WHITE HOUSE:

The White House focused this week on Venezuela, withdrawing from several international treaties, and finalizing deregulation in environmental permitting reform. Two items of interest:

·         With the caveat that this is, for now, simply a social media post by the President, he called for a 10% interest rate cap on credit card debt, building off a campaign pledge. It’s not clear how the Administration would enact the cap, but there is bipartisan Senate legislation (introduced by Senators Bernie Sanders and Josh Hawley) in Congress with a 10% cap. Obviously, this is aimed at the consumer market, but such a big move could have serious repercussions for the entire lending industry.

·         Continuing the fallout from the daycare fraud in Minnesota, they announced the formation of a new “Division for National Fraud Enforcement” within the Department of Justice. The initial focus remains on Minnesota, but the carryover effect to elsewhere remains to be seen.

CONGRESS:

For possibly the first time in the current Administration, the Republican Congress showed some backbone. After the Senate voted to restrict the President’s War Powers, the House voted to resurrect the healthcare subsidies with 17 Republicans joining Democrats to pass the bill. While the bill won’t pass the Senate as is, the hope is that it will spur the Senate to find a path forward, despite some difficulty finding consensus. In the meantime, Congress continues to work through the appropriations process, bill by bill, although the most difficult funding bills remain. Even so, there’s optimism that we’re gonna avoid another government shutdown as we get closer to January 30^th. Elsewhere in DC:

·         The Congressional departures continue with two more Democrats heading for the hills. It’s all part of a broader trend of Congressional members looking for other positions, such as Governor. 

·         Speaking of gubernatorial races, Pennsylvania Governor Josh Shapiro officially launched his 2028 reelection bid.

·         A look at the upcoming legislative session in Florida. The governor is also calling for a special legislative session following the regular session to consider redistricting. 

·         It’s getting expensive early for political fundraising, with House Democrats collecting more than $120 million in 2025 as they look to retake the House.

·         All the healthcare reforms coming out of the Administration is spurring a new wave of candidates: Doctors.

·         A good overview of the goals, priorities, and team members for incoming NJ Governor Mikie Sherill.

AGENCIES:

CMS put out a new QSO regarding the transition to a new survey system had on reporting to Nursing Home Compare. It’s available here (PDF). McKnight’s has a good summary of the changes.

Another pharmaceutical company announced that they’re joining the ranks of companies that will be providing lower direct to consumer pricing on TrumpRX. 

HHS announced a brand new set of dietary guidelines with a focus on real food. The full guidelines can be found at the new central resource page. The fact sheet is here.

HHS froze childcare funding in five states, although a federal judge temporarily restored the funding.

The FDA announced two new guidances designed to relax oversight of AI in wearables and software.  A good summary of the changes can be found here.

FROM THE NOTEBOOK:

·         Even the Legislators in Pennsylvania recognize that the state needs to fix its outdated funding formula for SNF’s.

·         Utah became the first state to allow AI to prescribe medication online in a new pilot program just launched for folks in the state.

·         Modern Healthcare has a roundup of new state level healthcare laws that went into effect on January 1^st.

·         19 states updated their minimum wage, effective January 1^st.

·         A study in the Journal of American Geriatrics Survey looked at survey teams and found that there’s little consistency among the surveyors & teams around the country. Shocking, I know…

·         Oregon joined the list of state suing drug companies and PBM’s for artificially inflated drug prices.

·         CBS News did a deep investigative dive into prior authorization denials by insurance companies.

·         HealthAffairs has a good breakdown of how hospital classifications (for example, whether it’s considered rural or not) can drastically effect their Medicare reimbursement. The post is a condensed version drawn from this very thorough (and quite wonky) explainer of how hospitals are paid via Medicare.

·         Two other interesting reads from HealthAffairs:

o   The latest in DC on drug pricing.

o   A deep dive into the usage of AI in health insurance utilization.

·         California dropped coverage of weight loss drugs from Medi-Cal citing cost. The lack of coverage by insurance companies has become a primary driver for the many older Americans who are stopping to take the drugs.

·         A look at a new homeless shelter specifically aiming to help the elderly population.