Simplicity is a virtue.

From Washington, DC,

• The Wall Street Journal reports,
  • “A top ally of Health Secretary Robert F. Kennedy Jr. is departing the Trump administration after frustrations with White House delays on Kennedy’s food agenda. 
  • “Calley Means, a senior adviser to Kennedy who also worked in the White House to further “Make America Healthy Again” policies, quit his role on Thursday, he told The Wall Street Journal.
  • “I leave with tremendous respect for President Trump and Robert F. Kennedy Jr.,” he said. “This movement is in the first inning and just getting started.” Means said he would continue working to further Kennedy’s MAHA agenda.”

• Per a Health and Human Services Department news release,
  • “The U.S. Department of Health and Human Services (HHS) today announced the 2026 Update to the National Plan to Address Alzheimer’s Disease and Related Dementias, taking Department-wide actions to guide coordinated federal action on dementia risk reduction, research and innovation, care, and support for people living with dementia and their families. Secretary Kennedy made the announcement at the Broward Health Medical Center in Fort Lauderdale, Florida.
  • “Millions of American families have seen the devastating toll of Alzheimer’s disease and related dementias,” said HHS Secretary Robert F. Kennedy, Jr. “Under President Trump, HHS is shifting the national strategy toward prevention, earlier detection, and faster development of better diagnostics and treatments. We are advancing gold-standard science, reducing risk where we can, improving care, and giving patients and families stronger support at every stage of the disease.”
  • “The updated plan puts greater emphasis on reducing dementia risk across the lifespan and translating scientific discoveries into better prevention, diagnosis, treatment, and care. It also formally recognizes related dementias in the plan’s title, reflecting public input and the shared challenges that patients and families face across different forms of dementia.” * * *
  • “Details on the National Plan and participating agencies’ initiatives are available at hhs.gov/aging/adrd.”

• The New York Times adds,
  • “Alzheimer’s Researchers Look at an Unusual Data Point: Head Shape.
    • “Could the geometry of our brains increase the risk of Alzheimer’s disease? It’s a provocative question, but one that some scientists are beginning to explore.”

• Beckers Health IT relates,
  • “HHS plans to award Anthropic a sole-source contract to keep its workforce on the company’s Claude AI tools without an open competition.
  • “The agency posted a notice of intent Oct. 19 on SAM.gov for a “limited continuity of services award.” The award would run until the department completes a competitive multiple-award blanket purchase agreement for enterprise frontier AI models. The notice did not list a contract value or projected award date.
  • “HHS argued that only Anthropic can meet the requirement because Claude is the company’s proprietary model family and is already integrated into department infrastructure. Covered capabilities include chat, drafting and summarization, coding assistance, agentic features, connectors, and administrative controls such as single sign-on and audit export.” * * *
  • “The notice comes as Anthropic’s discounted General Services Administration OneGov deal is set to expire Oct. 31, FedScoop reported. HHS rolled out Claude across the department in December 2025 after Anthropic offered its services to agencies for $1 a year.”
    
• Beckers Hospital Review tells us,
  • “Under the Healthcare False Claims Act Self-Disclosure Pilot Program, companies that meet the requirements can settle disclosed conduct through a coordinated civil release that covers the False Claims Act and certain HHS administrative authorities, according to an Oct. 22 news release shared with Becker’s. 
  • “To qualify, healthcare companies must:
    • “Reveal all relevant details of the potential violations;
    • “Provide documents that show the full nature and scope of the conduct;
    • “Detail remedial steps taken;
    • “Repay the government under the protocol, which applies a multiplier of 1.25 to 1.6
  • “The multiplier depends on various factors, including how quickly the company provided disclosure, and the scope and duration of the misconduct, whether senior leadership was involved, the company’s financial benefit, and whether the company inherited the liability via a transaction but fixed the issue promptly.
  • “In return, companies will get a Justice Department release for disclosing the conduct. As part of the resolution, the HHS Office of Inspector General will not impose exclusion or require a corporate integrity agreement. CMS will also not revoke billing or enrollment privileges, and neither CMS nor OIG will impose civil monetary penalties.”

From the U.S. Office of Personnel Management front

• Tammy Flanagan, writing in Govexec, considers
  • “If you already have FEHB, should you sign up for Medicare B?
    • “Pairing your federal health plan with Medicare can lower out-of-pocket costs, but monthly premiums and income-based surcharges add up. Here’s what to consider before deciding whether the extra coverage is worth the price.”

