In observance of the Sukkot, there will be no Digest on Monday October 21^st or October 28^th. We will return on Monday, November 4^th. Happy Holiday!

A very warm congratulations and best wishes to Clif Porter as he takes the leadership reins at AHCA. A worthy successor to Mark Parkinson, Clif brings a background in SNF operations and a wealth of knowledge to the role.

We wish him the best of luck!

MANDATORY PROVIDER REVALIDATION:

CMS released updated guidance to the new provider enrollment revalidation requirement that went into effect on October 1^st. It’s available here (PDF). This is a serious requirement that potentially impact billing. CMS will be holding an open-door forum on Thursday to discuss the new requirements. This is a good breakdown from a law firm on the new requirements. For those of you who are AHCA members, they’ve released a guide here and will be holding a webinar later this week.

WHITE HOUSE:

The White House focused this past week on increased sanctions on Iran, the federal government’s response to Hurricanes Helene & Milton, and they issued a final rule, via the EPA, on replacing all lead pipes nationwide in the next 10 years. One item of indirect interest for us:

• They provided an update on their White House Challenge on overdose prevention efforts. More than 250 stakeholders committed to participating in making available opioid overdose medication for emergency situations. Especially if you’re in rural areas, there may be opportunities for training or access. For more details on the challenge, the central resource page is here.

CONGRESS:

With Congress out of town in the final election sprint, the post-election to-do list is piling up, headlined by the government funding bill. Even with the need for more funding to help FEMA deal with the twin Florida hurricanes, Speaker Johnson remained clear that he’s not bringing folks back to DC yet. With the final days of campaigning heating up, there’s very little of substance happening in the political sphere at the moment. For now, it’s just all campaign, all the time. Elsewhere in the political world:

• The Vice President released a new plan to provide more services to allow seniors to age in place. While politically popular, any plan would require Congressional approval.

• As if there wasn’t enough spending on ads already, get ready for a deluge of more ads. The FEC allowed a controversial Republican plan to move forward, which significantly cheapens the cost of political ads.

• We mentioned Governor Newsom’s veto of California’s AI bill last week. There was a strong push from Congressional members urging the veto, which highlights yet again the difficulty in finding a regulatory path forward on AI.

• One CRS report: an updated guide to the legal challenges to the Medicare Drug Price Negotiation program. It’s available here (PDF).

AGENCIES:

Continuing the Administration’s Medicare drug pricing negotiation plan, HHS, via CMS, released a RFI on potential medications that they want to include in a new $2 Medicare drug pricing model. The RFI is here (PDF). CMS’ sample list of drugs that could be included in the model is available here (XLS spreadsheet). Comments to the RFI can be submitted here through December 9^th.

CMS initiated several waivers for healthcare providers in Florida in the wake of Hurricane Milton.

CMS released updated 2025 MA & Part D star ratings. Fierce Healthcare broke down the ratings for different insurers.

The OIG at HHS released an audit of compliance by SNF’s in Massachusetts with federal life safety requirements. The full report is here (PDF) and the summary is here (PDF).

The ongoing lawsuit by the FTC against PBM’s took a turn this week as the PBM’s requested that the FTC commissioners are biased against PBM’s and need to be recused.

20 states filed a lawsuit against CMS’ minimum staffing mandate. The complaint is attached. This is the third lawsuit filed against the minimum staffing mandate, joining the provider lawsuit by AHCA and one brought by the state of Texas.

The NLRB General Counsel released a memo in which she maintained that the agency will do everything in its power to fight non-compete agreements. The memo is here (PDF direct download). McKnight’s has a good summary.

The Congressional Budget Office released a new analysis of ways to reduce drug prices. The report is here (PDF). Fierce Healthcare has a good summary.

FROM THE NOTEBOOK:

• Microsoft unveiled a full suite of AI tools specifically designed to assist healthcare providers.

• A good read from the Washington Post on the challenges and heroic efforts by Florida providers as they rushed to evacuate residents prior to Hurricane Milton.

• The Kaiser Family Foundation did a deep dive into the Medicare Part D prescription drugs benefit.

• We mentioned the fight between Epic & Particle last week. While the dispute is still winding its way through the court, Carequality arranged a resolution for the parties, available here (PDF). A good summary of dispute and resolution can be found here.

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