WHITE HOUSE:

The White House focused this week on new STEM initiatives related to the “Space Workforce”, the release of the President’s economic blueprint (PDF download here), and a summit on accountability for tech platforms (which could lead to new HIPAA rules), as well as reacting to the passing of Queen Elizabeth. Two interesting items for our purposes:

• They laid out their aggressive plan to get folks vaccinate and boosted this fall. Part of the plan involves creating new tools via CMS to encourage residents to get boosted.

• They created a new resource designed to help identify location-based information related to climate change. In theory, the portal, located here, can be used to help understand physical plant risk to facilities around the country.

CONGRESS:

With the Midterm elections fast approaching, and a new spending bill needed before a September 30^th deadline, Congressional leaders are working on a short-term funding bill, called a "continuing resolution" (CR), that would last till mid-December, with a goal of creating a proper funding bill before the end of the year. The White House laid out the many different appropriations that need to be included in any CR (PDF download here), but this is a relatively normal tool to keep the government funded. The CR is considered a must-pass piece of legislation and is often used as a vehicle to attach other pieces of legislation that would have a more difficult time passing through regular order.

A few other notes from the Hill:

• The American Medical Association (among other physician groups) are ramping up lobbying efforts to avoid Medicare cuts scheduled to come on January 1^st. Several of those cuts impact us and this is helpful to the industry.

• We’ve been talking a lot over the last few months about the improving environment for Democrats. Building on that sentiment, Politico points out that for the first time in a while it appears that Democrats are “winning” the culture wars.

• Despite the positive signs, the House is still likely to flip to the GOP. Politico does a deep dive into what the relationship between the Biden Administration and a Republican House would look like. This is very important to us, especially since it might lead to more regulation by executive order (as opposed to Congressional Action).

• Under the assumption that the GOP will take control of the House, Axios reported on the broad strokes of Congressman Kevin McCarthy’s plan following the Midterms. As the likely Speaker of the House, Congressman McCarthy will set the agenda for the GOP.

• Finally, 538 had a wonky piece on political leanings in Michigan. One interesting takeaway is that despite all the rhetoric and polling, over the last 40 years control of the Presidency and Congress has pretty much worked out to a 50-50 split.

AGENCIES:

A few weeks ago, Kaiser Health News posted an article calling attention to debt collection practices by SNF’s. This week, HHS provided the regulatory follow-up, announcing a joint effort with the Consumer Financial Protection Bureau (CFPB – the federal agency in control of debt collection practices) reminding SNF’s that they are covered by the consumer debt protections. The formal CFPB announcement is here. The fact sheet is available here (PDF). CMS’ joint announcement with the CFPB is available here (PDF).

HHS also announced that the Department of Homeland Security (DHS) issued a final rule related to the “public charge”, essentially guaranteeing that immigrants who receive Medicaid benefits will not have their immigration decisions impacted by those benefits and reversing a Trump-era policy. The final rule is available at the federal register. CMS also issued their own announcement on the rule. The full 168-page rule can be accessed here (PDF). It’s important to note that this doesn’t expand Medicaid eligibility, but it clarifies a policy that potentially would have decreased Medicaid enrollment.

The OIG at HHS released a review of telehealth usage during the first year of the pandemic, specifically addressing potential parts of the program at risk of fraud and abuse. You can access the report here (PDF).

CMS put out a “Request for Information” (RFI) asking for public feedback on advancing health equity and understanding the impact that the waivers issued during the Covid-19 PHE had on healthcare delivery. Comments can be submitted here through November 4^th. The overview of the RFI can be accessed here (PDF).

CMS normally posts annual reports on Medicaid application processing times. As a result of the bump in FMAP during the PHE, CMS is now publishing the information on a quarterly basis, looking at processing times from January through March 2022. You can access the report here (PDF). It’s a good look at which states struggle with “pending” applications for Medicaid.

The National Labor Relations Board (NLRB – an independent federal agency responsible for employer-employee relations) issued a new proposed rule related to new standards on who qualifies as joint employers. The proposed rule is published at the federal register. Comments can be submitted through November 7^th. You can access the full rule here (PDF).

Other:

On the non-agency front:

• Earlier this year, Washington became the first state to pass a public long-term care insurance benefit. Now legislators in both NY (SB9082) and Pennsylvania (HB2779) are following suit. While both have a long way to go before becoming law, it’s a trend to monitor.

• 2 separate think tanks released reports this week reimagining long term care; one from NexusInsights (direct PDF download) and one from Convergence (PDF).

• The Journal of the American Geriatrics Society published a study on the use of telehealth in SNF’s during the pandemic. You can download it here (PDF).

• HMA, a consulting firm that many states consult with on matters related to public health policy and Medicaid published a blog post looking at CMS’ public documents related to the unwinding of the PHE.

• MEDPac, an independent group that advises Congress on Medicare policy, is taking a long look at MA plans and how “standardization” would help simplify the choices.

• PHI, a group that advocates on the direct care workforce, released their annual report on the direct care workforce. You can access it here (PDF).

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