July 1, 2025
[DXCM, TNDM, BBNX, RMD, CTEC.LN, COLOB.DC] Medicare Competitive Bidding Coming
Consistent with our long-held expectations – albeit coming sooner than we had anticipated – a draft CMS rule issued last night strongly suggests it intends to subject continuous glucose monitors (CGMs) [DXCM, ABT] and insulin…
June 30, 2025
[LIVN, INSP, GMED, MMSI, BSX, MDT] CMS Prior Auth Demo Device Headwinds
We view CMS’s new Medicare prior authorization model – announced late Friday and scheduled for implementation Jan. 1, 2026 – as an incremental headwind for device manufacturers within the selected therapeutic and geographic areas, which…
June 27, 2025
[EXAS, GH, GILD, MYGN, HOLX] Preventive Services: SCOTUS Takes
Consistent with our expectations, the Supreme Court today upheld the validity of U.S. Preventive Services Task Force (USPSTF) appointments and – by extension – the mandate that insures cover recommended services without patient cost-sharing, lifting…
June 27, 2025
PRCT: Medicare Rate Expectations
With CMS likely to publish its CY26 physician / hospital outpatient rate proposals the week of July 7-11, we continue to expect physician payments for PRCT’s Aquablation to fall ~20% ($765 to ~$600) [see prior…
June 24, 2025
[EW] Quick Word on TAVR Coverage Update
Having received a number of questions on an “update” posted to CMS’s National Coverage What’s New Report yesterday – which some have taken to imply a near-term reopening of the agency’s coverage policy for transcatheter…
June 12, 2025
Lantheus (LNTH): Where Do Hospital Rates Go?
Despite some speculation, we do not expect CMS to increase hospital payments for LNTH’s Pylarify from CY25’s mean unit cost (MUC) [$3.1K] to an average sales price (ASP) methodology [$5.8K] (+85%) in the draft CY26…
June 10, 2025
Lab Tools: Senate’s NIH Pushback
Today’s hearing on the FY26 NIH budget before a Senate Appropriations Subcommittee bolsters our view [see note] that lawmakers are highly unlikely to endorse the White House request for an $18B (40%) cut, with flat…
June 6, 2025
EW: Medicare Coverage Queue Delays?
We suspect the timeline for Medicare coverage expansion will be longer than investors anticipate for EW’s asymptomatic transcatheter aortic valve replacement (TAVR) indication. While we see eventual reductions in procedure volume requirements – expanding eligibility…
June 2, 2025
Lab Tools: NIH’s Bleak Budget & Reason For Hope?
We continue to expect FY26 NIH funding to remain largely flat YoY, despite White House calls for a -40% cut weighing on life science tools (LST) names, with the House likely to produce its own…
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 –…