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October 11, 2024

Cannabis Update: Take Tilray’s (TLRY) CEO’s Comment with a Grain of Salt

By Joe Lieber

Despite comments during an earnings call yesterday by Tilray’s (TLRY) CEO, who said with regard to the two presidential candidates and the elections that “something will happen in regards to Federal legalization, whether it’s medical…

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October 11, 2024

[LLY, NVO] GLP-1s & CBO Data Dive

By John Leppard

Key Takeaways: We continue to think legislation to allow Medicare Part D coverage of anti-obesity medications (AOMs) [Eli Lilly (LLY), Novo Nordisk (NVO)] is unlikely to pass this year, despite the relatively modest budgetary estimates…

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October 11, 2024

Negative Tone Confirmed for CY25 Medicare Advantage Stars and Beyond as Goalposts Continue to Move

By Beth Steindecker

Key Takeaways: As we expected, CMS’s release of the CY25 Medicare Advantage (MA)/Part D star ratings continues to limit program “largesse,” making bonus awards more selective and ratings harder to maintain YoY. For CY25, fewer…

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October 10, 2024

Potential Top Officials in a Harris Administration

By Joe Lieber

With our view that the odds slightly favor Vice President Kamala Harris winning the presidency in November (see here), we offer a comprehensive list of potential candidates for key Cabinet and other important positions below. …

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October 9, 2024

Harris’ In-Home Care, Vision, Hearing Aid Medicare Coverage Proposal – Likely an Undelivered Promise

By Beth Steindecker

We are skeptical of enactment for Vice President Kamala Harris’ campaign proposal to add a Medicare in-home care benefit, along with vision and hearing aid coverage, even if she were to win (our base case)…

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October 9, 2024

Exact Sciences (EXAS): Rate Reversal Prospects

By John Leppard

Key Takeaways: With FDA’s early approval of Exact Sciences’ (EXAS) Cologuard Plus last week coming on the heels of CMS’s preliminary rejection of EXAS’s requested 25% rate increase ($636) relative to the legacy product ($509),…

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October 9, 2024

Exact Sciences (EXAS): Rate Reversal Prospects

By John Leppard

Key Takeaways: With FDA’s early approval of Exact Sciences’ (EXAS) Cologuard Plus last week coming on the heels of CMS’s preliminary rejection of EXAS’s requested 25% rate increase ($636) relative to the legacy product ($509),…

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October 8, 2024

[EW, ABT] Tricuspid Coverage & Sales Trajectory

By John Leppard

Key Takeaways: As investors look to model out sales of Edwards Lifesciences’ (EW) Evoque tricuspid valve replacement in advance of CMS’s draft National Coverage Determination (NCD), which is expected by ~Dec. 20 (final policy due…

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October 8, 2024

Negative Tone Ahead for Medicare Advantage Stars While Awaiting CY25 Awards

By Beth Steindecker

Key Takeaways: Developments involving Humana (HUM) and UnitedHealth (UNH) last week show CMS remains intent on limiting the financial “largesse” insurers receive in its Medicare Advantage (MA)/Part D (PDP) star rating quality bonus program by…

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October 8, 2024

Slight Advantage for Harris

By Joe Lieber

With less than a month until Election Day, we view Vice President Kamala Harris as having a slight edge over Donald Trump. The House is likely to be controlled by whichever party wins the presidency,…

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