WHITE HOUSE:

With time winding down on the current Administration, they’ve shifted into the end of Administration mode, with the President announcing the single largest presidential “Day of Clemency” with nearly 1,500 pardons, releasing their final annual global health security report (PDF), looking back on their clean energy efforts and work in Africa, and signing a slew of outstanding bills.

CONGRESS:

Congress is in the home stretch of the 2024 session with only two major items left to go: the annual defense bill (NDAA) and government funding. Although usually bipartisan, the NDAA got more pushback this year owing to the presence of several controversial “culture war” provisions, but the House sent it to the Senate anyway, setting the stage for passage this week. The other big ticket item is the government funding Continuing Resolution, which is now expected to run through mid-March. There was an interesting development over the weekend when reports started to leak that Congress wanted to include a significant health care package in the CR, including a PBM measure. While the timing will be tight, the expectation is that a CR will get done before the government runs out of funding this Friday, December 20^th,, although Speaker Johnson will need Democratic support to get it done. Elsewhere in the political world:

• • One of the most powerful Congressional Committees is the House Energy and Commerce Committee, which has vast jurisdiction over many issues important to the SNF world, including Medicare & Medicaid, as well as the budget reconciliation process, which can be used by the GOP to pass an ambitious agenda by party line vote. This past week, Congressman Brett Guthrie of KY won an election to be the Chair of the committee in the upcoming Congressional session.

• • We’ve covered this several times, but the mechanics of how Elon Musk’s DOGE will work and the political realities of trying to cut government spending has Republicans nervous, especially now that they’re looking hard at healthcare spending.

• • While the short-term implications of losing the Senate are certainly impactful for Democrats, in the long-run, regaining control of the Senate is going to be extremely difficult, especially in rural America.

• • A group of Democratic lawmakers sent a letter to Dr. Mehmet Oz probing his past support of Medicare Advantage plans. You can access a copy here (PDF).

• • An early look at the candidates for New Jersey’s wide-open Democratic race for gubernatorial candidate in 2025.

• • Congressional Republicans are expected to take a swing at the SNF staffing rule, although the exact path they take is up for debate.

• • We’ve discussed the upcoming miniscule Republican majority in Congress. It just claimed its first victim: Oklahoma Republican Kevin Hern tabled his run for Governor so that he can stay in Congress.

• • 3 interesting CRS reports from the week (links are to the PDF)

• • R48296: With so much focus on the upcoming GOP effort to cut federal spending, an updated guide to improper payments by the federal government and legislative proposals to correct the problem.

• • IF10830: An updated guide to US healthcare coverage and spending. It’s useful to give you a scope of just how much the United States spends on healthcare.

• • IF12848: A guide to CMS’ insights into hospital ownership.

AGENCIES:

CMS released yet another update to their guidance on the new 855a used for provider revalidation. You can access a copy here (PDF). AHCA has a useful guide to the changes, which covers vendors and when information needs to be submitted.

CMS released their five year strategy on improving healthcare delivery. You can download a copy here (PDF).

The OIG at HHS released a special fraud alert highlighting the challenges in payments between MA plans and healthcare providers that might comprise illegal kickbacks. You can download a copy here (PDF).

HHS released the final rule related to the Healthcare Interoperability exchange. The final rule was published to the Federal Register on December 11^th and goes into effect on January 15^th. Fierce Healthcare has a good summary.

FROM THE NOTEBOOK:

• • A group of business owners in Missouri are suing to overturn the recent ballot initiative that raised the state’s minimum wage.

• • An embezzlement scheme at a county-run home was discovered when the facility was sold to new owners, who worked with the state to ensure that the appropriate parties were brought to justice.

• • Yet another study found that private insurance paid significantly more than Medicare did for the same services to hospitals.

• • An state audit found that Minnesota didn’t do a good enough job going after overpayments and debt owed by healthcare providers.

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