WHITE HOUSE:

The White House focused this week on Operation Epic Fury, working to lower rising oil costs (via a waiver issued by the Treasury Department that allows the US purchase of Russian oil), and new deregulatory efforts aimed at easing the barriers to construction of new, affordable housing. One item of indirect interest for us:

• Continuing the theme of making homeownership more affordable, the President signed a new Executive Order that directs federal regulators to facilitate more affordable mortgage credit and lending guidelines for homeownership. While specifically targeting the personal market, in theory, increasing liquidity and credit rules might have a positive impact on the commercial markets as well.

CONGRESS:

Stop me if you heard this before: Congress is nowhere. Even after the first set of missed paychecks for TSA workers, no progress has been made in finding a path to funding DHS, as the partial government shutdown continues. Despite the funding gridlock, the Senate did manage to pass a bipartisan housing Bill, but it faces an uncertain future in the House, highlighting, yet again, the challenges facing GOP Speaker Mike Johson. With the President dead-set on getting a voting bill passed, House Republicans threatening to stall legislation until the Senate does so, and the slim Republican majority facing internal turmoil, the outlook for Congressional business isn’t quite sunny at the moment. Elsewhere in DC:

• With an eye towards a tumultuous election season, Republicans are circling the wagons on maybe, possibly, potentially, thinking about another party-line Reconciliation bill, but it’s not going to be easy.

  
  

• A big primary coming up this week in Illinois, where voters will choose the state’s next Senator, along with a slew of other statewide and local races.
  
  

• Anxiety for the GOP is rising as the Midterms approach, with Democrats outperforming expectations in state-level Legislative races and the party’s messaging is all over the map.

  
  

• A busy week for the Congressional Research Service, with quite a few useful CRS reports:

-R48882: A breakdown of the benchmarking updates and rate adjustments in the recent MA rule

-IF11056: An update to their guide on the importation of prescription drugs

-IF12270: An update to their guide on the policy gap between federal and state regulation of Marijuana

-IF13182: An outline on the impact that generative AI may have on the labor markets. While not specific to the healthcare field, it’s always worth noting changes to the labor market, especially one that comes with the seismic upheaval that AI may lead to.

AGENCIES:

CMS announced the third round of drugs chosen for the Medicare Drug Price Negotiation program. The selection of the 15 chosen drugs kicks off a round of public input and negotiating between the manufacturers and CMS. The full details on the process can be found at the program’s central resource page.

CMS’ Center for Clinical Standards & Quality (CCSQ) released their roadmap for the nation’s clinical health standards and goals over the next few years. The roadmap can be accessed here (PDF).

CMS issued new patient protections guidelines related to organ donation and procurement. The QSO is here (PDF).

CMS is hosting their quality conference this week.

The DOJ announced an $117.7M settlement with Aetna for violations of the False Claims Act related to inaccurate diagnoses codes in their MA plans. Concurrent with the settlement, the OIG released a statement that even though Aetna settled with the DOJ, they refused to enter into a Corporate Integrity Agreement (CIA) with the OIG at HHS, and therefore the OIG is reserving the right to use other tools to monitor Aetna.

FROM THE NOTEBOOK:

• Big news out of Indiana where the Governor signed HB 1277, a bill that specifically carves institutional long-term care out of the state’s Managed Medicaid program following the exhaustion of a resident’s 100 days of Medicare eligibility. In addition to the practical benefits of having residents out of managed care, this is the first time a Republican state decided to exclude LTC from managed care, solely because managed care cost the state more than running their own Medicaid program. The full bill can be found here.

  
  

• In perhaps related news, MedPAC’s latest estimate is that MA will cost the federal government $76 billion more than if those enrollees were in traditional FFS. As a result of the overpayments, the Joint Economic Committee found that MA premiums rose by more than $200 per beneficiary, leading to $13.4 billion in higher premiums for seniors. Maybe those folks in Indiana are on to something…

  
  

• For the second straight year, Florida is ending its regular session without a budget. The legislature is aiming for a special session in mid-April to find a path forward.

  
  

• NJ Governor Mikie Sherill released the broad outlines of her first budget, with the full budget expected later this week. The budget in brief can be found here (PDF).

  
  

• A judge has ordered United Healthcare to hand over document related to nH Predict, the AI tool at the heart of a lawsuit against United related to the denial of post-acute care to members of their MA plan.

  
  

• Speaking of MA, Kaiser Health News and NPR did a deep dive into the comments submitted to CMS related to the recent payment rule that slashed rates. Guess what? More than 83% were identical to a letter found on the website of a trade association linked to MA plans. Maybe it’s time to rethink how popular the program actually is…

  
  

• Yet another study found that CMS’ star ratings aren’t reflective of the underlying quality provided in facilities.

  
  

• Microsoft is joining the AI health train with a new tool designed to act as a ‘Concierge Doctor’.

  
  

• Utah is leading the fight against AI.