This is the final digest of the year. The digest will return on Monday, January 6th.
Happy Holidays and New Year to all!
WHITE HOUSE:
The White House focused during this end of year period on signing the annual National Defense Authorization Act (NDAA), setting new climate change goals, announcing another round of student loan debt cancellation for public workers, addressing trade competition from China, participating in the global Mpox response, and signing another batch of federal bills (and vetoing one that would have added federal judges). They released 2 end of year summaries on items that may be of interest:
- A guide to all their efforts on behalf of rural communities, which includes financial investments in infrastructure, healthcare, and other areas.
- A recap of their efforts to strengthen America’s supply chain, which include many medical supplies and other products.
CONGRESS:
While the road getting there was a bit rocky, with one agreed-to spending bill derailed by opposition from the President-elect and Elon Musk, Congress, as expected, finally passed a government funding CR that will keep the government funded through March 14th. The struggle to get a funding bill through highlights one of the challenges that will face the Speaker in the new Congressional term: the narrow GOP majority is going to make finding consensus difficult. Additionally, conservative dissatisfaction with Speaker Mike Johnson following the funding battle could lead to a challenger for the Speaker’s role, with Democrats unlikely to step in and support him. It’s all adding up to a very challenging first few months of the next Congressional term for Republicans under the new Administration. Elsewhere in the political world:
- The fight over government spending highlights something we’ve touched upon: actually cutting government spending, especially in non-discretionary areas like healthcare entitlement programs, is very complicated.
- Questions about the age of Congressional members resurfaced when it was revealed that one member has been living in an independent living facility for the last six months. With Congress getting older, and the voting margins so slim, it’s an important trend.
- One victim of the spending fight? PBM reforms, which got yanked from the final spending bill after Congress agreed to them in the first CR.
- The numbers are in on political ad spending for the House in 2024 and they are staggering: more than $11 billion was spent on the election.
- Bloomberg took a look at the failure of state-based efforts to tackle private equity in healthcare (registration required).
- While there’s a public perception that Congress is ineffectual, it’s important to note that when the bill doesn’t touch upon something controversial, Congress can get meaningful stuff done, in this case a significant overhaul of the federal child welfare system.
- A look at the close to the 300 new laws set to take effect in Illinois on January 1st.
- One CRS report of interest: an updated guide to Congressional approaches to legislation on cybersecurity. It’s available here (PDF).
CMS issued yet another update to their guide on the new 855a. It’s available here (PDF).
CMS launched a new website to assist SNF’s with a Nursing Home Staffing Campaign to increase staffing. They also launched a site to help encourage folks to become CNA’s.
HHS, vis CMS, announced 64 new drugs that will have a lower Part B premium for the first quarter of 2025. A fact sheet with the list of drugs is available here (PDF).
The OIG at HHS did an audit states and how they calculated the state portion for the FMAP increase during Covid, finding that 12 of the 13 states underreported their share. While wonky, many state budget legislative efforts include a federal match as part of the discussions and this is something to be aware of. You can access copies of the summary (PDF) and the full report (PDF).
With weight loss drugs much more prevalent, and a major topic of conversation with the recent White House decision to authorize coverage by Medicare, the OIG at HHS did an audit on Medicaid coverage of the drugs (as used for diabetes treatment) and found a 540 percent increase in spending in the last 5 years. The full report is here (PDF).
CMS announced that they would be sunsetting their MA Value Based Insurance Design model at the end of 2025. Fierce Healthcare has a good summary of the decision.
The FTC announced the final rule banning junk fees. The rule is pending publication in the Federal Register, but for those so inclined, a prepublication copy of the 313-page rule can be found here (PDF).
New York’s highest court issued a ruling that bars New York City from switching their retirees to an MA plan. For those so inclined, the ruling can be found here (PDF).
From the notebook:
- Connecticut became the latest state to reject a staffing mandate, recognizing the severe financial strain it would cause.
- A very useful resource from the Kaiser Family Foundation on potential Administrative Actions that the Trump administration can take that would impact all areas of healthcare.
- During the first Trump Administration, hospitals were required to publish their prices online. A deep dive into the relatively negligible impact it’s had on prices.
- HealthAffairs posted an analysis from CMS’ Office of the Actuary that looked at healthcare spending in 2023, which reached nearly $5 trillion.
- With a Republican trifecta in place, and healthcare spending on everyone’s mind, the Kaiser Family Foundation explored Medicaid work requirements.
- A deep dive into the numbers on Medicare’s new ability to negotiate drug prices and how it compares to other countries.
- Oh look, another MA plan is alleged to have overcharged the government. A health plan in NY settled with the Justice Department for a $100 million for fraudulent billing.
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