2025 SNF PAYMENT RULE:

CMS released the 2025 SNF payment rule, which contains positive news in the form of a 4.1% market basket index. It also has some challenging items, including a proposal to expand the CMP system. The rule is scheduled to be published to the Federal Register on April 3^rd, which will kick off the 60 day comment period. You can download a copy of the prepublication rule here (PDF). You can find z-INTEL Co-Founder Marc Zimmet’s insights into one of the lesser known impacts of the rule, i.e. the “Area Wage Index”, here. Summaries of the rule can also be found at Skilled Nursing News & McKnight’s. If you’re an AHCA member, they have a thorough summary at the AHCA/NCAL Blog.

WHITE HOUSE:

The White House focused this week on gun violence prevention efforts, initiatives to support small businesses (with a specific focus on women-owned child care centers), and promoting their student loan efforts. Two items of interest to us:

• Via the White House’s Office of Management and Budget(OMB), they released the first government-wide policy guidance on mitigating risks from AI. While specifically governing the usage of AI by federal agencies, these are important steps in understanding how the White House will regulate AI and the steps they want to see taken. You can download a copy of the guidance here (PDF). Federal News Network has a good summary.

• Via HHS, they issued a final rule on “junk” insurance plans. These are short-term, limited health insurance plans that don’t cover pre-existing conditions or provide several basic benefits. They were originally banned by the Affordable Care Act, but the prior Administration had expanded their usage in 2018 as a more affordable option. The HHS press release is here. The CMS fact sheet is here. The final rule will be published to the Federal Register on April 3^rd, but you can access a prepublication copy here (PDF).

CONGRESS:

With the funding discussions wrapped up, and Congress out on a two-week recess for Easter, it was a relatively quiet week in DC. Speaker Mike Johnson continues to navigate a fine line between the need to pass aid to Ukraine, the ongoing frustration from Conservative GOP members, and what Democrats will want should the motion to vacate filed last week actually come to the floor for a vote. Meanwhile, the Congressional dysfunction continues to encourage early exits from Congress. Ultimately, with folks out of town, it’s been a week of news bytes without substance. Elsewhere in the political world:

• With almost all Congressional redistricting done for the 2024 elections, primary messaging points are coming into focus for Republicans and Democrats. Roll Call took an updated look at the ten races that will likely determine who will control the next Congress while Democrats have set their sights on the primary Congressional districts they believe have the best chance at flipping.

• With relatively little legislative time left before the November elections, an important item to keep in mind is the Congressional Review Act. The CRS has a good explainer here (PDF), but essentially the CRA allows Congress to overturn federal agency actions passed within 60 legislative days of a rule’s publication in the Federal Register. For now, it’s unclear when exactly that will be (estimates range from May to midsummer), but it compresses the available timeline for federal agency rules to be published.

• Politico looked at what the Senate calendar can look like over the next few months.

• With the funding bills done, a look at the $71 million in earmarks for Congressional members who voted against the bill.

AGENCIES:

It was a busy week for the agencies.

HHS issued a final rule governing Medicaid applications, renewals, and enrollment. CMS’ Fact Sheet is available here. The final rule will be published to the Federal Register on April 2^nd. You can access a prepublication copy of the rule here (PDF).

CMS released the 2025 Hospice payment rule. The proposed rule is scheduled to be published to the Federal Register on April 4^th, at which point the 60-day comment period will begin. You can download a prepublication version of the rule here (PDF).

With the effects of the Unwinding becoming clear, HHS issued a new special enrollment period (PDF) extending till November 30^thto allow more people time to find health insurance. As part of the release, they issued several new resources for states, Managed Care plans, and beneficiaries to help guide them on maintaining or renewing eligibility.

HHS announced the 41 drugs that will have lower Part B copays for April 1^st – June 30^th. You can download a copy of the list here (PDF).

HHS, via the Office of the National Coordinator for Health Information Technology (ONC), released the draft version of their 5 year federal health IT plan. The plan is available here (PDF). They also created a central landing page which can be used to submit comments.

HHS approved a plan by Michigan to become the first in the country to license “kinship caregivers”.

Several relevant SPA’s were approved this week (all are links to the PDF):

• Idaho
• Illinois
• Massachusetts
• Nevada

FROM THE NOTEBOOK:

• An interesting item out of Canada: the Provincial government of Newfoundland and Labrador has a clause with private agencies wherein the government is not allowed to hire agency nurses for a full-time position with the government. The no-poaching rule is designed to prevent folks from jumping ship.

• Kaiser Health News examined how the Unwinding directly impacted the cash flow for health care providers.

• Arizona became the latest state to pass a survey reform bill that would provide stability to the survey process. HB 2051was sent to the Governor for signature earlier this week. McKnight’s has a good summary.

• Earlier this month Indiana passed a law that will require covered healthcare entities to notify the state at least 90 days before closing. The Benesch Law Firm has a good overview of the new law.

• A look at the regulatory implications from the recent Change Healthcare cyberattacks.

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