WHITE HOUSE:

It was a relatively quiet week out of the White House as the President mainly pursued messaging, focusing on a robust job report, celebrating small business week, and issuing Presidential messages supporting Jewish American Heritage Month, National Nurses week, National Physical Fitness and Sports month, among others. One item of indirect interest:

• As we’ve been following, in an effort to lower drug prices, the Administration has pursued Most Favored Nation (MFN) drug pricing, a policy that ties drug prices in the US to those other developed countries. The White House’s Council on Economic Advisors (CEA) released an analysis of how the program works and the savings that it has brought Americans. The full analysis can be found here (PDF).

CONGRESS:

After a week off, Congress comes back with a relatively straightforward to-do list, although with funding for the government in place (more or less), there isn’t a must-pass bill on the docket. Republicans are interested in another Reconciliation bill that would fund many of their other priorities, although getting anything passed in Congress these days has been a slog. Republicans continue to snipe at each other, as Speaker Mike Johnson navigates an unruly Congress. Still, with little fiscal business on the immediate radar, things are relatively calm in DC. Elsewhere in the political arena:

• From last week, but the House Committee on Oversight and Government Reform is exploring how the complexity of healthcare billing is contributing to rising healthcare costs. The letter from Committee Chairman James Comer to CMS Administrator Dr. Oz is here (PDF).

  
  

• Things went south in a hurry for Democrats this week as the Virginia state supreme court struck down the redistricting effort in the state. Following last week’s Supreme Court ruling that opened the door to new state redistricting efforts, especially in the South, Republicans are now in a great spot to keep the House. On the flip side, Democrats might be in a better spot to take the Senate.

  
  

• The White House is firmly in “hope for the best, plan for the worst” mode as they prepare staff on how to handle a potential flip in House control and the ensuing Democratic oversight that would come with it.

  
  

• Noise continues to grow about more federal regulation of AI, even as the mixed messages from the Administration continue.

  
  

• One relevant CRS report from the week:

  
  

  IF13214: a very broad overview for Congressional offices on how private equity plays out in different industries

AGENCIES:

CMS Administrator Dr. Oz penned a blog post with an update on the pledge by insurers to modernize the prior authorization system.

CMS announced a new effort that will provide GLP-1’s to Medicare beneficiaries for $50 a month, starting July 1^st, 2026, and continuing through December 31^st, 2027. Full details on the program can be found at the central resource page here.

HHS Secretary RFK Jr, announced a new effort to “curb” overprescribing. HHS also published a “Dear Colleague” letter (PDF) outlining the deprescribing efforts.

ARPA-H announced the launch of its new “Intelligent Generator of Research” (IGoR) program, designed to accelerate next-gen research project using AI. The central resource page for the program is here.

The Social Security Administration released an analysis, highlighting the Agency’s modernization efforts, on the one-year anniversary of the appointment of its Commissioner.

FROM THE NOTEBOOK:

• The Kaiser Family Foundation did a deep dive into efforts, at the federal and state levels, to regulate the use of AI in the prior authorization and claims review process. 

  
  

• Modern Healthcare explored state level initiatives to regulate insurers, on a wide range of topics, including provider reimbursement and prior authorization.

  
  

• Colorado is expanding the use of CMP funds to address staffing shortages.

  
  

• United Healthcare said they’re eliminating prior authorization requests for another 30% of the healthcare services they offer.

  
  

• A good read from McKnight’s on an ongoing lawsuit related to CMS’ use of CMPs without a trial. 

  
  

• JAMA has an interesting analysis of the usage of management consultants by non-profit hospitals. The study found limited impact on healthcare outcomes f despite the nearly $8 billion spent by the hospitals.

  
  

• JAMA, in conjunction with Brown University, looked at the federal enforcement penalties on MA plans. Turns out that there isn’t a whole heck of lot of “enforcement” going on as penalties, in most years, work out to less than $3 per enrollee…

  
  

• We’ve discussed a lot about TrumpRX and the Administration’s efforts to lower drug prices. CBS News did a deep dive into the effort and whether it’s actually providing savings.

  
  

• An academic study examined the usage of machine learning to predict residents at high-risk of adverse outcomes, including death.

  
  

• Texas Attorney General Ken Paxton announced an investigation into nearly 30 businesses in the state for their usage of H1B visas.