Insights: Healthcare

Energy, Financials, Healthcare, Macro, Tech / Media / Telecom

Senate Republican negotiations on changes to the House-passed reconciliation bill are intensifying. It appears that changes under consideration in the Senate increase the deficit by ~$600-700b beyond the House-passed bill’s $2.4t deficit impact, though there is consideration of adding provisions to try to close that gap. House conservatives are...

Energy, Financials, Healthcare, Macro, Tech / Media / Telecom

Senate Republicans have indicated that the committees responsible for various components of their emerging reconciliation legislation will be releasing draft text in the next couple of days. The Senate Finance Committee, which is responsible for taxes and entitlement programs (e.g., Medicaid, ACA) is likely to be last, with release of its text...

340b Drug Discount Program

The Federal District Court for D.C. has ruled that the Health Resources & Services Administration (HRSA) has the authority to preapprove the use of 340B rebate models before they can be implemented by drugmakers.

Medicare Advantage (MA) RADV

The Centers for Medicare & Medicaid Services (CMS) issued a statement announcing its intent to restart Risk Adjustment Data Validation (RADV) audits, clear the existing backlog of incomplete audits by early 2026, and boost its auditing workforce/capabilities (i.e., 40 coding experts to 2k, new technology, auditing of every plan, from 35 records...

Medicare Advantage (MA) & UnitedHealthcare

Reports indicate the DOJ has launched a criminal investigation into alleged improper Medicare Advantage (MA) billing practices by UnitedHealth Group (UNH). These reports come on the heels of a similar civil investigation being launched by the agency in February of this year. It is unclear at this stage whether the investigations are separate or...

House Republicans are making a final push to pass their partisan reconciliation (tax/spending) legislation, with President Trump and House conservatives currently meeting at the White House to overcome their concerns about the bill’s SALT, Medicaid, and IRA clean energy provisions. The next step for the bill is for it to pass in the Rules...