WHITE HOUSE:

The White House focused this week on highlighting the success of the Administration’s Invest in America agenda, catching up on a whole lot of legislative bill signing (mostly ceremonial bills, likely facility naming, but a good look at the mundane side of government), and their efforts to solve HIV. Two items of interest for us:

• More specifics below in the agency section, but the Administration announced a proposed rule that would allow Medicaid and Medicaid to cover anti-obesity medications, such as GLP-1’s. Given the timing of the announcement, the final rule would be issued during the Trump Administration, although the popularity of the drugs may make it difficult for the new Administration to reject the rule.

• They announced new efforts to aid small businesses, including increasing the caps on lending programs and working to improve federal agency forecasting for contracting opportunities. Especially for those vendors who deal with government contracts, this may be helpful in better understanding the federal sales cycle.

CONGRESS:

Congress is scheduled to return tomorrow following the Thanksgiving recess with only 15 legislative days scheduled to get done the two main items on the agenda: government funding and the annual defense bill. The expectation is that they will do a short-term funding bill that will punt things into the Republican controlled Congress. The challenge, of course, will be that the GOP will have an extremely slim majority in the House. Add in an ambitious agenda for the first 100 days as well as figuring out how to pay for over $4.5 trillion dollars in expiring tax breaks that were passed during the first Trump Administration (which will renew debate on entitlement programs) and you’ve got a recipe for a very challenging political setup for the Republican Congressional leadership. With everyone having an opinion on Republican priorities, it’s going to be a wild ride. Elsewhere in the political world:

• A lot has been made about DOGE, the new venture led by Elon Musk and Vivek Ramaswamy with the goal increasing government efficiency and eliminating waste. It’s important to note that there are serious legislative hurdles to any cuts being implemented, although conservative think tanks have identified over $1 trillion in cuts that can be accomplished via Executive Order. Even though DOGE has no official legislative authority, lawmakers are lining up to work with them.

• The President-Elect has finished nominating his healthcare leadership across the various federal agencies, although what it means for the healthcare agenda is anyone’s guess.

• One relevant legislative battle to keep an eye on with a potential impact on SNF’s is the different views on immigration between several high-profile members of the new Administration.

• It looks like the President-Elect wants to bring in an “AI Czar” to help coordinate federal policy on AI, even as Hill staffers think that the new Congress and Administration will continue to search for a regulatory policy for AI.

AGENCIES:

As mentioned above, HHS, via CMS, released a proposed rule that would allow Medicare to cover anti-obesity medication. The proposed rule also includes a number of other regulations governing MA plans, including their usage of AI. A Fact Sheet on the proposed rule is here. The proposed rule will be published to the Federal Register on December 10^th, at which point the 60 day comment period will be kick off. For those so inclined, you can access a copy of the 713-page prepublication rule here (PDF). Healthcare Dive has a good summary of the MA components of the rule.

CMS finalized a rule that will improve access to kidney transplants for patients suffering from chronic kidney disease and ESRD. You can find a fact sheet on the rule here (PDF). The central resource page for the new model is available here. The final rule is scheduled to be published to the Federal Register on December 4^th. In the meantime, you can access a prepublication copy of the sleek 595-page rule (PDF) here (PDF).

CMS posted yet another update to their guidance on the 855a provider revalidation form. It’s available here (PDF).

CMS published a guide to states on the basic requirements for performing Medicaid renewals. It’s available here (PDF).

FROM THE NOTEBOOK:

• A good read from Axios on the growing discontent among GOP lawmakers with MA plans and just how much it actually costs the federal government, even as the program appears to be a favorite of incoming CMS nominee Dr. Mehmet Oz and the Trump Administration.

• Provider groups in Minnesota sued the state challenging the legitimacy of their new workforce standards and rules related to pay.

• Several healthcare groups in Minnesota will not be accepting MA plans in 2025.

• There’s been a lot of talk from the Administration on tackling Medicaid spending, mostly focused on the expansion population. The Kaiser Family Foundation explored what it means for Republican and Democratic states.

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