Cybersecurity Saturday

David Ermer

I am an attorney who practices law in Washington DC. My practice has involved the Federal Employees Health Benefits Program since 1983.

Cybersecurity Saturday

David Ermer–Cybersecurity, Generative AI–

From the cybersecurity defenses and law enforcement front

  • Cyberscoop reports,
    • Congress should use renewal of an expiring [in 2027] terrorism insurance program to create a federal backstop for cybersecurity insurance, according to a report out Tuesday that tries to thread many difficult needles to bolster an industry that its author says isn’t developing fast enough.
    • In an ideal world, cybersecurity insurance can be a valuable tool to protect policyholders and push everyone into adopting better cyber practices, but it will need government intervention to reach its full potential amid an array of challenges, Nick Leiserson writes in a study for the Foundation for Defense of Democracies, a D.C.-based think tank. 
  • and
    • “As spring gives way to summer, a wave of cybercrime crackdowns has taken root, with law enforcement and private security companies directing a surge of takedowns, seizures, indictments and arrests.
    • “Prolific infostealers, malware loaders, counter antivirus and encrypting services, cybercrime marketplaces, ransomware infrastructure and DDoS-for-hire operations have all been seized, taken offline or severely disrupted by global coordinated campaigns over the past six weeks.
    • “It’s been really energizing to see the volume and velocity of these takedowns in such a short period of time,” Flashpoint CEO Josh Lefkowitz told CyberScoop. 
    • “I can’t think of such a flurry and rapid succession — and then magnified by complementary takedowns by Europol and international partners,” he added. “It’s been a great couple of weeks for the good guys, and I wouldn’t be surprised if there’s more around the horizon.”

From the cybersecurity vulnerabilities and breaches front,

  • Bleeping Computer informs us,
    • “News broke [on June 18] about “one of the largest data breaches in history,” sparking wide media coverage filled with warnings and fear-mongering. However, it appears to just be a compilation of previously leaked credentials stolen by infostealers, exposed in data breaches, and via credential stuffing attacks.
    • “To be clear, this is not a new data breach, or a breach at all, and the websites involved were not recently compromised to steal these credentials.
    • “Instead, these stolen credentials were likely circulating for some time, if not for years. It was then collected by a cybersecurity firm, researchers, or threat actors and repackaged into a database that was exposed on the Internet.
    • “Cybernews, which discovered the briefly exposed datasets of compiled credentials, stated it was stored in a format commonly associated with infostealer malware, though they did not share samples
    • “An infostealer is malware that attempts to steal credentials, cryptocurrency wallets, and other data from an infected device. Over the years, infostealers have become a massive problem, leading to breaches worldwide.”
  • Cybersecurity Dive reports,
    • “Major insurance provider Aflac Inc. said Friday [June 20] that it was the target of a cyberattack on June 12 that is linked to a major cybercrime spree focusing on the industry. 
    • “The company said it was able to contain the attack within hours and confirmed its systems remain operational. 
    • “We continue to serve our customers as we respond to this incident and can underwrite policies, review claims and otherwise service our customers as usual,” the company said in a Securities and Exchange Commission filing. 
    • “The incident is part of a larger crime wave targeting the insurance industry that researchers have linked to a collective known as Scattered Spider. The group recently conducted a weeks-long attack campaign against retailers in the U.S. and the U.K.
    • “Erie Insurance Group last week disclosed that it was the target of a cyberattack that began on June 7. The company said Tuesday that it has regained control over its systems and sees no further evidence of malicious activity.”
  • Cyberscoop adds,
    • Scattered Spider is an amorphous band of young English-speaking cybercriminals affiliated with the larger sprawling network known as The Com. Scattered Spider associates recently ran roughshod over U.K.- and U.S.-based retailers before pivoting, once again, to insurance companies.
    • The ring of cybercriminals historically focus on one sector at a time, resulting in a wave of extortion attacks on companies in the same industry, which often use similar systems and processes. 
    • Google previously warned that Scattered Spider shifted its attention to U.S. retailers after the group hit multiple retailers and grocery stores in the U.K. in April. The pattern of recent activities attributed to Scattered Spider has been consistent.
    • “We are now seeing incidents in the insurance industry,” John Hultquist, chief analyst at Google Threat Intelligence Group, told CyberScoop on Monday. “Given this actor’s history of focusing on a sector at a time, the insurance industry should be on high alert, especially for social engineering schemes which target their help desks and call centers.”
  • The Wall Street Journal points out,
    • “Hackers in recent months have disrupted retail sales in the U.K. and U.S. and stolen hundreds of millions of dollars from crypto holders by targeting the outsourced call centers that many American corporations use to save costs.
    • “The hacks are often meticulously researched and use a variety of techniques, but they have one thing in common: low-level workers who staff call centers and have access to the kind of sensitive information that criminals need to commit crimes.
    • “The focus on outside call centers has allowed attackers to trick workers to get around so-called two-factor account authentication techniques that send codes by text to mobile phones. Those methods are commonly used to protect millions of bank and credit-card accounts, as well as a host of other online portals.”
  • Security Week lets us know,
    • “Healthcare services firm Episource has been targeted in a cyberattack that resulted in a data breach impacting more than 5.4 million individuals.
    • “Episource provides medical coding and risk adjustment services to doctors, health plans, and other types of healthcare organizations. 
    • “The firm revealed in a data breach notice that it detected unauthorized access to its systems in early February. An investigation showed that “a cybercriminal” was able to view and copy data belonging to some Episource customers between January 27 and February 6, 2025. 
    • “We quickly took steps to stop the activity. We began investigating right away and hired a special team to help us. We also called law enforcement. We turned off our computer systems to help protect the customers we work with and their patients and members,” the company said, noting that it’s not aware of any misuse of the compromised data.”
  • Per Dark Reading,
    • Cybercriminals are using fake search engine listings to hijack the results for people looking for tech support from brands like Apple, Bank of America, Facebook, HP, Microsoft, Netflix, and PayPal.
    • This type of deceptive scam is common, taking advantage of users’ trust in big name brands, beginning with a sponsored search result on Google — but this time, there’s a twist.
    • According to Pieter Arntz and Jérôme Segura, researchers at Malwarebytes Labs, cybercriminals start by paying for a sponsored ad on Google pretending to be a major brand. This advertisement will then lead people to the fake website.
    • “However, in the cases we recently found, the visitor is taken to the legitimate site with a small difference,” the researchers wrote in a post this week. “Visitors are taken to the help/support section of the brand’s website, but instead of the genuine phone number, the hijackers display their scammy number instead.”
    • “So, while the browser address is legitimate and shows no cause for concern, the fraudsters overlay the actual website with misinformation, directing the user to seek help from a fraudulent source.”
  • Cybersecurity Dive tells us,
    • “Researchers are urging Veeam Backup & Replication users to make sure their systems are fully upgraded to the latest version after the company released a patch Tuesday to address a critical remote code execution flaw. 
    • “The vulnerability, tracked as CVE-2025-23121, allows an authenticated domain user to run code on a backup server. 
    • “Researchers at watchTowr and Code White GmbH previously disclosed that a patch to address a prior vulnerability, tracked as CVE-2025-23120, could be bypassed. That disclosure led to the development of the new patch.”
  • and
    • “Hackers are exploiting a critical vulnerability in Zyxel’s Internet Key Exchange packet decoder, GreyNoise researchers warned on Monday.
    • “The vulnerability, tracked as CVE-2023-28771, powered a sudden wave of exploitation attempts Monday, with researchers observing 244 unique IP addresses involved in the activity. 
    • “All of the addresses were located in the U.S. and registered to Verizon Business, but researchers caution that because the vulnerability was located over UDP (Port 500), the attackers may have been spoofing those addresses.
    • “Additional analysis suggests that the activity may be related to a variant of the Mirai botnet, researchers said. 
    • “Mirai-linked payloads suggest the activity may be aimed at enrolling devices into botnets for automated attacks like DDoS or scanning,” GreyNoise researchers told Cybersecurity Dive via email.”
  • The Cybersecurity and Infrastructure Security Agency (CISA) added three known exploited vulnerabilities to its catalog this week.
    • June 16, 2025
      • CVE-2025-43200 Apple Multiple Products Unspecified Vulnerability
      • CVE-2023-33538 TP-Link Multiple Routers Command Injection Vulnerability
        • NIST discusses the Apple vulnerability here.
        • Security Week discusses the TP-Link KVE here.
    • June 17, 2025
      •  CVE-2023-0386 Linux Kernel Improper Ownership Management Vulnerability 
        • Security Week discusses this KVE here.

