earliest in the state’s two-year legislative session that the bill has been recommended by the Joint Committee on Public Health, and it’s the first time the bill has made it out of the Joint Committee on Health Care Financing, said Melissa Stacy, Northeast regional advocacy manager for Compassion & Choices, according to MASSterList.

Congresswoman Kat Cammack introduces legislation to block 80-20 Rule Home Health Care News; by Joyce Famakinwa; 4/26/24 ... On Thursday, Congresswoman Kat Cammack (R-Fla.) introduced a bill to block the U.S. Department of Health and Human Services (HHS) from finalizing the 80-20 provision. Additionally, the legislation would also block HHS from implementing any similar rules that place a minimum requirement for how much of Medicaid spending on HCBS goes towards direct workers’ wages. Cammack’s reason for introducing this legislation is her belief that the 80-20 provision will severely limit access to care at a time when providers are already struggling to serve patients.