April 27, 2026
Dialysis – CY27 Medicare Bundle: Phosphate Binders and Monthly Add-on Remain Swing Factors [DVA, FRE.DE, Innovative Renal]
With the CY27 Medicare end-stage renal disease (ESRD) payment proposal now under OMB review, uncertainty surrounding the extra payments for oral phosphate binders to dialysis centers [DVA, FRE.DE, private Innovative Renal] may emerge as an…
April 27, 2026
Washington Policy Weekly: Reconciliation, California Social Media Ban, Fed Transition, Iran, and Redistricting in Play
With both the House and Senate in session this week, there is a great deal happening in DC that will distract members from issues important to investors. For example, lawmakers will focus on reauthorizing the…
April 24, 2026
Hospice: Program Integrity Still Overhang, but Large Agencies Insulated; How SSVI May Be Tweaked [CHE, PNTG, BTSG, ADUS, AVAH]
CHE’s comments on its 1Q26 earnings call this morning regarding the government’s efforts to rein in Medicare waste, fraud and abuse in hospice reinforce our prior views that program integrity, instead of the sufficiency of…
April 23, 2026
RAPID Device Coverage: Rebrand or Brand New?
The joint CMS / FDA press release this morning outlining the Regulatory Alignment for Predictable and Immediate Device (RAPID) coverage pathway for breakthrough medical devices strikes us more as a rebranding of the existing transitional…
April 21, 2026
Another State PBM Ban on Pharmacies Invites Headline Noise – and Ultimately Legal Challenges [CVS, CI, UNH]
While the passage of another ban on PBM ownership of pharmacies – this time in Tennessee – could reignite some headline risk for CVS, CI, and UNH, we think the actual risk of it going…
April 21, 2026
Being Coy on BALANCE – How Could CMS and Insurers Get to Yes [UNH, ELV, HUM, CVS, CNC, CI, MOH]
UnitedHealth’s (UNH) comments on its earnings call this morning, responding to a question about potential participation in CMS’s BALANCE obesity drug model, suggest that further design changes will be required for it – and likely…
April 21, 2026
INSP: MAC Modifier Feedback Bolsters View
Amid persistent investor questions on Medicare Administrative Contractor (MAC) billing / coding requirements for Inspire Medical’s (INSP) Inspire V device, we continue to believe that the MACs will ultimately instruct providers to use the -52…
April 20, 2026
Capitol Policy Weekly: Reconciliation, Warsh, Export Controls, California Social Media in Focus
With the House and Senate both in session this week, Washington’s focus will remain concentrated on the Iran-U.S. conflict, which heated up yesterday after the U.S. seized an Iranian ship. We have though an escalation…
April 17, 2026
(META, GOOGL, SNAP, TikTok) California’s Bipartisan Push to Ban Under-16s from Social Media Clears First Hurdle
We assign roughly 65% probability that California’s pending legislation, AB 1709, which is a bipartisan ban on kids under 16 years old from creating accounts on social media platforms (META, GOOGL, SNAP, TikTok) that have…
April 15, 2026
Reconciliation 2.0: Defense and Healthcare in Focus
Congressional Republicans seem poised to move ahead with a “skinny” $65-$75 billion reconciliation bill that, importantly for investors, does not look like it will include: The ~$200 billion in additional defense funds, in part to…