From the ransomware front,

  • The Hacker News reports,
    • “An emerging ransomware strain has been discovered incorporating capabilities to encrypt files as well as permanently erase them, a development that has been described as a “rare dual-threat.”
    • “The ransomware features a ‘wipe mode,’ which permanently erases files, rendering recovery impossible even if the ransom is paid,” Trend Micro researchers Maristel Policarpio, Sarah Pearl Camiling, and Sophia Nilette Robles said in a report published last week.
    • “The ransomware-as-a-service (RaaS) operation in question is named Anubis, which became active in December 2024, claiming victims across healthcare, hospitality, and construction sectors in Australia, Canada, Peru, and the U.S. Analysis of early, trial samples of the ransomware suggests that the developers initially named it Sphinx, before tweaking the brand name in the final version.”
  • and
    • “The threat actors behind the Qilin ransomware-as-a-service (RaaS) scheme are now offering legal counsel for affiliates to put more pressure on victims to pay up, as the cybercrime group intensifies its activity and tries to fill the void left by its rivals.
    • “The new feature takes the form of a “Call Lawyer” feature on the affiliate panel, per Israeli cybersecurity company Cybereason.
    • “The development represents a newfound resurgence of the e-crime group as once-popular ransomware groups like LockBit, Black Cat, RansomHub, Everest, and BlackLock have suffered abrupt cessations, operational failures, and defacements. The group, also tracked as Gold Feather and Water Galura, has been active since October 2022.
    • “Data compiled from the dark web leak sites run by ransomware groups shows that Qilin led with 72 victims in April 2025. In May, it is estimated to be behind 55 attacks, putting it behind Safepay (72) and Luna Moth (67). It’s also the third most active group after Cl0p and Akira since the start of the year, claiming a total of 304 victims.”

From the cybersecurity defenses front,

  • Cybersecurity Dive reports,
    • “For organizations aiming to deploy generative AI at scale, focusing on the cybersecurity guardrails surrounding the technology can help ease adoption rather than hinder it, according to AWS CISO Amy Herzog. 
    • “Herzog, who took on the CISO role earlier this month, made the case for a closer enterprise focus on security during the company’s annual re:Inforce conference Tuesday. The strategy can pay off by speeding up adoption. 
    • “Security, when done right, can be a true enabler in adopting new technologies,” said Herzog. “What we’re noticing is customers with mature security practices and the ability to innovate while maintaining a high security bar, they’re adopting Gen AI faster.
    • “Companies in highly regulated environments, from finance to healthcare, have been able to rely on their existing security, privacy and data management guardrails to speed up AI adoption, Herzog said. 
    • “This enables them to reduce risks and pragmatically focus on scaling their use cases,” Herzog said.”
  • and
    • “Nearly one in 10 publicly accessible cloud-storage buckets contained sensitive data, with virtually all of that data considered confidential or restricted, according to a new report from Tenable based on scans conducted between October 2024 and March 2025.
    • “On the other hand, more than eight in 10 organizations using Amazon Web Services have enabled an important identity-checking service, according to the report, published on Wednesday.
    • ‘The number of organizations with triple-threat cloud instances — “publicly exposed, critically vulnerable and highly privileged” — declined from 38% between January and June 2024 to 29% between October 2024 and March 2025.”
  • Per Bleeping Computer,
    • “Microsoft has announced plans to periodically remove legacy drivers from the Windows Update catalog to mitigate security and compatibility risks.
    • “The rationale behind this initiative is to ensure that we have the optimal set of drivers on Windows Update that cater to a variety of hardware devices across the windows ecosystem, while making sure that Microsoft Windows security posture is not compromised,” Microsoft said.
    • “This initiative involves periodic cleanup of drivers from Windows Update, thereby resulting in some drivers not being offered to any systems in the ecosystem.
    • “As the company explained on Thursday, the first phase of this “cleaning up” procedure will involve drivers with newer replacements already published on Windows Update.”
  • CSO lets us know,
    • “Ransomware tabletop exercises confront participants with an attack scenario, offering them a way to test and improve their organization’s readiness and response capabilities.
    • “During this month’s Infosecurity Europe conference, CSO took part as a media advisor to a blue team, pitched against a red team of attackers in a ransomware tabletop simulation focused on the water industry. The “Operation 999” exercise was devised and run by cybersecurity vendor Semperis, a specialist in protecting Active Directory (AD) and hybrid identity environments.” * * *
    • “The “Operation 999” exercise offered a cybersecurity tabletop simulation designed to allow participants to exercise incident response strategies. The tabletop exercise offered an immersive experience without featuring any hands-on keyboard or analysis of technical data (such as exercise specific log files, or similar).”
  • Security Week discusses “Choosing a clear direction in the face of growing cybersecurity demands. In a rapidly changing AI environment, CISOs are worried about investing in the wrong solution or simply not investing because they can’t decide what the best option is.”
  • Here is a link to Dark Reading’s CISO Corner.

