CMS informed Medicare Advantage (MA) insurers [HUM, UNH, CVS, ELV, CNC, ALHC, MOH, CLOV] that it is voluntarily recalculating their CY26 Star Ratings, which determine CY27 Quality Bonus Payments (QBP). Under the agency’s approach, released…

We remain skeptical that Congress will pass comprehensive federal AI legislation this year or likely next year, leaving companies to navigate a state-by-state regulatory patchwork since no current federal law exists that broadly preempts state…

Yesterday’s disclosure by the Office of Management & Budget (OMB) that it is reviewing a finalized Medicare Part D Most Favored Nation (MFN) policy suggests the administration likely intends to move forward with its late…

CMS’s draft coverage policy for transcatheter aortic valve replacement (TAVR) appears largely consistent with our initial expectations, likely bringing some incremental upside as well. If finalized largely as proposed in Sept., as seems probable, we…

Last week’s ACA-related court ruling permanently, which enjoined key portions of the CY25 Obamacare regulation, may initially reassure insurers [OSCR, CNC, ELV] and hospitals [HCA, THC, CYH, UHS, ARDT] about certain enrollment-related program integrity headwinds….

We see three Washington policy-related risks that are likely to generate headline risk, including: A tentative U.S.-Iran agreement that will probably be extended beyond the 60-day timeframe and should hold at least through the midterm…

The Senate is in session, and the House is out this week, which matters because the calendar is becoming the biggest obstacle for several Republican and industry-backed priorities that still need meaningful floor time before…

In advance of the CMS draft coverage decision for transcatheter aortic valve replacement (TAVR) due June 15 (final Sept. 15), we expect policy changes that – while positive – may be more incremental in their…

Despite President Trump’s comments on Truth Social about the need to pass Reconciliation 3.0 for an additional $350 billion in defense spending, we think he will be disappointed. We continue our long-held belief that: Defense…

While Medicaid and ACA enrollment concerns have dominated the policy overhang for hospitals this year, Medicare-related risks could move higher on investors’ radar with the release of CY27 hospital outpatient prospective payment system (OPPS) proposed…

We wanted to provide our thoughts on comments made by President Trump earlier this afternoon when he said he was not looking to renew the USMCA. We do not interpret Trump’s comments as signaling an…

We see little reason to alter our base case regarding Medicare coverage of GKOS’s iDose following yesterday’s first contractor open meeting on the five-MAC draft LCD issued in late May. While we believe the MACs…

Both the House and Senate are in session this week, with the House expected to pass the $72 billion Customs and Border Protection (CBP) and Immigration and Customs Enforcement (ICE) reconciliation bill after weeks of…

In advance of Dexcom’s (DXCM) readout of its CONNECT RCT this weekend, which management positions as a “powerful anchor” for broader Medicare CGM coverage in “all people with diabetes,” we ultimately expect a material increase…

CMS’s long-awaited interim final rule implementing the One Big Beautiful Bill’s (OBBB) Medicaid Community Engagement (CE) requirements largely aligns with our expectations that CMS would defer to states on program design and implementation, which we…