GET OUT THE VOTE!!

After months of discussion regarding the midterms, election date is (finally!) tomorrow, Tuesday, November 8th. In addition to the legal obligations inherent in protecting our resident’s right to vote, as noted in this CMS QSO from 2020 (PDF), it’s important to encourage your residents to vote as elected officials look at voting numbers. Your facilities can find their local polling place for their residents here: Polling Place Locator - Vote.org.

WHITE HOUSE:

The White House focused this week on a new clean energy collaborative with the United Arab Emirates, the second international taskforce meeting to fight ransomware and a $1.5 billion investment in America’s national labs to focus on achieving net-zero emissions in several areas, including possible new incentives to drive widespread adoption of more efficient HVAC systems, among other priorities. You can access the national research plan, which lists their priorities, here (PDF). Two items of interest to us:

• The White House highlighted their efforts on workforce development. While primarily geared towards infrastructure jobs, they created a guide, available here (PDF), that lays out the federal resources available for workforce development.

• They described all the actions they’ve taken to lower energy costs for families, information that may be very welcome to your residents and staff. The most directly impactful appears to be the $4.5 billion they are investing in the Low Income Home Energy Assistance Program (LIHEAP) which will be especially helpful as we move into the winter months.

CONGRESS:

As we close on the election, the final polls are pretty much back to the traditional outlook on Midterms; the party is power is likely to lose a significant number of seats, which can result in a Republican takeover of Congress. On the other hand, the polling isn’t as confident as portrayed in the press and the D’s have a path to retaining the Senate (more unlikely in the House)

A few other Congressional and election notes:

• Senator Wyden of the Senate Finance Committee released a report describing some of the deceptive marketing practices that Medicare Advantage plans are taking. You can access a copy of the full report here (PDF). They also created a zip file that contains example of what deceptive marketing looks like (direct download link).

• Given the uncertainty in the Midterms, Congress has delayed action on several important pieces of legislation. One new point to consider: a Reconciliation style bill may be back on the table.

• Politico looked at the path Congressman Hakeem Jeffries took in becoming the frontrunner to replace Speaker Pelosi.

• The GOP released a report on their investigative priorities following the midterm, specifically starting with the FBI & the DOJ.

• Senator Manchin publicly pushed the need to protect Medicare and Social Security, something that will likely be very necessary if the GOP takes over Congress.

• One important state referendum to monitor: Nevada is holding a public referendum to replace the traditional primary with an open primary, which can significantly change voting patterns across the country (if it’s adopted elsewhere).

CMS:

CMS released several final payment rules this past week. While there are a few more, I’ve highlighted two. You can find the rest at the CMS newsroom site:

• The physician payment rule, covering Medicare Part B payments, among other items. There were also changes to the shared savings program. The press release can be found here. The final rule will go into effect upon publication to the Federal Register on November 18^th.

• They also released the ESRD final rule for dialysis providers. The final rule will go into effect upon publication to the Federal Register today (Monday, November 7^th).

• Following a recent trend, they approved Arkansas’ 1115 request to use Medicaid coverage for housing and other medically necessary services.

CMS revised Appendix PP of their State Operations Manual, governing oversight of SNF’s, went into effect on October 24^th. Howard Sollins of Baker Donelson posted a summary of the major provisions of the revision and how they impact SNF’s right here at the Ecap Intel Community.

OTHER:

A few other items of note:

• The National Governor’s Association released a report (PDF here) looking at what different states are doing with their Medicaid programs to support direct workforce wages.

• Thanks to hard work by the Pennsylvania Health Care Association (PHCA), Pennsylvania Governor Tom Wolf signed into law new legislation that provide more oversight on staffing agencies. On the other hand, the state also implemented new regulations governing SNF’s, including a minimum staffing standard and more CHOW oversight.

• In Washington, the hospitals publicly reported that the inability to staff SNF’s are causing bottlenecks in discharge at hospitals, and urged policymakers to help find solutions.

• NPR takes a deep dive into a court case in Indiana that can have significant legal repercussions for SNF’s.

• Finally, the DOJ sent out letters to the largest private equity firms to identify practices that may be a problem for antitrust.

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