We know what we know
Informed is a right to act
It begins again
The Rundown
- 2024 Election recap
- From our desks – the work of recess
- CMS releases final CY 2025 physician and outpatient payment rules
- Post-Election Conversation – November 18 at Noon
- Join the Duke Health Advocacy Network!
Federal Updates
Election Day Recap
Over 83 million votes were cast before Election Day, which represents slightly more than half the total number of votes in the 2020 presidential election. According to preliminary and unofficial election night results, nearly 5.7 million North Carolinians cast ballots in this election, a 73% turnout of the state’s 7.8 million registered voters. That number will increase as provisional and absentee ballots are counted during the 10-day canvass period.
As expected, not all races across the country have been called. As of this writing, results from Arizona and Nevada ballots are still unresolved, and the balance of power in the US House of Representatives has yet to be determined.
Federal
Former President Trump (R) is the President-elect, defeating Vice President Kamala Harris (D) by winning every battleground state, including North Carolina. Trump also achieved a decisive lead in the popular vote. He will become only the second person in American history to serve two non-consecutive terms, following President Grover Cleveland. The relative power of a second Trump administration will depend on the makeup of Congress, but a reliance on executive action and the judiciary may also be staples of policy implementation.
Control of the US Senate has flipped to Republicans based on current projections, with the gain of at least three seats. Incumbent Senator Jon Tester (D-MT) was defeated by his Republican challenger, Republicans gained control of the open seat in West Virginia, and Republican Bernie Moreno defeated incumbent Senator Sherrod Brown (D) in Ohio. Incumbent Senator Bob Casey (D-PA) currently trails in his race as final precincts begin reporting, while Democrats successfully held onto their seats in Michigan and Wisconsin. The remaining uncalled races in Arizona and Nevada will determine the size of the new Republican majority. A tighter majority may prove challenging to manage – and absent a change in Senate rules, most bills would still require the bipartisan support of 60 Senators to limit debate and enable a final vote. However, Cabinet positions requiring Senate confirmation only need a simple majority vote.
As of this writing, control of the US House of Representatives is too close to call. With 218 seats needed for a majority, Republicans currently have won 206 seats compared to the Democrats’ 192. Because of the number of mail-in ballots across several key states and races, the final makeup of the House may not be known for days or weeks. Within North Carolina, the current congressional delegation’s 7-7 split between Democrats and Republicans flipped to 10-4 with a Republican majority. Here's a quick look at our NC congressional delegation for the 119th Congress (new additions in italics) and a map of the new congressional districts.
NC-01: Don Davis (D)
NC-02: Deborah Ross (D)
NC-03: Greg Murphy, MD (R)
NC-04: Valerie Foushee (D)
NC-05: Virginia Foxx (R)
NC-06: Addison McDowell (R)
NC-07: David Rouzer (R)
NC-08: Mark Harris (R)
NC-09: Richard Hudson (R)
NC-10: Pat Harrigan (R)
NC-11: Chuck Edwards (R)
NC-12: Alma Adams (D)
NC-13: Brad Knott (R)
NC-14: Tim Moore (R)
What's happening statewide?
For an analysis of North Carolina statewide races, visit our colleagues at Duke State Relations.
From our desks: the work of recess
Over the congressional recess, our office supported Duke Health in its service to the communities impacted by Hurricane Helene, including by connecting with the NC congressional delegation about the limited supply of sterile IV fluids and about resources provided by the National Child Traumatic Stress Network to families and communities impacted by the storm.
Additionally, as negotiations continued with UnitedHealthcare, we served as a liaison with the NC congressional delegation to ensure offices had resources to understand the impact on patients in their district. We provided timely updates about Duke Health’s efforts to support and preserve access for our patients and shared information to help patients navigate potential changes.
Our team hosted several Members of Congress at Duke Health facilities, including Rep. Greg Murphy, MD (R-NC-03), who met with Duke Health leadership and a group of Duke Health urologists; a visit by Rep. Deborah Ross (D-NC-02) to Duke Medical Plaza Knightdale to learn more about physical and occupational therapy; and a meeting for Rep. Valerie Foushee (D-NC-04) with Duke AI Health leadership.
