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November 20, 2025

Dialysis: Modest Increase & Consistent Rates for Oral Phosphate Binders in Final Medicare Rule [DVA, FRE.DE, American Renal]

By Beth Steindecker

CMS’s final CY26 Medicare payment rule for dialysis centers [DVA, FRE.DE, privately held American Renal] largely aligned with expectations. The rule delivers: A slightly higher YoY increase in aggregate spending, reflecting updated inflation and productivity…

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November 20, 2025

(PCAR, VLVLY, DTRUY) EPA27 Truck Standards: Repeal Proposal Expected as Early as December

By Joe Lieber

We expect the administration to release a proposed rule in December to repeal or amend the Biden-era EPA27 light-, medium-, and heavy-duty vehicles standards, with a full repeal appearing more likely (65%) at this point. …

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November 19, 2025

Finance Committee Hearing: Still Think ACA Subsidy Deal is More Likely Even If Late [OSCR, CNC, CYH, UHS, DVA, FMS, HQY, WBS]

By Beth Steindecker

This morning’s Senate Finance Committee hearing on rising healthcare costs did little to break the stalemate on Obamacare, but no one expected a breakthrough today. The hearing primarily served as a venue for both sides…

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November 19, 2025

DC Quick Takes: Highway Bill, Permitting Reform, Federal AI Standard, GAIN AI Act, Federal Deposit Insurance

By Joe Lieber

Today we examine five market-relevant issues, including: Prospects for a highway bill next year [VMC, MLM, NUE, CX, CAT, DE, PSN, URI] Likelihood of permitting reform, which could accelerate infrastructure development, including utilities and energy…

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November 18, 2025

Defense Update: FY26 Spending, the NDAA and an Impending Defense Spending Fiscal Cliff

By Joe Lieber

We want to highlight three developments relevant to the defense sector:   Potential positive news for the sector this week, as the Senate could vote as early as today to begin consideration of the Defense Appropriations…

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November 18, 2025

IRTC Coverage Risks: Smoke or Fire?

By John Leppard

With shares of IRTC pressured yesterday amid speculation on the risks associated with a Sept. 25 draft local coverage determination (LCD), we suspect the final version – likely released in March / April – will…

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November 17, 2025

CMS Provider Tax Guidance: More Details, But Not Necessarily Stricter or More Aggressive Interpretation [ARDT, CYH, HCA, THC, UHS, CNC, MOH, ELV]

By Beth Steindecker

CMS’s preliminary guidance to states on its interpretation of the One Big Beautiful Bill’s  (OBBB) Medicaid provider tax provisions does not appear to tighten the screws on states, and thereby threaten hospitals [ARDT, CYH, HCA,…

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November 17, 2025

Capitol Policy Weekly: Another Government Shutdown, the Epstein Files, Deposit Insurance, the CFTC, BABA and the Saudi Visit

By Joe Lieber

Congress is in session this week before adjourning for the Thanksgiving holiday. Although lawmakers just passed legislation to keep the government open, there is already renewed concern about another potential shutdown on January 31, when…

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November 14, 2025

MMSI: Wrapsody Outpatient Margin Implications

By John Leppard

Consistent with our long-held expectations [here, here], MMSI’s disclosure yesterday that CMS has “deferred” a decision on its Wrapsody transitional pass-through (TPT) payment application suggests a greater likelihood that it was denied, in our view,…

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November 13, 2025

GKOS: iDose Medicare Coverage Expectations

By John Leppard

Yesterday’s Medicare Administrative Contractor (MAC) advisory committee (CAC) meeting on GKOS’s iDose bolsters our relatively sanguine outlook going into the event [here, here], and would expect any headwinds from a likely mid-2026 draft local coverage…

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