WHITE HOUSE:

Over the last few weeks, the White House focused on the President’s plan to provide student loan debt relief via debt cancellation, an executive order tied to the CHIPS Act that Congress passed, state-specific information on how the Inflation Reduction Act impacts healthcare & climate change, and their efforts to provide schools with the tools needed to stay open despite the ongoing presence of Covid. For our purposes, two key items from the student loan debt cancellation plan that may impact recruitment of staff and make it easier for folks to enter the field:

• They made a regulatory change to the student loan repayment plan, lowering monthly payment plans to 5% of discretionary income (down from 10%).

• They raised the income level protected from repayment to the approximate equivalent of someone earning $15 an hour.

CONGRESS:

With Congress out on summer break, there are approximately 15 “work” days for them through the November elections. For Democrats, especially with the likelihood that they’re going to lose their majority in the House, the single biggest piece of legislation that they’ll be working upon is the budget. Politically, there is going to be a lot of jockeying to get pieces from other legislation included in the budget bill. To that end, it’s a good time to preview several pieces of legislation that affect the industry:

• HR 2255 (Introduced by Congressman Brad Schneider: D – IL): This would allocate outstanding H1B visas to specifically be used for healthcare workers.

• HR 8576 (Introduced by Congressman Greg Murphy R – NC): This would require the GAO to evaluate how staffing agencies impacted healthcare during the pandemic.

• HR 7744 (Introduced by Congressman Brett Guthrie R – KY): This would reinstate the TNA waiver and extend the October 6^th testing deadline to get TNA’s certified.

On the elections front, a few items of note as we get closer to the midterms:

• We’ve talked a lot about the impact that the abortion ruling had on the upcoming Midterm elections. It would appear that the political environment is continuing to tilt in their favor with recent special elections and primaries highlighting a more favorable voting environment for the Democrats.

• In a similar fashion, the Cook Report (a political forecasting and analysis site), writes that the historical gains for the opposition party appear to be tied to a motivation to vote, something that may favor Democrats this cycle.

• One election trend that keeps popping up is that, by and large, moderate & centrist Democrats are the voter’s choice over the more progressive, left flank of the party.

• Finally, NPR takes a look at the 10 Senate seats that will decide the control of the Senate.

AGENCIES:

HHS awarded $25 million to five states to expand their offerings of Home & Community based services, including PACE programs.

As we’ve mentioned multiple times, HHS has promised (although they’re not legally obligated to do so) to give a 60-day notice prior to ending the PHE. That 60-day deadline was on August 16^th, strongly suggesting that the PHE will be extended again on October 15^th.

The OIG at HHS announced three new federal program audits that they plan on undertaking. These audits are analysis of different programs and can serve as the basis for further administrative action, once completed:

• An analysis of related party transactions by SNF’s. The estimated completion date is 2023.

• An analysis of healthcare personnel shortages at SNF’s throughout the pandemic. The estimated completion date is 2023.

• An analysis of how states will comply with the end of the PHE and Medicaid renewals. The estimated completion date is currently 2024, although it will depend on when the PHE finally ends.

They also provided an advisory opinion on providing gift cards to participants in MA plans who fill out specific types of surveys. You can access the advisory opinion here (PDF).

CMS released a guidance to state Medicaid agencies, urging them to start implementing nursing home quality initiatives as part of their Medicaid programs. It’s important to note that this is NOT a new mandate (yet). It’s simply a guidance for states and an insight into CMS’ thinking as it relates to quality metrics and staffing. You can access the guidance here (PDF).

Two important posts from CMS public blog:

• A post from Jonathan Blum (the COO for CMS) on creating a roadmap to end the PHE.

• A post from a senior researcher, detailing some of their early findings and their game plan in how they plan on conducting the staffing study.

For those of our readers involved with DME provision, CMS released a notice that they are discontinuing the use of “Certificates of Medical Necessity” for DME providers. More information is available in the notice (PDF).

The FDA finalized their over the counter hearing aids rule. You can access the full 65-page rule here (PDF).

OTHER:

On the non-federal agency front:

• The Kaiser Family Foundation did an analysis of MA enrollment and trends, concluding that nearly half of all Medicare beneficiaries are now in a MA plan.

• An important post from CMS Chief Medical Officer Dr. Lee Fleischer and other senior CMS personnel on lessons learned from the pandemic.

• Another post from Health Affairs in their ongoing series looking at dual-eligibles; this time focusing on recent Congressional legislation to create more coordinated care for dual-eligibles.

• The Boston Globe did a deep dive into comparing the United States system of long term care with the Netherlands, long presented as the gold standard for institutional long term care. An important takeaway is that the Netherlands spends nearly twice as much, proportionally, as the US on their system with corresponding results.

• Quartz highlighted the ongoing staffing struggles the industry with workforce and how much worse off LTC is compared to other healthcare providers.

Questions? Email us at support@myzpax.com.

z-INTEL WhatsApp info:

· Group Invite Link: https://chat.whatsapp.com/EoNiPi8ezrOBV6SW1Gf7nD

· Status Link: https://wa.me/message/WMSWZATTB5D6E1