WHITE HOUSE:

This week, the White House launched a new, comprehensive partnership with ASEAN (Association of Southeast Asian Nations), the G20 summit and resultant effort to collaborate on global infrastructure investment, and a new $13 billion effort to modernize the American power grid. Two items of note:

• They celebrated the one year anniversary of the passage of the bipartisan infrastructure law with updated state-by-state fact sheets and an interactive map showing where projects have been funded. This is a useful tool to identify potential resources for infrastructure projects.

• This week marked the completion of the 120-day “Cybersecurity Apprenticeship Sprint”. However, they still have resources available to create your own apprenticeship program that may help with staffing needs.

CONGRESS:

With the confirmation this week that the GOP formally won a majority in the House, Nancy Pelosi announced her resignation from her role as Speaker. While expected, this sets off a scramble for leadership posts in both parties. Congressman Kevin McCarthy took the first step towards becoming Speaker when he secured the GOP nomination for the post. However, he’ll still need a majority of Congress to support his candidacy, which will be difficult with the GOP only expected to control ~221 seats. On the Democratic side, Congressman Hakeem Jeffries is expected to replace Pelosi as the Democratic Leader and the party is coordinating on the other leadership positions. Quite a few other notes from Congress:

• With divided government on the horizon, the upcoming lame-duck session is extremely packed. For our purposes, the main legislation will be the government funding bill.

• Following up on last week’s note about Senator Wyden’s report on Medicare Advantage, several Democratic Senators pushed the Administration to create more consumer protections in MA plans.

• The GOP announced their top priority upon reclaiming the house: investigation and more oversight of the President.

• For the analytically inclined, the Washington Post did a comprehensive breakdown of voting patterns that led to the Republican majority.

• 538 did an analysis of the major gains Democrats made at the state level. They also took an initial look at election post-mortems.

• RollCall looked at how incumbents fared during the Midterms.

• The Republican Governor’s Association will have a new chair, Iowa Governor Kim Reynolds.

• We’ve discussed the diminishing value of investments in elections. Politico explored the more than $100 million that Rick Caruso spent in his losing bid for Los Angeles Mayor and the relationship between candidate and spending.

• With former President Trump’s formal announcement that he’s running again for President in 2024, the inevitable comparisons between him and potential front-runner Governor Ron DeSantis have begun.

• Finally, with the Democrats guaranteed a Senate Majority, there is diminishing interest in the upcoming GA runoff election.

AGENCIES:

Last Monday (November 14^th) was the 60-day threshold before the expiration of the PHE. As it passed without any notice by HHS, the PHE will be extended again upon its formal expiration in January.

The OIG at HHS examined long term trends of Psychotropic drug use in SNF’s. You can download a copy of the full report here (PDF).

CMS published their final physician payment rule to the Federal Register today (November 18^th). You can access a copy of the final rule here. The new rules have a significant impact on CHOW’s and background checks for the new owners. Please make sure to review the rule and confer with your legal advisors.

22 states have sued HHS to repeal the staff vaccination mandate. You can access a copy of the lawsuit here (PDF).

The Congressional Research Service prepared a useful report on the healthcare related provisions that are scheduled to expire, or that have expired, during the prior Congress. You can download a copy here (PDF).

The GAO (Government Accountability Office) reviewed the VA’s oversight on state-run veterans SNF’s and found that the VA needs to improve their oversight.

OTHER:

• NPR took a look at how hospitals are taking advantage of consumer’s medical debt.

• While regulators only focus on private equity in SNF’s, Kaiser Health News examined private equity takeover of other healthcare specialties and practices.

• The Texas Tribune looked at the ongoing nursing staff shortage in Texas.

• The Washington Post looked at the potential minimum staffing regulation that the Administration is working on.

• Kaiser Health News explored the federal government’s decision NOT to appeal a court ruling that allowed Georgia to implement work requirements for their Medicaid program.

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