Literature Review

The marginalizing and dehumanizing of our sickest and oldest Americans ABA - The American Bar Association; by Charles P. Sabatino; 3/19/25 Being old and with a disability ranks high as a target for discrimination in American culture, where ageism and ableism often prevent the public from seeing marginalization as an aberration. ... Summary:

Hospice Insights Podcast - Psychedelics and end of life care: Understanding the legal landscape Hospice Insight - The Law and Beyond; by Husch Blackwell LLP; 3/12/25 There has been a lot of buzz around psychedelics, and particularly their potential usefulness in treating existential suffering at the end of life. Husch Blackwell was the first law firm in the country to establish a Psychedelics & Emerging Therapies practice group devoted to helping clinicians, researchers, and investors navigate the complex and difficult legal and regulatory issues involved in developing new therapies in this space. In this episode, host Meg Pekarske is joined by the leaders of Husch Blackwell’s Psychedelics & Emerging Therapies practice group, Kimberly Chew, Karen Luong, and Natasha Sumner, who provide an overview of what psychedelics are, their legal status under federal and state laws, and liability considerations for clinicians.

An opportunity to advance cannabis science—DEA reschedulingJAMA Psychiatry; Kevin P. Hill, MD, MHS; Anshul V. Puli, BS; 2/25In 1970, the US Congress enacted the Controlled Substances Act (CSA), establishing a scheduling system for drugs based on their medical use, abuse potential, and safety. The most restrictive classification is Schedule I; cannabis along with other drugs, such as heroin and lysergic acid diethylamide (LSD), have this classification. May 13, 2024, the Drug Enforcement Agency (DEA), the agency regulating substance scheduling, issued a Notice of Proposed Rulemaking to investigate rescheduling cannabis from Schedule I to Schedule III. This was due to a recommendation from the US Department of Health and Human Services (HHS) to reschedule based on its review of the medical and scientific cannabis research. Still, the FDA investigated HHS’ CAMU [cannabis’ current accepted medical use] claim and found some credible scientific support for treating “anorexia related to a medical condition, nausea and vomiting (eg, chemotherapy-induced), and pain.”

Health policy challenges for 2025 and beyondJAMA Health Forum; Lanhee J. Chen, JD, PhD; 1/25Despite multiple reform attempts, the US health care system is still burdened by high costs, limited access to quality care, and policies that have resulted in the inefficient delivery of care. However, technological advances, insights from the COVID-19 pandemic, and approaching policy deadlines, such as expiration at the end of 2025 of enhanced coverage subsidies available through the Affordable Care Act (ACA), offer policymakers a reason to act. The next few years will present policymakers with opportunities to address key health care challenges, including the future of Medicare, the continuing implementation of the ACA, and the health care provisions included in the federal tax code. The new administration and Congress will have their hands full in 2025 because the expiring tax and subsidy provisions are action-forcing events. Lawmakers will face a unique opportunity to reform the system in a way that improves accessibility and affordability and enforces some measure of fiscal discipline, and to make decisions that could positively affect the future of health care for millions of individuals in the US.

Policy priorities for the first 100 daysC-TAC press release; 1/20/25The first 100 days of the Trump Administration and 119th Congress offer a pivotal opportunity to enact bold policies that improve the quality of care for individuals with serious illness while reducing overall healthcare costs. By addressing key policy priorities, we can create a healthcare system that delivers better outcomes for patients and families. C-TAC calls on policymakers to act now to advance solutions in the following areas:

Hospice Insights Podcast [The Law and Beyond] - A year in review: Reflections and hopes for the future JD Supra; by Husch Blackwell LLP; 1/8/25 It’s our first podcast of 2025 and we wanted to start the year out with some reflections. Join Husch Blackwell’s Meg Pekarske and Bryan Nowicki as they each share their biggest surprises and victories of 2024 and what is on their wish list for 2025. 

Santa Maria investment advisor pleads guilty to federal wire fraud chargeSannta Maria Times, Santa Maria, CA; by Dave Minsky; 1/2/25 A Santa Maria registered investment advisor pleaded guilty to a wire fraud charge after admitting to stealing $2.25 million from mostly elderly clients who put her in charge of their assets, according to a plea agreement filed in Los Angeles federal court earlier this month. ... Federal officials alleged that [Julie] Darrah’s scheme ran from November 2016 until about July 2023 and involved at least 11 victims who were mostly elderly, including some who were receiving end-of-life care. ... Prosecutors alleged Darrah would gain control of her clients’ assets in several ways, including making her the trustee of their trusts, having the victims executing standing letters of authorization that gave Darrah control of their accounts, making Darrah a signatory on their accounts and giving Darrah power of attorney over their property.