• FedWeek tells us,
  • “Several key figures are increasing for 2027 in the Social Security program affecting both current employees and retirees.
  • “For the former group, the 6.2 percent Social Security payroll tax will apply on up to $192,300 of earnings, up from $184,500. For FERS employees, that tax cuts off at that threshold and from there on they pay only the civil service retirement contribution (which is 0.8, 3.1 or 4.4 percent, depending on when they were hired).
  • “Above the cutoff CSRS Offset employees continue to pay 6.2 percent into Social Security and their pertinent percentage into the federal retirement fund, but all the money after that point goes into the federal retirement fund instead. Employees under “pure” CSRS don’t pay the Social Security payroll tax.
  • “For those drawing Social Security benefits, the earnings test applying to beneficiaries aged 62 through their “full” retirement age (65-67, depending on year of birth; 67 for those born in 1960 and after), will rise from $24,480 to $25,56v0. Those beneficiaries lose $1 in Social Security benefits for every $2 in earnings through employment or self-employment earnings above the limit.
  • “A separate earnings test applies only to earnings for months in the year an individual reaches full retirement age but prior to the individual attaining that age. One dollar in benefits will be withheld for every $3 in earnings above $67,920, up from $65,160. There is no limit on earnings beginning the month an individual attains full retirement age.”

From the U.S. Food and Drug Administration front,

• The Washington Post reports,
  • “Federal health officials are investigating a multistate salmonella outbreak that has been linked to raw oysters and sickened 27 people across a dozen states. 
  • “Five of the cases have involved hospitalizations, health officials said. 
  • “The Centers for Disease Control and Prevention said an investigation is underway of infections linked to raw oysters harvested by the Little Wicomico Oyster Co. from the Little Wicomico River’s harvest area in Virginia. 
  • “The company recalled oysters harvested from that area from Sept. 18 through Oct. 8. People are advised not to eat, sell or serve them, officials said.”

• Per an FDA news release,
  • “The U.S. Food and Drug Administration today announced the launch of the Neuroscience Advancement and Innovation Nexus (NAIN), a new agency program aligned with the Trump Administration’s efforts to accelerate medical innovation and deliver breakthrough treatments. NAIN is designed to advance the science, tools, and regulatory approaches needed to support the development of medical products for conditions affecting the brain and nervous system. NAIN’s inaugural initiative, the Alzheimer’s Prevention Accelerator, will focus on advancing medical products that help delay or prevent Alzheimer’s disease. Both efforts support the National Alzheimer’s Project Act (NAPA), the federal government’s comprehensive roadmap for coordinated action on Alzheimer’s and related dementias.”

• Beckers Hospital Review tells us,
  • “The FDA has granted accelerated approval to Ultomiris (ravulizumab) to reduce proteinuria in adults with primary immunoglobulin A nephropathy at risk for disease progression, making it the first and only C5 complement inhibitor approved for this use.
  • “The approval followed Priority Review and was based on a prespecified interim analysis of the I CAN phase 3 trial, according to an Oct. 21 news release. Ultomiris demonstrated a 43.4% reduction in proteinuria compared with placebo at 34 weeks.
  • “Ultomiris is administered intravenously every eight weeks in adults, based on body weight, following a loading dose. The trial’s safety profile was consistent with the known profile of Ultomiris, with no new safety concerns identified.”

• BioPharma Dive informs us,
  • “Compounding pharmacy Apothecary Pharma has issued a voluntary recall of its copycat version of Eli Lilly’s obesity drug Zepbound, stating in a notice that it couldn’t definitively guarantee the medication’s safety.
  • “The recall, of which Apothecary notified the Food and Drug Administration in September, covers 22 lots of compounded tirzepatide, the active ingredient in Lilly’s medicine. Those lots have beyond-use dates ranging from Oct. 8 to Nov. 26.
  • “Apothecary’s recall comes as Lilly and Novo, the only makers of FDA-licensed GLP-1 obesity medications, have sought to stop companies from selling compounded counterparts. The recall could help bolster Lilly and Novo’s claims that the knockoff versions don’t have the same quality, safety or efficacy as the FDA-approved ones.”

