May 21, 2025
Medicare Advantage: Ramping Up RADV Audits Clearly a Threat, But Does It Head Off Other Risks? [HUM, UNH, CVS, ELV, ALHC]
CMS’s announcement late Wednesday to turn the dial up on its risk-adjustment data verification (RADV) audits of Medicare Advantage (MA) contracts with an eye toward the entire landscape raises legitimate fears of recouping sizable past…
May 19, 2025
Expected Federal Report on Fertility Benefits: Regulatory Recommendations Likely Incremental [PGNY]
Since we are at the 90-day mark after February 18 release of the White House’s Executive Order (EO) supportive of in-vitro fertilization (IVF), there is a hope that the Trump administration’s anticipated report of potential…
May 19, 2025
Capitol Policy Weekly –May 19-23: Reconciliation, U.S. Debt Downgrade, and Trade
We think Speaker Mike Johnson (R-LA) is likely to pull off passing the reconciliation / tax bill this week before Congress goes out on its Memorial Day recess, though getting there is going to take…
May 16, 2025
[CNC, MOH, ELV, OSCR, ARDT, THC, ACHC]: What’s Next for Healthcare in House’s Reconciliation Proposal
As we head into this weekend, below are our latest thoughts on the healthcare components of the reconciliation bill and where things stand and what changes may be in store. This afternoon’s sidelining of the…
May 15, 2025
NIH & Lab Tools: Law vs Politics
Nearly five hours of testimony from HHS Secretary RFK Jr. yesterday on the administration’s FY26 budget request leaves us with little additional confidence in the overall trajectory for NIH spending and – by extension –…
May 15, 2025
IRA Green Energy Tax Provisions: House Mark Likely Worst-Case Scenario
We view the IRA green energy tax credits in the House Ways and Means Committee as a worst-case scenario. We believe that, in aggregate, these tax breaks won’t get worse when the Senate cobbles together…
May 13, 2025
Reconciliation Bill Moving Forward: House Business Tax Provisions
We continue to assign high odds that the reconciliation / tax bill will pass by late July / early August. The bill included many corporate and individual tax provisions. We focus on the corporate provisions…
May 13, 2025
[ELV, CNC, MOH, UNH, CVS] CMS Managed Care Provider Tax Proposal
Yesterday’s CMS proposal confirms our suspicion that the agency would seek to tighten state provider taxes – primarily those on managed care [ELV, UNH, CNC, MOH, CVS, CI, OSCR]– used to secure sizable federal Medicaid…
May 13, 2025
Trade Update: Reciprocal Tariffs in the Courts
We continue to believe that President Trump’s reciprocal tariffs face a real risk from the U.S. Court of International Trade (CIT) case, V.O.S. Selections, Inc. v. Trump, which will be heard today. In what might…
May 12, 2025
Rx Pricing’s Lucy & the Football Moment?
Investors should view today’s drug pricing Executive Order (EO) with relief, and while the biopharma industry remains on notice for potential future regulatory actions, we suspect the courts would intervene to stop any overly broad…