There will be no Digest next week. The Digest will return on July 24^th.

WHITE HOUSE:

With July 4^th this week, it was extremely quiet on the political front. The White House focused on the Hudson Gateway project (announcing nearly $7 billion for a project to rehabilitate mass transit between NY & NJ), continuing to tout their infrastructure investments, and meeting with a wide swath of union leaders to discuss how AI will impact union jobs. One item of interest to us:

• I’ll go into more detail in the agency section below, but they announced a series of new regulatory actions from several federal agencies designed to protect consumers from unanticipated health care costs.

CONGRESS:

With Congress out of town for the second week in a row, it remains quiet in DC. For the most part, Congressional members kept out of the press and enjoyed the holiday. On the bigger topic of the pending federal spending shutdown, one interesting strategy for the GOP appeared: potentially passing a short-term spending bill to give themselves more time and flexibility in building a consensus with their very slim majority. Although it can get a little wonky, these strategic discussions can have meaningful impact on federal funding. As always, until there’s a more concrete deadline, we’re likely in for a summer of posturing. Elsewhere in the political world:

• An interesting new bill was introduced by Congressman Jim Costa (D – CA). The bill would create a nursing task force to provide recommendations on how the country can address the healthcare staffing shortage. You can download copies of the legislation and summary (both PDF).

• A while back I shared the map of federal infrastructure projects and investments. The Department of the Interior released their portion of funding grants this week. It’s a useful tool to see where the feds are investing funds.

• Highlighting the struggles of the GOP’s slim majority is infighting between the conservative members of the House Freedom Caucus. The uncertainty is impacting their ability to build a consensus for how to approach the funding conversations.

• One item that pops up frequently during state legislative budget season (for example, in Wisconsin this week) is a Governor’s “line-item” veto power. The Hill has a good explainer of what it means and the power it has.

• One of the newest, most conservative, Republican members of the Senate is teaming up with one of the most liberal democrats in an intriguing push. While the legislation doesn’t directly impact LTC, it’s an indication for how political interests can align when there’s a motivation to make something happen.

• We often track how other advocacy groups tackle the geopolitical challenge of a divided country and bring legislation to potentially adverse areas. In that vein, Politico did a deep dive into the strategies that marijuana legalization advocates are pursuing in unfriendly states.

• Medicaid work requirements in Georgia began this past week. It’s going to be closely watched as a test case for how work requirements interact with Medicaid beneficiaries, especially with other states, like Ohio, exploring the same type of program.

• A look at the Congressional road map for 2024 and the difficult electoral math for Democrats, especially in the Senate.

AGENCIES:

Following on their earlier conditional approval, the FDA gave formal approval to Leqembi to treat Alzheimer’s. This is notable in that it means Medicare will pay for the treatment under specific conditions. There are already political murmurings about those conditions and whether to expand them.

As part of the White House’s regulatory efforts mentioned above, HHS released a proposed rule covering short-term insurance programs that offer limited healthcare coverage. CMS has a fact sheet explaining the rules.

HHS also released the first annual report on the impact that the No Surprises Act has had on the health care market. You can download a copy here (PDF). CMS also released an updated FAQ on the No Surprises Act (PDF).

Earlier this year, we tracked the successful lawsuit against HHS for the 340B drug program. CMS released a new proposed rule in response to the suit. The rule will be published to the Federal Register on July 11^th and comments will be accepted for 60 days. You can access a copy of the draft rule here (PDF).

The Consumer Financial Protection Bureau (CFPB), along with several other agencies, sent out a Request for Information (RFI) on consumer payment plans in the medical device and health market. You can download a copy of the RFI here (PDF).

The National Association of Home Care & Hospice filed a lawsuit against CMS challenging CMS’ rate cuts for home health benefits. It’s an interesting tactic to monitor for potential application to other payment rules. You can download a copy of the lawsuit for your legal advisors to review (PDF).

FROM THE NOTEBOOK:

• Axios looked at what the potential CMS staffing mandate means for unionization efforts among SNF workers. An early case study is Pennsylvania, where the state’s minimum staffing rules went into effect on July 1^st.

• With so many states providing Medicaid reimbursement increases, McKnight’s has an important read on the need to sustain advocacy and help lawmakers recognize just how challenging the environment is.

• With the approval of Leqembi, the Kaiser Family Foundation did a deep dive into the market for Alzheimer’s drugs and what it means for Medicare beneficiaries.

• Health Affairs looked at D-SNP’s and how it impacts the market for dual eligibles. You can access a copy here (registration required).

• The Los Angeles Times looked at the state’s new plan to assist inmates in accessing the state’s Medicaid program.

• The NY Times explored a new model for dementia care.

Registration for the 2023 Zimmet Conference at Mohegan Sun from August 9^th – 10^th is now open! Topic this year is “Roaring Reimbursement”. You can find more information and register at the conference site.

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