• STAT News adds,
  • “For the popular diabetes and obesity medications known as GLP-1s, addiction medicine is one of many possible promising next acts.
  • “Eli Lilly is investigating a new drug, brenipatide, and testing it in alcohol use disorder. A new company called Baseline Therapeutics is studying a GLP-1 receptor agonist in alcohol, cocaine, and methamphetamine use disorders; Altimmune is testing one called pemvidutide for alcohol. Addiction medicine specialists are hopeful that the Food and Drug Administration may soon approve a new medication for alcohol use disorder — the first in two decades. 
  • “But some telehealth platforms that specialize in treating addiction aren’t waiting. In the last year, a few companies have begun to market off-label prescriptions of GLP-1s, both branded and compounded, to treat alcohol use disorder and other addictions. 
  • “Trying to drink less but your doctor won’t prescribe a GLP-1?” reads a Facebook ad from a telehealth brand called Livelyhood, which started offering the drugs in April. “Livelyhood can.” 
  • “Another, called Quel, launched in September as an online extension of the off-label prescribing at a Pennsylvania-based addiction treatment center.” * * *
  • “Telehealth companies recognized the potential for opportunism in prescribing GLP-1s for addiction ahead of FDA approval, while maintaining that their platforms are the exception. And it’s not necessarily lucrative: “Economically, GLP-1 for alcohol use disorder is much tougher than pretty much any other GLP-1 indication,” said Lively. 
  • “If that’s the case, Witkiewitz wonders: Why not wait for an FDA approval? Klein and Lira said they look forward to prescribing new drugs if they are approved. But Witkiewitz worries that if early adopters see bad outcomes, patients could be deterred from seeking approved treatments in the future. “We’re so close to having this done right and well, or having it done in a way that protects patients to the best of our abilities,” she said. “Caution is warranted, and some patience is warranted.”

From the fraud, waste and abuse front,

• Beckers ASC Review reports,
  • “Five physicians are among 15 defendants charged in a Los Angeles healthcare fraud takedown involving $2 billion in alleged fraudulent claims, according to an Oct. 22 news release from the U.S. Attorney’s Office for the Central District of California. 
  • “Most of that total comes from a $1.6 billion substance abuse treatment scheme that DOJ calls the largest of its kind it has ever prosecuted. The physicians’ cases make up a smaller share.”

• The Wall Street Journal adds,
  • “A Southern California drug-rehab operator allegedly engaged in an elaborate scheme that involved providing recovering addicts with illegal drugs in order to keep billing their insurers for treatment, according to federal prosecutors. 
  • “Facilities associated with Nathan Young submitted more than $1.6 billion in claims to major health insurers and were paid over $210 million between 2020 and 2026, including billings for “non-existent and woefully inadequate ‘therapy’ sessions,” prosecutors said in a recently filed criminal complaint.
  • “Young and his father, David Young, were arrested last week. Lawyers representing the Youngs didn’t respond to requests for comment. The Youngs were charged with healthcare fraud and violating an anti-kickback statute, according to federal prosecutors.” 

From the public health and medical / Rx research front,

• Cardiovascular Business reports,
  • “Forty-three percent of on-duty firefighter fatalities over the last 35 years were attributed to cardiac causes, according to a new study published in JACC: Advances.[1] These findings call into question the types of screenings firefighters should undergo to detect potential heart problems.
  • “Researchers at Cedars-Sinai Health Sciences University explored autopsy findings from more than 3,000 on-duty firefighter deaths. The group said the proportion of cardiac-related fatalities has steadily increased over the years However, cardiac related deaths have been on the decline for the general U.S. population over the same time period.  
  • “These findings might indicate the need to change annual health screenings for firefighters. Current national screening recommendations rely on exercise stress testing, which can identify ischemic issues with blood flow, but may miss hidden structural remodeling of the heart that could lead to sudden cardiac arrest.
  • “Our research shows there may be a blind spot when it comes to routine heart screenings for firefighters in the U.S.,” senior author Alan Kwan, MD, assistant professor of cardiology in the Smidt Heart Institute at Cedars-Sinai, said in a statement. “Identifying heart conditions when they can be treated is key to addressing these new findings.”

