WHITE HOUSE:

The White House focused this week on new counter-terrorism efforts against weapons of mass destruction, increased pandemic anti-fraud efforts, and highlighting their efforts to expand broadband access. Two items of note for us:

• The Administration released a vast new national cyber-security strategy. The primary focus of the plan is to shift responsibilities for fighting cyberattacks from small businesses onto government and large-scale organizations that are more equipped to fight it. As healthcare is a primary target of cyberattacks, it’s something to keep an eye on. You can read the full strategy here (PDF download).

• In response to the ongoing chatter from the GOP regarding their plans for Medicare that we’ve mentioned the last few weeks, the White House posted the President’s official response. One line from the post that I found interesting: “Research shows that when nursing homes are paid less, residents get worse care.”

CONGRESS:

As to be expected in a divided government, it’s been relatively quiet in Congress. One notable piece of bipartisan legislation was a rail safety bill introduced by Senators Brown (D – OH) and Vance (R – OH) and supported by the President. For our purposes, the interesting part is that the bill is a collaboration between Senator Brown, a long-time Washington fixture, and Senator Vance, a new conservative Republican, who won a bruising race. On the debt ceiling front, the House Freedom Caucus, a group of far right conservatives, are working on a budget framework that will continue to cause difficulties in finding common ground on debt ceiling negotiations. Elsewhere from DC:

• With the GOP back in charge, they’ve banned earmarks from new appropriations, which (ironically) will make it harder to pass spending bills.

• We’ve touched upon Congressional interest in PBM’s. This week, House Oversight Chair James Comer (R – KY) announced a new oversight investigation into the topic.

• While there’s only one official Democratic challenger to the President for 2024, 538 found that there’s definitely interest among Democratic voters to a real alternative.

• An interesting look at the potentially expensive ad costs in challenging races in 2024.

• Finally, we’ve talked a lot about the GOP’s investigative approach to the President. A fascinating, if “inside-politics” look from NPR on how the President defends against the investigations.

One interesting Congressional Research Service Report from the week: an updated look at minimum wages in states across the country. You can download a copy here (PDF).

AGENCIES:

CMS produced a very useful guide to when all 50 states are planning to begin their unwinding process. Once Medicaid renewals begin, states can begin removing beneficiaries from their Medicaid programs. You can download a copy here (PDF).

This is from a few weeks ago. It’s CMS’ letter to state officials providing guidance on the end of the Medicaid continuous enrollment requirement that states have been operating under. It contains many of the technical details related to unwinding. While not meant for SNF’s, it’s a good look at how a state will be required to deal with removing folks from Medicaid. You can download a copy here (PDF).

As we get closer to the May 11^th end of the PHE, CMS provided updated guidance on the end for individuals. You can download a copy here (PDF). It’s not specific to skilled nursing facilities but highlight many areas of import.

As discussion on the 3-day stay waiver continues, CMS’ Innovation center looked at spending on the waiver in ACO’s. You can access a copy of the study here (PDF).

CMS held a stakeholder call this week. McKnight’s has an accurate summary of the call, which focused mostly on the QSO from last month related to schizophrenia.

After the Inflation Reduction Act capped insulin costs for Medicare beneficiaries at $35 a month, Eli Lilly announced that they would follow. HHS highlighted the move in a press release.

One item that I missed last week: The DEA announced a new set of proposed rules that would tighten prescribing rules via telehealth.

The FTC posted a blog warning companies involved with AI to make sure that marketing claims related to AI are actually feasible and fit within their existing marketing guidelines.

FROM THE NOTEBOOK:

• We’ve talked a lot about unwinding. Arkansas takes the lead as a state that is pushing the hardest to get Medicaid renewals done ASAP.

• One new wrinkle in the battle against dropped census: CT wants to fine facilities for empty beds in an effort to get them to delicense unused beds.

• In the latest example of a Republican state looking to expand Medicaid, North Carolina announced a deal to expand the program.

• The Kaiser Family Foundation (KFF) took a look at Medicaid enrollment growth over the pandemic and who’s at risk of losing coverage. In a separate brief, they also looked at the entirety of federal spending on healthcare.

• Newsweek took a deep dive into the extensive backlog of inspection surveys.

• Finally, USA Today explored the nuances of SNF funding.

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