May 21, 2025

Medicare Advantage: Ramping Up RADV Audits Clearly a Threat, But Does It Head Off Other Risks? [HUM, UNH, CVS, ELV, ALHC]

By Beth Steindecker

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…

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May 21, 2025

(KO, PEP, MNST, CELH, HSY) SNAP/Food Stamp Update: Reconciliation Cut and Soft Drinks and Candy in the Crosshairs

By Joe Lieber

The SNAP/food stamp program has been of focus lately as various states have filed for SNAP benefit waivers, and one, Nebraska, was granted approval for one. In addition, Republicans are looking to cut SNAP as…

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May 19, 2025

Expected Federal Report on Fertility Benefits: Regulatory Recommendations Likely Incremental [PGNY]

By Beth Steindecker

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…

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May 19, 2025

Capitol Policy Weekly –May 19-23: Reconciliation, U.S. Debt Downgrade, and Trade

By Joe Lieber

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…

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May 16, 2025

[CNC, MOH, ELV, OSCR, ARDT, THC, ACHC]: What’s Next for Healthcare in House’s Reconciliation Proposal

By Beth Steindecker

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…

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May 15, 2025

NIH & Lab Tools: Law vs Politics

By John Leppard

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 –…

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May 15, 2025

IRA Green Energy Tax Provisions: House Mark Likely Worst-Case Scenario

By Joe Lieber

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…

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May 13, 2025

Reconciliation Bill Moving Forward: House Business Tax Provisions

By Joe Lieber

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…

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May 13, 2025

[ELV, CNC, MOH, UNH, CVS] CMS Managed Care Provider Tax Proposal

By Beth Steindecker

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…

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May 13, 2025

Trade Update: Reciprocal Tariffs in the Courts

By Joe Lieber

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…

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May 12, 2025

Rx Pricing’s Lucy & the Football Moment?

By John Leppard

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…

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May 12, 2025

Capitol Policy Weekly—May 12 through May 16: Reconciliation, Medicare MFN, and Trade

By Joe Lieber

This week is an important week for the reconciliation / tax bill as three important committees plan to mark up their versions of the bill. In addition, President Trump is scheduled to sign an executive…

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May 12, 2025

Healthcare & Reconciliation: Worst Case Avoided

By Beth Steindecker

The House Energy & Commerce Committee’s (E&C) reconciliation draft (text and summary) seems to largely align with our expectations regarding cuts / risks in Medicaid, Obamacare, and pharmacy benefit managers (PBM).  While there were still…

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May 8, 2025

Trade Update: China Trade Talks, Reciprocal Tariffs and Semiconductors

By Joe Lieber

On the heels of the UK trade deal announced this morning, we have the following updates on: China trade talks; The U.S. Court of International Trade reciprocal trade case; and Potential semiconductor tariffs. On trade…

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May 7, 2025

Rx MFN Announcement Monday?

By John Leppard

Apropos of our note on the subject earlier today, there are reports this afternoon that as early as Monday, May 12 President Trump “is expected to sign an executive order directing aides to pursue ……

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