CNC (US)

We continue to be optimistic and think the odds have risen above 50% that Congress later this year reaches a compromise to “fix” the expiring enhanced Obamacare subsidies, which would further remove some of the…

Headline risk to Medicaid insurers [CNC, MOH], hospitals [CYH, HCA, THC], behavioral providers [UHS, ACHC], and Medicaid contractors [MMS] is likely to ramp up in the coming months as 15 states take affirmative steps toward…

A federal district court’s ruling Friday to stay part of CMS’s Obamacare program integrity regulation is a positive development for exchange insurers [OSCR, CNC, ELV, MOH], hospitals [HCA, THC, CYH, ARDT, MPW, municipal-backed facilities] and…

Today’s CMS release regarding its CY26 Medicare Part D program gives  the impression the agency is focusing on stability in its drug benefit program with the goal to ensure 1) enrollees – especially those in…

While exchange insurers (OSCR, CNC, ELV) and hospitals (THC, CYH, ARDT, UHS, HCA) try to figure out their  Obamacare businesses for next year with the various regulatory and reconciliation-related changes leading to anticipated enrollment declines…

While we still agree with consensus about the negative bias towards hospitals and Medicaid insurers from the One Big Beautiful Bill Act (OBBA) signed into law last Friday, we note a few tweaks in the…

CMS’s addition last week of 300+ Medicare Advantage (MA) [UNH, HUM, CNC, ELV, CVS, ALHC] contracts to be audited for risk adjustment data verification (RADV) during plan year (PY) 2019 raises the risk of larger…

We expect the Senate to pass the reconciliation bill within the next 24 hours, despite the current reconciliation drama (parliamentarian rulings, CBO projection of deficits post-2034, Senator Thom Tillis’s (R-NC) retirement announcement, House member opposition,…

The sizable hole left by the Senate parliamentarian decisions on various Medicaid and Obamacare provisions, which were reported this morning by Senate democrats (here and here) injects uncertainty for hospitals, Obamacare insurers, Medicaid managed care,…

Amidst the behind-the-scenes Senate debate of its draft reconciliation bill, CMS made good on its threat to jettison improper and fraudulent Obamacare enrollment, impacting ACA insurers [OSCR, CNC, ELV, MOH] and hospitals / behavioral facilities…