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SNF Digest|Clinical|Finance|Reimbursement|Compliance|Operations

SNF Digest #67

Freestyle6 min readNov 19, 2023

In observance of Thanksgiving, there will be no Digest next Monday. We will return on Monday, December 4th.


WHITE HOUSE:


The White House focused this week on combating rising antisemitism, particularly on college campuses, the President’s meeting with President Xi of China, and issuing a new “National Spectrum Strategy” (PDF) to plan out future wireless technology innovation. Two items of interest for us:



  • While not an actionable item per se, they issued the first ever Presidential Memorandum outlining the President’s perspective on worker’s rights, both domestically and abroad. It’s an important insight into the current Administration’s mindset as it relates to labor unions.


CONGRESS:


It looks like new Speaker Mike Johnson has gotten through his first major hurdle with the formal passage and signing of a two-tiered continuing resolution (CR) to keep the government funded. The CR extends government funding, at current levels, through January 19th for four agencies and till February 2nd for the rest of the government (including HHS). Despite the passage of the CR, behind the scenes, the Republican majority is in disarray with no clear governing path. The CR only passed with significant Democratic support, something that cost Kevin McCarthy his job. While Conservatives are not yet ready to push out the new Speaker, their frustrations are mounting and led to Congress leaving town earlier than expected for the Thanksgiving break. For now, we get a break from the constant government shutdown worries, but with a lot of work to do, expect another round of government shutdown talk as we get closer to the deadlines. Elsewhere in the political world:


  • Historically, major healthcare legislation gets included in year-end spending bills. This year, with no major immediate government shutdown threat, Axios took a look at where major Congressional healthcare legislation currently stands.



  • A group of bipartisan Senators, led by Senators Thune (R – SD) and Klobuchar (D – MN) introduced a new bill that would direct federal agencies to create new standards governing AI. A copy of the bill is available here (PDF).


  • With the President’s reelection campaign stagnating, and questions about his ability to win reelection circulating, the Washington Post looked at which alternate Democrat can actually win in 2024.


  • 538 explored what, if anything, the 2023 elections actually tell us about the 2024 elections.


  • Two interesting CRS report from the week (links are to the PDF):



  • R40611: An updated version of a CRS report summarizing the Medicare Part D Prescription Drug Benefit.


AGENCIES:


CMS issued the final rule related to SNF ownership transparency. The rule fact sheet can be found here. The full final rule is available at the Federal Register for download (PDF). In conjunction with the final rule, they also released research regarding trends of ownership and care. You can download a copy here (PDF).


HHS established a new advisory committee on Long Covid and is looking for nominations to the committee. More details are available in the official notice (PDF) published at the Federal Register.


Over the last number of months, it’s been clear that federal and state agencies are exploring using Medicare and Medicaid programs to tackle non-traditional uses, for example, to support affordable housing or address hunger. HHS released a full playbook on their goals of using federal program to deal with “social determinants of health” (PDF). It’s an interesting look at where the Administration wants to deploy federal healthcare dollars.


CISA (Cybersecurity & Infrastructure Security Agency) released a new mitigation guide (PDF) to help healthcare agencies navigate cyber threats.


The OIG at HHS released an audit of Pennsylvania SNF’s compliance with life safety, emergency preparedness, and infection control requirements, finding that the state could do a better job ensuring compliance. Here is the summary (PDF) and full report (PDF).


FROM THE NOTEBOOK:


  • The Kaiser Family Foundation released their annual survey of Medicaid Directors and found that they expect a sharp decline in Medicaid enrollees. The full brief is here.




  • Even the folks who worked for CMS have a tough time navigating Medicaid eligibility.


  • A lawsuit was filed against UnitedHealth that alleges their usage of AI in an algorithm systematically led to MA denials for seniors.


  • The Kaiser Family Foundation and the NY Times have a new joint series called “Dying Broke”, focusing on the high cost of senior care as well as stories from caregivers. It’s an important perspective that highlights the need for more investment by policymakers in long-term care.


  • With the federal staffing mandate now under consideration by CMS, a look at the real-world victim of a state staffing mandate, underscoring yet again that staffing mandates are not a solution to the staffing crisis.


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.


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SNF Digest #67

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