Washington Update: Monday, January 23, 2023
COVID-19 Enters Fourth Year With Hospitalizations on the Decline
This week marks the three-year anniversary since the CDC reported the first
confirmed American cases of Covid-19, detected in a Washington state nursing
home. As we enter the fourth year, COVID deaths are down but still number in the hundreds daily. The CDC reports that weekly tally for reported COVID deaths was about four thousand, about 72% lower than a year ago. We salute our colleagues who helped patients and facilities get thru the worst health crisis in a century.
“Super IRF” law goes into effect, creating new classification for IRFs.
Some IRFs successfully lobbied Congress – over five years - to create a new classification for IRFs with an average case mix of 1.2 who maintain specified teaching and research programs. The new law does not make any changes to IRF reimbursement. Other IRFs, including Select Medical, were neutral on the legislation, noting that dividing an already small hospital community was not very productive. Several of Select Medical’s IRFs will qualify for the new designation.
APTA & Select Medical will co-host event for Sen. Tom Carper (D-DE)
The Select Medical PAC is pleased to work with the American Physical Therapy Association (APTA) to host an event for Sen. Tom Carper (D-DE). Sen. Carper is a member of the Senate Finance Committee, which has jurisdiction over Medicare. Sen. Carper is a former Naval officer who served in Vietnam, then served in the US House and as governor of Delaware. Thanks to Select Medical colleagues who support the company PAC and who make our support possible.
SNF sector reels and resists new Biden Administration regulatory policies.
The SNF sector remains battered with many in financial distress, trying to recover from the COVID-19 pandemic and the same nursing shortage facing the rest of the nation. Medicare SNF rates are generous, but state Medicaid rates are low and vary by state. On top of all that, the Biden Administration has recently proposed new minimum staffing ratio mandates, increased financial transparency for operators, and programs to target ‘bad actors’ with financial penalties and increased scrutiny.
U.S. hits debt limit. Several months of “extraordinary measures” begin.
The Treasury Department formally notified Congress that the US Government had hit the Federal debt limit. Treasury can use “extraordinary measures” to avoid default for the next several months. A vote to increase the debt limit will need to occur sometime by early summer. House Republicans have said they will vote to do so only if President Biden and Democrats agree to big spending cuts. US governmental debt is now $31 trillion while US annual GDP is about $23 trillion.
Pennsylvania House remains up for grabs in February 7 special elections.
On February 7, several Pennsylvania districts will have special elections to fill several state house seats that were vacated since the elections. In November, Democrats won a one-seat majority (102-101) but then several Democratic vacancies opened up due to resignations and a death. The outcome of these special races will determine which party holds the majority in the state House which is at a standstill because of the ongoing uncertainty.
Pennsylvania Governor Josh Shapiro names his top health officials.
Gov. Shapiro appointed several officials to top healthcare positions: Valerie Arkoosh, MD, will become Secretary of Human Services. She is an official in Montgomery County and formerly with Drexel University College of Medicine. Dr. Arkoosh also previously ran for US Senate. Debra Bogen, MD, will become Secretary of Health. Dr. Bogen is a pediatrician who was previously with UPMC Children’s Hospital of Pittsburgh.
Pennsylvania may advance presidential primary election date.
Pennsylvania has now become the nation’s key swing state — as Florida and Ohio have become more reliably Republican. To reflect that new importance to the nation, some Pennsylvania legislators are looking to move-up the Commonwealth’s primary which usually happens in April of each presidential election year. April is long after most nominees are chosen and makes the state less relevant in the selection process. The new primary date would be early March.
MH: Many rural hospitals resist new law, decide to retain inpatient care.
Modern Healthcare reports that a new law, providing special financial payments to rural hospitals that close their inpatient services and focus on outpatient services, is being met with a shrug as many rural hospitals still struggle to keep their inpatient capacity. MH quotes experts saying that the financial incentives under the new designation may not be as appealing as initially forecasted. The new law was championed by Sen. Chuck Grassley (R-IA).