WHITE HOUSE:

The White House focused this week on the ongoing federal response to the train derailment in Ohio, a new executive order related to racial equity efforts and a new effort to create standards and charging stations for EV cars. One indirect note for us:

• They highlighted a new report from the Consumer Financial Protection Bureau (CFPB) highlighting a downward trend in Americans with medical debt (PDF of the report available here). For our purposes, their release showcases some of the programs we’ve mentioned over the last few months on different state and local programs to help individuals with medical debt. Your staff and residents might appreciate learning more about these programs.

CONGRESS:

With yet another federal report about the US hitting the debt ceiling around July, the conversations regarding how to negotiate for the debt limit continue to consume most of the oxygen in DC. The report also highlights another major challenge: Social Security and Medicare spending are expected to increase over the next ten years.

As highlighted by Senator Rick Scott’s turnaround on Medicare (after taking fire from everyone, as mentioned last week, he changed course to exclude cuts to Medicare), cutting Medicare is not politically appealing and not likely to be touched in any budget discussions despite noise to the contrary regarding entitlement programs. For now, the path forward remains unclear. You can access the full CBO report here (PDF).

A few other notes:

• Leading Age made a very public push this week to advocate for making the 3-day stay waiver permanent. You can access a copy of the letters sent to the HHS Secretary and the Congressional leadership for both parties (PDF download).

• The Senate’s HELP Committee held a hearing on the health care workforce crisis. The focus was primarily on education and ways to reduce barriers to entry into the workforce.

• The Senate Commerce Committee held a hearing on Pharmacy Benefit Managers (PBM’s).

• With the formal announcement by Nikki Haley that she’s running for President, our first two nominees are in. Speculation on other potential candidates remains rampant, but nothing official from Governor DeSantis yet. On the Democratic side, at least publicly, no obvious challenger to President Biden has gone public yet.

• While not focused on the SNF industry, there’s an interesting piece of legislation gathering steam in Congress focused on increasing SNAP benefits for military families. There may be some ancillary benefits to our residents and staff should the bill pass.

• We mentioned in the leadup to the Midterms that a divided Congress would likely end up with more oversight and regulatory hearings (as opposed to substantive legislation). A leaked GOP memo this week confirmed that strategy.

• Another point that came up often was GOP candidate quality. The GOP continues to strategize how to raise the level of candidate moving forward.

• After their analysis of the Republican Party, 538 did a deep dive into the political makeup of the different factions with the Democratic Party.

• One interesting Congressional Research Service report from this week on non-citizen eligibility to SSI. You can download a copy here (PDF).

AGENCIES:

Quite a busy week out of HHS & CMS:

• CMS proposed new transparency reporting rules for SNF ownership that would require disclosure of ownership information. A fact sheet is available here and the rule is available for comment at the Federal Register.

• HHS announced 3 new models that will be tested through the CMS Innovation Center to lower prescription drug costs. They’ve made available a fact sheet, full report and FAQ’s on the efforts (PDF downloads).

• The Office of Civil Rights (in charge of HIPAA) released their annual report to Congress on HIPPA compliance.

• Following up on their efforts regarding MA plans, and pushback by MA providers on the plan, HHS released a central hub to clarify their goals. It’s a helpful one-stop shop to see all their different goals for MA plans.

• Not sure if this impact residents, but CMS issued a National Coverage Determination (NCD) that allows Medicare to pay for power seat elevation on wheelchairs. The full NCD is available for comment for 30 days.

• Finally, following up on the court ruling we mentioned last week in favor of providers on the No Surprises Act, CMS has paused the implementation of their IDR process related to payment disputes. The formal notice is here.

MISCELLANEOUS:

• With the news that the PHE is ending, the White House is exploring post-PHE plans for the uninsured. Politico looked at the scene in SNF’s three years into the pandemic. The NY Times explored the implications for seniors in a post-pandemic world.

• Continuing the theme that challenges to the industry aren’t limited to the US, another Canadian province has announced a complete review of their long-term care system.

• Highlighting again the access problems that the entire healthcare system has when SNF’s are underfunded or unavailable, a report out of Montana on the bottleneck in hospitals when SNF’s close.

• An up-to-date exploration of the potential impact on Medicaid beneficiaries when the PHE ends.

• Several California legislators want to introduce a $25 minimum wage for healthcare workers.

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