WHITE HOUSE:

Over the last two weeks, the White House continued their focus on climate change efforts, lowering gas prices, efforts to improve battery recycling, updating the national security strategy, as well as the national biodefense strategy (PDF), and a new action plan to accelerate infrastructure investment (fact sheet & plan; PDF downloads). A few specific, notable items:

• Earlier today, the White House announced new efforts to improve quality of homes in the Special Focus Facility (SFF) program. More below on the SFF specifics in the HHS & CMS section but included in this announcement is a good summary of the different funding opportunities available for nursing training.

• Following up on the Inflation Reduction Act, the President issued an Executive Order requiring HHS to post within 90 days a plan on new payment models related to lowering drug costs that will be evaluated through the CMS innovation center. The fact sheet is here.

• In the past, we’ve mentioned the FDA’s authorization of over-the-counter hearing aids. As of this past Monday, hearing aids are now available at retailers around the country.

• The President signed several pieces of legislation that may impact several of you:

• S.442: The Bright Act, which requires federal buildings to utilize energy-efficiency lighting.

• S.2551; which requires the Government’s procurement office to develop a training program for procurement officials involved with artificial intelligence purchasing.

• S.958: Mobile Act, which allows community health centers to use federal funding for mobile health clinics.

• S.3157, Bridging the Gap, which requires the Department of Labor to study how to integrate foreign trained professionals into the US workforce, something that might be helpful for the healthcare workforce.

• HR. 1766, the FTC Collaboration Act, which requires the FTC to work with state attorney generals on preventing fraud, something that may impact your residents.

CONGRESS:

With Congress on recess, there has been a renewed focus on the upcoming midterms. With the polls slowly showing a better outcome for the GOP, there have been several interesting thoughts pieces on the post-election outlook, including what Republican policies to target inflation would look like. A few other interesting Congressional items:

• The ongoing uncertainty regarding the outcome of the Midterms has led to an enormous spending on lobbying. What’s particularly interesting is the list of top spenders, which include four healthcare groups, such as PhRMA, the AMA, the Hospital Association, and AARP.

• The Democrats laid out their plan to try to hold onto their majority in 2022 and the plan for 2024: Winning America.

• With the Republicans poised to take over the House, Politico looked at Congressman Jim Jordan’s plans as the potential Chair of the Judiciary committee.

• One intriguing long-term trend: A new Gallup poll showed that healthcare issues can cause voters to cross party lines in elections.

AGENCIES:

HHS announced several new funding initiatives. By and large, these aren’t directed at facilities, but there are opportunities that can be tapped into for partnership, especially if your facilities are located near the awardees:

• $13 million for nursing workforce development; $8.4 million to participants in the nursing preceptor academies program and $4.75 million to facilities in the registered nurse training program.

• $100 million, specifically for states, to strengthen their mental health resources for the workforce (in general, not healthcare specific).

• Another $15 million (on top of the $300 million already invested) in developing mental health clinics as part of Certified Community Behavioral Health Clinics. More details can be found at the SAMSHA page. While directed at states, the idea is to create better local partnerships in tackling the mental health crisis.

HHS provided more healthcare specific information related to the Administration’s biodefense plan mentioned above. One specific item of note is the effort to create a more consistent stockpile of PPE for future need.

The Surgeon General released a new framework for general workforce mental health wellbeing, something that our staff struggle with.

The OIG at HHS announced that they plan on doing an audit of preventable hospitalizations for SNF residents related to six specific healthcare conditions (pneumonia, congestive heart failure, UTIs, dehydration, chronic obstructive pulmonary disease/asthma, and sepsis). They expect to issue the report in 2024.

Earlier today, CMS announced a new oversight initiative related to special focus facilities. This QSO only applies to the 88 homes on the SFF list, although as always with CMS, this can portend future efforts to include them in regulations governing the industry. You can download the QSO here (PDF).

CMS approved an interesting Medicaid waiver request from Arizona that will allow the state to use Medicaid funds for housing related needs. The full waiver approval is available here (PDF).

MEDICARE ADVANTAGE:

A few items of note related to Medicare Advantage plans, all indicating the increased scrutiny that MA plans are getting:

• CMS sent a letter to MA plans notifying them that new television ads will require approval before airing and, in general, tightening the marketing requirements for MA plans. You can download a copy of the letter here (PDF).
• CMS announced that they are settling a lawsuit with Kaiser Health News and will make available the results of 90 audits of MA plans.
• A new study looked at why a majority of seniors are choosing MA plans over traditional Medicare.
• MedPageToday published a letter (registration required) that the Mayo Clinic sent to all Medicare beneficiaries in Florida & Arizona letting them know that they aren’t in-network with most MA plans. You can access a copy of the letter here (PDF).

OTHER:

A few other items of note:

• The IRS raised the limits for 401K contributions in 2023.

• MEDPac released a series of basic overviews for how Medicare Payment systems work. These are designed to explain the basics behind federal payment programs to regulators and elected officials. While every Medicare provider type has an overview at the central resource page, here are direct links to three of particular interest to our readers: Accountable Care Organizations, Medicare Advantage and Skilled Nursing Facilities.

• Tradeoffs, an online podcast aimed at exploring the nuanced world of healthcare policy, had a piece on building long-term careers for the long-term care workforce.

• The New England Journal of Medicine explored how the Inflation Reduction Act will impact prescription drug pricing (registration required).

• A study looked at which jobs in SNF’s are more and less “favorable”, focusing on a need to improve morale among the night shift. You can download a copy here ecap (PDF direct download).

• The Boston Globe looked at the impact of closures to SNF residents across Massachusetts.

• SEIU, among other labor unions, are pushing a $25 minimum wage for private healthcare facilities in cities in CA.

• An article in Vermont highlighted the bottleneck at hospitals when SNF’s don’t have staff.

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