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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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November 13, 2025

(NVDA, MSFT, GOOGL, AMZN, META) AI Sector: Federal Pre-emption of State Law Unlikely for Now

By Joe Lieber

We continue to believe that efforts to prevent states and localities from enforcing AI-specific laws or regulations for up to 10 years is unlikely to become federal law for at least the duration of President…

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November 10, 2025

Capitol Policy Weekly: Government Shutdown, Stimulus, ACA Subsidies, Syria and Ukraine

By Joe Lieber

Both the House and Senate will very likely be in session this week, with the government shutdown seemingly on the verge of ending later this week. In addition, President Trump has reiterated his desire to…

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November 9, 2025

Obamacare HIX Fix: HSAs for All or Compromise on Subsidy Changes? We Still Think the Latter [OSCR, CNC, ELV, MOH, UNH, HQY, WBS, EHTH]

By Beth Steindecker

President Trump’s Truth Social posts over the weekend, along with that of other Republicans, suggest an existential threat for Obamacare insurers [OSCR, CNC, ELV, MOH, UNH] and potentially other commercial health insurers [CI, CVS] while…

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November 7, 2025

Obesity Drug Pricing Deal: Devil in the Details

By John Leppard

As outlined by the Trump administration, we view yesterday’s obesity drug pricing deal with NVO and LLY as a modest near-term positive (potentially better for LLY), with the $245 / mo. price point for Medicare…

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November 6, 2025

(NVDA) Nvidia’s Blackwell Chips and the China Trade Outlook

By Joe Lieber

With Nvidia (NVDA) exports to China once again making headlines, we see roughly a 40–50% probability that the company will be permitted to export China-specific versions of its Blackwell chips as early as next year. …

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