Developing evidence-based health policy for dementia careJAMA Health Forum; Katherine Baicker, PhD; Kosali Simon, PhD; 12/24The rising prevalence of Alzheimer disease and related dementias (ADRD) represents a profound challenge to health care and long-term care systems. Promising diagnostic tools, medicines, and interventions for ADRD are on the horizon, but these medical advances will come with substantial costs. By 2050, the annual cost of care for patients with ADRD is projected to reach $1.5 trillion in the US, with 75% covered by Medicaid and Medicare. In addition to payment policy, the decision-making environment (what, when, and how information is presented and the way that different choices are framed) for both patients and clinicians will determine the quality and value of care delivered and how that varies across patient populations. With a rapidly aging population and rising prevalence of ADRD, the need for these efforts is urgent.

How the downfall of the ‘Chevron Doctrine’ could affect hospices in the courts Hospice News; by Holly Vossel; 12/16/24 Recent court rulings have the potential to make significant differences in the landscape of hospice regulatory oversight in coming years, particularly when it comes to audits and the forthcoming Special Focus Program (SFP). In June the U.S. Supreme Court overturned a ruling that in 1984 established the “Chevron Doctrine,” which instructed lower courts to defer to executive branch agencies to resolve ambiguities in laws passed by Congress. The decision marked the end of the practice known as “Chevron deference,” which required that courts must defer to regulatory agencies’ interpretations of “ambiguous” statutes within federal legislation as long as the enforcement activity is deemed “reasonable.” Hospices could potentially see a vastly different outlook in regulatory enforcement activity during a time of tremendous changes already taking place in the industry, [Bryan Nowicki, partner at the law firm Husch Blackwell] said.

Court rules against former Encompass Health officers in lawsuitHomeCare, Dallas, TX and Birmingham, AL; 12/9/24 The Delaware Court of Chancery ruled in the lawsuit against Encompass Health, a national home health and hospice provider, and Enhabit Home Health and Hospice, an owner and operator of rehabilitation hospitals. The lawsuit related to breaches of fiduciary duty by former company executives within Emcompass Health's former home health and hospice division, which is now Enhabit Home Health and Hospice. The court awarded judgment against VitalCaring Group, a home health and hospice business, as well as the private equity firms Vistria Group and Nautic Partners for aiding and abetting “the egregious breaches of the duty of loyalty” by former Encompass Health CEO April Anthony, former chief strategy officer Luke James and former chief financial officer Chris Walker. The court found that while employed by Encompass Health, Anthony, James and Walker usurped acquisition opportunities falling within Encompass Health’s line of business, used Encompass Health’s confidential information and swayed key Encompass Health employees to join them, with the promise of equity in the home health and hospice competitor that Anthony now heads, VitalCaring Group. 

Washington Paid Family and Medical Leave & Job Protection - Final Legislative Report University of Washington, Daniel J. Evans School of Public Policy & Governance; Lead investigator Heather D. Hill, MPP, PhD, with Tom Lindman, MPP, Diane Rucavado, MPA, and Elizabeth Ford, JD; 12/1/24 This research was funded by ESSB 5187. Additional support for data access and analyses for this research came from the UW Data Collaborative funded by the UW Population Health Initiative, UW’s Student Technology Fee program, the UW’s Provost’s office, and Eunice Kennedy Shriver National Institute of Child Health and Human Development research infrastructure grant, P2C HD042828 to the Center for Studies in Demography and Ecology at the University of Washington. The content is solely the responsibility of the authors.

[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.”

Challenges in health care for persons with multiple chronic conditions—where to go and how to get there?JAMA Open Network; Gregory M. Ouellet, MD, MHS; Jennifer A. Ouellet, MD, MHPE; Mary E. Tinetti, MD; 10/24Approximately 75% of older adults, and more than one-third of all adults receiving health care, have MCC [multiple chronic conditions]. As has been well reported, siloed, disease-based health care for persons with MCC may be burdensome, fragmented, of uncertain benefit and potential harm, and not aligned with individuals’ health priorities (ie, what matters most to them about their health and health care). The result of all this is the imposition of unwanted and unhelpful care, neglect of potentially helpful interventions that do not fall under the narrow confines of disease-based care, and inattention to what matters to each person. Finally, quality and payment metrics focused on what matters to the individual will both encourage, and result from, a push to whole-person care.