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House Energy & Commerce Republicans Press for 80-20 Repeal
Alliance Daily
On Friday, January 31, nine Republicans on the U.S. House of Representatives’ Energy and Commerce Committee sent a letter to President Donald J. Trump, asking his administration to repeal the Medicaid 80-20 provision. The letter encourages the new administration to prioritize overturning the 80-20 provision of the Access Rule and to instead work collaboratively with the home care community to address the core issues that contribute to low homecare access in Medicaid.
In the letter, Reps. Buddy Carter (GA), Kat Cammack (FL), John Joyce (PA), Gus Bilirakis (FL), Troy Balderson (OH), August Pfluger (TX), Dan Crenshaw (TX), Nicholas Langworthy (NY), Erin Houchin (IN) wrote:
“The untested, one-size fits all approach of the 80/20 rule will reduce, not expand, Medicaid access. The 80/20 rule was introduced without a basis in data, actual experience, or an understanding of costs associated with the provision of home-based care, nor was it the result of legislation […] Instead of mandating an unsustainable payment pass through, we request that the Administration work quickly to rescind this component of the Access Rule and instead turn the focus towards working with stakeholders to address the fundamental issues driving workforce shortages and the resulting lack of access for consumers.”
The Alliance appreciates the support and advocacy of these Representatives and looks forward to working with them and the Administration to develop policies that appropriately address the workforce needs shortage in our field.
The letter is available HERE. |
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Gabbard, RFK Jr. Pass Committee Hurdles in Win for Trump
The Hill / BY Al Weaver and Nathaniel Weixel
Tulsi Gabbard and Robert F. Kennedy Jr. on Tuesday cleared crucial hurdles toward winning Senate confirmation, handing President Trump a key win as he looks for an early display of loyalty from GOP lawmakers.
Gabbard and Kennedy overcame high-stakes committee votes that went down to the wire in their bids to lead the U.S. Intelligence apparatus and the Department of Health and Human Services, respectively.
Skeptical Republicans on each committee made the decision to back them in the final days before the votes after Trump officials, including Vice President Vance, and other GOP leaders cajoled them into maintaining an unblemished slate of nominees who have gone through the committee process.
How the process played out underscores how wary Republicans are of incurring Trump’s wrath only weeks into his administration.
“They’re not going to go against him. If they go against him, they go against 77 million people,” Sen. Tommy Tuberville (R-Ala.) said, referring to Trump’s popular vote total in November. “I don’t think they want that if they want [to get] reelected.”
Both nominees now appear likely to be confirmed on the Senate floor in the coming week, though the final votes could be close. Democrats remain vehemently opposed to both nominees, and there are a handful of Republicans who haven’t said how they intend to vote…
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Musk’s DOGE Team Mines for Fraud at Medicare, Medicaid
Modern Healthcare / By Riley Griffin and Madison Muller
Elon Musk’s team at the Department of Government Efficiency has been on-site at the Centers for Medicare and Medicaid Services to mine key systems for examples of what they consider fraud or waste, according to a person familiar with the matter.
The DOGE representatives have gained access to payment and contracting systems, according to the person, who asked not to be named discussing internal matters. They have also been working to cancel diversity, equity and inclusion-focused contracts at CMS and more broadly across the Department of Health and Human Services, the person said, including with organizations like Deloitte.
Elon Musk’s team of government efficiency enforcers have been tearing through U.S. agencies, including the Treasury Department and the U.S. Agency for International Development. The group, run by the world’s richest person and President Donald Trump’s largest donor, says it’s trying to cut costs and staffing levels across the U.S. government.
But the group’s actions are stirring up controversy among staffers, some of whom have tried to block DOGE representatives from accessing information, as well as lawsuits from unions that accuse agencies of illegally letting their members’ information be shared with DOGE. On Tuesday, USAID said most of its 10,000 employees will be placed on administrative leave starting Friday…
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ICE is Actively Conducting Raids and Investigations
SESCO Management Consultants
SESCO clients from multiple states and cities have contacted us concerning being investigated by U.S. Immigration and Customs Enforcement (ICE) officials.
This significantly increased activity is subsequent to Trump’s pledge to remove undocumented migrants from the country.
ICE Authority to Enforce Immigration Laws
- ICE has the authority to arrest and detain undocumented migrants. It can conduct workplace raids and other enforcement activities to effectuate these arrests.
- ICE must present a judicial warrant to enter nonpublic areas of a workplace. A judicial warrant is signed by a federal judge, not an immigration officer. The warrant must provide specific details, such as the name of the individual to be arrested, the location, and the reason for the arrest. Without a judicial warrant, ICE is only allowed to be in public areas of the workplace.
- ICE has the authority to execute the warrant and that may include detaining persons not specifically named in the warrants.
What To Do If an ICE Agent Visits
- All employees should remain calm and composed.
- Only the designated points of contact should interact with ICE agents. These individuals should be well-versed in the organization’s policies and the legal rights of employees.
- Designated points of contact should have ICE agents identify themselves by name and badge number. Employers must lawfully abide with providing information and access to facilities where a valid warrant is presented.
- Designated points of contact should politely request to see and review any warrants presented by ICE agents and ensure the warrants are valid and specific to the premises before permitting access to any private areas. For the warrant to be valid, it must be signed by a federal judge (a judge’s signature will indicate such). If the warrant is a Department of Homeland Security (DHS) Form I-200 or I-205 signed by an immigration officer, this is not a judicial warrant. In this case, the employer can advise the ICE agent that the warrant is not a valid judicial warrant and that the ICE agents may not enter any private areas – they must remain only in public areas.
- Points of contact should provide information or documents required by a valid warrant but need not provide information or records falling outside of the warrant.
- After the ICE visit, document the event by immediately identifying the names and badge numbers of ICE agents who were present, the time and duration of their presence, and any actions taken by the agents.
SESCO is suggesting that all clients review and prepare I-9 documentation for such an investigation. If you have any concerns about your I-9 compliance, please contact SESCO immediately.
Finally, SESCO can conduct an I-9 audit to determine compliance. |
Home-Based Care Outlook: 55% of Leaders Name Staffing as Top Challenge, Tech Investment on Rise
Home Health Care News / By Audrie Martin
Optimism is on the rise for 2025 as providers shift their focus toward strategic growth, and to leveraging technology investments to address persistent staffing challenges and enhance patient outcomes.
That’s according to the Home Health Care News Home-Based Care Outlook Survey for 2025. Findings from the survey, which was sponsored by Homecare Homebase, were recently released.
The survey results reflect the views of 103 professionals in the home-based care industry. Among these respondents, 75% occupy C-suite positions, including vice presidents and directors. Regarding the daily census, 39% of organizations report an average of 1 to 100 clients, while 24% serve between 101 and 500 clients; most of these organizations operate within a single state.
Staffing has emerged as the industry’s most significant challenge, with 30% of respondents indicating that their companies could achieve the greatest business efficiencies by addressing this area. On a positive note, staffing concerns have decreased by 4% compared to previous assessments.
Although worries about changing payment dynamics have increased, staffing technology is expected to yield the highest return on investment among technology expenditures.
Respondents were nearly evenly divided in their expectations regarding agency profit margins. The majority believe margins will remain stable in 2025 compared to the previous year. Additionally, half of the respondents reported that Medicare Advantage negatively impacts margins and will likely continue to do so…
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