WHITE HOUSE:

With time winding down on the current Administration, the White House focused this week on the G20 Summit, a new clean energy partnership with Brazil in President Biden’s final trip there, and a renewed push to get Congress to expedite emergency funding for the recent hurricanes.

CONGRESS/TRANSITION:

With the transition well underway, President-Elect Trump finished nominating all the primary spots in the Cabinet. Most important for SNF’s is the appointment of Dr. Mehmet Oz to the role of Director of the Center for Medicare and Medicaid Services (CMS). Dr. Oz’s track record on SNF-specific issues is sparse, although in the past he’s promoted (YouTube video) Medicare Advantage on his show. In fact, back in 2020, he co-wrote a piece advocating a “Medicare Advantage for All” style program, which would provide MA plans for everyone. This is an in-depth analysis of potential changes in store for the agency under the new administration. The rest of the appointments are fairly run-of-the-mill with few truly controversial names. Elsewhere in the political world:

• With a limited amount of legislative time left, a look at Congress’ to do list. Tops on the list is government funding, which must be done by December 20^th. Speaker Johnson wants a short-term Continuing Resolution that would punt the real decisions into the new Congress (and full Republican trifecta), which is the most likely option given the tight time frame.

• On the heels of significant pushback, the President-Elect’s most controversial nominee, Matt Gaetz, withdrew from the race. In his stead, Pam Bondi, formerly the Attorney General for Florida, was announced for the role.

• Elon Musk & Vivek Ramaswamy co-authored an Op-Ed in the Wall Street Journal in which they laid out their vision for the new “Department of Government Efficiency” (DOGE). They’re going to have an interesting ally: Representative Marjorie Taylor Greene announced that she’s going to be heading up a new Congressional subcommittee to support their efforts to identify fraud and waste in government spending. Senator Joni Ernst of Iowa will lead a similar committee for the Senate.

• One way that the new Administration can tackle Medicaid spending? Allowing states to impose work requirements on eligible beneficiaries.

• Axios took a look at the different approaches to pharma regulation among the President-Elect’s key appointees.

• It’s important to note that many of the goals laid out by the President-Elect will require buy-in from Congress, which is very quietly thinking about that responsibility.

• With the new administration coming into focus, a good look at how Democrats will navigate the political waters. Leading the charge in Congress will be Congressman Hakeem Jeffries, who was elected the House Democratic Leader In an expected move. Looking ahead, even as Democrats continue their election post-mortem, they’ve started laying out their political goals for the future.

• One interesting CRS report from the week: a guide on elder financial exploitation. You can access a copy here (PDF).

AGENCIES:

CMS issued a revised set of guidance to the LTC survey process. The svelte 902-page document is available here (PDF).

CMS also released a revision to Appendix Q, their guidance on Immediate Jeopardy. It’s available here (PDF).

The OIG at HHS released an updated compliance program guidance for SNF’s. It’s available here (PDF).

The FDA held a 2 day Digital Health Advisory Committee Meeting which focused on the usage of generative AI in the agency’s mission. Meeting materials and links to videos of the hearings are available at the hearing page. A summary can be found here.

A Texas Judge blocked an Administration rule related to overtime pay for white collar workers.

FROM THE NOTEBOOK:

• The Kaiser Family Foundation took an updated look at Medicare Part D in 2025. The also updated their FAQ on the Medicare Drug Price Negotiation Program to reflect CMS’ latest guidance on the program.

• With the incoming Administration expected to focus on introducing work requirements to Medicaid programs, KFF also looked at the latest on existing waiver requests and legislative activity around the country.

• Maine proposed new staffing requirements for assisted living and residential care facilities.

• New York State enacted a new set of regulations aimed at PBM’s.

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