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Having received a number of questions on an “update” posted to CMS’s National Coverage What’s New Report yesterday – which some have taken to imply a near-term reopening of the agency’s coverage policy for transcatheter…

In the upcoming CY26 Medicare payment proposal for home health (HH) agencies [AMED, PNTG, BTSG, ADUS, AVAH, UNH], which we expect within the next two weeks based on historical patterns, we think it is more…

The House and Senate are both in session this week with the U.S. attack on Iran and reconciliation likely leading the headlines.  President Trump is scheduled to give a speech at the NATO summit in…

Amidst the behind-the-scenes Senate debate of its draft reconciliation bill, CMS made good on its threat to jettison improper and fraudulent Obamacare enrollment, impacting ACA insurers [OSCR, CNC, ELV, MOH] and hospitals / behavioral facilities…

Amid reports that HHS is considering steps to curtail direct-to-consumer (DTC) drug advertisements – with negative implications for high spenders in this area [ABBV, NVO, REGN] – we see significant impediments to how far /…

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…

Late Friday, CMS announced the latest list of Medicare Advantage (MA) contracts to be targeted for risk adjustment data verification (RADV) audits – this time for payment year (PY) 2019 – and its associated processes…

In light of the weighty sports betting tax hike in Illinois over the weekend and the modest increase in Maryland last week, investors should continue to expect tax hikes in various states offset at times…

The early part of this week will be busy with the Senate Finance Committee expected to release today its version of the reconciliation bill, which includes the important tax and Medicaid/health care portions of the…

With many 2025 state legislative sessions having concluded, pharmacy benefit managers (PBMs) have – for the moment – successfully avoided various bills seeking to aggressively curb industry practices, except for a few new laws in…