Colorado May Become the 3rd State to Drop its Medical Aid-in-Dying Residency Requirement

The Colorado Sun | By Jesse Paul

Senate Bill 68 would also shorten the mandatory waiting period for people seeking to end their lives to 48 hours from 15 days. Additionally, it would let advanced practice registered nurses prescribe aid-in-dying medication.

Colorado may become the third state to allow out-of-state residents to receive medical aid in dying through a bill that would also shorten the mandatory waiting period for people seeking to end their lives.

Senate Bill 68, which was introduced in the legislature on Jan. 22, would shrink the waiting period to 48 hours from 15 days and also let advanced practice registered nurses, in addition to doctors, prescribe aid-in-dying medication. 

The bill comes eight years after Colorado voters overwhelmingly approved Proposition 106, which legalized aid in dying in the state for terminally ill adults given less than six months to live and who get the approval of two doctors.

Proponents of the bill say it would remove barriers that the ballot measure unintentionally put in place. 

“There are more people who are utilizing this option for end of life,” said Sen. Joann Ginal, a Fort Collins Democrat and one of the lead sponsors of the legislation. “We just want to make sure that those people are getting the care and the medication in the best way possible so that their lives will end in a more peaceful manner in the way they want at the time they want.”

Colorado is among just 10 states that currently allow medical aid in dying. Washington, D.C., does, too. 

Oregon was the first to drop its residency requirement, in 2022. Vermont followed in May. 

There are sure to be concerns raised about so-called aid-in-dying tourism in Colorado if the measure passes. But because the changes in Oregon and Vermont are so recent, there’s a dearth of data on whether removing the residency requirement affected the use of the aid-in-dying option in those states. 

Kim Callinan, the CEO of Compassion and Choices, a group that advocates for medical aid-in-dying legislation across the country, said fears that terminally ill patients would suddenly flood to Colorado if Senate Bill 68 passes are overstated.

“A person who is terminally ill and at the very end of their life — it takes a considerable amount of effort to get up and move to another state,” she said. 

Most states where medical aid in dying is legal have a waiting period of at least 15 days between when someone asks a medical professional to sign off on the end-of-life option and when they can get the medication…

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Key Lawmakers Urge CMS to Curb Medicare Advantage Fraud, Abuse

McKnight’s Home Care | By Adam Healy
 
The Centers for Medicare & Medicaid Services should take swift action to “curb abusive practices” by Medicare Advantage plans, senators said in a letter sent Thursday. 
 
“The MA program is based on the premise that private insurance companies can and would administer Medicare coverage more cost-effectively — but it has failed to do so every single year,” Sens. Pramila Jayapal (D-WA) and Elizabeth Warren (D-MA) wrote in their letter. 
 
The Medicare Payment Advisory Commission has estimated that MA plans average receiving as much as 6% more per enrollee than traditional Medicare, the letter writers said. On top of that, MA plans also spend roughly 25% less on healthcare services per enrollee, they noted.
 
“It is imperative for CMS to rein in these abuses and protect Medicare coverage for
the seniors and people with disabilities who rely on it,” the senators wrote.
 
Jayapal and Warren recommended improvements in four areas. First, they advised CMS to augment base MA payments to offset overpayments due to favorable selection. Since MA beneficiaries are typically younger and healthier, they wrote, MA insurers may receive higher-than-average reimbursement from CMS while also paying out fewer claims, resulting in “gross overpayments.”
 
They also recommended CMS get more aggressive about recouping overpayments, implement a “network quality” measurement to MA plans’ star ratings, and limit insurers’ use of health risk assessments — which have been criticized for their lack of transparency.
 
Jayapal and Warren also noted MA plans’ use of artificial intelligence to “systematically deny care.” In November, UnitedHealthcare, the largest MA insurer, was alleged in a class action lawsuit to have used artificial intelligence tools to deny hundreds of patients post-acute care services, including home health.
 
Also on Thursday, CMS issued an extensive request for information seeking details about nearly all aspects of the MA program. They include care access data, prior authorization results, statistics related to patients’ outcomes and more. Still, Jayapal and Warren sought further enforcement action in their letter to the agency.
 
They gave qualified praise to steps CMS has already taken to limit overpayments.
 
Nonetheless, they noted, the Committee for a Responsible Federal Budget has projected that CMS will overpay MA insurers by as much as $1.56 trillion over the next decade. 
 
“As enrollment in MA continues to grow, CMS must take more aggressive action to ensure Medicare’s sustainability, protect taxpayer dollars, and curb abusive practices,” they said.