We also coordinated meetings for Dr. Geeta Swamy, Associate Vice President for Research, Vice Dean for Scientific Integrity, and the Haywood Brown, MD Distinguished Professor of Women's Health, to meet with staff for Rep. Alma Adams (D-NC-12) and Rep. Ross’s office to discuss maternal health and support for research at the National Institutes of Health. Dr. Heather Whitson, Director of the Center for the Study of Aging and Human Development and Co-Director of the Duke & UNC Alzheimer’s Disease Research Center, connected with staff for Rep. Foushee to discuss Duke Health’s Alzheimer’s research leadership. Finally, our team connected Chief Data Scientist and Director of Duke AI Health Michael Pencina with staff for Rep. Ami Bera, MD (D-CA) to discuss policy priorities for AI in healthcare.
Our team coordinated a health-system supported effort to encourage the Centers for Medicare and Medicaid Services (CMS) to revisit policies for telehealth reimbursement of interpretations of continuous glucose monitoring data.
With our focus turning to the return of Congress and pending issues impacting Duke Health, our office has been working to address the pending 2.8% scheduled cuts to physicians’ payments resulting from CMS’s Medicare Physician Fee Schedule final rule. Rep. Greg Murphy introduced the Medicare Patient Access and Practice Stabilization Act (H.R. 10073) to eliminate the looming 2.8% payment cut and provide a 1.8% payment update in 2025. We are urging our congressional delegation to cosponsor this important bill and are pleased that Reps. Don Davis (D-NC-01) and Deborah Ross have signed on.
We are also supporting advocacy efforts urging Congress to avoid a potential “telehealth” cliff at the end of the year and extend flexibilities for Medicare reimbursed telehealth and the Acute Care Hospital at Home program beyond the current December 31, 2024 expiration date.
Further, we coordinated efforts for Duke Health to join Duke University in supporting the Ad Hoc Group for Medical Research’s letter asking Congress to finalize the Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) spending bill by the end of the calendar year with a robust investment in the NIH. Specifically, the letter, urges Congress to “provide no less than the Senate Appropriations Committee-approved level of $48.9 billion for NIH, in addition to funding for the Advanced Research Projects Agency for Health (ARPA-H).”
CMS releases final CY 2025 PFS and OPPS rules
The Centers for Medicare and Medicare Services (CMS) has released final rules for the calendar year (CY 2025) Physician Fee Schedule (PFS) and Outpatient Prospective Payment System (OPPS)
The CY 2025 PFS rule includes updates to 2025 payment rates for physicians and other health care professionals, new payment options for primary care services, extension of certain telehealth policies, refinements to the Shared Savings Program for accountable care organizations (ACOs), revisions to policies for the 2025 performance year of the Quality Payment Program, and other policies. Rule text and CMS resources are linked below.
- PFS final rule text
- Physician Fee Schedule fact sheet
- Medicare Shared Savings Program fact sheet
- Quality Payment Program fact sheet
The CY 2025 OPPS rule, among other provisions, includes slight increases to OPPS payment rates for qualifying hospitals, changes to reimbursement policies for radiopharmaceuticals, and updates to conditions of participation for obstetrics and gynecological services. Rule text and CMS resources are linked below.
Our team coordinated the health system response to both rules as initially proposed over the summer and we are grateful to our experts and leadership for their contributions and guidance on the final comment letters. We continue to analyze the final rules and will share updated resources from CMS and coalition partners as appropriate.
Join us on November 18th for a Post-Election Conversation!
Join Duke Health Government Relations and Duke State Relations on Monday, November 18 at 12:00pm ET for a virtual information session where we will discuss outcomes of the election, state and federal legislative issues that impact Duke Health, how to engage in advocacy, and more. All members of the Duke Health community are invited to attend.
Register for the event here.
Join the Duke Health Advocacy Network!
Looking for more opportunities to connect with fellow advocates and professionals interested in public policy across the health system? Join the Duke Health Advocacy Teams Channel! We’re growing leaps and bounds and hope you’ll consider joining us!
Managed and moderated by Duke Health Government Relations and Duke State Relations, the purpose of the platform is for you to connect with your colleagues throughout the health system who are engaged and/or interested in public policy advocacy. We hope the channel will be used as a space for sharing ideas, collaboration, and engaging with the government relations teams on the issues most important to your work.
We encourage you to explore the channel, as we will post relevant news items, policy updates, questions, advocacy resources, and opportunities for engagement. As importantly, this is your space to do the same and to help grow the community.
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