HHS/CMS is making forward progress, usually when mandated to do so by Congress. Granted, whenever a new requirement comes into play, cue frantic scrambling by

HHS/CMS is making forward progress, usually when mandated to do so by Congress. Granted, whenever a new requirement comes into play, cue frantic scrambling by underfunded provider/insurer IT departments to support, followed by a few years of waivers from HHS to allow everyone to implement, followed by support a decade later. But it is moving the system forward.