July 28, 2025
Capitol Policy Weekly: Trade, Govt Spending, Gambling, and AVs
With the House out of session until September 2 and the Senate scheduled to leave for its August recess at the end of this week, trade seems likely to continue to dominate the headlines as…
July 23, 2025
Guardant Health (GH) Reveal Rate Expectations
We view CMS’s clinical laboratory advisory panel today as an incremental positive for Guardant Health (GH), despite what appears to be a lack of endorsement for the company’s request that payments for Reveal (0569U: $1,644)…
June 27, 2025
[EXAS, GH, GILD, MYGN, HOLX] Preventive Services: SCOTUS Takes
Consistent with our expectations, the Supreme Court today upheld the validity of U.S. Preventive Services Task Force (USPSTF) appointments and – by extension – the mandate that insures cover recommended services without patient cost-sharing, lifting…
April 29, 2025
[EXAS] Screening Uncertainty Post-SCOTUS?
Late last week the U.S. Supreme Court (SCOTUS) ordered the parties in Kennedy v Braidwood – evaluating mandatory cost-free coverage of preventive services recommended by the U.S. Preventive Services Task Force (USPSTF) – to submit…
April 21, 2025
Diagnostics: Supreme Court Quick Takes
Following oral arguments this morning, we continue to believe that the Supreme Court will preserve HHS authority to enforce mandatory cost-free coverage of U.S. Preventive Services Task Force (USPSTF) recommendations, preserving the positive status quo…
April 21, 2025
Diagnostics & Supreme Court Expectations
With the Supreme Court (SCOTUS) to hear oral arguments this morning 10-11 am ET [live stream] on the legality of mandatory cost-free coverage of U.S. Preventive Services Task Force (USPSTF) recommendations, we reiterate our long-held…
March 21, 2025
EXAS, GH: Colorectal Cancer Coverage in Hand, Edits to Come?
An update to CMS’s colorectal cancer (CRC) screening National Coverage Determination (NCD) formally establishes coverage for EXAS’ Cologuard Plus ($592) and GH’s Shield ($1,495), with claims processing likely available within 30 days. While we have…
March 12, 2025
Guardant Health (GH): Next Steps on Shield
With the Medicare rate for GH’s Shield colorectal cancer (CRC) screening test set to increase 62% on April 1 ($920 to $1,495) following designation yesterday as an Advanced Diagnostic Laboratory Test (ADLT) – in line…
February 6, 2025
[EXAS, GH, GRAL] Multi-Cancer Coverage: Take 2
Bicameral reintroduction this week of legislation to allow – not require – Medicare coverage of multi-cancer early detection (MCED) tests starting in 2028 bolsters our view of its likely inclusion in a mid-March spending bill…
January 21, 2025
Guardant (GH) Reveal Medicare Coverage FAQ
Following GH’s announcement this AM of Medicare coverage of its tissue-naïve Reveal test for minimal residual disease (MRD) surveillance testing, we wanted to highlight some additional salient points omitted from the company’s press release. The…