Starting tomorrow, we’re going to be at the annual Zimmet Conference, hosted by ECap Intel Co-Founder Marc Zimmet. The theme of this year’s conference is “Bon Voyage Reimbursement”. If you’re around, come say hi!

WHITE HOUSE:

Over the last two weeks, the White House focused on the 75^thanniversary NATO summit, launching Women Lead (a public-private partnership (PDF) to support women in political leadership roles), strengthening the shipbuilding industry, investing more than $2 billion in the American auto industry (via the Department of Energy), and investing in twelve more regional “Tech Hubs” to spur economic growth in innovative industries, (the full list of 31 Tech Hubs is here - PDF). Two items of interest for us:

• They announced another large investment in the federal registered apprenticeship program, which is designed to spur workforce development in high-demand sectors. While the primary focus of the announcement is centered on public works projects in Philadelphia, they also included more than $280 million, via the Department of Labor, to specific programs and states around the country to be used to develop apprenticeship programs. To apply to join the apprentice program, you can visit the central resource page here.

• They announced new federal actions to protect workers from heat related concerns. Included is a new proposed rule from OSHA related to heat protections as well as the award of $1 billion, via FEMA’s “Building Resilient Infrastructure and Communities” grant program, for climate resilience programs at the state level. While the funding is directed at states and community organizations, there may be opportunities to partner at the facility level with local institutions.

CONGRESS:

After several years of dealing with their own internal party dysfunctions, Republicans are enjoying watching Democrats having to navigate the turmoil at the top of the presidential ticket. Even as Minority Leader Jeffries met with the President to quell concerns among the party, yet another Democratic member (the 18^th so far) called on the President to step aside. Despite the high level fireworks, the day to day job of governing soldiers on, with the Senate calmly advancing an appropiations bill, the House failing to do so, and messaging bills continuing to factor in. Still, with Senate appropriators narrowing the gap on topline numbers, necessary progress is slowly being made on funding the government. Elsewhere in the political world:

• On the heels of the Supreme Court’s Chevron ruling, several House committees, including the House Committee on Oversight and Accountability, sent letters to federal agencies requesting a review of regulations that may run afoul of the new standards laid out by the court. This, of course, can have significant implications for many of the administrative and regulatory practices of HHS. The letters can be found here (a 113 page-PDF with every federal agency letter included).

• The House letters about Chevron join one sent by the Senate HELP Committee Ranking Member Bill Cassidy (R – LA) to HHS that essentially asks the agency how their regulatory agenda complies with the Supreme Court’s ruling. You can access a copy of the letter here (PDF).

• Politico did a deep dive into the thorny question of how will Congress legislate in the post-Chevron era, which will require more expertise on the part of lawmakers.

• With pressure mounting from within, the Biden Campaign is hard at work keeping staff on board. Of course, it’s hard to do so when more than $90 million in pledged donations are on hold in the latest sign of fallout surrounding the President’s ability to stay in the race.

• Very quietly, the House Freedom Caucus is losing members, something that bodes well for Speaker Mike Johnson’s ability to keep the most conservative members of the caucus of the GOP in line.

• A good look at the new normal in New Jersey politics, following several recent scandals involved prominent political figures.

• One interesting CRS report to note: We’ve mentioned the Congressional Review Act, which is a Congressional mechanism to undo federal regulations, in the context of overturning the minimum staffing mandate. The CRS issued a report on how the complicated timing of the Act works. You can access it here (PDF).

AGENCIES:

CMS issued a new QSO outlining changes to the staffing level metrics for Care Compare, as well as the methodology for the turnover numbers. You can access a copy here (PDF).

CMS released the 2025 Medicare Physician Fee Schedule proposed rule. The fact sheet can be found here. The central resource page with links to each component is here. In addition to the financial implications of the rule, there are also regulations covering telehealth provision and portions related the Medicare Prescription Drug Inflation Rebate Program (PDF). The rule is scheduled to be published at the Federal Register on July 31^st, at which point the 60-day comment period will kick off. In the meantime, should you be in the mood for some easy summer reading, you can download a copy of the 2,248 page rule here (PDF). Fierce Healthcare has a good summary of the rule.

HHS, via CMS, authorized 5 states (Illinois, Kentucky, Oregon, Utah, and Vermont) to issue Medicaid coverage to incarcerated individuals before release from prison to facilitate a seamless transition back into civilian life and avoid gaps in coverage.

CMS issued a guide to states to comply with the Ensuring Access to Medicaid Services final rule issued back in April. You can download a copy of the guide here (PDF).

CMS issued an update on the launch of the GUIDE (Guiding an Improved Dementia Experience) model, which is designed to provide a better experience in treating individuals dealing with dementia.

HHS, via HRSA, announced the award of more than $200 million to help develop and train providers dealing with older adults. A full list of awardees can be found here. If you’ve got a facility in the vicinity of one of the chosen organizations, there may be partnership opportunities available.

HHS, via the ONC (Office of the National Coordinator for Health Information Technology), issued a proposed rule governing patient data and interoperability. All information related to the proposed rule can be found at the central resource page. Should you be so inclined, you can download a copy of the relatively svelte 1,067 page proposed rule (PDF).

The HHS at OIG released a new impact brief on Medicare Advantage fraud, focusing on their $172 million settlement with Cigna. You can download a copy of the brief here (PDF).

The FTC released a new report on the impact that PBM’s are having on drug pricing. You can access a copy here (PDF). The report comes amidst reporting from the Wall Street Journal that the FTC is preparing a lawsuit against the three largest PBM’s.

The FDA approved a new treatment for Alzheimer’s, called donanemab.

A federal judge issued a narrow injunction blocking the FTC’s ban on non-compete clauses from going into effect. While it doesn’t yet have a nationwide impact, the court said they’d issue a formal ruling by August 30^th.

CMS revised the star ratings for many systems following a lawsuit. Here’s a breakdown of the new ratings.

FROM THE NOTEBOOK:

• The Wall Street Journal did a deep dive into the numbers on Medicare Advantage, finding more than $50 billion in payments for services that weren’t rendered. For the more mathematically inclined, they explained their methodology here.

• Good news out of PA, where the Governor signed a budget that includes a significant increase for long-term care providers.

• Ohio announced that CMS approved a proposal to incentivize private rooms in SNF’s. The Governor also penned an op-ed outlining the changes.

• Oklahoma’s Lieutenant Governor joined the chorus of elected officials recognizing that the minimum staffing mandate can’t solve the core problem: there simply isn’t enough staff to go around.

• It’s not just here in the United States. Japan, which is also suffering a severe shortage of long-term care workers, had more than 81 facilities declare bankruptcy in the past 6 months.

• On the heels of the Supreme Court Chevron’s decision, there have been quite a few worthwhile reads on the impact it’s going to have on healthcare policy and the ability of federal healthcare agencies to regulate, including from the Washington Post and the Kaiser Health News.

• The Kaiser Family Foundation explored the growth of foreign nurses in the healthcare workforce and the impact that visa restrictions are having.

• A blog post in Health Affairs called on regulators to step up their oversight game on the usage of AI, including how it impacts prior authorizations.

• While we often focus on how AI is used against providers, the NY Times explored how providers are using AI to help.

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