WHITE HOUSE:

The White House focused this week on federal efforts to repair the Francis Scott Key bridge in Baltimore, providing an update on their efforts to expand medicinal access around the world, and hosting a roundtable on increasing state-based paid family and medical leave. One item of indirect interest for us:

• They announced the award of $20 billion in EPA funding for green projects, including $6 billion for the Clean Communities Investment Accelerator (CCIA) fund. These funds will be used to help finance projects that upgrade buildings in rural and disadvantaged areas to become more climate-friendly. If you have buildings in those areas, there may be an opportunity to refurbish the physical plants.

CONGRESS:

As Congress heads back to town on Monday after the two-week break, there are several items on the agenda. With the government funding bills in place through the end of the year, the big-ticket item is funding associated with foreign aid, specifically Ukraine and Israel. For our purposes, the main issue that affects SNF’s is the path GOP Speaker Mike Johnson takes in addressing Ukraine and what that means for his long-term prospects as Speaker. Even the White House appears to be putting politics to the side to get something done on Ukraine, although whether that will help or hurt the Speaker remains unclear. Elsewhere from the political world:

• The House Ways & Means Subcommittee on Health will be hosting a hearing this week on how to increase telehealth access and existing legislative proposals. While the imminent passage of any of the bills under discussion is unlikely, it’s a sign that Congress is thinking about how to make telehealth a more permanent part of the health continuum. You can find the agenda (which lists all the bills) and watch the hearing at the committee hearing site.

• In case you ever wonder about the impact that getting involved in voting can have, yet another reminder: there’s a race in California that is tied at 30,249 votes apiece! It’s a visceral way of seeing why get out the vote campaigns are important and the role they can play.

• One thing that often crops up in conversations is the perception that the polarization in Congress is getting worse, and with that, Congress’ increasing inability to govern along with leading Congressional members to head for the hills. It appears that this is true for Congressional staff as well. A recent study found that the rhetoric and polarization are causing Congressional staff to think about leaving as well. The full study is here (PDF).

• Another Congressional committee is looking into private equity’s role in healthcare. The Chairman of the Senate’s Homeland Security and Government Affairs sent letters to several private equity firms to understand how their involvement affects patient care at emergency departments.

AGENCIES:

CMS issued an updated organizational chart outlining the full leadership structure. You can find it here.

CMS finalized their Medicare Advantage & Medicare Part D final rule that aims to better protect beneficiaries on those plans. One key part is a plan to better monitor the usage of prior authorization and whether it’s causing denial of access to care. The fact sheet for the rule is here. The rule will be published to the Federal Register on April 23^rd. If you’re up for some bedtime reading, you can download a copy of the 1,327 page rule here (PDF). AHCA has posted a public summary here.

In addition to the final rule, CMS issued the final MA and Part D payment rates for the programs. The fact sheet for the rates is here. They also issued a fact sheet on the Part D redesign. The formal rate announcement is available here (PDF).

CMS issued a final rule on parameters on marketplace health plans covered by the Affordable Care Act. One interesting tidbit is that CMS authorized all states to allow adult dental services to be considered an Essential Health Benefit (EHB). The fact sheet is here. The final rule isn’t yet scheduled for publication to the Federal Register, but you can download a copy of the rule here (PDF).

HHS, via ASPE, released a new white paper on drug shortages and steps to take to mitigate future risk. You can download a copy of the white paper here (PDF).

The OIG at HHS released 2 separate reports on SNF initiated discharges for residents with mental health disorders, one focused on the challenge to SNF’s and one focused on CMS oversight. The SNF challenge summary is here (PDF), while the CMS summary is here (PDF). The full SNF challenge report can be accessed here (PDF) while the CMS oversight report is here (PDF).

This is from 2 weeks ago, but ARPA-H, the federal agency tasked with innovation in healthcare, is joining forces DARPA (the original agency responsible for many of the federal government’s innovative technology breakthroughs) to launch a new “Cyber Challenge” to utilize AI in better protecting healthcare institutions from cyberattacks. You can find more information here.

The Department of Commerce announced a new MOU between the United States and United Kingdom on AI safety. The UK announcement is here. The details of the MOU are here. You can find a summary of the MOU here.

FROM THE NOTEBOOK:

• A former New Hampshire Department of Health Commissioner wrote an op-ed against the proposed minimum staffing mandate. It’s always great to hear from folks who understand why the mandate is so ineffective at its stated goal.

• Sellers Dorsey, a consulting firm to Medicaid agencies and providers, released their analysis of 2025 proposed state budgets. It’s a useful resource when thinking about advocacy. You can access a copy of the analysis here (registration required).

• The Kaiser Family Foundation released a new report on how the unwinding impacted enrollment at the five largest publicly traded Medicaid MCO’s.

• With AI increasingly scraping the web for data to train machine models, Axios explored the legal landscape related to what “publicly available” on the internet actually means.

• The Aspen Institute, a non-profit that focuses on public policy issues, is hosting a webinar next week on the “The Future of Public Benefits Modernization”. The event, cohosted with the White House’s OMB, will discuss public benefits, and includes a full section on the Medicaid Unwinding.

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