Happy 4^th of July to all!

The White House focused on the President’s trip to Germany & Spain for the G7 & NATO summits, the ongoing Roe v. Wade response and the launch of a new international partnership focused on global infrastructure. A few items of note from the Administration:

• Following up on an item from last week regarding the mental health funding in the bipartisan gun control deal (which the President signed last week). The bill allocates $250 million in funding for a federal program, called the “Community Mental Health Services Block Grant” which is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). The funding goes to states for use in programs that provide community mental health services.

• The White House secured “pledges” from 61 of the largest health & hospital systems to cut their greenhouse gas emissions by 50% by 2030. If you have a facility associated with one of those health systems, it’s something to be aware of.

With the July 4^th break on the horizon, Congress was quiet in terms of legislation passed. For the most part, the talk was on two large pieces of legislation that Congress wants to pass prior to the August recess:

• “USICA” – a bill focused on competition with China that has significant bipartisan support.

• A new, smaller, partisan, reconciliation bill that would focus on climate and drug prices. Reconciliation refers to a bill that Congress can pass on a simple majority vote, although there are complex rules as to what can & can’t be included in reconciliation. For our purposes, the revised reconciliation bill is significantly smaller than originally envisioned and any funding for expanded HCBS services appears to be off the table for now.

One important hearing from Congress this week: The Energy & Commerce Subcommittee on Oversight & Investigations held a hearing on Medicare Advantage plans looking into their pattern of denying care, overcharging the government and the fact that CMS hasn’t completed audits on the MA plans that began in 2011 (!). The home page for the hearing has a link to the full video, as well as witness testimony. Kaiser Health News has an excellent summary of the hearing (for those who’d rather not watch a 2 hour plus Congressional hearing).

A few notes on the elections front:

• 538 released the first version of their 2022 elections forecast tool (which is continuously updated as new polling is released). At this time, the Senate is slightly favored to turn Republican, while the GOP is heavily favored to take the House. They have a solid explainer on why it’s much harder to take the Senate.

• Re: the impact that Roe v. Wade can have on elections, Roll Call has a good analysis of why you need to wait a few weeks to understand the true impact and whether the anger that Democrats feel now can be sustained till November.

• In a troubling sign for Democrats, more than one million voters have switched parties to the GOP over the last year.

• A new poll released Friday show that 71 percent of voters do not want the President to run again.

• Finally, Politico had 5 takeaways as we reach the midway point to the midterm elections.

HHS announced two new initiatives this week. I don’t believe either directly impact the SNF community, but as many of our readers are involved with other healthcare providers, I’m sharing them:

• Strengthening primary care – a new initiative aimed at improving access to primary health care across the country.

• A new, voluntary model to identify ways to build better cancer care for dual eligibles. The formal fact sheet can be found here.

The OIG at HHS released their report on vaccine intake at SNF’s, finding that at least 91 percent of staff were vaccinated. The full report can be downloaded here (PDF).

As the digest evolves, we will be quoting OIG advisory opinions here. The OIG’s office updated their FAQ’s on what an advisory opinion is, how to use it and who can rely upon it.

CMS issued a new set of minimum standards for SNF’s with an anticipated rollout date of October 24, 2022. A summary of the big ticket items can be found in the fact sheet. Among items included are new rules on reporting, infection control specialists and arbitration agreements. The QSO for state survey agencies can be found here (PDF). CMS also made available draft versions of the new policy documents, available for download at the QSO site here. The new training modules can be found at the Quality, Safety and Education Portal.

CMS also announced the availability of a new dataset along the financial relationships between GPO’s and healthcare providers (primarily targeting pharmaceutical companies). The dataset can be found here.

The Supreme Court declined to take up a PBM case that would have held PBM’s have a fiduciary duty to lower drug prices if they can.

In non-agency news of the week:

• Effective Friday, July 1^st, a Trump era transparency rule went into effect requiring health insurers to publicly list their negotiated prices online. CMS has created a “Transparency in Coverage” with guidance. The resources page can be found here. In theory, this also applies to self-insured employers. If you’re self-insured, please consult with your legal advisor to see if you’re required to comply.

• The rule only requires that insurers make available machine-readable data, which isn’t usable for consumers. However, several startups are working to make the data more transparent and consumer friendly.
• For those inclined to work with large amounts of data, here are links to the datasets for a few of the larger health insurers:
• Anthem
• Centene
• United Healthcare

• Speaking of data, Governing.com analyzed a recent survey from Ernst & Young that showed the challenges that public health systems have in modernizing their systems and managing their data, a problem that anyone who has ever worked with a Medicaid system recognizes.

• This is from Spain (and the article is in Spanish but should be automatically translated by Chrome or another modern web browser), but Spain just banned new construction of any nursing homes larger than 120 beds. Considering the CMS rules referenced above urging (but not requiring) operators to limit room size, it’s an important trend to be aware of.

• This is from the Kansas and technically was in relation to retailers, but it might impact facilities in Kansas with depressed census. The state Supreme Court ruled that local tax authorities have the authority to determine tax appraisals for the building as if they’re full and active. If you’re in Kansas, please consult with your local tax folk for how it impacts you.

• LeadingAge in California secured a $25 million grant to strengthen the development and training of CNA’s & HHA’s. You can find their press release here (PDF).