Week in Washington

Shutdown – Generally no updates on the shutdown, which will be the longest in US history. Several observers noted that this week’s election, which favored Democrats, could change the dynamics of the shutdown. There continue to be some conversations on potential off ramps/policy compromises but no leadership level conversations.

Two shutdown related stories

• A federal judge ordered the Trump Administration to begin SNAP payments to states although the Trump Administration has stated it is only possible to provide partial payments in November.
• The FAA announced that would be reducing air traffic in the 40 busiest cities due to the shutdown. The exact cities have not yet been named.

Tariffs – The Supreme Court expressed skepticism, according to reports, over the Trump Administration usage of tariffs. A Supreme Court ruling could curtail many of the current tariffs as well as require the Administration to pay back tariffs that have already been applied. 

CMS–

• CMS finalized the Medicare physician fee schedule rule. The rule includes a -2.5% adjustment to select services. CMS also updated conversion factors. The update to the conversion factor is three times (0.75% compared to 0.25%) as large for doctors in qualifying APMs than those not. Finally, CMS finalized a significant reduction in skin substitutes in direct response to recent improper spending.
• CMS ordered state Medicaid agencies to investigate 170,000 Medicaid members to confirm that they are ineligible due to immigration status. State agencies were concerned that the numbers were inaccurate, and the eligibility checks could result in eligible enrollees being disenrolled.