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Both the House and Senate are in session this week, with the House expected to pass the $72 billion Customs and Border Protection (CBP) and Immigration and Customs Enforcement (ICE) reconciliation bill after weeks of…

In advance of Dexcom’s (DXCM) readout of its CONNECT RCT this weekend, which management positions as a “powerful anchor” for broader Medicare CGM coverage in “all people with diabetes,” we ultimately expect a material increase…

CMS’s long-awaited interim final rule implementing the One Big Beautiful Bill’s (OBBB) Medicaid Community Engagement (CE) requirements largely aligns with our expectations that CMS would defer to states on program design and implementation, which we…

Last week’s federal court ruling in favor Clover Health (CLOV) against CMS injects fresh uncertainty into the Medicare Advantage (MA) Star Ratings and quality bonus payment framework [UNH, HUM, ELV, CVS, ALHC, CNC, MOH]. While…

The House and Senate are both in session this week, but the market-relevant question is less about what Congress does over the next couple of weeks and more about how much time Republicans waste before…

This morning’s final rule revising operations of the No Surprises Act (NSA) federal independent dispute resolution (IDR) process does not seem to upset the balance that has favored certain out-of-network specialist physicians and hospitals [NUTX,…

With Noridian (17% of services) including instructions that physicians bill for Inspire Medical’s (INSP) Inspire V procedure with a -52 (reduced work / payment) modifier this morning, following a similar update from WPS on May…

We wanted to give you and update on two bills in the California legislature, impacting META, GOOGL, SNAP, STUB, and LYV, that we have been following and which we expect to be considered on the…

Following last week’s draft LCDs requiring Glaukos (GKOS) iDose patients to first fail ≥ 2 topical medications and selective laser trabeculoplasty (SLT), the absence of reliable data on the proportion of existing patients that can…

CMS’s long-awaited proposed rule implementing the One Big Beautiful Bill’s (OBBB) restrictions on state directed payment programs (DPPs) pushes the envelope a bit further than the statute itself, particularly for hospitals [HCA, THC, CYH, UHS,…