WHITE HOUSE:

The White House focused this week on funding for child care providers (state-by-state breakdown available here), more investment in rebuilding public school infrastructure and strengthening cybersecurity resources for private companies, specifically those in the chemical sector. One item of note:

• They announced new compliance guidance from the Consumer Financial Protection Bureau (CFPB) on overdraft and “depositor” (i.e. bounced check) fees that impact consumers. You can access the overdraft guidance here (PDF) and the depositor guidance here (PDF). This might of great interest to your staff and residents who can be impacted by these fees. More information is available at the CFPB main resource page here: Junk fees | Consumer Financial Protection Bureau (consumerfinance.gov)

CONGRESS:

With Congress out through the Midterms, and the outlook looking better for the GOP, the focus is on post-election strategy. The biggest discussion is around the debt ceiling and whether fiscal conservatives in the GOP will use it to leverage cuts to entitlement programs, like Medicare. In the meantime, a few other interesting items from the week:

• We focus primarily on activity at the federal level here at SNF Digest, but regulation at the state level is just as impactful. 538 took a long look at the state legislatures up for grabs this year.

• Florida appears to be entirely off the table for Democrats with early signs pointing here heavily in favor for the GOP. In fact, more Republicans have cast early ballots than Democrats.

• Roll Call looked at some of the tools that the GOP can use to increase oversight into the Administration.

• An interesting look at the demographics of voters and how young voters are less likely to participate in the Midterms.

• As this is the first major Midterm election post-2020 and voting during Covid, the logistics of how people vote is being closely followed.

AGENCIES:

Late Friday afternoon, CMS released a final rule regarding Medicare enrollment and eligibility. They also released a fact sheet that details the major changes. The rule will go into effect upon publication in the Federal Register this Wednesday, November 3^rd, but you can access a copy of the final rule here (PDF). There are several technical changes related to eligibility, enrollment, and state buy-in on Medicare premiums that can impact ease of enrollment and eligibility.

CMS also released two new important guidance documents:

• QSO-23-02-ALL (PDF): This streamlines and clarifies staff vaccination requirements.

• S&C 17-15-LSC (PDF): This clarifies earlier regulations related to FSES and NFPA101. It’s very helpful for some older buildings that rely upon on certain life safety code waivers.

The OIG at HHS completed an audit on the accelerated payment program that was made available to Part A providers under the Cares Act and found that providers complied with federal requirements. Here are the direct links to the report in brief (PDF) and the complete report (PDF).

They also released an analysis on Medicare Part C & D MA plans to ensure that managed care benefits went to eligible beneficiaries, finding that, by and large, they complied with federal requirements. Here are the direct links to the report in brief and the complete report.

Other:

A few other notable items from the week:

• The Kaiser Family Foundation released their annual 50-state Medicaid budget survey. There’s some very interesting tidbits in there that can help with budget planning, but the biggest takeaway is that state Medicaid agencies anticipate the Covid PHE will end in 2023. The full survey results are at the central resource page.

• With the end of the PHE in sight, MEDPAC called on CMS to make available reports related to the ending of the PHE and Medicaid enrollments. It’s important to realize that many residents will be impacted by the end of the PHE and the need for renewal and it’s something that must be planned for.

• With the GOP likely to take over the federal funding apparatus (i.e. Congress), this report from the PEW center that looked at state budgets is very important as you prepare for 2023 and the financial outlook for your interaction with state Medicaid programs.

• The Center for Connected Health Policy (CCHP), a non-partisan group focused on Telehealth policy, created a useful database to track which states are spending on remote patient monitoring.

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