Park Place Live’s mobile-friendly site will be launched shortly.

WHITE HOUSE:

The White House focused this week on extending the TikTok ban delay (while potentially agreeing to a framework for a sale with China), signing a new “Tech Prosperity Deal” with the UK, and intervening to avoid a LIRR strike. Two items of interest for us:

• • The White House announced a new $100,000 fee for new H1-B applicants, along with several other restrictions. The full Proclamation is here. Following uncertainty after the initial announcement they also published a FAQ to clarify the specifics. The proclamation is certain to invite litigation.

• • They also launched a new “gold card” program that would allow expedited immigration for those who contribute a $2 million “gift” to the United States. The full Executive Order is here.

CONGRESS:

Congress continues to barrel towards a government shutdown at the end of the month. After the House passed a GOP-only “clean” Continuing Resolution that would fund the government for the next 7 weeks (through November 21^st), a follow-up effort in the Senate failed. With Democratic leaders demanding a sit-down with the President, Senate Majority Leader Thune is reluctant to move forward until the President weighs in. With only 10 days to go till the government shuts down, and any Senate bill requiring some Democratic votes to get to the 60 vote threshold, Democrats are playing hardball as they exercise the limited leverage they’ve got. As always, whenever government funding is at stake, it’s a race to the deadline. Elsewhere in the political world:

• • One of the big hang-ups on the Democratic side is their push to make sure that the ACA subsidies, which make healthcare affordable, are included in any funding plan. It even has some Republican support, to their political detriment. Democrats think it’s the reason that any shutdown would be blamed on the Republicans.

• • The new era of fiscal conservatism in healthcare coming out of DC is shaping up as one of the big ticket items in the midterms.

• • Even with the redistricting gains made by the GOP, the House remains a toss-up for 2026.

• • A running list of the Congressional Members that are not seeking reelection in 2026.

• • The race for the open Senate seat in North Carolina is on pace to be the most expensive Senate race in history, with some projecting that it’s going to exceed $1 billion dollars.

• • A deep dive into the seamy side of the connection between lobbyists and the Administration.

AGENCIES:

CMS opened applications to states for the $50 billion Rural Health Transformation Fund, created by the One Big Beautiful Bill. For now, states will apply to CMS for the funding which will be awarded before December 31, 2025. Once states get the funds, they will then be able to create programs for their health care providers. If you’re interested in the mechanics, there’s a central resource page from CMS with all the technical details. As part of the PR blitz surrounding the program, HHS Secretary RFK Jr. and CMS Administrator Mehmet Oz authored an op-ed on the program. Dr. Oz also released a video on it. On the political side, it’s gonna be messy .

Following Dr. Oz’s recent video announcement on X that CMS is opening up applications, and the release of a guidance letter to governors (PDF), CMS updated the central resource page for the campaign with a timeline targeting Spring 2026.

While CMS announced way back in May that they plan on hiring 2,000 auditors to go after Fraud, Waste, & Abuse in Medicare Advantage programs, it looks like they’re having trouble meeting their self-imposed deadline.

HHS held a pair of roundtables this week to address Long Covid.

Following last week’s Presidential Memorandum directing HHS to look at deceptive advertising in Pharma, RFK posted a video to his X account discussing the effort.

The OIG at HHS released a new report finding that SNF fail to report more than 40 percent of falls. The full report is here(PDF). The summary is here (PDF). A companion data snapshot is here.

Nothing official yet, but SEC Chairman Paul Atkins publicly announced that the agency will be proposing a rule to eliminate the quarterly earnings report, following a push by the President.

FROM THE NOTEBOOK:

• • The Joint Commission joined forces with the Coalition for Healthcare AI to launch the first set of guidance for “responsible AI Adoption” in healthcare systems.

• • A new working paper from several researchers, including Dr. David Grabowski, found that I-SNP’s are very effective at reducing rehospitalizations. The paper can be accessed here (PDF).

• • Add Michigan to the states facing a severe budget crunch.

• • Despite the Administration’s best efforts, the federal bureaucracy is putting up a real fight.

• • AETNA made a change to its reimbursement policies for hospitals under their MA plans to has hospitals up in arms.

• • Optum RX is increasing the payment floor to approximately 2,300 pharmacies across the country for certain brand name drugs. HealthcareDive has the details.