WHITE HOUSE:

With Thanksgiving this week, it was a relatively quiet week in DC. The White House announced several initiatives focused on strengthening the US-Philippines Alliance, another $400 million (already appropriated) in support of Ukraine, and increased strategic partnership with Thailand. For our purposes, one item of note:

• They announced a new six-week campaign to encourage more vaccinations. In addition to new funding to support helping older adults obtain vaccinations, there was new guidance issued from CMS on the requirements of SNF’s to offer updated vaccines to staff and residents. You can access the QSO here (PDF).

CONGRESS:

With two races still officially undecided, and the GOP leading in both, the final tally for the upcoming Congressional session looks to be 222-213, the exact opposite of the most recent Congress (which was 222-213 in favor of the Democrats). The unexpectedly tight GOP majority, combined with the Democratic majority in the Senate, is causing major concern about the upcoming December 16^th deadline to fund the government. It’s also having significant repercussions on any appropriations related funding, such as the raising the debt ceiling or funding election reform. Of course, there’s also the practical question of whether Congressman McCarthy can get the 218 votes needed to be speaker. In short, the likelihood is that outside of the consensus “must-pass” bills, like defense authorizations, we’re in for two years of little Congressional action. A few other notes from Congress:

• The National Association of Medicaid Directors (a trade association in DC that provides support to state Medicaid agencies) asked Congress to codify several items related to ending the PHE. You can access a copy of the letter here (PDF).

• The Senate Finance Committee released a statement on the heels of the OIG report we mentioned last week regarding the use of psychotropic drugs in SNF’s.

• Speaker Nancy Pelosi’s retirement highlighted the need for younger leadership among Democrats. A major challenge on the Presidential side is the lack of a natural successor to President Biden.

• With Democratic control of the Senate secure for two more years, Senate Leader Schumer is exploring the best way to set up his leadership group.

• On the GOP side, there’s little Senate support right now for another presidential run from former President Trump, with several other non-obvious folk considering a run. The most obvious choice, of course, is Florida Governor Ron DeSantis. Florida’s state legislature appears ready to make a change to state law that would facilitate a campaign. The Hill took an early look at obstacles to a DeSantis campaign.

• We mentioned last week that Republican control of the House would lead to more intense oversight of the Administration. Politico did a deep dive into how the White House is preparing for the investigations. One early investigative target popped up this week as Republicans said the White House used funds that were intended for providers to fund the vaccination campaign mentioned above.

• 538 looked at election outcomes in specific states.

• NPR explored GOP election gains in a traditionally democratic areas of Texas.

AGENCIES:

As part of the vaccination campaign, HHS announced $350 million for health centers that will encourage vaccinations in the community. HRSA has a central resource page for the health center program.

HHS also released a study on the impact of long-covid and what it means for providers. You can download a copy of the study here (PDF).

The OIG at HHS performed an audit on providers that perform Advance Care Planning (ACP) and found that they didn’t always comply with Medicare billing requirements. You can access copies of the report in brief and complete report (PDF).

As mentioned above, CMS issued a notice regarding ensuring timely access to therapeutics and vaccines for staff and residents. The QSO is attached.

Miscellaneous:

On the non-agency front:

• Health Affairs explored whether HUD can be used to incentivize innovation in SNF, including new quality metrics and projects like Green House. On the heels of the report, Dr. David Grabowksi posted a companion thread on Twitter with choice insights.

• Following up on a Kaiser Health News FOIA request regarding MA plan audits by CMS that we’ve mentioned in the past, KHN posted the first story on the audits, revealing that MA plans consistently overcharge CMS by millions each year.

• The NY Times posted an explainer on the differences between Medicare and Medicare Advantage, something that may be useful to families of residents.

• Axios explored private equity in SNF’s and why it remains a challenging investment.

• AARP released an updated framework that they use to analyze a state’s provision of long-term support and services. You can download a copy here (PDF).

• Finally, an interesting look at ways to integrate tech into senior care.

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