We're just a few weeks away from this year's Zimmet Conference. The conference will be at Mohegan Sun from August 12-14. You can register here: https://www.zimmetconference.com/. Hope to see you there!

WHITE HOUSE:

Over the last two weeks, the White House focused on signing the first Congressional bill governing digital currencies, called the “GENIUS” Act (a through summary is here), continuing with his tariffs implementation, creating a new class of government employee (to help with Presidential policy setting), issuing several deregulatory proclamations aimed at undoing the prior Administration’s energy policies (such as coal or "green energy" sources), signing a Congressional bill that increases the penalties for Fentanyl trafficking, called the “HALT Fentanyl” Act, and announcing more than $90 billion in AI investments in PA.

CONGRESS:

With the passage this week of the first successful “recissions” passage in nearly 30 years, Congress deferred, yet again, to the White House on federal spending. The bill codifies $9.4 billion in cuts originally identified by DOGE, primarily from foreign aid and public broadcasting. While the financial effects of the bill are relatively minor (in the context of the overall federal budget), the continued encroachment by the White House on Congress’ power of the purse is making Congressional members very uncomfortable. With the Republicans starting to think in earnest about the government funding bills that need to get done by the end of September, the White House likely to try to get another Recissions bill done, and Conservatives hoping for another bite at using another Reconciliation bill to tackle more spending cuts, it’s going to be a challenging run up to the September 30^th government funding deadline. Elsewhere in DC:

• That didn’t take long… Senator Josh Hawley (R – MO) has already introduced legislation that would roll back the Medicaid cuts he voted for in the One Big Beautiful Bill. In the meantime, hospitals are gearing up for the legislative fights that will take place over the next few years.

• Ever wonder how a Congressional budget bill to save money turns into a nearly $5 trillion boondoggle? Politico has a really good breakdown on what happened in the recent Reconciliation bill and which provisions are costing the most money.

• The House Ways & Means Committee is holding another hearing on Medicare Advantage next week.

• It’s gonna be a busy week for the Committee as Dr. Oz is scheduled to chat with a bipartisan group next week about CMS priorities that fall under the Committee’s jurisdiction.

• An early look at the five Senate seats that are most likely to flip in 2026. Meanwhile, on the House side, Republicans are outraising Democrats in battleground districts.

• Looks like a whole bunch of Congressional members are joining the ChatGPT train.

AGENCIES:

CMS found 2.8 million individuals that had a duplicate enrollment in more than one Medicaid plan, whether in multiple states or multiple types of plans. Moving forward, CMS plans on partnering with states to reduce the duplicate enrollment.

CMS announced that they’re going to tamp down on the usage of Medicaid funds for projects that aren’t aligned with Medicaid’s traditional mission. Their two areas of focus are continuous eligibility (PDF), and workforce initiatives (PDF) using Medicaid funding. The workforce initiative is something that has benefited several SNF’s in the past and is currently active in 5 states (CA, MA, NC, NY, & VT).

CMS released several FY26 proposed payment rules:

• Physician Fee Schedule (PFS). The formal rule can be found at the Federal Register page.
• Hospital Outpatient & Ambulatory Surgical Center (ASC). The formal rule can be found at the Federal Register page.

As part of the payment rules, CMS issued several proposals to modernize the system and eliminate FWA (fraud, waste, & abuse). Included are proposals that would reduce spending on skin substitutes (in the physician payment rule), beef up the hospital price transparency requirements (in the ASC rule), and make several changes to the hospital 5-star system (in the ASC rule).

The IRS published a new fact sheet on several of the new deductions included in the One Big Beautiful Bill.

ARPA-H launched a new project, titled FRONT (Functional Repair of Neocortical Tissue), with the ambitious goal of restoring brain tissue for those with brain damage. Grant details can be found here. The press release can be found here.

FROM THE NOTEBOOK:

• As the Administration continues to crack down on Immigration, especially for those in the country under a Temporary Protected Status (TPS), SNF’s are getting particularly hard hit.

• The Kaiser Family Foundation explored Medicare’s standalone Prescription Drug Market plan and what it means for insurers.

• Through the first few months of the year, MA plans were fined by CMS more than the last four years combined, according to a new analysis by Healthcare Dive.

• As more details on the Justice Department’s investigation into United Healthcare’s Medicare billing practices emerged, the NY Times did a deep dive into United Healthcare’s aggressive campaign to go after their critics.

• Humana lost a lawsuit against CMS challenging their star rating.

• Arizona erased more than $429 million in medical debts for residents of the state.

• Governor Abbott is bringing the Texas Legislature back for a special session, with redistricting on the menu.

• Perhaps mostly of interest to those in the advocacy world, but a good read on what went wrong for hospitals in their advocacy efforts during the leadup to the One Big Beautiful Act.

• Axios examined the challenges that states will face as they race to implement the new work requirements required under the One Big Beautiful Bill.

• No one has any idea how the $50 billion rural hospital transformation fund is going to work.