From Washington, DC

• The House of Representatives and the Senate remain in session this week on Capitol Hill for Committee business and floor voting. Roll Call discusses this week’s schedule here.

• Beckers Payer Issues tells us,
  • “A group of House Republicans are backing the newly filed Bipartisan Premium Tax Credit Extension Act, which would extend enhanced ACA subsidies for one year beyond their current expiration date at the end of 2025.
  • “Under the legislation, the premium tax credits would expire Jan. 1, 2027. The bill would also maintain the expanded eligibility criteria that allows households earning more than 400% of the federal poverty level to qualify for subsidies.
  • “Insurers nationwide have requested a median 15% rate increase for 2026, citing both the anticipated expiration of the tax credits and rising medical costs. The tax credits, first expanded under the American Rescue Plan and extended by the Inflation Reduction Act, have helped drive record marketplace enrollment, with more than 24 million people signing up for coverage in 2025.
  • “The group of 10 Republican lawmakers supporting the bill is made up of some of the most politically vulnerable incumbents heading into the midterms, per Politico.”

• The AP informs us,
  • “Republican senators say they are prepared to change the chamber’s rules to get around the Democratic blockade of President Donald Trump’s nominees and are discussing a proposal to make it easier to confirm multiple nominees at once.” * * *
  • “GOP senators discussed one proposal in a private meeting on Wednesday [September 3] that would enable them to confirm large tranches of nominees “en bloc,” or several at once, if a majority of senators agree, according to multiple senators who attended the meeting. 
  • “Currently, the objection of a single senator forces multiple votes on most nominations. The rules change would likely only apply to executive branch nominations, not lifetime judicial appointments, and would exclude many of the most high-profile positions, such as Cabinet nominees, that require a longer debate time.”

• Here’s a link to the Federal Register’s PDF version of OPM’s September 8, 2025, final rule titled “Reinvigorating Merit-Based Hiring Through Candidate Ranking in the Competitive and Excepted Service (Rule of Many).” The rulemaking was first mentioned in last Friday’s FEHBlog.

• HR discusses the Labor Department’s recently posted semi-annual regulatory agenda.
  • “The U.S. Department of Labor said Thursday it intends to revisit its overtime regulations under the Fair Labor Standards Act but did not disclose a deadline by which to issue an update on the subject, according to a press release.”

From the public health and medical/Rx research front,

• The New York Times considers “Why Are More Older People Dying After Falls? Some researchers suspect that rising prescription drug use may explain a disturbing trend.”
  • “The Beers Criteria, a directory of drugs often deemed inadvisable for older adults, recently published recommendations for alternative medications and nonpharmacological treatments for frequent problems. Cognitive behavioral therapy for sleeplessness. Exercise, physical therapy and psychological interventions for pain.
  • “It’s a real tragedy when people have this life-altering event,” Dr. Steinman, co-chair of the Beers panel on alternatives, said of falls. He urged older patients to raise the issue of fall risk increasing drugs (FRIDs) themselves, if their doctors haven’t.
  • “Ask, ‘Do any of my medications increase the risk of falls? Is there an alternative treatment?’” he suggested. “Being an informed patient or caregiver can put this on the agenda. Otherwise, it might not come up.”

• NPR Shots reports,
  • “By age 40, more than half of Americans have high blood pressure, but many are unaware of it. Hypertension has long been known as the silent killer. When it’s left untreated it can be deadly. And it’s considered a silent threat since most people have no symptoms. You can’t feel the pressure in your blood vessels increasing.
  • New recommendations from the American Heart Association aim for early treatment, including lifestyle changes and medications, once systolic blood pressure rises above 130/80 mm Hg, (which stands for millimeters of mercury, a measure of pressure). Experts say it’s clear that the sooner you take action, the more you can protect yourself.

• Medscape lets us know,
  • “The proportion of patients taking a GLP-1 weight-loss drug following bariatric surgery increased substantially in recent years, although the timing of initiation after surgery varied widely, a large retrospective cohort study showed.
  • “GLP-1 initiation was also more common among women, those who underwent sleeve gastrectomy, and those with lower postoperative weight loss as measured by BMI.
  • “Some patients do not lose as much weight as expected, or they regain weight after a few years. In such cases, GLP-1 therapies are emerging as an important option for weight management,” said principal investigator Hemalkumar Mehta, PhD, associate professor at Johns Hopkins Bloomberg School of Public Health in Baltimore.”
• and
  • identifies natural remedies for folks with gastrointestinal issues.
    • “Almost two thirds of Americans are burdened by gastrointestinal (GI) symptoms like heartburn, abdominal pain, bloating, diarrhea, and constipation. And for almost 40% of Americans, uncomfortable bowel symptoms are bad enough that they forgo routine activities such as exercising or spending time with their families.
    • “Medications, both over the counter and prescription, targeting GI conditions are plentiful. Yet more and more patients are requesting natural routes to relief, doctors told Medscape Medical News, and it’s likely your patients are, too.
    • “Here are some examples from doctors on how they’ve integrated natural remedies into their practice for specific common complaints. Some remedies have published research to back them up, while others are anecdotal, but backed by patients and doctors reporting that they do work.”

