Summary
Priority for this week in Congress is for the House Republicans to elect a Speaker. After last week’s drama filled ousting of Kevin McCarthy as Speaker the House recessed until Tuesday evening for the Republican conference to try and organize themselves. Currently a vote is scheduled for Wednesday, but there is little expectation that a winner will emerge easily and quickly. In order to be Speaker, a candidate must garner 218 votes. With Republicans holding a very slim majority, and Democrats all but guaranteed to vote for Democratic leader Hakeem Jeffries, a candidate can only lose 4 Republican votes. In January it took Kevin McCarthy 15 tries to get the necessary votes to win. With a deeply divided conference, it will be a challenge for the Republican conference to quickly coalesce around one candidate. Currently, the two members that have announced they are running for the position are current Majority Leader Steve Scalise (R-LA) and Rep. Jim Jordan (R-OH), a founding member of the House Freedom Caucus, and the divisive Chairman of the Judiciary Committee. No legislative business can proceed in the House without a Speaker, and with only 40 days left until the current Continuing Resolution expires, the stakes are very high.
The Senate is in recess this week. They will return next Monday afternoon when they will once again continue on appropriations packages.
Regulatory Update
The Office of Management and Budget (OMB) is currently reviewing the following rules:
- CMS Enforcement of State Compliance with Medicaid Reporting and Renewal Requirements –The interim final rule would establish rules regarding CMS enforcement of states’ compliance with reporting requirements and renewal requirements during the period that begins on July 1, 2023 and ends on June 30, 2024. The interim final rule may codify existing guidance and provide more details on how CMS may enforce the requirements. The interim final rule was not included in the Spring 2023 Unified Agenda.
- Annual Rulemaking for Commercial Insurers – Proposed rules for the CY 2025 Policy and Technical Changes to Medicare Advantage and Part D (expected in October 2023) and CY 2025 Notice of Benefit and Payment Parameters (expected in November 2023)
- Annual CY 204 Medicare Payment Updates – Final rules for home health, hospital outpatient, and the physician fee schedule.
- 340B Program – Final rule on the Hospital Outpatient Prospective Payment System: Remedy for 340B-Acquired Drugs Purchased in Cost Years 2018-2022.
- Surprise Billing Regulations – A proposed rule to amend requirements for the independent dispute resolution (IDR) process. Due to legal challenges, the Departments have temporarily suspended the IDR process for new disputes. Certified IDR entities are only permitted to resume processing all single and bundled disputes already submitted to the IDR portal and assigned to a certified IDR entity, as of September 21, 2023.
- Conscience Rights in Health Care – Final rule to safeguard the rights of federal conscience and religious nondiscrimination while protecting access to care, including abortion.
- Skilled Nursing Facilities – Final rule to require the disclosure of certain ownership, managerial, and other information regarding Medicare skilled nursing facilities (SNFs) and Medicaid nursing facilities. Interestingly, the Unified Agenda forecasted action in February 2026.