Friday Report

David Ermer–CDC, CMS, Congress, COVID-19, FDA, Generative AI, Medical / Rx research, OPM, SCOTUS, U.S. Healthcare–

FEHBlog note: Since the FEHBlog launched in 2006, the FEHBlog has featured a photograph at the top of the post. The FEHBlog learned today that email subscribers to the FEHBlog see a blank spot at the top of the page as the email system blocks photographs. For that reason, the FEHBlog has stopped using photographs in the blog except when necessary.

From Washington, DC,

  • Roll Call informs us,
    • “Senate Republicans say they are looking for ways to safeguard rural hospitals from proposed cuts to a key Medicaid funding method, amid concerns from the powerful hospital lobby and others that the budget reconciliation bill could force many facilities to close.
    • “The draft text that the Senate Finance Committee released this week reduces the ability of states who expanded Medicaid under the 2010 health care law to levy taxes on providers to fund their programs. 
    • “Senate Majority Leader John Thune, R-S.D., told reporters Wednesday he is working on the issue, though he did not offer details. Leadership is attempting to balance directives to cut government spending with demands from senators like Josh Hawley, R-Mo., who said that the bill should protect rural hospitals from the effects of shrinking provider taxes.
    • “The right thing to do is not defund rural hospitals to pay for your pet projects,” Hawley said. “So, if you want your pet project in the bill, go find your own money. Don’t defund rural hospitals.” 
    • “Medicaid is often one of the top payers for rural facilities.”
  • STAT News adds,
    • “Hospitals are now lobbying senators to return to the House’s version of the bill, which also is expected to substantially cut hospitals’ revenues and the number of patients covered — but less so than the Senate’s version of the bill. 
    • “But that lobbying effort is butting up against senators who want to further reduce government spending. The Congressional Budget Office has not yet projected the budget impact of the Senate bill.”
  • The American Hospital Association News tells us,
    • The Centers for Medicare & Medicaid Services June 20 announced it is finalizing its 2025 Marketplace Integrity and Affordability final rule. The rule shortens the open enrollment period for the federal marketplace to Nov. 1-Dec. 15 starting in 2027, and limits open enrollment periods for state-based marketplaces to Nov. 1-Dec. 31. The rule also includes a change to the premium adjustment percentage that would increase the maximum annual cost sharing limitation. Additionally, the rule makes updates to the income verification process and pre-enrollment verification process for SEPs, changes to the essential health benefits, modifications to the redetermination and re-enrollment processes, and ends a special enrollment period for low-income individuals, among other policies. Many of the provisions reinstate policies finalized during the prior Trump administration.
  • Here is a link to CMS’s fact sheet on this final rule.
  • Govexec lets us know,
    • “The White House and its Department of Government Efficiency are spearheading efforts to shake up the Postal Service, according to details of the meetings obtained by Government Executive, with topics including pricing for mail and general reform proposals. 
    • “The meetings were not clearly within the scope of a memorandum of understanding former Postmaster General Louis DeJoy signed with DOGE, which focused on specific cost-cutting measures and real estate planning. Some of the meetings also involved top officials from the Treasury Department, White House attorneys and policy advisors and additional USPS executives. A source familiar with the meetings confirmed DOGE has been active at the Postal Service’s Washington headquarters in recent months.” 
  • Per an OPM news release,
    • This week, the U.S. Office of Personnel Management (OPM) Inspector General (IG) released a report that uncovered widespread compliance failures and weak internal oversight in the agencyʼs telework and remote work programs during the Biden Administration.
    • The report revealed more than half of OPM employees reviewed failed to meet basic in-office requirements and nearly a third of sampled teleworkers had expired or missing agreements. Additionally, 15 percent of remote workers had no approved agreement on file, and many discrepancies flagged by HR remained unresolved for months.
    • Since President Trump took office, OPM has reinstated in-office requirements to restore a culture of accountability and public service.
    • “Under the previous administration, OPMʼs telework and remote work policies were mismanaged and oversight was virtually nonexistent,” Acting Director Chuck Ezell said. “That era of telework abuse is over. At President Trumpʼs direction, OPM has restored in-person operations to ensure federal employees are working for the taxpayers.”
    • OPM has already implemented new internal controls and compliance reviews, and effective March 3, 2025, all employees are required to report to their official duty station full-time.
    • Read the OIG report here.

From the Food and Drug Administration front,

  • The Wall Street Journal reports,
    • “Sanofi and Regeneron Pharmaceuticals said they got Food and Drug Administration approval for anti-inflammatory drug Dupixent as a treatment for a rare skin disease, adding an eighth indication in the U.S. for their blockbuster medicine.
    • “France’s Sanofi and Tarrytown, N.Y.-based Regeneron said Friday that the FDA gave the green light for Dupixent as a treatment of adult patients with bullous pemphigoid, a skin disease that mainly affects elderly people and is characterized by itch, blisters and lesions, as well as a reddening of the skin.”

From the judicial front,

  • SCOTUSblog reports,
    • In a splintered decision, the Supreme Court did not allow a retired firefighter to sue her prior employer under the ADA. The majority opinion, written by Justice Gorsuch, determined the retiree was not a “qualified individual” under the law. In dissent, Justice Jackson called the majority opinion “counterintuitive.”
  • and
    • “On Friday, the Supreme Court opined on a challenge by retailers of e-cigarettes to an FDA decision. The majority opinion, written by Justice Amy Coney Barrett, held that the challengers were “adversely affected” by the FDA’s decision and could thus seek judicial review in the 5th Circuit.”
  • The AHA News relates,
    • “The U.S. District Court for the Northern District of Iowa June 18 vacated components of the Centers for Medicare & Medicaid Services’ minimum nurse staffing rule requiring nursing homes to have a registered nurse onsite 24/7 and prescribing a minimum total nurse staffing hours per resident day. The court kept in place the rule’s enhanced facility assessment and Medicaid reporting requirements.
    • “CMS’s general rulemaking power to promulgate ‘such other requirements as the Secretary deems necessary’ does not constitute clear authorization to mandate rigid staffing requirements for [long-term care] facilities,” wrote District Court Judge Leonard T. Strand in the ruling. “Therefore, I find that CMS did not have authority to promulgate the 24/7 RN requirement and the HPRD requirements pursuant to its health and safety rulemaking authority.”
    • “A district court in Texas also vacated the minimum staffing mandate in April.”
  • Beckers Payer Issues points out,
    • “New York City can implement an Aetna Medicare Advantage plan for its retirees, the state’s highest court ruled June 18. 
    • “The city has pushed to switch its health benefits for retired city employees to a Medicare Advantage plan since 2021. A group of retired employees sued to block the plan, arguing that the city had promised to provide supplemental Medicare benefits, and that their healthcare benefits would be diminished under an MA plan. 
    • “The New York Court of Appeals ruled against the retirees, reversing lower courts’ decisions. The judges ruled the city was not obligated to offer Medigap plans to its retirees. The court also ruled the retirees did not prove their care would be harmed under an MA plan.” 

