If I Stop Treatment Will I Start Dying

By Barbara Karnes

If I stop treatment does it mean I stop trying? If I stop trying does it mean I’ll start dying? I don’t want to die.

When faced with the above considerations, what decision do we make? How do we face the realization “I am going to die”?

Most of us go through life with the notion that other people die, not me or anyone close to me. Yet for all of us that bubble of illusion will someday break.

If we don’t die a fast death, by accident (no warning), we will die a gradual death from disease or old age. Either way someday all of us will die. How do we prepare for that day? Do we or should we prepare for that day?

I don’t have a one size fits all answer to those questions. Each of us will prepare for our eventual (assumed gradual) death in our own way, according to our personality. Doer personalities will have their advanced directives and Five Wishes completed and filed away. They will have talked with their family and significant others years before that information will be needed. A procrastinator personality may never address their advanced directives even though they may have given it some thought. An easy going personality ——it goes on and on. Think about who you are and how you are addressing your eventual death…

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CALL TO ACTION: 2023 Proposed Home Health Rule

HHAC stands with the National Association for Home Care and Hospice (NAHC) in combating several of the key provisions found in the 2023 Proposed Home Health Rule, and echoes the statement made by NAHC President, Bill Dombi, that: 

"With significantly rising costs for staff, transportation, and more, home health agencies across the country cannot withstand the impact of the proposed rate cut. Reliable analyses proves that PDGM underpaid home health agencies. We will be taking all steps to protect the home health benefit as this proposed rule advances and have fully prepared for congressional action and more.” 

According to a recent analysis performed of available data, NAHC estimated that should the proposed rule pass in its current form, 37% of free-standing home health agencies and 50% of all non hospital-based agencies would be operating at <0% net margin. 

The best time to begin our grassroots efforts against the destructive proposed changes will be when Congress is at recess in August. In the meantime, please use this link to go to the Federal Register and submit a formal comment about the rule. Let CMS and Congress know what it would do to your agency and those you care for. Comments must be submitted by 08/16/2022 to be considered. 

Resources: 

• Summary of Previous and Newly Proposed Medicare Home Health Cuts
• Talking Points: Congress Must Act to Prevent Home Health Cuts that Will Devastate Access to Care 

Dems Want to Tax High Earners to Protect Medicare Solvency

Associated Press / By ALAN FRAM
 
WASHINGTON (AP) — Senate Democrats want to boost taxes on some high earners and use the money to extend the solvency of Medicare, the latest step in the party’s election-year attempt to craft a scaled-back version of the economic package that collapsed last year, Democratic aides told The Associated Press.
 
Democrats expect to submit legislative language on their Medicare plan to the Senate’s parliamentarian in the next few days, the aides said. It was the latest sign that Majority Leader Chuck Schumer, D-N.Y., and Sen. Joe Manchin, D-W.Va., could be edging toward a compromise the party hopes to push through Congress this summer over solid Republican opposition. Manchin scuttled last year’s bill.
 
Under the latest proposal, people earning more than $400,000 a year and couples making more than $500,000 would have to pay a 3.8% tax on their earnings from tax-advantaged businesses called pass throughs. Until now, many of them have been using a loophole to avoid paying that levy.
 
That would raise an estimated $203 billion over a decade, which Democrats say would be used to delay until 2031 a shortfall in the Medicare trust fund that pays for hospital care. That fund is currently projected to start running out of money in 2028, three years earlier.
 
Most U.S. businesses are pass throughs, which include partnerships and sole proprietorships and range from one-person law practices to some large companies. Owners count the profits as income when they pay individual income taxes, but such companies do not pay corporate taxes — meaning they avoid paying two levels of taxation.
 
Democrats this week also sent the parliamentarian a separate 190-page piece of the emerging Schumer-Manchin compromise that would lower prescription drug costs for patients and the government. Provisions include requiring Medicare to negotiate drug prices, limiting beneficiaries’ out-of-pocket costs to $2,000 annually and increasing federal subsidies for copays and premiums for some low-income people.

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Health Care Fraud and Abuse Control Program FY 2021 Report Issued

From the Health Group

The Department of Health and Human Services and the Department of Justice have released the Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2021. 

During FY 2021, the federal government won or negotiated more than $5 billion in health care fraud judgments and settlements.  The Report provides highlights of significant criminal and civil investigations by type including:

• Ambulance transportation services
• Clinics
• Diagnostic testing
• Drug companies
• Durable medical equipment
• Electronic health records
• Genetic testing
• Home health providers
• Hospice care
• Hospitals and health systems
• Laboratory testing
• Managed care
• Medical devices
• Nursing homes and facilities
• Pharmacies
• Physical therapy
• Physicians and other practitioners
• Prescription drugs and opioids
• Psychiatric and psychological testing and services
• Substance use treatment centers

The Report provides an all-inclusive look into the current and potential activities relating to the identification and pursuit of fraudulent and abusive activities, including Medicare provider screening.  All providers should be continuously aware of areas of focus as described in the Report.  The entire Report is available at FY 2021 HCFAC Report (hhs.gov).