Insights: Clients

Medicare FFS Prior Authorization (WISeR Model)

The CMS Innovation Center (CMMI) has announced the Trump administration’s first new model, known as the Wasteful & Inappropriate Service Reduction (WISeR) Model. At a high-level, the model will test the expansion of prior authorization (PA) requirements in traditional fee-for-service (FFS) Medicare and the involvement of private sector tech...

Medicare DME Competitive Bidding (CBP)

The Trump administration continues to signal that a new round of the Durable Medical Equipment, Prosthetics, Orthotics, & Supplies (DMEPOS) Competitive Bidding Program (CBP) is in the offing. Earlier this year, a proposed rule aimed at improving the “fiscal sustainability of the CBP” appeared on the HHS unified agenda (release tentatively...

Medicare FFS Reimbursement (Home Health)

CMS has issued the CY26 Home Health Agency (HHA) proposed rule. Under the rule, CMS proposes decrease payments by -6.4% (-$1.135b) for CY26 relative to CY25. Comprising that net update is a 2.4% market basket update, a -0.5% outlier payment decrease, and an aggregate -3.7% prospective behavioral adjustment due to the continued implementation of...

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

Senate Republicans yesterday overcame the first procedural hurdle in passing the reconciliation bill and are planning for a Monday vote on final passage, though numerous of them continue to have reservations. House Majority Leader Scalise (R-LA) has indicated a House vote on the bill could take place by Tuesday or Wednesday, though a significant...

Energy, Healthcare, Macro

The Senate parliamentarian has deemed numerous provisions of the reconciliation bill, including major components of the planned Medicaid cuts, procedurally impermissible, which some estimates suggest would add ~$250b in deficit impact back to the bill. Finance Committee Chair Crapo (R-ID) indicated to his colleagues late yesterday that the...

Energy, Healthcare, Macro

President Trump is intensifying his push to have the reconciliation bill enacted by July 4th. It appears the Senate parliamentarian will continue her review of the bill through today, with Majority Leader Thune now planning to commence with consideration of the bill on the Senate floor tomorrow and concluding over the weekend, giving the House...