From the public health and medical research front,

  • The Centers for Disease Control and Prevention announced today,
    • “Seasonal influenza activity is low. COVID-19 and RSV activity is very low.
    • “COVID-19
      • “COVID-19 wastewater activity is low and emergency department visits and laboratory percent positivity are at very low levels.
    • “Influenza
    • “RSV
      • “RSV activity is very low.
  • The University of Minnesota’s CIDRAP adds,
    • “New findings presented at the annual meeting of the American Society for Microbiology suggest increased levels of fungal spores in the air are strongly linked to surges in cases of influenza and COVID-19.
    • “The study was based on daily spore samples taken in 2022 and 2024 in San Juan and Caguas, Puerto Rico, where fungal spores and pollen are endemic and present year-round. The data on spores was matched to data on the daily incidence of people diagnosed with COVID-19 and flu.
    • “The researchers found increases in fungal spore counts matched surges in flu and COVID activity. There was no relationship between pollen levels and respiratory illness activity.
    • “The findings from our study suggest that monitoring airborne fungal spore levels could help predict short-term outbreaks (spikes) of flu and COVID-19, giving public health systems an early warning signal,” study author Felix Rivera-Mariani, PhD said in a press release from the American Society of Microbiology. “Our findings also highlight the potential role of environmental factors—not just person-to-person spread—in contributing to the incidence of respiratory viral infections. That could open new doors for targeted public health alerts, especially in areas with high outdoor airborne fungi.” 
  • and
    • “The US Centers for Disease Control and Prevention (CDC) reported 17 more measles cases today in its weekly update, bringing its total for the year to 1,214 confirmed cases from 36 jurisdictions.
    • “Although measles cases have slowed since peaking in late March, the uptick in cases brings the country closer to surpassing the 1,274 cases reported in 2019, which to date is the highest number reported in a single year since the disease was eliminated from the United States in 2020. There were 285 confirmed measles cases in 2024. 
    • “The CDC reported two additional outbreaks (three or more related cases), bringing the 2025 total to 23 outbreaks. Of the 1,214 confirmed US cases, 89% are outbreak associated. Only 16 outbreaks were reported in 2024, with 69% of confirmed cases associated with those outbreaks. The biggest outbreak in 2025 has been in West Texas, which has seen 750 confirmed cases since late January.”
  • and
    • “Since late April, an infectious diseases specialist at Stanford University and his colleagues have been volunteering their time on a project they hope will help educate the public, and combat misinformation, about the safety and efficacy vaccines.
    • “The project, led by Jake Scott, MD, is a spreadsheet of all the randomized controlled trials (RCTs) that have ever been conducted for licensed vaccines. The idea, hatched on the social media site X, was prompted by responses to an old video of current Department of Health and Human Services Secretary Robert F. Kennedy Jr., in which he claims that none of vaccines mandated for US children has ever been tested in preclinical studies against a placebo. In one of the responses, infectious disease physician Brad Spellberg, MD, suggested a crowd-sourced effort to identify and post all of the RCTs in which vaccines have been tested against a placebo.
    • “That night Scott, a self-proclaimed “spreadsheet geek” who has previously collaborated with Spellberg, began building a spreadsheet using Google Sheets, creating criteria for inclusion, and seeding it with seven vaccine RCTs. Each entry has columns for the name of the vaccine, the date the RCT was published, which populations were studied, how many people were involved in the study and, importantly, the types of placebo or active comparator that were used for the control group.
    • “By the next morning, there were 20 vaccine RCTs on the spreadsheet. By May 5, the list had grown to 100. The spreadsheet now stands at more than 270 RCTs and continues to grow. Scott and his colleagues, who aim to eventually publish a peer-reviewed paper on the project in a medical journal, thoroughly review each entry before inclusion and provide links to the RCTs on PubMed.
    • “I think we’re kind of looking at the tip of the iceberg,” Scott told CIDRAP News. “There’s going to be, I would say, easily 400-plus, maybe 500-plus trials with millions and millions of participants.”
  • The AP reports,
    • “Older U.S. adults are increasingly dying from unintentional falls, according to a new federal report published Wednesday, with white people accounting for the vast majority of the deaths. 
    • “From 2003 to 2023, death rates from falls rose more than 70% for adults ages 65 to 74, the report from the U.S. Centers for Disease Control and Prevention said. The rate increased more than 75% for people 75 to 84, and more than doubled for seniors 85 and older.
    • “Falls continue to be a public health problem worth paying attention to,” said Geoffrey Hoffman, a University of Michigan researcher who was not involved in the new report. “It’s curious that these rates keep rising.”
  • MedTech Dive notes five things to watch at the American Diabetes Association’s upcoming scientific session.
    • “At the American Diabetes Association’s Scientific Sessions, companies like Abbott, Dexcom and Beta Bionics will share the latest data on diabetes technology and new partnerships.
    • “The annual conference takes place June 20-23 in Chicago, with industry leaders gathering to discuss new developments in diabetes treatments. This year’s event follows new ADA standards of care that would expand access to continuous glucose monitors, recommending that the devices be used in adults with Type 2 diabetes who are taking glucose-lowering medications other than insulin.”

