WHITE HOUSE:

As the White House eases into the New Year, they continued to sign legislation, explore new ways to tackle the border crisis, and promote the ongoing projects arising out of last year’s bipartisan infrastructure law. Two important executive branch actions:

• USCIS announced a new proposed rule that would raise fees for visa applications, including for H1-B applicants. They also published a FAQ on the new rule. Their stated goal is to cover their organizational budget and hire more staff to eliminate any outstanding backlog. You can access a copy of their most recent progress report here (PDF). The full proposed rule can be found at the Federal Register and comments can be submitted through March 6^th.

• The FTC announced a proposed rule that would ban non-compete clauses in employment agreements. The proposed text of the new rule can be found here and the full text can be found here. They also published a fact sheet on the new rule (PDF). While the rule is virtually certain to be challenged in court, and it’s too early to speculate on what a timeline for implementation would be, if you utilize non-compete clauses, it’s something to monitor.

CONGRESS:

It took 15 separate votes (the most in 100 years!), but Congressman Kevin McCarthy finally secured the role of Speaker of the House. A core group of conservative House members held back their support until they received several important concessions that will impact how the House conducts business over the next two years. It’s important to note that until the Speakership was resolved, no House business could occur, including swearing-in of new members and paying committee staff. A few other items from Congress this week:

• While the House was in chaos, with no rules in place, the Senate got off to a relatively peaceful start.

• The announcement by Michigan Senator Debbie Stabenow that she will not run for reelection highlights the struggle Democrats will face in holding the Senate in 2024.

• The Speaker struggle made it clear that the GOP will have a very difficult time finding consensus over the next two years, something that will impact the House’s ability to find common ground for legislation.

• Following up on notes from earlier digests, the data is starting to show that mail-in voting doesn’t favor either party.

• Politico looked at the healthcare advocacy scene in DC as Senator Bernie Sanders steps into his new role as Chairman of the Senate’s HELP committee.

• A deep dive from the NY Times on where the red wave narrative came from and what pollsters will be doing to correct it moving forward (something that will shape political activity over the next two years).

• Finally, a fascinating scene unfolded in Pennsylvania, where the new Speaker was chosen by consensus among Democrats and Republicans. Following his election, he immediately resigned from the Democratic party and will lead as an independent.

AGENCIES:

Several important items out of CMS this week:

• They released an outline of key dates related to the unwinding and other provisions included in the government funding bill. You can access a copy here (PDF).

• In conjunction with the new deadlines established by the Congress, they updated their guide to managed care plans and the unwinding of the rules that will allow states to remove beneficiaries from their Medicaid programs. You can access a copy here (PDF).

• A new guidance letter to state Medicaid officials on the usage of Medicaid Managed Care programs to fund “In Lieu of Services” (ILOS) benefits. Essentially, this allows state to build programs that fund social equity challenges (like affordable housing or nutritional efforts). You can access a copy of the letter here (PDF).

• A guidance letter that approves Medicaid/CHIP funding for conversations between professionals that take place without the beneficiary present. You can access a copy here (PDF).

On Friday, the FDA approved a new drug that may help treat Alzheimer’s patients.

OTHER:

On the non-agency front:

• MACPAC (a non-partisan federal agency that advises Congress on Medicare/Medicaid) released their latest report on Medicaid SNF payments, finding that a significant majority (approximately 80%) of base Medicaid payments were below the cost of care. You can access a copy of the report here (PDF).

• The National Conference of State Legislatures (NCSL) released an interactive database of the more than 165,000 pieces of legislation introduced across state legislatures in 2022, highlighting trends that can predict what will happen this coming year.

• A new study was released analyzing Medicare’s efforts to reduce hospitalizations among long-stay residents, identifying the necessary components for successful implementation.

• JAMA published a study highlighting the relationship between staff vaccination rates and lower incidences of Covid-19 among residents/staff.

• Penn University launched a new $7.5 million initiative to encourage local high school students in Philadelphia to pursue a career in nursing.

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