WHITE HOUSE:

The White House focused this week on new national regulatory standards for cleaner water, a new executive order on gun violence (summary here), and calling for more accountability on the banking sector (in response to the recent failure of SVB and several other banks). Two items of interest to us:

• More below on the specifics of the drug plan, but they pushed new data showing that prescription drug prices are continuing to decrease as a result of the Inflation Reduction Act, in addition to getting the primary insulin makers to cap the costs for the public, regardless of insurance plans. Overall, it’s an important trend to monitor. (Important aside: If you want a wonky, behind the scenes look at how federal policy impacts private company drug pricing, here’s an in-depth look at why the pharma companies agreed to lower their prices. Short version is that it wasn’t altruistic of them).

• In the past, we’ve mentioned their efforts to increase access to broadband, especially in rural communities. They announced the release of another $73 million in funding to increase public access to the Affordable Connectivity Program. As many of your residents, staff and their families may benefit from these programs, they’ll probably appreciate hearing it from you. The website for the public is here.

CONGRESS:

As we’ve mentioned many times, the divided Congress is making passing any legislation a daunting task. While the GOP’s big energy permitting legislation was formally introduced earlier this week, it’s clear that getting it through the Democrat Senate is an uphill battle. In the meantime, the fight over which party is more protective of Social Security and Medicare continues unabated. For our purposes, the political popularity of the programs was underscored this week with a new poll that showed 88% (!) of Americans opposed any reduction in spending on the programs, an important point to consider as the discussions on the federal budget continue. Elsewhere from the political scene:

• Tracking federal immigration efforts, a new GOP effort to find common ground in the party.

• With several Senate Democratic seats opening up in 2024, there are repercussions for Democrat’s plans for the House as Congressional members leave the House to run for the open seats. Having said that, in Michigan, it looks like support has crystalized around Congresswoman Elissa Slotkin as their presumptive candidate in the race to replace Senator Stabenow.

• In the ongoing 2024 presidential campaign, former President Trump continues to see Governor DeSantis eat away at his lead, even as supporters filed a complaint arguing that Governor DeSantis is running a “shadow campaign” and causing angst among the Florida Congressional delegation who will eventually have to choose sides. On the Democratic side, President Biden’s continues his centrist approach, calculating that he’ll have the party’s overall support.

• An interesting profile on how Congressman Patrick McHenry (R – NC) has matured from a far-right wing conservative to a more effective political figure in the wake of the SVB banking crisis. It’s a good look at how crisis shapes elected officials.

• Finally, with several healthcare items on the Democratic wish list in the rear-view mirror (such as allowing Medicare to negotiate drug prices), it’s not clear what the next big-ticket item is going to be.

One interesting CRS report from the week. An updated guide to the health insurance exchanges, which may be valuable for folk that are going to be impacted by the unwinding.

AGENCIES:

As mentioned above, HHS announced the next steps in the program allowing Medicare to negotiate drug pricing. You can access copies of the fact sheet, timeline, and formal guidance (PDF downloads). CMS also published their own fact sheet with more specifics on the plan.

HHS also announced 27 Part B prescription drugs that are subject to the rebate provisions in the Inflation Reduction Act, which require manufacturers to pay Medicare a rebate when they raise drug prices faster than inflation. Specific to this week’s announcement, you can access a copy of the fact sheet on the guidance to the rebate program, the list of Part B drugs covered, and a fact sheet about the Part B rebates. CMS created a central resource page for all information related to the inflation rebate program.

Concurrent with both announcements related to lower drug prices, HHS, via the Assistant Secretary for Planning & Evaluation (ASPE), issued a new report showing the cost savings resulting from the Inflation Reduction Act. You can access a copy of the report here (PDF).

While not geared to SNF’s, LIHEAP (Low Income Home Energy Assistance Program) is a federal program that helps low-income households with energy costs. HHS announced the release this week of another $560 million in funding for the program this week. As many of your residents and staff may be eligible for the program, they may appreciate hearing about it from you. Eligible applicants can apply here.

Finally, HHS, via the Substance Abuse & Mental Health Services Administration (SAMHSA), announced $15 million to 15 states to plan new Medicaid programs for Certified Community Behavioral Health Clinic (CCBHC) with 10 states being chosen in 2024 for enhanced Medicaid reimbursements for treatments in these clinics. If you’re in one of the chosen states, there may be opportunities to partner with the states.

Three of CMS’ top officials penned a blog post announcing a new focus on patient safety across all health care providers. The post was more general in nature and short on specifics.

As part of their annual budget request, the OIG at HHS released their “justification” for their budget to Congress. You can access a copy here (PDF). As expected, their investigatory work of SNF’s gets prime placement.

In an unexpected ruling, the VA announced that they would cover a new Alzheimer’s drug for veterans that fit certain criteria. The coverage determination was unexpected after Medicare choose not to cover earlier Alzheimer drugs.

FROM THE NOTEBOOK:

• Kaiser Health News looked at state efforts to cap price gouging by staffing agencies.

• The Kaiser Family Foundation reported the latest results of their annual 50-director Medicaid survey, which provides valuable insight into the latest information on the program.

• An in-depth read on how MA plans use of algorithms and AI is leading to denial of necessary care.

• An exploration of the impact prior authorization requirements have on healthcare.

• MEDPAC released their March report to Congress. This is the section on SNF’s (PDF download).

• Using KFF’s useful Medicaid waiver tracker, Axios looked at the next states that may get a Medicaid waiver for food programs.

• The National Conference of State Legislatures (NCSL), which provides support to state legislature across the country, updated their guide on direct care workforce strategies that are being employed across the country.

• Not sure what this looks like practically, but Google announced that they are making more efforts to support folks searching for information related to the Medicaid unwinding.

• Finally, we mentioned a few weeks ago about North Carolina becoming the latest red state to expand Medicaid. A fascinating op-ed from Republican State Senator Phil Berger on why he went from being one of the biggest opponents to the bigger supporter of the expansion.

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