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We view CMS’s new Medicare prior authorization model – announced late Friday and scheduled for implementation Jan. 1, 2026 – as an incremental headwind for device manufacturers within the selected therapeutic and geographic areas, which…

Consistent with our expectations, the Supreme Court today upheld the validity of U.S. Preventive Services Task Force (USPSTF) appointments and – by extension – the mandate that insures cover recommended services without patient cost-sharing, lifting…

With CMS likely to publish its CY26 physician / hospital outpatient rate proposals the week of July 7-11, we continue to expect physician payments for PRCT’s Aquablation to fall ~20% ($765 to ~$600) [see prior…

The sizable hole left by the Senate parliamentarian decisions on various Medicaid and Obamacare provisions, which were reported this morning by Senate democrats (here and here) injects uncertainty for hospitals, Obamacare insurers, Medicaid managed care,…

In our view, the debate over the reconciliation bill isn’t about whether or not it will pass—it’s mostly a foregone conclusion that it will—but whether Congress can get it done by President Trump’s desired date…

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 /…