From the U.S. healthcare business front,

  • The Wall Street Journal reports,
    • “Health insurers will pledge to smooth the preapproval process following backlash after the killing of an executive last year.
    • “Insurers will create a standard for electronic requests by 2027, with 80% answered in real time if documentation is included.
    • “The industry plan includes reducing procedures subject to authorization, improving explanations, and helping patients changing insurers.”
  • and
    • “Planes have been jetting from Ireland to the U.S. this year carrying something more valuable than gold: $36 billion worth of hormones for popular obesity and diabetes drugs.
    • “The frantic airlift of those ingredients—more than double what was imported from Ireland for all of last year—reflects the collision of two powerful forces: tariff-driven stockpiling and weight-loss drug demand.
    • “The peptide- and protein-based hormones feed into a category of drugs that include wildly popular GLP-1 treatments and newer types of insulin known as analogues. Taken together the shipments weighed just 23,400 pounds, according to U.S. trade data, equivalent to the weight of less than four Tesla Cybertrucks.
    • “Fit into temperature-controlled air-cargo containers, the pharmaceutical ingredients have had a huge impact on the U.S. trade imbalance. The shipments have propelled Ireland, a country of only 5.4 million people, to the second-largest goods-trade imbalance with the U.S., trailing only China. They accounted for roughly half of the $71 billion in goods the U.S. imported from the country in the first four months of the year.
    • “Nearly 100% of the imports had a final destination of Indiana, according to U.S. customs records. Eli Lilly, the drug giant behind weight loss and diabetes drugs Zepbound and Mounjaro, is headquartered in Indianapolis.”
  • Mercer Consulting notes,
    • “It’s been over three years since group health plan sponsors and issuers, in order to comply with the Transparency in Coverage final rule, began posting Machine-Readable Files that contain in-network negotiated charges for every medical item and service with providers in their networks, as well as out-of-network allowed amounts and billed charges. This data had previously been considered by insurers as proprietary and confidential, but the government recognized the need to make healthcare costs more transparent. The rule also requires group health plan sponsors and issuers to post files for negotiated rates and historical net prices for covered prescription drugs, but regulators have delayed that particular requirement .
    • “But even though the data has been available to the public since July 2022, almost 70% of very large employers (5,000+ employees) responding to our 2025 Health Policy Survey report that they have yet to meaningfully use the data.
    • “Impeding use is the sheer amount of data that was dropped on the internet all at once, but not all in one place. According to a recent report from the Congressional Review Service, users have faced significant challenge * * *.
  • Per Fierce Healthcare,
    • “Hinge Health, which just went public last month, launched a referral network of in-person providers to complement its virtual physical therapy platform.
    • “The curated provider network for musculoskeletal (MSK) care, called HingeSelect, includes imaging centers and brick-and-mortar physical therapy providers to help bridge the gap between in-person and digital care. The aim is to offer a more comprehensive end-to-end MSK care model, executives said.
    • “Hinge Health’s technology and in-house orthopedic physicians triage and direct downstream care. When in-person care, such as imaging or injections, is required, members are connected to pre-vetted providers at up to 50% below PPO rates.” 
  • Per Beckers Payer Issues,
    • “Philadelphia-based Independence Blue Cross has launched a new GenAI customer service tool to support customer service representatives in improving accuracy and speed of customer interactions, according to a news release shared with Becker’s. 
    • “The pilot, initiated in February 2025, tasked more than 40 customer service representatives with using the tool to assist with member-specific questions, summarize complex medical policies and search benefits. 
    • “The AI tool was found to have reduced the number of steps customer representatives must take to access critical information and improved efficiency by increasing the percentage of customers who receive solutions on their first inquiry. It also documents responses and validates the information with Independence Blue Cross’ existing customer relationship system.”

Happy Juneteenth

David Ermer–CDC, FDA, Medical / Rx research, SCOTUS, U.S. Healthcare, Uncategorized–

From Washington, DC,

  • Fierce Healthcare tells us,
    • “At AHIP’s annual conference, the trade group told reporters they oppose the reconciliation bill moving through Congress because of the impacts it would have on Medicaid and the individual market.
    • “AHIP executives said they will continue to work with other prominent healthcare organizations to convince lawmakers to protect federal health programs and help Americans remain insured—both by avoiding the harshest cuts and changes to Medicaid and the Affordable Care Act and extending the ACA enhanced premium tax credits.
    • “We are working arm in arm with hospitals, with physicians, with nurses, with patient advocates to try to mitigate these provisions,” said CEO Mike Tuffin. The group is continuing to meet with lawmakers and Congressional staff members to warn of dangers, should the bill pass.”
  • Per an HHS news release,
    • “Today, at the urging of Vice President JD Vance, under the leadership of U.S. Health and Human Services Robert F. Kennedy, Jr., the National Institutes of Health (NIH) launched a five-year, $10 million research initiative to assess and address the long-term health outcomes stemming from the 2023 train derailment in East Palestine, Ohio.” * * *
    • The multi-disciplinary, community-focused series of studies that will focus on:
      • “Longitudinal epidemiological research to understand the health impacts of exposures on short- and long-term health outcomes including relevant biological markers of risk.
      • “Public health tracking and surveillance of the community’s health conditions to support health care decisions and preventive measures.
      • “Extensive, well-coordinated, communications among researchers, study participants, community stakeholders, health care providers, government officials, and others to establish a comprehensive approach to address the affected communities’ health concerns.
    • “Technical details, application information, and other background material to the public were released today. It is expected that a series of grants will be issued to analyze various types of studies and community activities. The deadline to submit research proposals is July 21. Research projects to start this fall. Learn more here.”

From the public health front,

  • The Washington Post reports this afternoon,
    • Three people have died, and more than a dozen others were hospitalized following an outbreak of listeria that has been linked to premade chicken fettuccine alfredo meals sold nationwide at Kroger and Walmart, federal health officials said Wednesday.
    • FreshRealm, the Texas-based food manufacturer that makes the packaged products, issued a voluntary recall on Tuesday of chicken fettuccine alfredo meals made before June 17 “out of an abundance of caution,” the company said in a statement Wednesday.
    • “FreshRealm is issuing this voluntary recall strictly as a precautionary step with a full commitment to public health and safety,” the company said.
    • The outbreak spans 13 states, including Florida, North Carolina, Texas and Virginia, according to the Food and Drug Administration.
  • Medscape informs us,
    • “The upcoming American Diabetes Association (ADA) 85th Scientific Sessions will focus on new and evolving weight-loss treatments for people with and without diabetes, along with new biological and technological approaches for managing type 1 diabetes (T1D).
    • “Late-breaking symposia will include data from trials of a once-monthly injectable for obesity treatment, a nonpeptide oral GLP-1 receptor agonist (RA), and a medication combining a GLP-“1 RA with another drug designed to augment fat loss while preserving lean mass. Other new findings at the meeting include the use of a GLP-1 RA in T1D and the latest data on stem cell-derived islet cell transplantation in T1D. And always, there’s much more.
    • “The meeting will take place from June 20 to 24, 2025, in Chicago. “This year again, it will be heavily focused on obesity but more on the next generation of obesity drugs. We’re progressing to therapy that may be more amenable to the patient, with less frequent dosing and greater convenience,” Marlon Pragnell, PhD, ADA’s vice president of research and science, told Medscape Medical News.”
  • The New York Times reports,
    • “A cutting-edge cancer therapy offers hope for patients with lupus
    • “Lupus can be debilitating and sometimes deadly for the 3 million people who have it. A treatment called CAR-T appears to stop it in its tracks.”
  • STAT News lets us know,
    • Reliable communication for people with paralysis is nearing reality. Researchers have now demonstrated that a brain-computer interface can reliably translate thoughts into speech, including matching a person’s intended tone and pitch. 
    • It is the second study in as many months to validate the concept’s safety and initial efficacy. The findings are welcome news for a field that has spent decades trying to transform brain activity into reliable communication for people with paralysis. 
    • “Ten years ago … we were talking about point-and-click-based communication for people with paralysis,” said David Brandman, a study co-author and neurosurgeon at the University of California, Davis. “And now we’re talking about creating a digital voice box.”
    • “The findings were published in Nature on June 12. Brandman and the rest of the team showed that a 45-year-old man with amyotrophic lateral sclerosis was able to speak after having a device implanted into his brain.” 