• Health Day relates,
  • “Newly eligible younger adults are less likely to have discussed colorectal cancer (CRC) screening with their clinician compared with their older counterparts, according to a study published online Oct. 18 in the Journal of General Internal Medicine to coincide with the American Association for Cancer Research Conference on The Science of Cancer Health Disparities, held from Oct. 18 to 21 in Atlanta.” * * *
  • “This finding strongly suggests that patients who are newly age-eligible for screening are not receiving adequate information about their screening options from a health professional, and that could be contributing to low screening rates in this age group,” [lead researcher] Jordan Baeker Bispo, Ph.D., M.P.H. said in a statement.
• and
  • “Smartphones are costing teenagers a good night’s sleep, a new study says.
  • “Teens who use their phones late into the evening suffer from delays in falling asleep, shorter total sleep time, and sleep that’s more restless and broken, researchers reported Oct. 19 in JAMA Pediatrics.
  • “These findings suggest that reducing evening smartphone use, particularly after 10 p.m. and immediately before bedtime, may help improve sleep health in adolescents,” concluded a team led by Dr. Dimitri Christakis, a professor of general pediatrics at Seattle Children’s Research Institute.”

• Nature adds,
  • “The speed at which regions of the brain mature during early adolescence can forecast the emergence of mental-health conditions up to four years before symptoms develop, according to a study of nearly 12,000 young people in the United States.
  • “By tracking the brains of adolescents over six years in nearly 30,000 scans, researchers mapped how the brain’s outer layer, the cerebral cortex, thins as children grow into teenagers. The team observed that sensory areas of the cortex thinned, or matured, first, followed by the regions responsible for complex thought.
  • “The findings, posted on 11 October on the preprint server bioRxiv¹ ahead of peer review, challenge the theory that psychiatric disorders are caused by defects in specific brain circuits. Instead, they indicate that vulnerability to mental-health symptoms could involve disruption of the brain’s developmental timeline and could be set in motion by genes that are active before birth.
  • “The work “provides one of the clearest pictures yet of how the cortex develops from childhood into adolescence”, says Avram Holmes, a systems neuroscientist at Rutgers University in New Brunswick, New Jersey, who was not involved in the study. “It makes you think about the timing of brain development, not just the location [in the brain], when we look at psychiatric symptoms,” he says.
    
• Beckers Clinical Leadership informs us,
  • “Receiving a personalized mRNA-based cancer vaccine alongside immunotherapy lowered the risk of recurrence or death by 42% versus immunotherapy alone in a phase 3 clinical trial of patients with surgically resected stage 2B to 4 melanoma.
  • “The vaccine, called intismeran autogene and jointly developed by Merck and Moderna, was tested in combination with Merck’s immunotherapy Keytruda after surgery as part of the phase 3 INTerpath-001 trial, according to an Oct. 22 news release from the companies. 
  • “The trial results were leaked online Oct. 22, The Wall Street Journal reported, two days before Merck and Moderna were expected to present the data at the European Society for Medical Oncology conference in Madrid.” * * *
  • “Read the latest trial results from Merck and Moderna here.”  
    
• Fierce Pharma points out,
  • “Delaying the use of subcutaneous Parkinson’s disease treatments by one year increases annual medical costs by 59.1%, AbbVie-sponsored research found.
  • “The study, which researchers will present (PDF) at the AMCP Nexus Conference this month, modeled the impact of delaying the initiation of two subcutaneous therapies by one year. One therapy comprised foslevodopa and foscarbidopa, the combination that AbbVie sells as Vyalev. The other therapy featured apomorphine, the active ingredient in Supernus Pharmaceuticals’ Onapgo.” 

From the U.S. healthcare business and artificial intelligence front,

• The Wall Street Journal reports,
  • “A KFF survey shows the average cost of a family health plan rose 5% this year, while workers’ contributions increased 9% to $7,471.
  • “Employers are facing healthcare cost increases driven by high-cost drugs and hospitals raising prices and using AI tools to boost billing.
  • “To manage rising costs, some employers are increasing workers’ premium contributions, raising deductibles and dropping coverage for GLP-1 drugs.”

