Creator: JJ Rabinowich
SNF Digest #191
From the White House to Congress to the regulatory agencies, JJ gives you the inside word on what is what for this week.
Publication Notice - Starting next week, in observance of the Jewish Holidays, we will be posting the SNF Digest on Wednesday mornings.
WHITE HOUSE:
This past week, the White House focused on continuing their effort to lower meat prices, protect ranchers from environmental threats, and negotiated an oil deal with Venezuela. Two items of interest:
More below in the Congressional section, but the President signed the short-term funding bill that will kick the funding debate till after the midterms.
They announced another round of agreements with nine new pharmaceutical manufacturers for Most Favored Nation pricing for purchases by American and state Medicaid programs. In theory, the move should continue the downward trajectory on drug pricing.
CONGRESS:
As expected, the House easily passed the continuing resolution sent over by the Senate, sending the bill to the President who signed it. The funding bill was mostly “clean,” with only a few added items, including a delay on a ban of hemp products and a block on a proposed rule that gave political appointee more approval power over federal grants. With the government now funded through December 11th, the Speaker cancelled the last two weeks of September session. For our purposes, Congress is now shut down through the election. Elsewhere in the political world:
The House Veteran Affairs Committee held a hearing this week on the rapidly inflating cost of the VA’s new EHR from Oracle. It got ugly quickly and now the Committee is subpoenaing Oracle execs to discuss the increasing cost for the project.
A pair of court rulings gave Democrats some good news on redistricting, while the GOP isn’t projected to do nearly as well as they hoped when they started the redistricting wars.
At the top of the Democratic wishlist for the next Congress if they take back the reins? Healthcare.
Democratic incumbents performed well in Massachusetts this week, a change of pace from the upstart wins we’ve been seeing.
As we get closer to the midterms, the parties are coalescing around messaging. The GOP’s is the President, while the Democrats are all in on data centers.
A few useful CRS reports from the week:
o An overview of assisted living facilities
o A guide to the latest state efforts to lower drug prices
o A trio of reports on Social Security; including an overview, a deeper dive, and a look at taxation on benefits for those under 65
AGENCIES:
CMS announced the latest batch of awards from the Rural Health Transformation Fund, including:
The OIG at HHS released a report that found CMS could do a better job on their oversight over how states rely on contract surveyors to perform required surveys of SNF. The summary is here (PDF) while the full report is here (PDF).
The OIG at HHS also did an audit on Medicare Part D plans making payments for drugs that were available over-the-counter, and thus ineligible for coverage. The full report is here (PDF) while the summary is here (PDF).
HHS, via SAMSHA, awarded $77 million to strengthen substance use prevention and mental health services.
The SBA, HHS, and CMS announced a new type of healthcare plan for small businesses to offer their employees called CHOICE. CMS has a comprehensive guide here.
Slightly far afield, but as several of you advertise on Amazon, this is worth tracking. The FTC and 22 states filed a lawsuit against Amazon alleging that the company deceptively increased their ad prices.
FROM THE NOTEBOOK:
CMS hasn’t yet approved several programs for Texas hospitals, owing to a concern in how the state collects taxes in the local districts. The current held amount is nearly $10 billion. It doesn’t look like this affects SNFs, but this is yet another fallout from the One Big Beautiful Bill.
United Healthcare announced that they’re eliminating nearly 30 percent of prior authorization requirements.
OpenAI announced a new integration between Epic and ChatGPT for Healthcare, as well as several other official public healthcare sources.
Louisiana became the latest state to take on PBMs, as the state’s Attorney General filed a lawsuit against Express Scripts.
A recent JD Powers survey found that, for the second year in a row, satisfaction with MA plans continues to drop among beneficiaries. The full survey is here.
With all the focus on AI usage, it’s nice to see a company giving out bonuses for “human” skills.
