CHANGE HEALTHCARE CYBERATTACK:

For those impacted by the Change Healthcare Cyberattack, CMS has activated the Medicare Accelerated Payments program for affected Medicare Part A & B providers, based upon guidance released by HHS earlier in the week. On a more practical note, United Healthcare expects to be back on their feet towards the mid-March. At the state level, PHCA sent a letter to the Governor’s requesting Medicaid based advance payments to affected facilities.

WHITE HOUSE:

The White House focused this week on the President’s State of the Union Address (for those so inclined, you can watch the whole thing here), issuing a new Executive Order expanding the use of “Registered Apprenticeships” in the federal government (full text here), and hosting a roundtable with healthcare stakeholders to discuss the role of PBM’s in drug pricing (you can watch the roundtable here). One item of indirect interest:

• Continuing the Administration’s efforts on “junk fees”, they announced a new set of regulatory actions to rein in fees and promote competition. The Consumer Financial Protection Bureau issued a final rule (available here) that lower credit card late fees to $8, among other items. Additionally, they are launching a “strike force”, initially co-chaired by the DOJ & FTC, that will focus on illegal pricing and anti-competitive behavior. These are developments that are worth monitoring, especially following up on their announcement last month of their request for comment on GPO’s, which still runs through April 15^th and currently has more than 4,000 comments.

CONGRESS:

The first round of federal funding bills, covering six agencies, passed out of the House on Wednesday, the Senate late Friday evening, and was signed by the President to avert a government shutdown. Even as the posturing continues, the government will now likely be funded through December. The passage in the House relied on significant Democratic support and ultimately had over 80 GOP defections. For now, the question remains whether there will be any political blowback on the Speaker. Ultimately, as we’ve discussed all along, there’s a bit of theater in play as neither party ever wants to truly risk the consequences of a government shutdown. Elsewhere in the political world:

• The new government funding bills include a partial reversal of the Medicare Part B cuts that were in the 2023 final rule. Fierce Healthcare has a more complete summary.

• The House Ways and Means Committee passed a bill that would block the Administration from implementing the minimum staffing mandate. The text of the bill is here. While the vote was almost exclusively along party lines, Alabama Congresswoman Terri Sewell, a rural Democrat, recognized how damaging the minimum staffing mandate, joined her Republican colleagues in supporting the legislation to block the mandate. Although the bill is not likely to pass the full House, it is an important piece of the overall argument that the minimum staffing rule is simply bad policy.

• With the new set of funding bills in place, and many of the health provisions removed (as mentioned last week), Roll Call took an early look at the health provisions that are likely going to be tackled during the lame duck period post the November election.

• Following the news that John Barrasso has dropped out of the race to replace Mitch McConnell, an updated look at the two remains Johns as well as potential outsiders that may join in.

• This may be of interest only to the political nerds, but a fun read on a social media account that has been a major source of the arcane rules governing House & Senate procedure. Besides controlling the day-to-day within Congress, these rules can have a real-world impact on legislation and is a valuable tool for those in the political arena.

AGENCIES:

For those whose SNF’s service an Orthodox population, an interesting item from HHS regarding the resolution of complaints centered on New York Presbyterian Hospital wherein the hospital agreed to provide “kosher” devices for Jewish patients. These are devices that are heavily filtered from internet usage. Please review with your legal teams to see if it applies to your circumstances.

After the latest court ruling in support of the Government’s plan to allow Medicare to negotiate drug prices, the drugmakers submitted their counteroffers as the process continues. Concurrent with the announcement, HHS’ Office of the Assistant Secretary for Planning and Evaluation (ASPE) released a new report on projected impacts for rural Medicare enrollees from the Inflation Reduction Act.

CMS released their 2023 “Accomplishments” to outline their progress on the strategic pillars in the CMS strategic plan. You can access the report here (PDF).

As mentioned last week, the FTC held a workshop on private equity in healthcare. The full video is here. Concurrent with the workshop, three agencies (the FTC, the Department of Justice, and HHS) issued a joint RFI (PDF) asking for public comment on competition and private equity in healthcare. Comments can be summited at the Regulations.gov site through May 6^th, 2024. The Wall Street Journal has a good summary of the effort.

The OIG at HHS released a new report on HRSA distribution from the Provider Relief Fund during Phase 2, finding that HRSA potentially overpaid several recipients. You can access the summary and full report (both PDF).

STATE PLAN AMENDMENTS:

Two relevant approvals this week (links are to the PDF):

· New York: Updated nursing home reforms,

· North Dakota: Navigating the number of therapeutic leave days for SNF’s.

FROM THE NOTEBOOK:

• AHCA released its 2024 State of the Sector report highlighting the ongoing struggles for the sector. You can download the report here (PDF).

• We’ve discussed Mark Cuban’s Cost Plus pharmacy program in the past. CHS Health Systems became the first for-profit healthcare system to partner directly in purchasing directly from Cost Plus.

• HealthAffairs released a new analysis of Medicare Part D drug utilization. Fierce Healthcare has a summary.

• A study released in StatNews highlighted the practice of related party transactions in SNF’s. It was based on cost reports from Illinois. McKnight’s has a summary. While the report is lacking context, it’s important to be aware of.

• A bill in West Virginia that would have loosened CON laws is likely dead this session. As written, the bill wouldn’t have affected SNF’s.

• New York City hired a “Director of AI and Machine Learning” to oversee the implementation of the city’s AI action plan.

• Kaiser Health News did a deep dive into the Change cyberattack and what cyberpolicy changes might be in store in the future.

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