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January 8, 2025

Conference Policy Prep Pack: Healthcare Providers & Insurers

By Beth Steindecker

With a handful of healthcare provider and insurance companies headed to San Francisco next week for a key investor conference, below we provide a set of significant policy-related questions we would like to see management teams address…

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January 8, 2025

Exact Sciences (EXAS): Cologuard Plus Coverage Questions

By John Leppard

A Jan. 1 update to CMS’s colorectal cancer (CRC) screening guide appears to support our view that Medicare coverage of EXAS’ Cologuard Plus (0464U: $592) and its 16% rate premium over the legacy version (81528:…

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January 6, 2025

Conference Policy Prep Pack: Devices, Diagnostics, & Tools

By John Leppard

With medical device, equipment, diagnostics, and life science tools (LST) companies set to descend on San Francisco next week for a key investor conference, below we provide a set of significant policy-related questions for clients…

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January 6, 2025

DC Quick Takes: Reconciliation (Tax bill), Immigration (GEO, CXW) and Cabinet Hearings

By Joe Lieber

While most of the action in DC this week will be ceremonial with Congress certifying the election of President Trump and Vice President JD Vance, much of the talk in town will be on the…

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January 2, 2025

DC Quick Takes: Speaker’s Vote, the Debt Limit and Healthcare Extenders

By Joe Lieber

We think House Speaker Mike Johnson (R-LA) faces uphill odds on retaining his Speaker’s role. It’s close to a tossup but if Johnson is re-elected, it isn’t likely to be on the first ballot. Keep…

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December 20, 2024

Government Shutdown Update and What the Divide Might Mean for the Next Congress

By Joe Lieber

When Speaker Mike Johnson (R-LA) initially pulled his negotiating continuing resolution (CR) with the Democrats, our view was that a government shutdown was unlikely.  Yes, we might have technically had one over the weekend, but…

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December 20, 2024

EW: Tricuspid Coverage Positive, With Some Caveats

By John Leppard

We view CMS’s draft coverage policy for transcatheter tricuspid valve replacement (TTVR) as incrementally more positive for EW’s Evoque relative to our initial expectations. The lack of facility / operator volume thresholds will likely allow…

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December 18, 2024

Government Shutdown Unlikely; CR Likely to Pass

By Joe Lieber

Despite all the criticism, especially from President-elect Trump, Vice President-elect JD Vance and Elon Musk, we do not believe there will be a government shutdown this week and expect Congress to pass a continuing resolution…

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December 18, 2024

[PBMs, Cancer Screening, Medicare Advantage] A Few Surprises in the Healthcare Spending Package but Otherwise Mirroring Prior Compromise

By Beth Steindecker

Following Tuesday night’s release of a short-term continuing resolution (CR) funding the government through March 14, we outline some key differences from previously-reported iterations of the healthcare extenders package, involving PBMs [CI, CVS, UNH, ELV],…

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December 17, 2024

[GRAL, EXAS, GH] Multi-Cancer Test Coverage: Details Fall Flat

By John Leppard

While positive on its face, the inclusion of multi-cancer early detection (MCED) screening test [GRAL, EXAS, GH] coverage provisions in tonight’s continuing resolution (CR) to fund the government through March 14 leaves much to be…

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