News : Fear and loathing over long-term care rules

Monday, July 31, 2023

Fear and loathing over long-term care rules

Jul 31, 2023

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By Daniel Payne

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Driving the Day

A nursing home resident | Getty Images

The Biden administration is moving forward with new staffing policies for nursing homes. | David Ramos/Getty Images

BRACING FOR IMPACT — New federal staffing requirements for nursing homes have both industry leaders and patient advocates fearful — even before the rule’s release, your host reports.

The historic regulation, aimed at improving outcomes in long-term care facilities, is expected, for the first time, to set the number of hours staff must work per resident.

The groups, which rarely agree, are preparing to decry the rule’s impact, though for different reasons.

— Advocates for patients fear the rule won’t require enough caregivers per resident, allowing them to receive poor treatment.

— But industry leaders worry the rule’s requirements will be too expensive amid workforce shortages and say it would lead to facility closures.

The groups — along with the White House — agree on one thing: The rule’s impact will be substantial.

The Biden administration has touted its long-term care industry reforms for years, and the industry and patient advocates see the staffing policy as among the most consequential parts of the plan.

CMS declined to comment on the coming rule.

Stakeholders are watching several elements expected to be part of the rule: the number of required staffing hours per resident a day, the possibility of waivers for some facilities, the compliance timeline and the enforcement details.

WELCOME TO MONDAY PULSE, where we’re interested to see HHS’ Hubert H. Humphrey Federal Building take to X, formerly known as Twitter, today to defend itself against “unfair and very personal attacks against its appearance.”

Are other federal buildings planning to take to social media soon? Help us be the first to report it — and the biggest health stories of the day — by dropping me a line at dpayne@politico.com.

TODAY ON OUR PULSE CHECK PODCAST, host Kelly Hooper talks with Daniel about his reporting on the forthcoming Biden administration regulation — equally opposed by industry leaders and patient advocates — that would set minimum staffing requirements for nursing homes.

Listen to today’s Pulse Check podcast

A message from PhRMA:

Insurance isn’t working like it should. The latest Patient Experience Survey uncovers the challenges insured Americans face affording care and how practices by health insurers and middlemen put patients at risk. Learn more.

At the Agencies

Woman walking seen through window of an outpatient Medicaid office door.

The Medicaid unwinding has resulted in more than 700,000 being removed from the rolls. | AP Photo/Julie Jacobson

CMS’ MEDICAID COUNT — More than 700,000 people lost Medicaid coverage in April, according to the first federal data release, POLITICO’s Megan Messerly and Robert King report.

That data will begin shedding light on a historic unwinding that’s expected to see as many as 15 million people lose their health insurance.

The release covers only 18 states that had completed one full round of Medicaid renewals as of April 30. But it provides an early — albeit incomplete — picture of the disruption taking place across the nation and comes amid increasing pressure from Democratic lawmakers who are calling on the Biden administration to cut Medicaid funding from states doing a poor job of redetermining the program’s eligibility.

MASSIVE HACK — CMS said Friday that hackers had accessed 612,000 Medicare beneficiaries’ data, including Social Security numbers and medical records, POLITICO’s Ben Leonard reports.

The breach is tied to software a third-party contractor used — MOVEit, from Progress Software, which has been vulnerable to attack before.

And it’s more than just Medicare patients. Maximus said in an SEC filing Wednesday that “at least” 8 to 11 million peoples’ data was accessed, a number that includes mostly non-Medicare patients.

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In Congress

A GOP PLAN FOR DRUG SHORTAGES — House Energy and Commerce Republicans unveiled a broad proposal Friday that aims to stop or lessen generic drug shortages, POLITICO’s Megan R. Wilson reports.

Energy and Commerce Chair Cathy McMorris Rodgers (R-Wash.) said in a statement that she hoped the discussion draft could lead to a bipartisan measure, but the release comes after a falling out with the panel’s Democrats over whether to include drug shortage policies in legislation that renews federal pandemic and emergency preparedness programs.

Democrats insisted the issue was important enough to be put on the must-pass bill, but Republicans said they wanted to take a broader swipe at the problem.

ORGAN OVERHAUL — Congress has signed off on an overhaul of the nation’s organ donation system, POLITICO’s Erin Schumaker reports.

The bill, the Securing the U.S. Organ Procurement and Transplantation Network Act, will now head to the White House for President Joe Biden’s approval.

For nearly 40 years, the government has contracted with a single organization, the nonprofit United Network for Organ Sharing, to match patients with donated organs. But a Senate Finance Committee investigation into UNOS concluded that the network was putting Americans' lives at risk by failing to ensure organs weren’t lost or destroyed in transit. The committee recommended breaking up the existing contract.

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Public Health

ANOTHER OTC OPTION — The FDA approved another over-the-counter opioid overdose antidote Friday, POLITICO’s Katherine Ellen Foley reports.

RiVive, the second nonprescription medication of its kind, is a nasal spray containing 3 milligrams of naloxone, a drug that reverses opioid overdoses.

The drug’s maker, nonprofit Harm Reduction Therapeutics, receives funding from private donors as well as oxycontin maker Purdue Pharma. The company said it would give away 200,000 doses of the spray and plans to price it roughly at cost, or about $36 for a pack of two.

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Names in the News

Kahaari Kenyatta, who was a Director at Waxman Strategies lobbying on health care reimbursement policy and public health issues, is leaving the firm to begin law school.

The National Pharmaceutical Council announced two hires: Jon Campbell as chief science officer and Michael Pratt as chief communications officer.

What We're Reading

POLITICO’s Gary Fineout reports on the role abortion may play in the future of Florida politics.

The New York Times reports on the tick-linked meat allergy that might affect half a million Americans.

NBC News reports on the threat of disease-carrying mosquitoes becoming resistant to insecticides.

A message from PhRMA:

Insurance isn’t working like it should. 53% of insured Americans say they can’t anticipate what they’ll pay for health care services, even if those services are covered by their insurance plan. Learn more about the cost and coverage barriers Americans face. 