WHITE HOUSE:

The White House focused this week on the President’s address to the World Economic Forum in Davos, new guidance to federal agencies on how to handle environmental permitting requests during emergency situations, and ratifying the new Charter of the Board of Peace. Two items of interest for us:

·         The White House’s Council of Economic Advisors released a new report on AI titled “Artificial Intelligence and the Great Divergence”. While short on specific policy actions, it provides real insight into the Administration’s agenda related to AI: more deregulation, faster adoption, and doing everything possible to support the growth of American AI. The full report is here (PDF).

·         While not relevant to SNF’s specifically, I know that many of our readers are involved in the real estate world as well. The President issued a new Executive Order that directs federal agencies to explore ways to block institutional investors from buying single family homes, as well as create policies that would promote the ability of families to buy those same homes. While not clear if the EO will actually drive down housing prices, the President is getting strong political support from an unlikely ally: progressive Democrats. The EO is here.

CONGRESS:

What once looked promising is no longer a sure thing. Ahead of the government funding deadline this Friday (January 30^th), the House passed the last of the funding bills on Thursday, which included HHS and DHS. The unfortunate events over the weekend in Minnesota has Senate Democrats up in arms, with several switching sides and publicly proclaiming they won’t vote for a bill that funds DHS & ICE. The Senate will have even less time to deal with it this week as Monday’s session was cancelled owing to the ongoing winter storm battering the East Coast. For now, another government shutdown is in the hands of Senate Minority Leader Chuck Schumer. Elsewhere in DC:

·         The HHS funding bill passed by the House contained several PBM reforms. While final passage of the bill is dependent on the Senate figuring out a path forward on DHS (as mentioned above), there is strong bipartisan support for this component of the government funding bill.

·         In back-to-back hearings this week, first with the Ways & Means committee, and then with the House Energy & Commerce Health Subcommittee, the CEO’s of the largest health insurers were grilled by Congress over rising insurance costs. Despite efforts to point blame at hospitals and drugmakers, lawmakers didn’t seem to buy it.

·         The House Judiciary Committee released a report this week that found CVS may have violated antirust law with their PBM practices. The full report is here (PDF).

·         California’s redistricting efforts faces its final challenge as an appeal is headed to the Supreme Court.  Assuming it survives the challenge, and that Virginia voters approve a new plan to redistrict,  there’s a real chance that Democrats are going to win the redistricting war and end up with an easier path to a House majority.

·         As the GOP majority dwindles, it’s causing headaches for votes with GOP leadership imploring members to do everything possible to be in DC.

·         With midterms coming up, it’s gonna be all campaign season, all the time, starting with the President.

·         2025 numbers are showing more lobbying revenue than ever.

·         While the election landscape in DC is getting less competitive, it looks different at the state level, with 15 states looking like real contenders for flipping.

AGENCIES:

CMS posted updated 2026 federal poverty level standards, which set the financial guidelines to qualify for Medicaid. The full memo is here (PDF).

HHS announced this week that the United States has formally withdrawn from the World Health Organization.

HHS continues to beef up its anti-fraud division.

FROM THE NOTEBOOK:

·         I’m shocked, shocked, at a new study that found a “positive” association between higher Medicaid payments and higher star ratings. Who woulda thunk? The study’s authors presented their findings on a webinar hosted by the Moving Forward Coalition. The slides from the presentation are here. McKnight’s also has a good summary.

·         The folks in Ohio are still waiting to get paid following the state’s court ruling in favor of SNF’s.

·         Acentra Health, a QIO that works with CMS to help Medicare beneficiaries, performed an audit on coverage denials that led to an appeal. They found that 93 percent (!) of SNF based appeals came from MA beneficiaries despite MA only accounting for 52 percent of Medicare benficiaries… McKnight’s has a good summary of the webinar this week where they presented their findings.  

·         Florida is moving forward on an AI Bill of Rights, which cleared its first procedural hurdle with passage out of a Senate Committee this week.

·         The Washington Post did a deep dive on the lawsuit (filed by Epic) that we mentioned last week which alleges patient data is being sold by EHR companies.

·         It’s not just health insurance companies that are facing backlash: all insurance companies are feeling the heat.

·         SNF’s on Ice? This was a fun read.