WHITE HOUSE:

The White House focused this week on developing their relationship with India, announcing more infrastructure projects (including in New York), and new initiatives as part of the Cancer Moonshot initiative (their new efforts to tackle cancer). Several items of interest:

• The big news, of course, was the formal announcement by the President that the PHE will end on May 11^th. The notice is available here (PDF). While the 6.2% FMAP increase was decoupled from the PHE by the year-end omnibus bill, and is on a quarterly path down to zero in January 2024, ending the PHE will end the 1135 waivers. Both RollCall and McKnight’s have good summaries of what the end of the PHE means for SNF’s.

• On the 30^th anniversary of the Family and Medical Leave Act (FMLA), they announced a new Presidential Memorandum that provides expanded access to FMLA leave to federal employees. While not targeting the non-government sector, it may increase the push for more leave in the private sector.

• A new proposed rule from the Consumer Financial Protection Bureau (CFPB) to cut late credit card fees. This may help your staff and residents.

• A new call to increase competition in the mobile app space (i.e. reduce dependence on Apple/Google). The full report is here (PDF). As many of you work with software developers, it’s worthwhile to monitor.

CONGRESS:

As the US gets closer to the debt ceiling, Speaker McCarthy had his first meeting with the President to start the negotiations. It’s still early in the process, but speculation on the different paths to an agreement is rampant. For our purposes, one important point is that McCarthy has publicly said the GOP won’t touch Medicare as part of the discussion. At the same time, the GOP itself is struggling to unify around a budgetary goal for the conversations. Regardless, the conversation continues to drown out everything else in DC. A few other interesting notes:

• It would appear that Democrats are going all in on President Biden as their nominee in 2024.

• The Republican side received a jolt this week when news broke that Nikki Haley will be announcing her Presidential campaign on February 15^th. For now, the GOP field looks like it’ll be relatively small. Meanwhile, former President Trump continues to take shots at his foremost competitor, Governor Ron DeSantis.

• A look at the state political agendas for potential presidential contenders among current governors.

• We mentioned a few times over the course of the 2022 Midterms the problems the GOP was having with candidate quality. It looks they’re finally making a move to shore up their candidates.

• While most of the focus is on the House, where the debt ceiling negotiation will take place, the Senate finally got back to work this week with the formal organization of committees.

• Finally, an interesting look at the modern GOP and how their ideological positions are structured.

AGENCIES:

HHS, through CMS, released their final rule that governs MA plans. CMS also issued a press release along with a fact sheet. The full final rule can be accessed at the Federal Register here (PDF).

HHS released a “snapshot” on their efforts in 2022 to “build a healthier America”. It’s a useful PDF that shows all their different programs over the last year. You can download a copy here (PDF).

HHS warned the health sector about increased risks of cyberattacks. You can access a copy here (PDF). Please make sure your IT teams are aware.

CMS released an advance notice for proposed payment rates for 2024 and Medicare Part D. A fact sheet is also available. The full notice, along with a zip files with county by county percentages can be accessed here.

The Government Accountability Office (GAO) released an analysis of supplemental benefits offered by MA plans. Fierce Healthcare has a summary of the report.

The Federal Trade Commission announced a new HIPAA enforcement action against GoodRX. For those involved in digital health apps, it’s an important trend to monitor.

MISCELLANEOUS:

On the non-agency front:

• A worthwhile long read on how California, along with a few other states, are starting to manufacture their own insulin. If successful, this could have an enormous impact on the pharmaceutical industry.

• Kaiser Health News took a deep dive into how immigration can be a key part of the solution to the long-term care staffing crisis.

• MACPAC released their annual Databook with an overview of dual eligibles. You can download a copy here (PDF).

• A new study looked at psychiatric care, or lack thereof, after admission into a SNF.

• Following up on last week’s note about the fake nursing diploma mill, states are tracking down employees utilizing the degrees.

• The medical leaders across CMS proposed a “universal foundation” for quality measures in the New England Journal of Medicine.

• Challenges affecting the long-term care industry are not limited to the US. Canada is struggling with many of the same issues, with a panel issuing new recommendations including higher pay and more direct care hours.

• The American Hospital Association released their 2023 advocacy agenda, available as a PDF here. It’s always worthwhile to see what the hospitals are focusing on.

• An interesting use of ARP funding out of CT. The Governor wants to use $20 million to cancel medical debt for CT residents.

• VA is making an effort to ease the regulatory requirements for CNA’s in the state as they tackle their nursing shortage.

• Finally, AZ is investing $5.5 million in a new accelerated program to graduate more nursing students in one year.

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