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • Aetna has big plans to revamp the way it interacts with providers and policyholders, President Steve Nelson said during the AHIP 2025 conference this week.
    • The CVS Health subsidiary aims to eliminate some prior authorization requirements, automate precertification approvals and partner with health systems in hopes of smoothing over often-contentious relationships.
    • “We are going through a cultural transformation,” Nelson said in an interview Tuesday at the health insurance industry trade group AHIP’s event, which ran Monday through Wednesday.
    • “The initiative is part of CVS Health’s recently announced $20 billion, decade-long plan to improve the digital experience for members and providers. The healthcare conglomerate’s commitment is part of the larger trend of health insurance companies working to build trust amid widespread industry criticism that erupted after the fatal shooting of UnitedHealthcare CEO Brian Thompson in December.”
  • Per Becker Hospital Review,
    • “A new report from Vizient highlighted the 10 drug shortages placing the most pressure on U.S. hospitals, with the injectable lorazepam topping the list for both general and pediatric facilities. 
    • “These shortages [which are listed in the article] span a range of essential drug categories, including sedatives, crash cart medications, pain management treatments and oncology treatments.”
  • Modern Healthcare adds,
    • “As of April, bad debt as a percentage of gross revenue had increased at a median 2.9% year over year, according to an analysis from consulting firm Kaufman Hall, which pulled data from about 700 hospitals.
    • “Bad debt refers to revenue that providers were expecting to receive from patients or payers, but did not end up collecting despite multiple attempts. Providers often write off these unpaid balances once they are deemed uncollectible. 
    • “The unpaid balances are separate from charity care, which is free or discounted healthcare offered to patients who cannot otherwise pay for treatment. 
    • “Many hospitals are reaping the benefits of higher volumes, but more patients do not necessarily translate into a stronger balance sheet. Much of the payoff depends on payer mix. Hospitals serving a larger portion of uninsured patients or patients covered by government payer plans tend to be more at risk for bad debt balances.”

Midweek Update

David Ermer–CDC, CMS, FDA, Medicare, OPM, Patient safety, SCOTUS, Telehealth, U.S. Healthcare–
Photo by Kelly Sikkema on Unsplash

From Washington, DC,

  • Roll Call tells us,
    • “Higher health care costs and a law Congress passed last year to boost retirement benefits for public sector workers worsened the long-term outlook of Social Security and Medicare trust funds, according to annual reports released Wednesday by the programs’ trustees. 
    • “The trust funds for Medicare and Social Security benefits would be depleted faster than expected compared to last year’s estimates, losing the ability to provide full benefits to retirees in some cases years earlier than previously projected.
    • “The Hospital Trust Fund will only be able to pay 100 percent of scheduled benefits until 2033, three years earlier than the trustees reported last year, according to the trustee report. After that point, the program will only be able to pay 89 percent of total scheduled benefits, a summary says.” * * *
    • “The long-term combined outlook of the Social Security Old-Age and Survivors Insurance Trust Fund and Disability Insurance Trust Fund worsened slightly, speeding up by about three calendar quarters compared to last year’s projection, thanks largely to the passage of a law last year that boosts benefits for public sector retirees.
    • “Absent congressional action to shore up the program, the Social Security Old-Age and Survivors Insurance Trust Fund would lose the ability to pay full benefits to retirees starting in the first quarter of 2033, at which point benefits would face a 23 percent cut. That’s the same calendar year projected last year, but the estimated depletion date moved up three calendar quarters, the trustees said in the report. 
    • “If combined with the Disability Trust Fund, which would require congressional action, the Social Security Trust Fund could pay out full benefits until the third quarter of 2034, three quarters earlier than last year’s 2035 projection. At that point, retirees would see their benefits cut by 19 percent.” 
  • Federal News Network informs us,
    • “The Trump administration is attempting to address what it says are inflated numbers of high-performing federal employees, while also telling agencies to swiftly discipline or remove any feds deemed poor performers.
    • “In a memo published Tuesday, the Office of Personnel Management told agencies to begin adopting a new performance management system designed by the Trump administration. The new system attempts to more strictly delineate between different levels of employee performance and encourage agencies to rate fewer employees as high performers.
    • “For many decades now, performance management across the federal workforce has fallen short of what the American people should expect,” OPM Acting Director Charles Ezell wrote in Tuesday’s memo to agencies. “Too often, this has resulted in a lack of accountability and inflated performance ratings.”
    • “OPM began its reform efforts earlier this year by updating the performance standards and expectations for career members of the Senior Executive Service, as well as those in Senior Level, Scientific and Professional positions. Those performance expectations are now being broadened to cover nearly all career federal employees.”
  • Healthcare Dive notes,
    • “A nascent form of health coverage that creates an alternative gateway for employers to offer Affordable Care Act coverage to their workers is seeing rising uptake, especially among midsize to large employers.
    • “Adoption of individual coverage health reimbursement arrangements, or ICHRA plans, rose 34% from 2024 to 2025 among employers with 50 or more full-time employees, according to a new report from trade association the HRA Council.
    • “Still, the vast majority of ICHRA users remain companies with fewer than 20 employees, most of which are providing health coverage for the first time through the arrangements, the HRA Council said.”
  • Beckers Hospital Review ranks States by percentage of Medicaid births using a new KFF analysis.

