WHITE HOUSE:

The White House focused this week on the President’s “Roadmap to Support Good Jobs”, which includes the creation of 5 workforce hubs, state-specific fact sheets on infrastructure investments, and more federal action to reduce gun violence, outlined in a Presidential op-ed on the efforts. Two items of interest for us:

• They announced several new items related to the mental health crisis. While the primary focus is schools, they also launched programs through the Department of Labor (DOL) and OSHA to provide more resources to help employees with mental health and burnout issues.

• Following up on their December “ALL IN” (PDF) plan to end homelessness, they launched “ALL INside” which is designed to provide more resources to tackle homelessness, including leveraging Medicaid to provide state-level assistance. It’s a program to monitor as there may be opportunities to partner with state & federal agencies.

CONGRESS:

Following some early week optimism that there was movement on the debt ceiling discussions, there was a bit of back & forth over the weekend regarding negotiations, with a new round of talks scheduled for Monday (as of the time of this writing at approximately ~6 PM EST Sunday May 21) . Part of the early optimism was the hint that the White House was considering

budging on work requirements for the Medicaid population. There needs to be movement soon if there’s any chance of a deal getting voted upon before the Memorial Day break next week.

Elsewhere from the political world:

• A good reminder on why the debt ceiling conversations are so important for healthcare providers: The Washington Post went through federal obligations through the first week of June (the anticipated day the government would run out of cash) and $64 billion worth of Medicare/Medicaid payments are scheduled for then. The Hill also explored the debt ceiling conversation, specifically for healthcare providers.

• Talks of using the 14^th Amendment to avoid the debt ceiling crisis is facing pushback, both from the White House and more traditional business advocates.

• On the 2024 front, Senator Tim Scott formally joined the Presidental race, while Governor DeSantis is expected to officially launch his campaign this week. 538 did a deep dive into Florida legislative efforts under Governor DeSantis and what it means for a national electorate. An early poll had DeSantis in a good spot in a hypothetical 2024 matchup against President Biden.

• One potential wrench for DeSantis: the Democratic candidate won Jacksonville’s mayoral race, potentially showcasing local discontent with the Governor.

• The US Senate Special Committee on Aging held a hearing on the survey system this week, with Senator Casey released a report (PDF) arguing that more resources are needed to strengthen the system. The two-page summary is available here (PDF).

• The Senate Permanent Subcommittee on Investigations held a hearing on denials and delays in Medicare Advantage, calling out insurers for delayed payments and denials.

• The House Committee on Oversight & Accountability held a hearing on SNF mortality rates during Covid, although the focus appeared to be more on destructive state government policies , like New York’s, that forced SNF’s to accept Covid positive residents.

• Despite Senator Feinstein’s return to the Senate, the political intrigue around the push for her resignation continues to bubble, especially as it relates to her potential successor.

• The Energy & Commerce Health Subcommittee moved several pieces of legislation out of committee that focus on PBM’s and transparency-related bills. Axios & Politico have good summaries. Much like the Senate bills we mentioned last week, the bills likely won’t pass as stand-alone legislation, but pieces will find their way into a larger legislative healthcare package.

• While 2024 is the big year for elections, NJ will have several important races this year. A look at the races and what’s in play.

• Finally, both the Senate and the House are exploring how to regulate artificial intelligence, something that impacts those developing AI tools. The Senate Special Committee on Aging also sent a letter (PDF) to the FTC asking for information related to what the FTC is doing to protect seniors from AI-based scams.

Three interesting CRS reports this week on issues we’ve been tracking (links are to PDF’s):

• R47555: A full rundown on Medicare’s new ability to negotiate drug prices.

• R44954: A guide to the “Chevron Deference”, which the Supreme Court is looking at and acts as the legal authority for many federal agency actions, including those by CMS & HHS.

• R43414: An overview of the Older Americans Act (OAA) which governs many of the federal policies for older Americans.

AGENCIES:

We mentioned last week that CMS was initiating a review of Medicare payments (PDF). ECap Intel Co-Founder Marc Zimmet hosted a webinar this week on the review and what to expect, which may be helpful for your billing teams. You can access a copy of the webinar here (free registration required).

Following up on the White House’s announcement on mental health, HHS delved into the specifics of the plan. CMS posted a fact sheet, informational bulletin (PDF) and step-by-step guide for school districts(PDF).

CMS issued a National Coverage Determination (NCD) allowing Medicare to cover power seat elevation for wheelchairs, something that positively impacts those of you involved with DME.

State Plan Amendments (SPA) are the state plans for Medicaid that need to be approved by CMS and which govern approved funding uses by state Medicaid programs. A few interesting approvals from this week. All links are to downloadable PDF’s:

• Connecticut: covering the state’s funding for ICF/ID facilities.

• Missouri: covering the state’s new reimbursement system for SNF’s, as well as an increase in rates.

• North Dakota: covering the state's new nursing facility increase.

Two interesting items from the Federal Trade Commission:

• They added two GPO’s (Zinc Healthcare Services & Ascent Healthcare) to their ongoing PBM investigation.

• They issued a new warning about collecting biometric information. The full policy statement is here (PDF).

Finally, the VA announced they’ve renegotiated their agreement with the vendor responsible for modernizing their health records.

FROM THE NOTEBOOK:

• The Kaiser Family Foundation (KFF) released new research on Medical Loss Ratios and the expected $1.1 billion in rebates that they’ll issue this year. Axios has a good summary.

• JAMA published a study on dual-eligibles and how their Medicare/Medicaid utilization manifests, a study that can shape policy discussions moving forward.

• Health Affairs called on the White House to utilize funding grow the direct care workforce.

• An updated look at how the Medicaid unwinding is going.

• A deep dive into the over-the-counter (OTC) market for hearing aids seven months after the FDA finalized the rule permitting OTC sale.

• Crowe, a public accounting firm, released an analysis of delays by commercial insurers in payments. Fierce Healthcare has a summary of the report, which you can access here (PDF).

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