Coming up in just a few short weeks is the annual Zimmet Conference, hosted by ECap Intel Co-Founder Marc Zimmet. The theme of this year’s conference is “Bon Voyage Reimbursement”. It’s a great opportunity to hear from some of the smartest minds in the sector. Owing to some calendar quirks, this year's conference is being held earlier than usual. For more information and to register, please visit the conference site. Rooms are selling out quickly and you don't want to miss your chance. We’d love to see you there!

WHITE HOUSE:

The White House focused this week on a new immigration policy for noncitizen spouses, a conservation strategy for national forests, and new climate “adaptation plans” for federal agencies (available here). Two items of interest for us:

• They announced, via the IRS and the Department of the Treasury, the issuance of the final rule related to prevailing wage and apprenticeship tax breaks available for companies involved in clean energy projects. While primarily geared to developers involved in clean energy, there are tax credits available for retrofitting commercial projects to be more energy efficient. The main resource page is here. You can find a fact sheet of the prevailing wage program here (PDF) and a fact sheet for the requirements here (PDF). The final rule is scheduled to be published at the Federal Register on June 25^th. In the meantime, you can download a copy of the final rule (PDF). Please consult with your tax advisors to see if this is relevant to you.

• They provided an update on executive actions related to refugee resettlement. One interesting component is the “Welcome Corps”, which is designed to assist private groups interested in helping refugees settle into new communities. There may be opportunities to partner with local groups for job placement and hiring.

CONGRESS:

Would you look at that?? Congress actually passed meaningful, bipartisan legislation! On Tuesday, the Senate sent a major energy bill to the President that focuses on nuclear energy. It’s an important reminder that when attention is focused elsewhere, without “messaging” issues, legislation can actually get passed, albeit after years of work. Of course, with many tax breaks from 2017 scheduled to expire next year, Democrats gung-ho on increasing taxes on the wealthy, and the federal deficit expected to reach more than $50 trillion in the next 10 years, don’t expect bipartisan cooperation to become the norm, even as the Senate is set to begin deliberations on the annual funding bills after July 4^th. Elsewhere from the political world:

• We’ve mentioned the Congressional Review Act several times as a tool that can be used by Congress to overturn rules issued by federal agencies issued within 60 days of the end of Congressional session. We likely crossed that date this week, unless Congress adds additional legislative days to the calendar.

• Another week, another set of primaries in the books. Importantly, one of the most closely watched races remains uncalled as Republican Bob Good, a key member of the House Freedom Caucus, trails by several hundred votes. The Congressman is promising a “full recount” even as his opponent declared victory.

• This coming week is the primary in New York, where the most expensive House race in history has seen more than $23 million spent on political advertising. Of course, that pales in comparison to the spending on federal elections, as Republicans unveiled a plan to spend more than $100 million this summer. Good luck with political ads if you’re in a battleground location…

• This may be of interest only to the politically engaged, but one CRS report of note from the week. A guide to the role that PAC’s and Super PAC’s play in federal elections. You can access a copy here (PDF).

AGENCIES:

The IRS announced that they had completed their initial investigation of ERC claims with plans to deny high-risk claims and begin to process new lower risk claims. As part of their findings, they think that a significant percentage of claims are “improper”. Additionally, during a chat with reporters, the IRS Commissioner asked Congress to shut the program down entirely.

CMS released a new QSO with guidance related to the facility assessment required under the new minimum staffing rule. Please make sure to share with your clinical and operating teams. You can access a copy here (PDF).

CMS is investigating Missouri and Texas for their ongoing delays in the Medicaid application process. You can read the letters sent to Missouri (PDF) and Texas (PDF), as well as the push from Texas Congressman Lloyd Doggett’s office on the matter.

Following the Change cyberattack in March, CMS activated their Accelerated Payments program for affected providers. They issued a notice that they will be closing the program to new applicants on July 12^th.

The OIG at HHS updated their work plan with several new planned oversight audits. Several interesting items, including a review of the revised SFF program, yet another look at prior authorizations by MA plans, and a look at whether states that use Medicaid Managed Care organizations are meeting their required medical loss ratio minimums of 85 percent and appropriately paying back the federal government.

The IRS also issued new guidance regarding upcoming regulations governing partnerships and utilizing pass-throughs for related parties. The formal notice can be found here (PDF). The proposed regulations can be found at the Federal Register where comments can be submitted through August 19^th. Please consult with your tax advisors for the practical ramifications.

The Department of Justice issued a report strongly criticizing the state of Missouri for its practice of placing individuals with disabilities in SNF’s. The full report can be accessed here (PDF).

FROM THE NOTEBOOK:

• The Kaiser Family Foundation released their annual 50-state survey of Medicaid officials, which provides a good insight into Medicaid processes at the state level. Especially as we emerge from the unwinding, it’s a good insight into how states are approaching Medicaid applications in the post pandemic era. They also released a more targeted report, focusing specifically on seniors.

• The NY Times did a deep dive into PBM’s.

• We mentioned last year that Scripps Health was dropping several MA plans for several of their practices. Six months in, Modern Healthcare looked at the impact of the decision.

• A group of researchers penned an article in Health Affairs calling on HUD to use the section 232 program to incorporate more quality metrics into the program and use it to incentivize different models of SNF care.

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