CHANGE HEALTHCARE:

As many of you are aware, Change Healthcare was the victim of a cyberattack, which is continuing to cause problems for providers. United Healthcare has created an update page to track the ongoing issue. They've also created a temporary loan program for affected providers.

Both the American Hospital Association & AHCA have created resource pages to help providers navigate the crisis. In the meantime, AHCA sent a request (PDF) to HHS to clarify that providers affected by the outage should be able to request advance payments from their MAC under the Medicare Accelerated Payment program.

WHITE HOUSE:

Over the last two weeks the White House focused on a new effort to support cybersecurity for US ports (with an accompanying executive order, a new $6 billion investment to deliver clean water to communities, address potential security risks from China, cancel more student loan debt, and announced $1.7 billion in new public-private partnerships to address hunger. 4 items of interest to us:

• They announced a new set of federal actions to lower housing costs, including a new $115 million grant to HUD’s section 202 Support Housing for the Elderly program, as well as other program that assist in the building of affordable housing. There are quite a few opportunities here, including for those involved in developing affordable housing, as well as for eligible recipients of affordable housing.

• Following up on their announcement last year to support child care, they issued (via HHS’ Office of the Administration for Children & Families) a final rule to strengthen the Child Care & Development Block Grant (CCDBG) program. The goal is to help working families with childcare and accessibility. As many of your residents may benefit from provisions of the program, they may appreciate hearing about it from you. The fact sheet can be found here.

• With data privacy breaches consistently happening, they issued a new Executive Order (available here) that direct the DOJ and other federal agencies to draft new regulations to protect private data from foreign actors. While specifically aimed at foreign actors, there may be unintended consequences for HIPAA and other data privacy laws. It’s something to monitor.

• The White House’s Office of the National Cyber Director (ONCD) issued a new report advocating for smarter software development and moving away from programming languages that are ripe for hacking. The fact sheet is here. The full report is here (PDF). While this is aimed primarily at software developers, as many of our readers are involved in tech start-ups, it’s something to keep an eye on.

CONGRESS:

To the surprise of no one, Congress elected, yet again, to punt on finding a real funding path for the government. Late last night, they sent a Continuing Resolution (CR) to the President for signature. This is the fourth CR that has been passed since October and keeps funding flowing for another two weeks at current levels. The challenge, of course, is that passing this CR required significant Democratic support to pass, which is what cost former Speaker McCarthy his job. In the meantime, the Conservative Freedom Caucus is pushing hard for a yearlong CR, which would trigger automatic funding cuts, adding to the challenge for Speaker Johnson in wrangling the GOP to common ground. On the other side of the aisle, House Minority Leader Jeffries will have a difficult decision to make as to whether to support Speaker Johnson and protect him should the rest of the GOP revolt. Regardless, we now have two more weeks to see what happens. Elsewhere in the political world:

• With GOP Senate Leader Mitch McConnell announcing his retirement, the stability that existed in the Senate for the GOP is now threatened. Here’s a rundown of the "3 Johns", as the 3 Senators most likely to replace McConnell are known.

• The House, of course, has not had any stability in quite some time. Here’s a useful guide on the five different factions among the House GOP. Meanwhile, the ongoing retirements continue to wreak havoc on institutional knowledge.

• With primary season underway, a look at political takeaways from this past week.

• Wisconsin has new legislative maps that will be in place in time for this November’s elections. The maps are likely to swing several seats in favor of Democrats and created a more balanced legislature.

• Politico looked at the difficulties facing federal regulators in creating a meaningful path forward on AI regulation.

AGENCIES:

The FTC will be holding a virtual workshop on private equity in healthcare on March 5^th. They released the agenda (PDF). The link to the webcast can be found here.

CMS issued final guidance for the new Medicare Prescription drug payment plan. This new plan allows beneficiaries to pay for out-of-pocket costs over the course of the year. You can access copies of the fact sheet, full guidance and updated timeline (all are PDF links). The resource hub with all details regarding the new prescription payment plan can be found here.

HHS released a final rule covering religious discrimination for beneficiaries of federal funded social services. The final rule can be found at the Federal Register.

CMS sent out a State Medicaid Director letter (PDF) providing guidance on the expansion of federal funding for certain behavioral health professionals. Concurrent with the notice, HHS, via the Substance Abuse and Mental Health Services Administration (SAMHSA), is making available $37 million in funding grants for expanding behavioral health services. The different opportunities are listed at the site.

HHS, via the Administration for Community Living (ACL), created two new technical resources to better help states build programs to recruit direct care workers. The full details are available at the technical assistance page. ACL also created a new central resource page to help state better identify ways to recruit new direct care workers.

The OIG at HHS released a final report on lessons from the pandemic as they relate to SNF’s. The full report is available here (PDF).

The VA will be opening enrollment for all veterans exposed to toxins while serving in the military. This is an expansion under the PACT Act, which was passed in 2022. Enrollment begins March 5 and is expected to make VA benefits available to millions of veterans.

STATE PLAN AMENDMENTS:

Every state is required to have a state plan outlining how they are going to administer their Medicaid program, which must be approved by CMS. Whenever a change is made, such as an increase in rates or an expansion of the program, they must get the change approved. These documents are known as state plan amendments (SPA). A more thorough description of the process can be found here. A few notable approvals from CMS over the last few weeks (all are direct links to the PDF):

• Hawaii: The transition to PDPM based rates.

• Indiana: A different payment methodology.

• Maine: A one-time payment bump.

• New Hampshire: Quarterly approval related to the state’s MQIP program.

• North Dakota: A rate increase.

FROM THE NOTEBOOK:

• HealthAffairs posted a blog outlining all the changes contained in the CMS proposed rule from November covering dual eligibles. It’s a good summary of the changes.

• NPR took a look at the Consumer Financial Protection Bureau (CFPB)’s efforts to tackle health care debt.

• Despite all the efforts that we’ve been tracking on PBM legislation, any meaningful reform appears unlikely in the short-term. Fierce Healthcare looked at the long-term forecast.

• It’s not just the US that’s expected to experience a silver tsunami. A new report out of Canada is forecasting a big new demand for home health care.

• Fox News examined accelerated training programs designed to create more nurses in 1 year.

• SNF’s in Ohio are suing the state Department of Medicaid for shortchanging facilities. All the legal documents related to the case can be found here.

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