HAPPY 4^th of July to all!

There will be no Digest next week. We will return Monday July 20^th.

WHITE HOUSE:

The White House focused this week on America’s 250^th birthday, a new Executive Order that promotes the “Freedom to Fix” (a deregulatory effort aimed at giving folks more ability to fix their own vehicles), looking at the one year marks for a permitting deregulatory effort (aimed at speeding approvals of projects) and the One Big Beautiful Bill, and temporary limiting the duties on the import of fertilizer products from Morocco.

CONGRESS:

Congress came to a screeching halt earlier this week when conservatives gummed up the works, forcing GOP House Speaker Mike Johnson to send everyone home early for the July 4^th Holiday week recess. That leaves just eight legislative days for Congress before the summer recess, pretty much ending hopes that any legislation is gonna move before they head home for the summer. At this point, despite the Speaker’s push to get Reconciliation 3.0 done, with all the trimmings for conservatives, Republican infighting continues to torpedo his efforts. Elsewhere in DC:

• The House Subcommittee on Health, Employment, Labor, and Pensions held a hearing on “Direct Contracting”, a new model that would allow employers to more directly control healthcare costs. You can watch the hearing here. The official recap is here.
  
  

• Congressman Dr. Greg Murphy’s HR 9504, a bill that would increase the transparency requirement on non-profit hospitals, passed out of committee this week. The bill can be found here.
  
  

• The Democratic establishment candidates continued to flounder as two more long-time incumbents lost out to more progressive candidates. It’s causing a reckoning among House members as they grapple with the newfound fervor for fresh candidates.
  
  

• The loss of the Colorado House Member Diana DeGette has already started the musical chairs to replace her on the Energy & Commerce Health Committee.
  
  

• The Hill looked at the governor races most likely to flip this November.
  
  

• Should the House flip to Democrats after the midterms, they’re likely to launch a series of oversight investigations into Republican activity. Republicans are preparing for that outcome.
  
  

• A good read from Politico on just how different advocacy is in the current Administration.
  
  

• Sometimes politics can just get a little… odd. Since 2015, Alaska’s Junior Senator has been Republican Dan Sullivan. Well, he’s got a new opponent whose name might be familiar: Dan Sullivan.
  
  

• A guide on the TPS decision that could potentially have an outsized and unfortunate impact on SNFs.

  
  

AGENCIES:

USCIS extended the guidelines for TPS status for Haitians through July 10^th.

CMS released the 2027 prospective home health payment rule. In addition to a 2.4% payment bump for home health, there are quite a few fraud provisions related to non-compliant Medicare providers. The fact sheet is here. The proposed rule can be found at the Federal Register, where comments can be submitted through August 31^st.

CMS also released the proposed prospective hospital payment rule, with several provisions related to the 340B program that have the goal of lowering pharmaceutical prices. The fact sheet is here.  Here’s a good summary of the rule. The rule is scheduled to be published to the Federal Register on July 7^th, but if you’re dead-set on being an early bird, you can access a prepublication copy of the 723-page rule here (PDF).

The CMS pilot program that covers GLP-1 drugs for Medicare beneficiaries launched on July 1^st.

It’s mostly moot at this point, but HHS Secretary RFK Jr. officially terminated the Covid-19 emergency use authorizations for drugs and other medical devices.

The White House’s Office of Personnel Management wants to make it easier to remove federal employees. They published a proposed rule in the Federal Register that simplifies the process.

HHS announced that they’re suspending funding to New York’s Medicaid Fraud Control Unit (MFCU), the second state to have their funding suspended by HHS. The letter is here (PDF).

The VA’s Undersecretary of Health is resigning. Among his duties was overseeing the deployment of the VA’s new EHR modernization program.

Twenty-six states filed a lawsuit against the work requirements provisions within the One Big Beautiful Bill.

A new NIH study found that there may be biomarkers to detect Alzheimer’s disease.

FROM THE NOTEBOOK:

• The North Carolina Legislature finally sent the Governor a budget, where it awaits his signature. You can access a copy of the 634-page budget bill here (PDF).
  
  

• Virginia Governor Spanberger signed her first budget, which can be found here.
  
  

• California passed its $352 billion budget bill. The central budget resource page is here.
  
  

• New Jersey passed its budget. A full copy of the 357-page budget can be found here (PDF).
  
  

• One of the provisions passed by New Jersey would charge fees to companies that have at least 50 employees on the state’s Medicaid program.
  
  

• The Massachusetts Legislature passed a budget and sent it to the Governor, where it awaits her signature.
  
  

• Elevance, a MA plan, is taking the fight to CMS as it sues the agency to recalculate its star ratings after CMS reran the numbers for another MA plan.
  
  

• A judge blocked Colorado’s new law that capped the price of a drug.
  
  

• North Carolina became the first state in the country to ban third-party investments in litigation, a move that may control litigation costs. New Jersey is working on a similar bill.
  
  

• A new KFF brief found that the government is gonna spend more than $13 billion on MA quality programs in 2026.
  
  

• KFF also did a deep dive into MA “Coding Intensity”, i.e. one of the major reasons why MedPAC estimated that MA costs the government $76 billion more than traditional Medicare.
  
  

• A good reminder that when a beneficiary chooses a MA plan over traditional Medicare, it can cost them if they ever want to go back to traditional Medicare.
  
  

• The New York Times continued its reporting on the crazy and unintentional ways the federal No Surprises Act is shaping healthcare pricing.