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Take Action: Protect & Preserve Tax Exemption for Municipal Bonds
On March 4, LeadingAge issued an action alert to urge congress to protect and preserve the tax exemption for municipal bonds during budget reconciliation negotiations. Lawmakers are considering elimination of the tax exemption for interest earned on municipal bonds as a way to generate revenue to help pay for a budget reconciliation package that would extend expiring tax reductions, reduce taxes in other ways, and increase spending in areas such as border security and defense. Read and respond to the action alert here.
Senate Bill to Halt Federal Staffing Mandate Reintroduced
U.S. Senators Deb Fischer (R-NE) and James Lankford (R-OK) introduced on February 16 the Protecting Rural Seniors’ Access to Care Act (S. 750) to reverse the federal minimum staffing rule for nursing homes and instead establish a nursing home workforce advisory panel to analyze workforce shortages and make practical recommendations to address them. A similar bill was introduced last Congress to prevent the proposed staffing rule from taking effect. The new bill would halt the final rule’s implementation. The Senate bill’s introduction comes on the heels of a similar bill that was introduced in the House of Representatives by Representative Michelle Fischbach (R-MN) on February 13, the Protecting American Seniors Access to Care Act (H.R. 1303). While both bills would prohibit the Secretary of Health and Human Services from implementing, administering, or enforcing the final minimum staffing rule, Representative Fischbach’s version of the bill does not contain the provision to establish a workforce advisory panel.
LeadingAge president and CEO Katie Smith Sloan issued the following quote on the Senate bill’s introduction: “Ensuring access to quality care is a top priority for our nonprofit and mission-driven nursing home members. Quality care and staffing are tightly connected. However, the federal minimum staffing rule for nursing homes, while well-intentioned, will only exacerbate the current challenges that providers, particularly those serving rural communities, must navigate: a shortage of qualified workers and a highly competitive labor market. The federal staffing mandate does not include any funding to help pay for staff recruitment and training. Without staff, there is no care; shortages force providers to make difficult choices, including limiting admissions, taking beds offline, or, worse yet, closing wings or even ceasing operations. Solutions to address longstanding workforce issues in aging services are needed. We commend Senators Fischer and Lankford for their leadership on the Protecting Rural Seniors’ Access to Care Act to stop implementation of this unworkable staffing rule and also create an advisory panel to tackle the ongoing workforce shortages facing aging.”
HHS Secretary Proposes to Limit Public Participation
U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. proposed on February 28 a controversial policy to limit public participation in HHS decision-making by rescinding a long-standing waiver that allowed public input on agency rules regarding grants, loans, benefits, and contracts. The policy, which will be formally published in the Federal Register on, March 3, contradicts Secretary Kennedy’s earlier pledges of “radical transparency” and has sparked concerns and confusion among legal experts and advocates.
“The possibility that HHS under the Trump White House will eliminate or significantly scale back public comment on policies impacting payment, regulations, safety, operations, and other critical areas is truly troubling–a move we can only hope will not have the negative impact that we fear it might. We will closely monitor its implementation,” LeadingAge president and CEO Katie Smith Sloan said in a February 28 statement responding to the new HHS policy.
Before issuing a new rule or regulation, the public is given an opportunity to submit written comments in support of or in opposition to government proposals, as well as to request clarifications of proposed policies. This has been the case for five decades under something called the Richardson Waiver, through which HHS went beyond narrow public comment requirements of the Administrative Procedure Act (APA) to secure more public comment than was officially required.
As stated in HHS’s February 28 policy statement, “Effective immediately, the Richardson Waiver is rescinded and is no longer the policy of the Department. Under the APA, matters related to agency management, personnel, public property, loans, grants, benefits, or contracts are exempt from the notice and comment procedures of 5 U.S.C. 553, unless otherwise required by law. While agencies and offices within the Department have the discretion to apply notice and comment procedures to these matters, they are not obligated to do so unless otherwise mandated by law.”