• Beckers Payer Issues relates,
  • “Molina Healthcare reported $38 million in net income for the third quarter of 2026, a 52% year-over-year drop from $79 million.
  • “The insurer attributed the decline mainly to a higher consolidated medical loss ratio, which was  92.9% in Q3, up from 92.6% a year earlier. Total revenue for the quarter was $11.1 billion, down 3.4% year over year. Premium revenue fell approximately 4% to $10.5 billion, reflecting lower membership in Medicaid and the ACA marketplace, partially offset by rate updates.
  • “With the apparent plateauing of medical cost trend, which remains at elevated levels, and the strength of recent rate updates for 2027, we believe we are likely observing the beginning of the turn in Medicaid margins,” President and CEO Joseph Zubretsky said in an Oct. 21 news release.”
• and
  • “Medicare Advantage annual enrollment kicked off Oct. 15, and the ACA open enrollment period is around the corner. Employers are also navigating cost pressures, opening the door to innovative plans.
  • “Insurers have been primed to consider new health plans across commercial and government programs, and many are biting.
  • “Not every organization rolling out health plans in the coming years is a traditional insurer, however. For example, Tacoma, Wash.-based MultiCare Health System and the Muscogee (Creek) Nation are entering the MA market.
  • “The trend has extended to the employer space. Tech-enabled healthcare company Included Health said it will introduce health plans for self-insured employers Jan. 1, 2028, following its acquisition of Firefly Health, a clinically integrated health plan and advanced primary care company. Health technology and benefits administration platform Judi Health is launching a Medicare Part D Employer Group Waiver Plan, as well.”

• Fierce Healthcare tells us,
  • “Redesign Health is making a major push deeper into health system-led innovation, merging with Sheba Medical Center’s innovation arm ARC Global.
  • “Together, the organizations want to create an end-to-end platform that helps health systems turn ideas originating with their own clinicians and operators into technology products and standalone companies that can then be scaled across a global network, company executives said. The deal was announced Thursday.
  • “The combined company is valued at approximately $2 billion, according to a source with knowledge of the deal.”
•  and
  • “Talkiatry is expanding virtual therapy services nationwide as part of a broader push to provide comprehensive behavioral health services across the acuity spectrum, from low to high.
  • “As a national mental health practice that provides in-network psychiatry and therapy, the expansion also positions the company to offer broader behavioral health services to health systems, payers and employers.
  • “The company initially built its scale around telepsychiatry, with more than 800 employed psychiatrists and a large national insurance footprint. Talkiatry claims to be the nation’s largest private employer of psychiatrists as well as the preferred in-network psychiatry partner for more than 70 U.S. health systems.”

• Per MedTech Dive,
  • “Labcorp said Tuesday that it has agreed to acquire Myriad Genetics’ prenatal health testing business for $210 million.
  • “The deal covers tests for assessing fetal risk of certain conditions and other aspects of prenatal care. Labcorp expects the tests to add about $160 million in revenue in year one. 
  • “Evercore ISI analysts see room for Labcorp to improve the economics of the acquired business using its infrastructure and to broaden access to the tests through its provider relationships.”

• SmartBrief informs us,
  • “AI is making medical information easier to access.  According to a recent KFF poll, nearly a third of US adults have used AI for health information or advice in the past year, and nearly 1 in 5 have used it to compare treatment options.
  • “The appeal is clear. People can ask health questions in their own words and get answers almost immediately. But receiving an answer and knowing how and when to use it—and whether they can rely on it—are different things.
  • “Health plans will see an increasing number of members using AI to evaluate their care options. That reality creates a need for plans to fill in the gaps of today’s AI capabilities.”
  • The article identifies pathways.

• Beckers Health IT adds,
  • “Microsoft’s AI diagnostic system correctly diagnosed 83.2% of complex New England Journal of Medicine cases, compared with 36.1% for generalist physicians, according to a study published Oct. 22 in Science.
  • “The system, called Diagnostic Orchestrator, or DxO, simulates a panel of physicians. It starts from a brief clinical presentation, then asks questions, orders tests and revises the differential diagnosis step by step. Microsoft researchers tested it on 304 NEJM clinicopathological conference cases and 325 emergency department admissions from the MIMIC-IV-ED dataset.
  • “On the emergency cases, DxO running OpenAI’s GPT-5 reached 80.3% accuracy, compared with 46.8% for physicians.
  • “The researchers also tracked estimated testing costs, using the chargemaster of Kaiser Permanente Washington’s Central Hospital in Seattle. With no budget limits, DxO averaged $5,431 per complex case. With budget constraints, it hit 80.9% accuracy at $2,241. Physicians using search and reference tools averaged $4,725.” * * *
  • “Microsoft plans to evaluate DxO in real-world settings through a partnership with Beth Israel Deaconess Medical Center in Boston, TechCrunch reported Oct. 22.”