April 2, 2025

Extending the TCJA Tax Cuts Cost Free—Well, Maybe

By Joe Lieber

As we await President Trump’s reciprocal tariff announcement this afternoon, there was some progress on the budget resolution / reconciliation bill yesterday that could:   Make passing the reconciliation / tax bill much cheaper and potentially…

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March 31, 2025

Capitol Policy Weekly—March 31 through April 4: Trade, Reconciliation/Taxes/Debt Limit, Banks and Special Elections

By Joe Lieber

This week looks like an important and busy week in Washington and beyond with: The Senate is seeking to pass their budget resolution by week’s end. President Trump announcing his reciprocal trade policy on April…

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March 31, 2025

Procept Biorobotics: Expecting ~20% Medicare Rate Cut

By John Leppard

With CMS likely to propose a new Medicare physician payment rate for PRCT’s Aquablation in early July – with a final policy in early Nov. and rates effective Jan. 1, 2026 – we expect to…

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March 28, 2025

INSP, NYXH, LIVN: Sleep Apnea Coverage Timeline

By John Leppard

We view the delayed approval of Nyxoah’s (NYXH) Genio announced this week as positive for Inspire Medical (INSP) insofar as it not only pushes out competition – albeit to an uncertain extent – but may…

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March 27, 2025

Auto and Reciprocal Tariff Update

By Joe Lieber

We have the following comments about Trump’s auto tariff announcement yesterday, given that some of the guidance was unclear, and in the lead up to the reciprocal tariff announcements expected on April 2. We have…

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March 26, 2025

DC Quick Takes: Reciprocal Trade, Reconciliation, Trade and the Debt Limit

By Joe Lieber

As we await President Trump’s decision on auto tariffs, we see a lot going on in DC that we want to address: 1) trade; 2) reconciliation; 3) tax cuts; and 4) the debt limit.  Reciprocal…

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March 25, 2025

HUM, ALHC, UNH: Optimistic for Mid-Single Digit MA Rate Increase for CY26, Upcoding Remains a Longer-Term Issue

By Beth Steindecker

Anticipating CMS’s issuance of its final CY26 Medicare Advantage (MA) rate notice within the next two weeks (on or before Monday, April 7), we remain optimistic about near-term regulatory changes for MA insurers [HUM, ALHC,…

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March 24, 2025

Capital Policy Weekly-March 24-28: Trade, Budgets, Taxes and Noms

By Joe Lieber

Congress is back in session for three weeks after a weeklong recess.  Focus this week will likely be on:   President Trump’s tariff announcement next week on April 2.  Negotiations between the House and Senate on…

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March 21, 2025

EXAS, GH: Colorectal Cancer Coverage in Hand, Edits to Come?

By John Leppard

An update to CMS’s colorectal cancer (CRC) screening National Coverage Determination (NCD) formally establishes coverage for EXAS’ Cologuard Plus ($592) and GH’s Shield ($1,495), with claims processing likely available within 30 days. While we have…

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March 20, 2025

Tariffs, Tax Cuts and Deficits

By Joe Lieber

We continue to believe some of President Trump’s tariffs will stay in place longer than the markets seem to expect (see below) and won’t be negotiated away in short order. We also continue to anticipate…

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March 20, 2025

EW, ABT: Tricuspid Replacement Coverage Benign

By John Leppard

We view CMS’s final coverage decision on transcatheter tricuspid valve replacement (TTVR) as an incremental positive for Edwards Lifesciences’ (EW) Evoque, in that it eliminates proposed limitations to only those with severe tricuspid regurgitation (TR)…

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March 14, 2025

Oz Nomination: Moving towards Senate Confirmation, Medicare Advantage Comments Show Mixed View

By Beth Steindecker

Today’s Senate Finance Committee confirmation hearing of Dr. Mehmet Oz as Trump’s CMS Administrator provided limited new insights into his approach to Medicare, Medicaid, Obamacare, pharmacy benefit management reforms, health savings account adoption, and healthcare…

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March 14, 2025

After Govt. Shutdown Avoided, Will Next Year’s Spending Process Look Similar?

By Joe Lieber

With Senate Minority Leader Chuck Schumer (D-NY) relenting on passage of what DC is calling a “year-long” continuing resolution (CR) through Sept. 30, as we expected, we think the same scenario could play out next…

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March 12, 2025

Government Shutdown Now likely?

By Joe Lieber

Moments ago, Senate Majority Leader Chuck Schumer (D-NY) stated that that Republicans don’t have the 60 votes in the Senate to pass the seven-month continuing resolution (CR), which some speculate could lead to a shutdown….

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March 12, 2025

Guardant Health (GH): Next Steps on Shield

By John Leppard

With the Medicare rate for GH’s Shield colorectal cancer (CRC) screening test set to increase 62% on April 1 ($920 to $1,495) following designation yesterday as an Advanced Diagnostic Laboratory Test (ADLT) – in line…

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