From the judicial front,

  • The Wall Street Journal reports,
    • “The Supreme Court cleared the way for states to restrict gender-transition treatments for minors, rejecting arguments that Tennessee’s ban on puberty blockers and other medical therapies amounted to unconstitutional discrimination. 
    • “Wednesday’s decision, which broke 6-3 along ideological lines, was the latest setback for transgender rights, after several months in which the Trump administration has adopted policies that range from expelling transgender personnel from the military to halting educational funding for states or institutions that permit transgender athletes on women’s sports teams. 
    • “This case carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field,” Chief Justice John Roberts wrote for the court. “The voices in these debates raise sincere concerns; the implications for all are profound,” he continued, but the Constitution “does not resolve these disagreements. Nor does it afford us license to decide them as we see best.”
    • “That task, he wrote, was best left to the legislature.”
  • KFF adds,
    • “As a result of the decision, minors across the US will continue to see their access to gender affirming care determined at least in part based on where they live. However, access to these services is being debated in venues beyond the judiciary, including in Congress and by the Trump Administration. The Trump Administration has taken a range of actions aimed at limiting access to gender affirming care, especially for minors and Congress too has taken up the issue. The reconciliation bill still being finalized includes a prohibition on Medicaid covering gender affirming care in Senate and House-passed versions. These efforts will likely face, and some cases already have faced, litigation. While the ruling on this case is quite limited (narrowly focused on equal protection claims and Tennessee’s ban), it could have some bearing on the outcome of future challenges.”
  • Bloomberg Law reports,
    • “A Biden administration rule prohibiting health care providers from sharing reproductive healthcare information with law enforcement was invalidated by a federal judge Wednesday.
    • “Judge Matthew J. Kacsmaryk ruled that the US Department of Health and Human Services’ rule was contrary to law since it illegally limits state public health laws, impermissibly re-defines “person” and “public health,” and oversteps the authority delegated by US Congress, he said in an opinion.” * * *
    • “The case is Purl v. Dep’t of Health and Human Services, N.D. Tex., No. 2:24-cv-00228, 6/18/25.”
  • Per Beckers Payer Issues,
    • “A former Medicare Advantage executive has been found not guilty of healthcare fraud. 
    • “A jury found Kenia Valle Boza, the former director of Medicare risk adjustment analytics for HealthSun Health Plans, not guilty of one count of conspiracy to commit healthcare fraud and wire fraud, and three counts of major fraud against the U.S., according to court documents. 
    • “The Department of Justice alleged Ms. Boza orchestrated a scheme to submit fraudulent and false information to CMS to increase the reimbursement HealthSun received from the federal government. 
    • “The department declined to prosecute HealthSun, which was acquired by Elevance Health in 2017, because of the organization’s “prompt voluntary self-disclosure, cooperation, and remediation,” according to a 2023 news release. The company also agreed to pay $53 million in repayments to the government.” 

From the Food and Drug Administration front,

  • STAT News points out,
    • “Vinay Prasad will now hold three separate jobs at the Food and Drug Administration, solidifying his position as a top adviser to Commissioner Marty Makary.
    • “Prasad will serve as the agency’s chief medical and scientific officer, in addition to leading the center that regulates vaccines, gene therapies, and the blood supply, according to an internal memo obtained by STAT. Traditionally, the agency’s chief scientist and chief medical officer have been two distinct roles. 
    • “In this capacity, he will serve as a trusted advisor to the FDA Commissioner and other senior officials on cross-cutting and emerging medical and scientific issues impacting regulatory science and public health,” Makary wrote in the memo announcing the news to staff. The agency didn’t immediately respond to a request for comment.
    • “The role greatly expands Prasad’s purview, giving him explicit authority to oversee and weigh in on regulatory issues in any center. He will advise Makary on medical policy and regulatory decisions and represent the FDA at advisory committee meetings and external forums.”
  • The Wall Street Journal reports,
    • “FDA approved Gilead’s Yeztugo, a twice-yearly injectable PrEP drug, showing 99.9% effectiveness in trials.
    • “Analysts project Yeztugo sales to reach $1.6 billion in 2028, posing competition to GSK’s Apretude.
    • “Yeztugo, priced at $28,218 annually, offers improved HIV prevention uptake.”
  • Per MedTech Dive,
    • “A problem with Dexcom’s receivers for its glucose sensors may cause people to not get an audible alert for low or high blood sugar levels, the Food and Drug Administration said in an enforcement report posted Monday. More than 2 million devices are affected by the Class I recall, the highest risk category.
    • “The receiver, a handheld device that gives glucose readings, may not provide an audible alert due to a manufacturing problem. Dexcom said in a letter to customers that, as of May, it had received 56 reports of severe adverse events, such as seizure, loss of consciousness, and other hypoglycemic or hyperglycemic symptoms. All of the people recovered, the company said.
    • ‘The recall applies to receivers associated with Dexcom’s G7, G6, One and One+ CGMs. Dexcom is asking users to return the affected devices and is offering replacements.”
  • and
    • “Q’Apel Medical has recalled a device for removing blood clots in the brain over an issue linked to two injuries, the Food and Drug Administration said Tuesday.
    • “The company asked customers to return Hippo 072 Aspiration Systems and Cheetah Delivery Tools after receiving a warning letter in which the FDA raised concerns about the device’s tip.
    • “Using the recalled devices may have serious adverse health consequences including contractions or tears in the blood vessels and death, the FDA said.”
  • and
    • Centerline Biomedical has recalled guidewires used in vascular procedures over a fault that could cause serious injury or death, the Food and Drug Administration said Friday.
    • The company has asked customers to return devices from the affected lots because the coating can come off during the procedure and be left inside the patient.
    • No customers have reported serious injuries or deaths associated with the fault. The potential for serious harm led the FDA to publish a Class I recall notice.

From the public health and medical research front,

  • The Washington Post reports,
    • “A simple test of your balance, strength and flexibility, known as the sitting-rising test, could be an early indicator of how long you’ll live, according to a large-scale new study of mobility and mortality.
    • “The study, published Wednesday in the European Journal of Preventive Cardiology, looked at how well 4,282 men and women aged between 46 and 75 could lower themselves from a standing position to the floor and then stand back up again with as little assistance as possible from their hands, knees, furniture or human helpers.
    • “The test assesses “all the aspects of fitness that are not aerobic,” said Claudio Gil Araújo, the study’s lead author and research director at an exercise-medicine clinic in Rio de Janeiro, where the data were collected. Those aspects include muscular health, balance, flexibility and body composition, he said, each of which is important for longevity and health.”
  • The New York Times relates,
    • As Americans scramble to respond to rising rates of suicidal behavior among youth, many policymakers have locked in on an alarming metric: the number of hours a day that American children spend glued to a glowing screen.
    • But a study published on Wednesday in the medical journal JAMA, which followed more than 4,000 children across the country, arrived at a surprising conclusion: Longer screen time at age 10 was not associated with higher rates of suicidal behavior four years later.
    • Instead, the authors found, the children at higher risk for suicidal behaviors were those who told researchers their use of technology had become “addictive” — that they had trouble putting it down or felt the need to use it more and more. Some children exhibited addictive behavior even if their screen time was relatively low, they said.
  • Health Day lets us know,
    • “People with severe depression who receive electroshock therapy are significantly less likely to commit suicide, a new evidence review says.
    • “Electroconvulsive therapy (ECT) lowered the risk of death by suicide 34% among patients with severe depression, according to findings published June 13 in the journal Neuroscience Applied.
    • “Depression patients receiving ECT also had a 30% lower risk of death from any cause, researchers said.
    • “They said these benefits might be even greater than reflected, given that ECT has improved as a psychiatric treatment.
    • “Modern ECT appears to be more effective than it was in the past,” said lead researcher Dr. Timur Liwinski, a clinician scientist at the University of Basel in Switzerland.
    • “Since our analysis spans many decades, it’s likely that today’s ECT offers even stronger protection against suicide than the 34% reduction we identified overall,” Liwinski said in a news release.”
  • Per MedPage Today,
    • “A meta-analysis of 24 observational studies confirms excess risks of heart attack, stroke, and cardiovascular death among cannabis users.
    • “The report joins a growing body of evidence linking cannabis use to significant health harms.
    • “Nevertheless, the meta-analysis was unable to account for cannabis mode of administration, product potency, or intensity of use.”
  • Per STAT News,
    • “Scholar Rock said Wednesday that its investigational therapy helped preserve lean mass among patients taking a powerful weight loss drug, as concerns grow that patients taking new obesity treatments may be losing too much muscle.”
  • CBS News reports,
    • “At least 3% of measles cases confirmed so far this year have been in people who received two doses of the measles vaccine, meaning they were fully vaccinated, the Centers for Disease Control and Prevention says. 
    • “About three dozen of the nearly 1,200 measles infections in 2025 have been in people with two vaccine doses, the agency said Friday in its weekly update on cases. An additional 2% of cases were in people who received at least one dose of the measles vaccine.
    • “Many of the cases were in Texas, which on Tuesday counted a 21st confirmed measles case in someone with at least two doses of the vaccine.”

