Happy New Year to all!

WHITE HOUSE:

Over the last few weeks, the White House focused on a new $10 billion investment to modernize the USPS, a new strategic plan targeting homelessness (available here as a PDF), more energy efficiency standards (this time related to light bulbs), and signing a whole bunch of Congressional legislation. Two items of interest:

• They published a 2022 in review blog post, outlining their big-ticket items from the past year. It’s an interesting look at what the Administration sees as “success” and provides insight into their thinking for next year.
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• Among the many bills signed by the President is the Small Business Cyber Training Act, which requires that federal small business development centers build out their cybersecurity teams. In theory, this could allow facilities to tap into federal expertise on navigating cybersecurity challenges.

CONGRESS:

The big news out of Congress was the passage of the $1.7 trillion omnibus government funding bill. You can access the Congressional overview of the many different pieces of the bill here (PDF). The Hill has a good overall picture of what made it into the bill and what didn’t make the cut, while Fierce Healthcare and Politico have summaries of the healthcare specific pieces. The American Hospital Association has a summary of the full slate of healthcare provisions (PDF). For our purposes, three specific items:

• Medicare cuts were reduced to 2% next year (2023) then an additional 1.25% the following year, for a total of 3.25% in 2024.

• Congress is now allowing states to begin the process of removing folks from Medicaid roles, called “unwinding”, starting on April 1, 2023, as well as phasing out the enhanced FMAP match in three successive financial quarters (5% starting April 1, then 2.5% the next quarter and finally 1.5% in the final quarter of 2023) with a formal termination on January 1, 2024. This is a good summary of these specific provisions. The Center on Budget and Policy Priorities also has a solid overview. Fierce Healthcare explores some of the granular requirements related to the unwinding.

• Congress included a fix to the Electoral Reform Act to clarify some of the issues that happened following the last presidential election.

As we move into 2023, a few other notes from Congress:

• The vote for GOP Speaker is scheduled for tomorrow (Tuesday, January 3^rd). The likeliest scenario remains Congressman McCarthy becoming Speaker, but the negotiations behind-the-scenes continue to play out.

• One key part of the Inflation Reduction Act was giving Medicare the ability to negotiate drug pricing. Politico looks at how it will play out over the next year.

• In July 2021, the FDA approved Aduhelm, a new Alzheimer’s drug from Biogen, despite scarce proof that it actually worked. As a result of the controversy, CMS provided very limited scenarios where they’d approve paying for the treatment. Following the entire brouhaha, the Joint Congressional Committee on oversight released a report critical of the FDA’s process, which may impact future approvals. The full report is here.

• After nearly three years, Capitol Hill will, once again, be open to the public.

• The strong performance by Democrats in the midterm elections also extended to the state level.

• While Democrats won a majority of seats at the state level in Pennsylvania, the razor thin margin is leading to chaos in the state house, and it’s unclear who will actually be the Speaker there.

Two interesting Congressional Research Service reports were recently issued (links are direct to PDF):

• An updated version of their primer on Medicare FFS rules, including citations to all the latest federal action.

• An analysis of a recent study analyzing income levels for folks 65 and older, information that may shape trends for Medicaid eligibility.

AGENCIES:

HHS issued a new rule governing religious beliefs and non-discrimination in a healthcare setting. You can access a pre-publication version of the rule here (PDF), which will be available at the Federal Register starting January 5^th with a 60-day comment period.

HHS also issued a proposed rule to standardize the format for electronic health records. A fact sheet is available here. The full rule can be accessed at the Federal Register, with comments open till March 21^st.

The OIG at HHS released an analysis of providers claiming bad Medicare debt on their cost reports and their lack of compliance with federal requirements. You can access the full report and report in brief (both PDF).

CMS created a new database of information related to ownership transparency for hospitals. This is like the ownership database they created for SNF’s and is part of the administration’s philosophy related to ownership of healthcare providers. It can be accessed at the CMS data site.

As part of the No Surprises Act, CMS is required by law to produce an annual report on the IDR process. The report is available here (PDF).

OTHER:

• We’ve been monitoring states that have introduced their own public health insurance option. Politico did a year-end analysis on those programs.

• It’s nice when a SNF is in the news for good things!

• The Denver Post reported on a visit by HHS Secretary Xavier Becerra to a SNF in Denver their discussion regarding the latest with Covid-19 and SNF’s.

• Nevada’s nursing shortage has prompted the local hospital association to push for more changes to the multi-state nursing compact, although it doesn’t solve the core problem: there simply aren’t enough qualified nurses.

• Unrelated to healthcare, but important from a news perspective, Axios looked at the traditional Friday afternoon news dump and how the strategy is changing.

• Cleaning up the end-of-year notebook, an important look at the finances of taking care of the elderly from the perspective of a family member.

• Finally, Next Avenue, a non-profit publication specifically for older adults, published an analysis of the efforts by the Moving Forward coalition related to SNF reform.

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