LeadingAge will continue to monitor these developments and provide updates to members as necessary.
CMS Rescinds Prior Guidance on HRSN in Medicaid
U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. proposed on February 28 a controversial policy to limit public participation in HHS decision-making by rescinding a long-standing waiver that allowed public input on agency rules regarding grants, loans, benefits, and contracts. The policy, which will be formally published in the Federal Register on, March 3, contradicts Secretary Kennedy’s earlier pledges of “radical transparency” and has sparked concerns and confusion among legal experts and advocates.
“The possibility that HHS under the Trump White House will eliminate or significantly scale back public comment on policies impacting payment, regulations, safety, operations, and other critical areas is truly troubling–a move we can only hope will not have the negative impact that we fear it might. We will closely monitor its implementation,” LeadingAge president and CEO Katie Smith Sloan said in a February 28 statement responding to the new HHS policy.
Before issuing a new rule or regulation, the public is given an opportunity to submit written comments in support of or in opposition to government proposals, as well as to request clarifications of proposed policies. This has been the case for five decades under something called the Richardson Waiver, through which HHS went beyond narrow public comment requirements of the Administrative Procedure Act (APA) to secure more public comment than was officially required.
As stated in HHS’s February 28 policy statement, “Effective immediately, the Richardson Waiver is rescinded and is no longer the policy of the Department. Under the APA, matters related to agency management, personnel, public property, loans, grants, benefits, or contracts are exempt from the notice and comment procedures of 5 U.S.C. 553, unless otherwise required by law. While agencies and offices within the Department have the discretion to apply notice and comment procedures to these matters, they are not obligated to do so unless otherwise mandated by law.”
LeadingAge will continue to monitor these developments and provide updates to members as necessary.
Explainer: EO 14173 on DEI, Equal Employment Opportunity
Executive order (EO) #14173, Ending Illegal Discrimination and Restoring Merit-Based Opportunity, signed by President Trump on January 21, 2025, and published to the Federal Register ten days later, repeals the 1965 EO #11246 on affirmative equal employment opportunity actions and creates new obligations for federal contractors, subcontractors, and recipients of federal grant money related to diversity, equity, and inclusion (DEI) activities. Read LeadingAge’s article here.
Bipartisan Reintroduction of Hospice Recertification Flexibility Act
Representative Carol Miller (R-WV) and five colleagues, Representatives Jared Golden (D-ME), Beth Van Duyne (R-TX), Don Davis (D-NC), Aaron Bean (R-FL), and Joe Morelle (D-NY) reintroduced the Hospice Recertification Flexibility Act on February 27. The bill would allow the hospice face to face recertification to take place via telehealth through December 31, 2027, and establish a claims code to track telehealth recertification. Telehealth flexibilities for hospice are currently authorized through March 31, 2025.
New HelpDesk Emails for CMS
The Centers for Medicare & Medicaid Services (CMS) shared with LeadingAge two new HelpDesk emails for providers with questions about Life Safety Code and Emergency Preparedness issues. General questions can be sent to EP-LSC@cms.hhs.gov. Non-deemed providers with questions regarding the Fire Safety Evaluation System (FSES) or waivers can email LSC-Waiver-FSES@cms.hhs.gov.
Weekly Recaps: Wednesday, March 5
Affordable Housing Weekly Recap. Here is your weekly Affordable Housing Weekly Recap.
Home Health Weekly Recap. Here is your weekly Home Health Weekly Recap.
Hospice Weekly Recap. Here is your weekly Hospice Weekly Recap.
Life Plan Community Weekly Recap. Here is your weekly LPC Weekly Recap.
Medicaid, HCBS, and PACE Weekly Recap. Here is your weekly Medicaid, HCBS, and PACE Weekly Recap.
Nursing Home Weekly Recap. Here is your weekly Nursing Home Weekly Recap.
