WHITE HOUSE:

The White House focused this past week on the ongoing response to Hurricane Helene (even as Florida prepares for the arrival of Milton later this week), new efforts on the border, and the latest gathering of the “International Counter Ransomware Initiative”, a group of cybersecurity experts from multiple nations dedicated to helping counter the threat of ransomware. One item of indirect interest for us:

• They announced a new series of actions designed to help consumers with medical debt. In addition to general efforts on the part of the public, they also tasked HHS with adding questions about medical debt to the Medicare Current Beneficiary Survey (MCBS), which is designed to help HHS better understand seniors’ healthcare needs. As this can shape federal healthcare policy, it’s something to keep an eye on.

CONGRESS:

With Congress out of town till after the election, it’s been all campaign, all the time. Even with the fund most used for disaster relief running low, Speaker Mike Johnson is not planning on bringing lawmakers back. Although things can change with a second hurricane in a week hitting Florida, the game plan for Congress is a five-week lame duck session starting November 12^th with several items on the agenda, including figuring out a spending plan for the coming fiscal years and the annual defense bill, always seen as one of the “must-pass” pieces of legislation. For now, let’s enjoy the relative calm out of DC. Elsewhere in the political world:

• Two vetoes out of California that also have national import:

• The Governor vetoed a bill that would have given the state the ability to block private equity takeover of health care providers.

• He also vetoed SB 1047, the landmark AI regulation bill that would have installed the first serious set of regulatory rules on the development of AI. This was a controversial bill that didn’t fall neatly into traditional partisan lines, but the likelihood is that there will be more efforts in future sessions to find something that works.

• As we get closer to the election (now less than 30 days away!), the map continues to be in flux, with Democrats more optimistic about taking over the House.

• Republicans are trying to even the playing field with early and mail in voting, but convincing the public remains a challenge. In the meantime, hurricane season is wreaking havoc on early elections in several swing states.

• A good look at what the future of the GOP would look like, should the election go poorly.

• One very useful CRS report from last week: an updated version of their guide to state minimum wages. You can access a copy here (PDF).

AGENCIES:

HHS, via CMS, released the final guidance for phase two of the Medicare Drug Pricing program. The fact sheet is here (PDF). Should you really be in the mood, you can access a copy of the full 313 page guidance here (PDF). The next set of 15 drugs chosen for the program will be announced by February 2025. Many of the drugs chosen in the first round are heavily utilized by residents of SNF’s. As the program is politically popular, it’s likely here to stay.

CMS activated the Advance and Accelerated Payments program for providers affected by Hurricane Helene.

CMS issued a revision to the staffing and quality measures for Nursing Home compare. You can access the QSO here (PDF).

CMS published their annual report on their progress towards the agency’s health goals. It’s available here (PDF).

CMS issued a new set of draft items for MDS reports, scheduled to go into effect on October 1, 2025.

HHS finalized the new federal health IT plan with their goals over the next five years. It’s available here (PDF).

FROM THE NOTEBOOK:

• The Kaiser Family Foundation explored Medicare Part D premiums for next year.

• They also explored Medicare coverage of telehealth and the Congressional outlook for the flexibilities that were introduced during Covid.

• It looks like insurers are cutting back on their MA plans, something to keep an eye on as the business outlook for MA suffers.

• Missouri launched a new algorithm to determine eligibility for at-home services. Up to 8,000 folks are expected to lose eligibility.

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