September 9, 2025
[Hospitals, Nursing Homes, Medicaid Providers] CMS Guidance on SDPs Fleshing Out OBBB; Possible Negative Bias?
Late Tuesday, CMS released a letter to state Medicaid offices with its preliminary interpretations of the One Big Beautiful Bill (OBBB) Act’s provision placing total payment limits on hospitals, nursing homes, and certain practitioners at…
September 3, 2025
Nursing Homes & DOJ’s Shot Across the Bow [ENSG, PACS, WELL, OHI, SBRA, LTC]
Tuesday’s announcement by the DOJ to join a 2016 False Claims Act (FCA) whistleblower lawsuit against non-profit ProMedica Health System and its HCR ManorCare nursing homes may represent a new front in attacking long-term care…
August 1, 2025
Hospitals, LTCHs, SNFs: Thoughts on Medicare’s Final FY26 Inpatient Rate Rules
Medicare’s final FY26 payment regulations for inpatient hospitals [HCA, THC, CYH, ARDT, UHS, MPW, municipal bond-backed facilities], long-term care hospitals (LTCHs) [SEM, Kindred], and skilled nursing facilities (SNFs) [ENSG, PACS, Providence] with implications for their post-acute…
June 17, 2025
Healthcare: Thoughts on the Senate Finance Draft’s Healthcare Provisions
The Senate Finance Committee’s (SFC) draft healthcare and tax portion of the reconciliation bill makes some changes, relative to the House-passed measure, but is overall consistent with that version, with the implications being lower Medicaid…
February 23, 2025
Medicaid Reform Watch: Still Early On – What to Watch for [CNC, MOH, ARDT, CYH, ENSG, ADUS]
As the budget resolution process and subsequent reconciliation strategy unfolds, Medicaid reforms that have posed headline enrollment and payment risk to Medicaid insurers [CNC, MOH, ELV], dual eligible insurers [UNH, HUM, ELV, CVS],hospitals [ARDT, CYH,…
February 10, 2025
Sizing Medicaid Work Requirement Risks [CNC, MOH, ELV, THC, ARDT, ENS, ADUS]
As we await the House’s budget reconciliation strategy this week, the Senate FY25 budget resolution proposal released late Friday bolsters our expectations for Medicaid work requirements, which we see as one the most likely Medicaid-related…
February 4, 2025
[ENSG, PACS, SBRA, OHI]: Potential Timing of the Nursing Home Staffing Rule’s Demise
With the briefing in a federal lawsuit having concluded and Congress on the hunt for legislative savings, the question is when, not if, CMS’s minimum nurse staffing rule is killed, eliminating the overhang and potential…
January 28, 2025
[CNC, MOH, ARDT, UHS, ENSG, ADUS]: Medicaid Funding & Best Bet on OMB Funding Memo
We lean against yesterday’s OMB directive for temporarily pausing federal funding for grants, loans and programs applying largely to Medicaid’s payments to the states for Medicaid insurers (CNC, MOH, ELV, UNH, CVS) or for reimbursements…
January 17, 2025
MedPAC Provider Recs Likely to Be Ignored in Favor of Savings Targets Like Site Neutrality, Medicaid, Rule Repeals
We doubt Medicare Payment Advisory Commission’s (MedPAC) FY/CY26 Medicare payment recommendations for home health agencies, inpatient rehab facilities, skilled nursing facilities, hospices, dialysis centers, hospitals, and physician offices, which were voted on Thursday in nearly…
November 19, 2024
Healthcare Extenders in FY25 Spending Bill: What Is Likely, Unlikely or Toss-Up?
With likelihood growing that Congress focuses on emergency spending and a short-term continuing resolution funding the government into Q1 next year during this lame duck period, we expect that translates to Congress punting on nearly-annual,…