Literature Review

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.

Senators introduce bipartisan bill to expand zccess to senior care program [PACE] FCFreePress.com; by News Desk - Health News; 7/25/24 [Thursday, 7/25/24,] U.S. Senators Bob Casey (D-PA) and Mike Braun (R-IN), leaders of the U.S. Senate Special Committee on Aging, introduced the bipartisan PACE Anytime Act. This legislative move seeks to broaden the accessibility of the Program of All-Inclusive Care for the Elderly (PACE) which serves thousands of lower-income seniors and individuals with disabilities by offering comprehensive, integrated care. ... Under current regulations, eligible individuals can only enroll in PACE programs at the beginning of each month. The PACE Anytime Act proposes to remove this restriction, allowing for enrollment at any time during the month, thereby making the program more accessible. 

Alpharetta City Council considering fee for lifting assistance calls Appen Media, Alpharetta & Roswell, GA; by Jon Wilcox; 7/16/24 The Alpharetta City Council is considering a fee for residents and assisted living homes who make multiple calls a month for emergency responders to help people who have fallen. Director of Public Safety John Robison told the council July 15 that calls for lifting assistance come at significant cost and tie up responders who may be needed for other emergencies. Last year, Robison said, 328 calls for lift assistance cost the city $78,844, almost double the cost from the previous year, which saw 190 calls at a cost of $32,275.30. ... A proposed ordinance suggests a schedule of fees for calls asking responders to assess people who have fallen and may be injured. ... Hospice patients would be exempt from the fees. 

Hospice CARES Act would update medical reviews, seek to reduce audits Hospice News; by Jim Parker; 7/12/24 The forthcoming Hospice Care Accountability, Reform and Enforcement (Hospice CARE) Act from U.S. Rep. Earl Blumenaur (D-Oregon), if enacted, would implement a number of changes to medical review processes. ... Though the bill language is still in development, it will likely contain proposed updates to payment mechanisms 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 among recently established providers concentrated primarily in California, Arizona, Texas and Nevada. ... Among the anticipated provisions of the bill would be an item requiring the U.S. Centers for Medicare & Medicaid Services (CMS) to use documentation in a patient’s medical record as supporting material. The documentation would include the reasons that an attending physician certified a patient for hospice and establish a six-month terminal prognosis.

DOH releases 2023 Our Care, Our Choice Annual Report State of Hawaii, Department of Health, Honolulu, HI; 7/8/24 More patients utilized the Medical Aid in Dying (MAID) program last year than in 2022, according to the 2023 Our Care, Our Choice Act (OCOCA) Annual Report, prepared by the Hawaiʻi Department of Health (DOH) Office of Planning, Policy and Program Development, July 1, 2024. Last year, 91 patients received aid-in-dying prescriptions, which is 31 more than the 2022 total. The Office of Planning, Policy and Program Development said that this is also in line with national data trends and may be due to the increased accessibility that took effect June 1, 2023. The annual report provides statistics for the OCOCA, which was enacted January 1, 2019. The act allows eligible individuals with terminal illnesses to request medicine that will help them control when and how they choose to die. Amendments to the OCOCA went into effect on June 1, 2023, resulting in the following changes: [Click on the title's link to continue reading.]

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.”