WHITE HOUSE:

The White House focused this week on the President’s meeting with the family of hostages still held in Gaza, the 29^th UN Climate Change Conference (COP29), and another $18 million for energy efficiency projects (via the Energy Efficiency and Conservation Block Grant Program). Two items of interest for us:

• To mark Veteran’s Day, they highlighted the many actions that the Administration has taken over the last few years to support veterans, including investments in healthcare for vets. Especially if you deal with a veteran population, it’s a good resource to see all the different programs available.

• They hosted a “Classroom to Career” summit to highlight the more than $80 billion that has been invested by the Administration to support career pathways to grow the workforce, such as their registered apprenticeship programs or their new “Skills-First” hiring guide (PDF), a tool to identify ways to promote employees based on the skills they already have. There are good resources available that can potentially help with workforce shortages.

PRESIDENTIAL TRANSITION & CONGRESS:

With the formal confirmation that Republicans have secured control of the House, giving them a trifecta for the next two years, the President-elect began the process of nominating members to serve in Cabinet positions. The most important announcement to date for the long-term care sector is also, potentially, the most controversial: Robert F. Kennedy Jr. to lead the Department of Health and Human Services (HHS). This is a good breakdown of his stances on health issues and what he can, and can’t do, in the role. Of course, his confirmation by the Senate, even with a Republican majority, is far from a sure thing. His official record is very sparse on SNF issues, although his general philosophy appears to align with the GOP agenda of deregulation (with the exception of food manufacturing). Overall, it makes the choice of CMS secretary that much more important for the sector. Elsewhere in the political world:

• It’s important to remember that even with a trifecta, the margins for the GOP remain slim. One important procedural change was agreed upon by the GOP: the “Motion to Vacate” threshold was raised from one member to nine. This was the tool used to force out former Speaker McCarthy and raising the threshold gives the Speaker Johnson more breathing room.

• Speaking of Speaker Johnson, as part of the agreement, he received unanimous support to be the nominee for now. Conservatives are still somewhat frustrated with him, but he is expected to keep the role when it’s voted upon by the House in January.

• On that note, during a TV interview on Sunday, Speaker Johnson said that the GOP is likely to punt government funding till early 2025, setting the stage for another continuing resolution come December.

• Senator John Thune of South Dakota won the race to replace Senator Mitch McConnell as the new Senate Majority Leader. Possibly the most moderate of the candidates, the well-liked Thune’s first tough test will be shepherding the President Elect’s cabinet nominees through the difficult confirmation process.

• Even with a relatively large majority in the Senate, it’s important to identify the moderate Senators who will be the face of the middle in the new Congress.

• Now firmly in the minority, Democrats are taking two different approaches to governing: the nice guys and the folks itching for a fight.

• No rest for the weary, of course. Even with a strong win for the GOP in the elections, there’s an internal struggle brewing on how to approach the 2026 mid-terms.

• Every new Congress brings new faces, but this one is expected to be particularly tumultuous for health care policy.

• One specific policy initiative to keep an eye on: what’s going to be with the Medicare Drug Policy Negotiation program that has directly impacted drug prices, many of which are heavily utilized by the long-term care population.

• Two useful CRS reports from the week (links are to the PDF):

• R47846: This might be of more interest to the accountants, but an updated guide to all the expiring tax benefits coming in 2025, many of which will be part of the conversation surrounding federal funding.

• IN12458: A rundown of all the CRS resources available on federal policies for AI.

AGENCIES:

CMS released the 2025 premiums and deductibles for Medicare Part A & B beneficiaries. They also released the 2025 SSI standards. You can download a copy of the notice here (PDF).

CMS released a new QSO directing state survey agencies to look for potential fraud in hospice care. While meant specifically for hospice surveyors, it highlights the way the agency is thinking regarding changes of ownership. You can access a copy here (PDF).

CMS approved 1115 waiver demonstrations that provides coverage for incarcerated individuals leaving prison in Colorado (PDF) and Pennsylvania (PDF).

CMS, together with the Federal Transit Administration (FTA), released their updated guide to Medicaid transportation for non-emergency medical transport. You can access a copy here (PDF).

The OIG at HHS released an audit of provider relief fund payments to hospices, finding that 7 of the 30 programs didn’t comply with federal requirements for the fund. The summary is here (PDF). The full report is here (PDF).

FROM THE NOTEBOOK:

• A major concern with a Republican trifecta is the idea of Medicaid block grants, which would switch funding for the program from an entitlement program to block grant program. While any effort would likely not be targeted at the long-term community, a think piece from Kaiser Family Foundation pointed out in March an effort to switch to block grants would be exceedingly complex, both politically and practically.

• We’ve often talked about the black hole that is Medicare Advantage data. The Kaiser Family Foundation filed a lawsuit against HHS seeking disclosure of audits performed on the plans by the OIG’s office.

• While many changes to Medicare and Medicare will require Congressional approval, the Kaiser Family Foundation laid out what the Administration can do without Congressional action.

• HealthAffairs did a deep dive into how the election results will impact healthcare policy.

• Kentucky joined the ranks of states exploring how to tackle AI, with a legislative task force making 11 recommendations to the state legislature before the upcoming legislative session.

z-INTEL WhatsApp info:

• Group Invite Link: https://chat.whatsapp.com/EoNiPi8ezrOBV6SW1Gf7nD
• Status Link: https://wa.me/message/WMSWZATTB5D6E1