In observance of the end of year holidays, there will be no digest next week. Our next digest will be Monday, January 2^nd, 2023. Happy Holidays and Happy New Year!

WHITE HOUSE:

The White House worked this week on a new vision for the partnership between the US & Africa, with investments in health workforce, food security, trade and technology; a roundtable with state leaders on affordable housing, and signing HR 8404, the Respect for Marriage Act. For our purposes, two items of note:

• They released a new guidebook on the federal incentives and funding programs related to clean energy programs. As there may be programs that can be used to upgrade existing buildings and HVAC equipment, it’s worth exploring. You can download a copy of the guidebook here (PDF). They also created a central resource hub that will be updated with the latest information.

• They published a winter Covid-19 preparedness plan, that includes changes to whom at SNF’s are eligible to administer vaccines to residents. They also made available four more free at-home Covid tests. They plan on releasing a more formal guide shortly.

CONGRESS:

While Congress appears to be close on final negotiations for a government funding omnibus bill, they bought themselves a little time with an one-week extension. No details have yet been released on the funding bill, although reports peg the final numbers at around $1.7 trillion. The Omnibus bill will also include pieces from other legislative priorities, although it appears that immigration and federal marijuana banking reform isn’t going to make it in. In the meantime, Congress sent the $858 billion National Defense Authorization Act (NDAA) to the President, clearing one major item. Several other items on the Congressional front:

• One key Senate committee for the SNF industry is the Senate’s Health, Education, Labor and Pensions committee, which governs (among other items) Congressional healthcare policy. Politico looked at the priorities for the incoming Chairman: Senator Bernie Sanders. One interesting point: Both Senator Sanders and his GOP counterpart on the Committee, Senator Bill Cassidy (R – LA) expressed an interest in figuring out ways to tackle the nursing shortage.

• The ongoing saga of Congressman Kevin McCarthy’s effort to become the Speaker continues, with the repercussions impacting possible committee leadership roles. The Hill looked at multiple possible outcomes, although the likeliest remains McCarthy being elected Speaker.

• Although unlikely to move in the Senate, the House passed a bill that would give Puerto Rico a chance to vote on becoming a state. You can read the bill here.

• With the GOP taking over the House, Conservatives are exploring different paths to reining in government spending. One possibility: forcing the government to vote on every appropriations bill independently, as opposed to the current omnibus style.

• Another week and more fuel to the DeSantis for 2024 hype, along with speculation on what it means for the 2024 race.

• This may just be for those of us who actually wade through all those government reports, but a Congressional committee just tried a new tactic: they released a documentary along with a paper report.

• 538 did a deep dive into voting and Gen Z, an important item to consider as we move into a new election cycle.

AGENCIES:

As part of the Administration’s winter Covid-19 preparedness plan mentioned above, HHS Secretary Becerra wrote a letter to governors outlining steps to take, and resources available, to combat Covid.

HHS released nearly $50 million in awards to states to help build local support for the 988 lifeline.

HHS, via SAMHSA, proposed an update to federal rules to expand access to opioid use treatment. SAMHSA released an FAQ on the proposed rule, which is available for public comment at the federal register. You can access a copy of the 135-page rule here (PDF) and submit comments here.

HHS, via CMS, issued a proposed rule that would strengthen MA oversight and expand Medicare Part D coverage. They also released a fact sheet outlining the proposed changes. A 60 day comment period will start when the rule is formally published to the federal register on December 27^th. You can access a copy of the 957-page rule here (PDF). If you’d rather not read the whole rule, Fierce Healthcare has a summary.

For the data wonks, CMS released an analysis of 2021 health spending trends. The highlights are here (PDF) and the full dataset is available at their national health expenditure data site.

As part of the No Surprises Act, CMS established a “Ground Ambulance & Patient Billing” (GAPB) committee to provide recommendations on how to incorporate billing for ambulance providers. CMS announced members of the committee this week. The central GAPB page, with committee schedules and other information, is here.

MISCELLANEOUS:

On the non-federal agency front:

• Kaiser Health News broke down how the 2023 Medicare Physician Payment rule impacts Medicare coverage of dental services.

• Ohio passed a $6 billion budget that includes funding for SNF’s.

• NPR looked at the Medicare Advantage overcharges.

• KHN also did a deep dive into the exclusion system that OIG uses for oversight into healthcare providers.

• In another reminder that Covid and staffing shortages isn’t unique to the US, a look at the impact it had on homes in England & Scotland.

• KHN also looked at Covid vaccine numbers in SNF’s. This is particularly important now as the Administration has made vaccine intake a priority for enforcement.

• The NY Times looked at how a non-profit hospital created their own staffing shortage.

• Finally, a look at where Medicaid expansion efforts stand, through the eyes of Florida, after the recent expansion success in South Dakota

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