Happy Hanukkah!

WHITE HOUSE:

The White House focused this week on a new $8 billion investment in a West-Coast high-speed rail project, their ongoing commitment to Israel, and more support for tribal nations, including a new Executive Order designed to simplify how the federal government funds Tribal nations. One item of interest for us:

• A key Administration priority has been to lower health care costs. As part of that effort, they announced a new series of actions to promote competition. There are two items of particular relevance:

• 1) They are exploring how to use “march-in” rights that would allow the federal government to override patent law on projects, such as pharmaceuticals, developed using federal funding. The proposed rule is available at the Federal Register, where comments can be submitted through February 6^th.

• 2) They are launching a new cross-agency investigation into the intersection of private equity and healthcare, that includes the FTC, DOJ, & HHS. To that end, the three agencies will be sending out a joint Request for Information (RFI) that will serve as a basis for future regulation.

CONGRESS:

With former Speaker McCarthy’s announcement that he’s leaving Congress before the end of the year, the GOP majority is down to 3 seats. With two more seats up for grabs (expelled NY Congressman George Santos and leaving OH Congressman Bill Johnson), the math for new Speaker Johnson in finding a funding deal is that much tougher. While the Senate continues to look for common ground in funding talks, the federal funding numbers aren’t pretty if the two sides can’t come to an agreement. With the last day of session for the House on Thursday and the Senate on Friday, talks will likely continue off the record through the end of the year. Elsewhere in the political world:

• In addition to the White House’s efforts on private equity, Senators Whitehouse (D – RI) and Grassley (R – IA) announced a bipartisan investigation into private equity’s ownership of hospitals. They sent letters to five different PE firms that are involved in hospital acquisitions and ownership. Fierce Healthcare has a good summary of the dual federal efforts to explore PE and hospitals.

• Senator Tester, along with Senators Joe Manchin, Susan Collins, and Angus King, joined in with Senator Deb Fischer’s ‘Protecting Rural Seniors’ Access to Care’ legislation that would prevent CMS from implementing the minimum staffing rule. This is the Senate companion version of a House Bill introduced by Minnesota Congresswoman Michelle Fischbach. This continues to add to the political pressure on the White House in finding a reasonable path forward on the minimum staffing rule.

• With inexperienced Speaker Mike Johnson in for a rough ride as he leads the GOP through, NBC provided a good look into his world.

• As progressive incumbents face serious primary challenges owing to their stance on Israel and over 40 Congressional members (between House & Senate) leaving Congress, it’s worth noting that spending on political ads is expected to exceed $16 billion this year!

• The NY Times had a good summary of all the different government approaches to regulating AI. Meanwhile the EU finalized their Artificial Intelligence Act.

• One interesting CRS Report (PDF): An analysis of the industry response to the Medicare Drug Pricing provisions in the Inflation Reduction Act. Many of the initial drugs selected for negotiation are heavily utilized by seniors.

AGENCIES:

At an open door forum this week, CMS suggested that they’re going to evaluate new survey processes in order to help surveyors more efficiently complete their surveys. Both McKnight’s and Skilled Nursing News have summaries of the call. The need to rethink how surveys are done and minimize the delays in the process was highlighted in an excellent guest column at McKnight’s by Steven Littlehale of Zimmet Healthcare Services.

CMS issued an interim final rule (PDF) that would allow them to withhold Medicaid funding from states that don’t comply with federal rules related to Medicaid unwinding. Becker’s has a summary.

HHS released a new concept paper outlining their plans to strengthen cybersecurity for the healthcare industry. The full paper is available here (PDF).

FROM THE NOTEBOOK:

• The Wall Street Journal did a deep dive into Medicare Advantage and how it appears that the business side is slowing down.

• A look at a new effort by an Ohio based SNF to use robots to help alleviate staffing shortage. The program is funded by a local Canton based agency.

• CVS is exploring a new pricing model for its drugs called Costvantage. Fierce Healthcare has a good summary of the model and how it compares to similar models, such as Mark Cuban’s Cost Plus.

• A good look at the fundamental shortfalls in Medicaid funding through the prism of a 50 year old non-profit that is holding bake sales to cover the gap.

ECAP INTEL TOOL OF THE MONTH: Medicare Part B Reimbursements

z-INTEL has released detailed Medicare Part B therapy reimbursement for every SNF in the country. As Intel draws directly from distinct CMS datasets, SNFs can measure Part B reimbursement against rehab department expenses. This analysis is critical for therapy contract pricing, long-term Quality Measures, and ISNP financial performance. The information can be found under the Part B billing tab for each facility.

Questions? Email us at support@myzpax.com.

z-INTEL WhatsApp info:

• Group Invite Link: https://chat.whatsapp.com/EoNiPi8ezrOBV6SW1Gf7nD
• Status Link: https://wa.me/message/WMSWZATTB5D6E1