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January 13, 2025

Medtronic: Medicare RDN Coverage in 4Q24

By John Leppard

In keeping with expectations laid out in our note late last week, CMS’s opening of a National Coverage Analysis (NCA) for renal denervation (RDN) [Medtronic (MDT), Otsuka (4578.JT) / ReCor] this afternoon has a target…

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January 13, 2025

Inspire V Payment & Coverage Quick Take

By John Leppard

INSP’s disclosure today that physicians will likely be billing its Inspire V device procedures under CPT 64568 ($596) during a “transition period” – rather than existing Inspire IV code CPT 64582 ($816), as we had…

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January 13, 2025

Capitol Policy Weekly: Jan. 13-17

By Joe Lieber

This week starts a host of hearings on President-elect Trump’s cabinet nominees (see below). The Senate is also expected to pass an immigration bill, the Laken Riley Act (S. 5), which would require the Dept….

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January 12, 2025

Diagnostics’ New Supreme Court Risk

By John Leppard

The Supreme Court’s (SCOTUS) decision on Friday to hear oral arguments in Becerra v. Braidwood, presumably in late March / early April, will likely serve as an overhang for screening test manufacturers [EXAS, GH, MYGN,…

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January 11, 2025

[HUM, UNH, CVS, ELV, ALHC] CY26 Medicare Advantage Rates: Likely Upswing in the Final

By Beth Steindecker

CMS’s Friday release of the CY26 Advance Notice (AN) for Medicare Advantage (MA) insurers [HUM, UNH, CVS, ELV, ALHC, CLOV, CNC] came in better than our net YoY benchmark expectations with a proposed net increase…

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January 10, 2025

Medtronic (MDT): Renal Denervation Coverage Read-Through?

By John Leppard

This morning’s opening of a Medicare National Coverage Determination (NCD) for privately-held Impulse Dynamics’ Optimizer System bolsters our view that coverage for renal denervation (RDN) systems [Medtronic (MDT), Otsuka / ReCor (4578.JT)] is unlikely to…

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January 10, 2025

2025 Tax Primer: Extending the Trump Tax Provision et al.

By Joe Lieber

We continue to believe that Congress is likely to pass a massive $5 trillion- plus tax bill that would extend the 2017 Trump tax cuts, known as the Tax Cut and Jobs Act (TCJA). We…

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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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