• Per Fierce Pharma,
  • “Industry watchers who cheered on Summit Therapeutics’ claim that the first global phase 3 trial of its Akeso-partnered PD-1xVEGF [cancer] drug showed consistent benefit between China and Western populations may be disappointed, although hopes for an approval remain alive thanks to newly calculated patient survival data from a longer follow-up.”
• and
  • “Facing increased EGFR [mutation] competition from a new drug combination by Johnson & Johnson, AstraZeneca has come up with its own solution to prolong the lives of patients who take the company’s decade-old medicine Tagrisso.
  • “The method involves pairing Tagrisso with chemotherapy. The combo significantly reduced the risk of death by 23% compared with Tagrisso alone in patients with previously untreated EGFR-mutated advanced non-small cell lung cancer, an updated analysis of the phase 3 Flaura2 trial has found.
  • “Patients who received Tagrisso and chemo lived a median 47.5 months, versus 37.6 months for the Tagrisso monotherapy group, according to data presented at the 2025 World Conference on Lung Cancer in Barcelona, Spain.
  • “The latest data drop helps re-level the playing field for Tagrisso after J&J’s combination of Rybrevant and Lazcluze recently became the first regimen to demonstrate an overall survival benefit against Tagrisso in first-line EGFR-mutated NSCLC.”

From the U.S. healthcare business front,

• Medical Economics shares a slideshow about “health care spending per person in the 12 states where it is highest.”

• Beckers Payer Issues points out,
  • “For more than two years, Becker’s has reported on the intensifying trend of Medicare Advantage reimbursement fights between hospitals and insurers that has contributed to a dizzying and ever-changing environment for older adults to navigate each enrollment period. 
  • “Now, that environment is experiencing more upheaval as the nation’s largest insurers pull backfrom Medicare Advantage markets to protect profit margins amid new federal cost-containment measures and rising medical expenses.
  • “This retrenchment is not entirely new, with some regional and mid-sized health plans scaling back their MA offerings for 2025 coverage. But with the biggest players now also making cuts, the ripples are getting bigger, and a wave of market exits and membership losses are reshaping the program for 2026.” * * *
  • “As national players retreat, some nonprofit and provider-owned MA plans are moving to make up ground that’s been lost in recent years. BCBS Wyoming, SCAN Health Plan, and WVU Medicine’s Peak Health have announced plans to launch or expand within the program for 2026, for instance.”
    
• Fierce Pharma notes,
  • “Specialty and orphan drugs continue to dominate the development pipeline, and a new report from Optum Rx spotlights three products payers should be watching.
  • “The pharmacy benefit manager recently released its summer Notable New Drugs report, highlighting three products: Brinsupri (brensocatib), tolebrutinib and a subcutaneous version of Leqembi (lecanemab-irmb). All three are specialty drugs that aim to treat chronic conditions—non-cystic fibrosis bronchiectasis, multiple sclerosis and Alzheimer’s disease, respectively.
  • “Arash Sadeghi, senior clinical pharmacist on OptumRx’s pipeline and drug surveillance team, told Fierce Healthcare that specialty products represent between 70% and 75% of novel drugs approved each year, making it critical for health plans to monitor what’s coming to market.
  • “Any time we talk about the pipeline or drugs that are going to be high impact or blockbusters, so much of that time is devoted to specialty products, specifically,” Sadeghi said.”

• Per Kaufman Hall,
  • “One-third of discharged patients go to a different hospital when requiring a readmission, according to data from Vizient’s CMS Qualified Entity Public Report, published last month. The highest proportion of different-hospital readmissions were for behavioral health (61.3%) and neurosciences (55.6%). Readmission rates were higher in urban areas (16.7%) than rural areas (15.4%), but rural patients were more likely to be readmitted to a different hospital, 35.1% vs. 32.3% for patients residing in urban areas. These “invisible returns” complicate care coordination and outcome tracking. Such fragmentation disproportionately affects high-risk populations, particularly those in vulnerable areas (as measured by the Vizient Vulnerability Index) and those covered by Medicaid or Medicare. The implications for patient retention are clear: if patients aren’t satisfied with the treatment at your hospital, they’ll go somewhere else.”

• The Wall Street Journal reports,
  • “How much would you invest in the possibility of living to 150 or beyond? Or having 20 extra healthy years?
  • “For the ultrawealthy, it’s more than $5 billion over the past 2½ decades, according to a Wall Street Journal analysis of longevity investment deals in PitchBook, public company statements and regulatory filings.
  • “Silicon Valley giants Peter Thiel, Sam Altman, Yuri Milner and Marc Andreessen are among the boldface names behind the influx of money in the longevity industry. Thiel’s quest for longer life spans nearly a dozen companies—some of which were funded by his venture firm and others by a nonprofit foundation he backed—that raised more than $700 million, according to the Journal’s analysis.”