SNF Digest #197

WHITE HOUSE:

With the President on the campaign trail, it was a quiet week out of the White House. They issued a new Executive Order focused on the import of robotic & machine parts, a new MOU with Finland on technology, and a new analysis (PDF) from the White House’s Council of Economic Advisors on the benefit of deregulating environmental permitting.

CONGRESS:

With Congress home through the midterm elections, we’re going straight to the political roundup:

·      With the midterms this week (finally), a look at the 10 races most likely to determine control of the House. Meanwhile, Politico did a deep dive into 17 different elections on the ballot Tuesday that are indicative of bigger trends.

·      A shock out of Michigan where Democratic Congresswoman Haley Stevens endorsed the Republican candidate for Senate, leading to a spate of resignations from her staff.

·      Happy that the midterms are here? Guess what; there’s always another election around the corner.

·      Midterms are Tuesday, but better late than never for a cool site that combines prediction markets, fundraising, and public polls to forecast the outcome of the elections of Congress.

·      The GOP has set a November 10^th date for post-midterm elections for leadership roles within the conference.

·      If the elections turn out the way the GOP fears, the question on everyone’s mind is what that means for the President’s relationship with the GOP, although the President says he’s got a plan.

·      Connecticut Senator Chris Murphy was hospitalized with a stroke, becoming the latest Senator struggling with health concerns.

·      A deep dive into one of the most invaluable resources for election prognosticators.  

·      Desperate times lead to desperate decisions... A wild story out of the Kansas Senate race.

·      One useful CRS report from the week: A guide for Congressional offices on the slowdown in the US labor market. While not specifically focused on healthcare, many of the raised issues are specifically impactful for healthcare, including the aging population and decline in immigrant workers.

AGENCIES:

As you may have heard, the midterms are Tuesday. It’s a good chance to highlight CMS July memo on protecting residents’ voting rights. The QSO is here (PDF).

The latest batch of Rural Health Transformation Program awards are in:

·      California

·      Idaho

·      Missouri

·      Texas

·      West Virginia

On his official X feed, Dr. Oz celebrated the fact that all 50 states have now “obligated” their first-year RHTP funds, along with a select list of highlights.

The Department of Labor released the final PBM transparency rule, which will add significant disclosure requirements on the plans. It’s available at the Federal Register. Healthcare Dive has a good summary.

The OIG at HHS looked at the minimum spending requirements on direct care implemented in four states and highlighted the challenges inherent in these regulations. The summary is here (PDF) and the full report is here (PDF).

The OIG at HHS provided an updated FAQ on the exclusionary authority that was delegated to CMS.

The Treasury Department, together with CMS, announced several new initiatives to combat fraud.

CMS released the final payment rule for End Stage Renal Disease (ESRD). The final rule is available at the Federal Register.

HHS, via the Office of the National Coordinator for Health Information Technology (ONC), released the final deregulatory rule related to health IT certification. More information is available at the central resource page. The final rule is available at the Federal Register.

CMS released a final rule regarding oversight on organ procurement organizations. The Fact Sheet is here. The final rule is scheduled for publication to the Federal Register on November 3, but if you simply cannot wait, you can download a prepublication copy of the 171-page final rule here (PDF).

More than 250 hospitals signed onto the Make Hospital Food Healthier pledge, committing to serve more nutritious food.

The OIG at HHS looked at CMS’ oversight of Part B providers, finding several vulnerabilities in CMS’ processes. The summary is here (PDF) and the full report is here (PDF).
 

The OIG at HHS also found that Louisiana overpaid MCOs for incarcerated Medicaid beneficiaries. The summary is here (PDF) and the full report is here (PDF).

The FTC sent out another round of letter to airlines, ride-sharing companies, and food-delivery firms looking for more information on their surveillance pricing usage. A sample letter is here (PDF).

A federal judge struck down one of the key provisions of the Medicaid work requirements rule related to the definition of “medical frailty.”

FROM THE NOTEBOOK:

·      Ohio published an update to their vent program regulations. The Fact Sheet is here (PDF).

·      Virginia’s Joint Commission on Health Care submitted a report (PDF) to the General Assembly on staffing levels in the state.

·      A new study in JAMA found that CMS didn’t do a whole lot of enforcement on MA plans for inappropriate denial of care.

·      Missouri’s Attorney General sent a cease-and-desist letter to Eli Lilly regarding their 340B drug pricing practices in the state. A copy of the letter is here (PDF).

·      The Kaiser Family Foundation determined that Medicare Part D premiums will be going up for stand-alone plans. They also found that more than 4 million beneficiaries will have their plans terminated at the end of the year.

·      McKnight’s did a deep dive into the growth of unspent CMP funds.

·      Yet another MA plan sued CMS over their Star ratings, as Aetna became the 5th insurer to sue CMS.

·      Six large employers filed a lawsuit against UnitedHealthcare for allegedly “breaching their fiduciary duty” to the employers for inflating costs while collected fees.

·      JAMA did a deep dive into what would Medicare for All look like.

·      Another expose from the Electronic Frontier Foundation on CMS’ use of AI for prior authorization as part of the WISeR model.

·      Not quite SNF specific, but Stat News did a very lengthy look at how Epic is “choking” healthcare innovation.

·      Going after PBMs has become a bipartisan issue, with Republicans leading the way.

·      New York became the first state to ban several AI chatbot features for minors.

·      A new study from the Committee for a Responsible Federal Budget found that anticompetitive contracts by consolidated hospital networks, locking in providers, is driving up healthcare costs.