WHITE HOUSE:

The White House focused this week on a new Executive Order aiming to switch federal contracting to more fixed-price contracting with performance-based incentivizes, King Charles III’s State visit to the US, new sanctions on Cuba, and the launch of a new public-private partnership effort by the CEQ (Council on Environmental Quality) to modernize the federal permitting process. One item of indirect interest:

• The President signed a new Executive Order to assist American workers in connecting with federal IRAs for employees who do not have employer-sponsored retirement accounts. The accounts, which will live at TrumpIRA.gov, would create a federal match, of up to $1,000, for contributions by individuals. The details still need to be worked out, but the goal is to have the site live by January 1, 2027. Many of the employees in SNFs would, in theory, be eligible to tap into these accounts. The full text of the EO is here.

CONGRESS:

After 76 days, Congress finally passed, and the President signed, legislation funding the Department of Homeland Security and ending the longest partial government shutdown on record. After waiting more than a month, the House agreed to the same bill the Senate originally sent over, leaving the question of funding for immigration and border control to a Reconciliation bill that would be party line. The entire process has the GOP reeling as frustrations with Speaker Mike Johnson reach a boiling point. Despite the frustration, with a short-term extension of another must-pass bill, the Foreign Intelligence Surveillance Act, under their belt, Reconciliation 2.0 underway, and the government funded, Congress bought themselves some time to act. Elsewhere in the political world:

• Just when you thought we were out… The Supreme Court struck down a Louisiana redistricting map with a major decision that changed how the Voting Rights Act is defined. The impact on redistricting was immediate, as Louisiana, Alabama, and Tennessee all announced that they’re delaying their primaries to consider new maps. If you’re looking for a scoreboard to keep track of where we stand, here you go.

  
  

• A new poll out this week showed that voters, regardless of party, are quite unhappy with insurance companies and want elected officials to take ‘em on. The full analysis is here (PDF).

  
  

• The House Ways & Means Committee held a hearing for Hospital CEOs during which they were taken to task by Republican leadership. Fierce Healthcare has a good summary. If you want to form your own opinion, you can watch the nearly 5-hour long hearing here.

  
  

• We’ve got our latest contender for a federal AI bill that examines the impact of AI on the American workforce. Senators Mark Warner (D – VA) and Ted Budd (R – NC) introduced the Workforce Transparency Act, which is already gathering support from industry heavy hitters.

  
  

• Here’s a fun little project for those who follow DC politics: NOTUS, a site launched by veteran DC reporters, launched a new site to track the net worth of Congressional members. It’s quite enlightening.

  
  

• In a perhaps unrelated note, the Senate unanimously banned lawmakers and staff from participating in prediction markets, a move the House may follow soon.

  
  

• As we draw closer to the midterms, Democrats are struggling to figure out messaging that works, while the GOP is raking in the contributions. Still, the midterms look rough for the GOP, both in the House and, maybe even the Senate.

  
  

• Several useful CRS reports from the week:

  
  

1. R46797: An updated guide for Congressional offices on where to find the many different rules that govern Medicare payments to providers.

2. IG10095: A look at Medicare payments for rural hospitals.

3. LSB11424: A legal guide on where things stand with medical marijuana following the recent reclassification by the DOJ.

AGENCIES:

Last week, the DOL announced a new proposed rule to clarify the definitions of joint employer status. The proposed rule can be found at the Federal Register, where comments can be submitted through June 22^nd, 2026. 

The FDA announced a new two-step effort to implement real-time clinical trials that would rely on AI to modernize the process and increase efficiency. Step one is two proof-of-concept trials. Step two is a RFI for a pilot program to be launched this summer. The RFI can be found at the Federal Register, where comments can be submitted through May 29^th, 2026.

CMS announced an extension of the application deadline for manufacturers to join the GENEROUS model that looks to lower cost of drugs manufacturers for Medicaid programs.

The OIG at HHS took a look at the state of emergency power systems for SNF’s, finding that many do not have adequate or reliable backups in place. The summary is here (PDF) while the full report is here (PDF).

The Department of Education issued a final rule related to loan limits for student loans established in the One Big Beautiful Bill. Despite significant public pushback, the department did not include nursing among the professional degrees that would qualify for a higher borrowing cap. A fact sheet on the rule is here (PDF). The full rule can be found at the Federal Register.

CMS notified Minnesota that they’re holding on to another $91 million in Medicaid funding, pending a further review of the state’s Medicaid programs.

CMS’ new website for SNF nursing careers is live.

In a video on his X account, HHS Secretary RFK Jr. continued the agency’s push for more price controls, this time calling on pharmacies to adopt prescription price transparency.

The FDA proposed to exclude the GLP-1 drugs from their bulk lists, which can limit their usage by compounding pharmacies.

FROM THE NOTEBOOK:

• UnitedHealth’s former Chief Medical Officer published a series of posts on just how profitable the entire prior authorization process has become for the MA plans, as well as their incomplete compliance with CMS requirements regarding transparency. It’s staggering.

  
  

• The Kaiser Family Foundation posted a new breakdown of IJ tags issued for SNF’s in rural areas. It’s part of the wide range of data they’ve compiled on SNF’s in general, as well as SNF’s specifically in rural areas.

  
  

• Oops! CMS accidentally exposed Social Security numbers for many health care providers in their new Medicare provider directory.

  
  

• Nebraska became the first state to roll out work requirements for Medicaid recipients. It comes as KFF released their latest survey of state Medicaid officials highlighting their struggles in implementing the requirements.

  
  

• A whole slew of MA plans are cutting the extra benefits that attract beneficiaries.

  
  

• An interesting read from Axios on the latest lawsuit in the price transparency efforts.

  
  

• A recap of the final day of Iowa’s legislative session.

  
  

• A new study in JAMA explored the relationship between SNF capacity and hospital length of stay.

  
  

• Nothing to do with SNF’s, but apparently AI systems need some very, um, curious directions…