April 3, 2025
Senate Budget Resolution & Healthcare Offsets
In response to yesterday’s Senate budget resolution proposal and the GOP’s assumption of the current policy baseline for scoring purposes, we think Congress continues to target Medicaid, Medicare hospital site neutrality, and PBM reforms as…
April 2, 2025
Extending the TCJA Tax Cuts Cost Free—Well, Maybe
As we await President Trump’s reciprocal tariff announcement this afternoon, there was some progress on the budget resolution / reconciliation bill yesterday that could: Make passing the reconciliation / tax bill much cheaper and potentially…
March 31, 2025
Capitol Policy Weekly—March 31 through April 4: Trade, Reconciliation/Taxes/Debt Limit, Banks and Special Elections
This week looks like an important and busy week in Washington and beyond with: The Senate is seeking to pass their budget resolution by week’s end. President Trump announcing his reciprocal trade policy on April…
March 31, 2025
Procept Biorobotics: Expecting ~20% Medicare Rate Cut
With CMS likely to propose a new Medicare physician payment rate for PRCT’s Aquablation in early July – with a final policy in early Nov. and rates effective Jan. 1, 2026 – we expect to…
March 28, 2025
INSP, NYXH, LIVN: Sleep Apnea Coverage Timeline
We view the delayed approval of Nyxoah’s (NYXH) Genio announced this week as positive for Inspire Medical (INSP) insofar as it not only pushes out competition – albeit to an uncertain extent – but may…
March 27, 2025
Auto and Reciprocal Tariff Update
We have the following comments about Trump’s auto tariff announcement yesterday, given that some of the guidance was unclear, and in the lead up to the reciprocal tariff announcements expected on April 2. We have…
March 26, 2025
DC Quick Takes: Reciprocal Trade, Reconciliation, Trade and the Debt Limit
As we await President Trump’s decision on auto tariffs, we see a lot going on in DC that we want to address: 1) trade; 2) reconciliation; 3) tax cuts; and 4) the debt limit. Reciprocal…
March 25, 2025
HUM, ALHC, UNH: Optimistic for Mid-Single Digit MA Rate Increase for CY26, Upcoding Remains a Longer-Term Issue
Anticipating CMS’s issuance of its final CY26 Medicare Advantage (MA) rate notice within the next two weeks (on or before Monday, April 7), we remain optimistic about near-term regulatory changes for MA insurers [HUM, ALHC,…
March 24, 2025
Capital Policy Weekly-March 24-28: Trade, Budgets, Taxes and Noms
Congress is back in session for three weeks after a weeklong recess. Focus this week will likely be on: President Trump’s tariff announcement next week on April 2. Negotiations between the House and Senate on…
March 21, 2025
EXAS, GH: Colorectal Cancer Coverage in Hand, Edits to Come?
An update to CMS’s colorectal cancer (CRC) screening National Coverage Determination (NCD) formally establishes coverage for EXAS’ Cologuard Plus ($592) and GH’s Shield ($1,495), with claims processing likely available within 30 days. While we have…