February 19, 2025
Renal Denervation: Medicare Coverage at 10%-20% of TAM?
We suspect CMS’s draft National Coverage Determination (NCD) for renal denervation (RDN) [Medtronic, Otsuka] – scheduled for release July 13 – will limit eligibility to 10-20% (~3.1M-7.5M) of the estimated ~32M Medicare beneficiaries with hypertension…
February 19, 2025
[CHE, ADUS, Gentiva, Compassus]: CMS Grants Hospices Their Wish on SFP But Careful What You Wish For
While hospices [CHE, ADUS, private Gentiva, Compassus] are receiving a reprieve for now from more intensive oversight and the threat of termination from Medicare after CMS announced it was going to sideline the statutorily mandated…
February 18, 2025
Capitol Policy Weekly: Feb. 18-21: Budget Resolution, Reconciliation, Government Shutdown and Nominations
This week, we expect the Senate to consider their FY25 budget resolution that would set off the two-reconciliation bill strategy. In addition, Kash Patel is likely to be confirmed by the Senate as FBI Director…
February 13, 2025
(WMT, KR, ACI, DG, KHC, PEP, CAG) SNAP / Food Stamp in the Crosshairs
The House Republican budget released yesterday includes potential cuts to the food stamp / SNAP program that could be as high as $230 billion over ten years, which would be a negative for Walmart (WMT),…
February 12, 2025
DC Quick Takes: Reconciliation, Defense Spending, Trade, Medicaid, a Government Shutdown, Fed Independence and Nominations
Below we go over a host of issues that DC is grappling with from reconciliation / tax cut to defense spending, trade, Medicaid cuts, a potential government shutdown, the Fed’s independence and RFK’s nomination to…
February 10, 2025
HUM: Government Legal Response Puts Up Fight in Star Ratings Lawsuit, We Still Favor HUM
We expect Humana (HUM) to ultimately prevail in its lawsuit against HHS to secure higher 2025 Medicare Advantage (MA) star ratings, but it may take longer than we originally expected (as early as March-April). While…
February 10, 2025
Capitol Policy Weekly: Feb. 10-14—Tariffs, Reconciliation and Nominations
Trade, budget reconciliation, and nominations are likely to dominate Washington this week. Meanwhile, current government funding expires on March 14 and Republicans and Democrats are still reportedly very far apart on top-line spending numbers for…
February 10, 2025
Sizing Medicaid Work Requirement Risks [CNC, MOH, ELV, THC, ARDT, ENS, ADUS]
As we await the House’s budget reconciliation strategy this week, the Senate FY25 budget resolution proposal released late Friday bolsters our expectations for Medicaid work requirements, which we see as one the most likely Medicaid-related…
February 8, 2025
Life Science Tools: NIH Indirect Cost Cut Risks
NIH’s surprise announcement Friday of a 15% cap on indirect costs for both new and existing grants will likely trigger fresh uncertainty for life science tools (LST) manufacturers. While indirect costs are technically distinct from…
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…