While we wait for Inauguration Day on January 20^th and the 119^th Congress to be sworn in, there are many issues that the 118^th Congress needs to address by end of year. Because Republicans will hold the White House and the majority in Congress next year, they don’t have an incentive to negotiate major policies at this time. We are expecting Congress to seek a short-term continuing resolution to fund the federal budget, perhaps through March 2025. Issues such as funding for Medicare Dependent Hospitals, extending the telehealth flexibilities, and mitigating the upcoming 2.8% payment reductions in the physician fee schedule, will likely be addressed either as part of a short continuing resolution or a one-year extension. Congress continues to debate how to fund these extensions, which includes a proposal to adopt site neutral payments. The framework released on November 1^st  by Sens. Bill Cassidy (R-LA), who is a physician, and Maggie Hassan (D-N.H.) goes further than site-neutral payment plans previously proposed for drug administration services.