From the U.S. healthcare business front,

  • Fierce Healthcare reports from the AHIP 2025 conference which concluded today in Las Vegas.
    • “Medicare Advantage has historically enjoyed bipartisan popularity, but, as the program has grown, so too has scrutiny of insurers’ practices.
    • “Mike Hoak, vice president of public policy at Humana, said this is a natural cycle for public programs like MA, where policymakers don’t want to see it fail or kill it outright but want to continue evolving it to ensure it works effectively. 
    • “There was a similar reappraisal of Medicare Part D, he said.
    • “There is a really bipartisan feeling amongst policymakers: ‘I love the program,’ and—for some of them, at least—’I’d like to see it grow, but it is time for some nips and tucks,'” Hoak said. “I think Medicare Advantage is at that inflection point right now.”
  • and
    • Cigna Healthcare’s chief medical officer, Amy Flaster, M.D., joined the insurer at a difficult time for the industry.
    • Flaster stepped into the CMO role in December as health plans grappled with a wave of public outcry and frustration following the murder of UnitedHealthcare CEO Brian Thompson. 
    • She said in the wake of the shooting and public conversation that followed, the insurer “took time to reflect” on what its customers and society as a whole were saying and used that as fuel to make several “commitments to better” that are powering the company’s work moving forward.
    • “I think it was also an interesting turning point at Cigna, where we heard a lot of feedback and loud voices coming from society, from our customers, wanting to see a better system that serves their needs more efficiently, more effectively,” Flaster said in an interview with Fierce Healthcare at AHIP 2025.
  • Per Healthcare Dive,
    • “Ascension has entered a definitive agreement to acquire ambulatory surgery provider Amsurg, the nonprofit health system said Tuesday.
    • “The deal, which Ascension expects to close later this year pending regulatory approval, will add more than 250 ambulatory surgery centers across 34 states to Ascension’s outpatient portfolio.
    • “A spokesperson for the health system declined to comment on the size of the deal. However, sources told Bloomberg that Ascension was paying $3.9 billion for the provider.” 
  • Per Beckers Hospital Review,
    • “Mark Cuban’s Cost Plus Drug Co. and virtual care provider 9amHealth have partnered to offer obesity medications through a new program targeting self-insured employers. 
    • “Under the partnership, 9amHealth will use low-cost oral obesity medications sourced from Cost Plus Drugs alongside branded GLP-1 drugs acquired through direct manufacturer deals, according to a June 17 news release from the company. 
    • “The medications are a part of a broader obesity treatment program that includes telehealth-based support from clinicians specializing in conditions such as diabetes, high blood pressure and high cholesterol. 
    • “The program is aimed at employers who are looking to expand weight management coverage for workers without relying on traditional pharmacy benefit managers, the release said.” 
  • and
    • “Hospital labor costs related to drug shortage management have significantly increased, from $359 million in 2019 to $894 million in 2024 — a nearly 150% increase, according to a Vizient report published June 17. 
    • “Vizient surveyed 132 of its clients to measure the financial toll of medication shortages. Respondents included pharmacy and procurement leaders at health systems, medical centers, children’s hospitals, critical access hospitals, specialty hospitals, clinics and ambulatory care facilities. 
    • “Pediatric facilities were particularly strained, as they monitored 25% more shortages and exceeded pharmacy budgets more often than general facilities. 
    • “Overall, hospitals and other healthcare facilities spent 20.2 million hours in 2024 managing these shortages. In 2019, that figure was 8.6 million hours. 
    • “To cope, most facilities shifted workloads onto already stretched staff, while only a fraction opted to hire additional pharmacy personnel,” the report said. “These findings underscore an urgent issue: Drug shortages aren’t just about supply — they’re draining time, money and an already fragile healthcare system.”

Tuesday report

David Ermer–Congress, FDA, Medical / Rx research, Medicare, NIH, U.S. Healthcare–

From Washington, DC,

  • KFF compares the healthcare provisions in the House of Representatives big, beautiful bill against the developing Senate version. Of note the Senate version does not include the House bill’s provisions expanding the utility of health savings accounts.
  • STAT News adds,
    • “The Medicare pay bump for doctors that was part of the House version of Republicans’ tax bill was dropped in the Senate’s version, released Monday evening. 
    • “The provision, which would boost doctors’ payment for treating Medicare patients by tying it to inflation, has long been a top priority for physician groups.” 
  • Federal News Network tells us,
    • “The Trump administration is attempting to address what it says are inflated numbers of high-performing federal employees, while also telling agencies to swiftly discipline or remove any feds deemed poor performers.
    • “In a memo published Tuesday, the Office of Personnel Management told agencies to begin adopting a new performance management system designed by the Trump administration. The new system attempts to more strictly delineate between different levels of employee performance and encourage agencies to rate fewer employees as high performers.
    • “For many decades now, performance management across the federal workforce has fallen short of what the American people should expect,” OPM Acting Director Charles Ezell wrote in Tuesday’s memo to agencies. “Too often, this has resulted in a lack of accountability and inflated performance ratings.”
  • Radiology Business reports,
    • “Radiology Partners has “significantly outmatched other provider groups” via the No Surprises Act, scoring wins at more than 600% of the initial “qualifying payment amount” offer, according to new research. 
    • “The Centers for Medicare & Medicaid Services recently released NSA data from the first half of 2024. As Radiology Business reported previously, industry giant Rad Partners was the No. 1 initiator of these disputes tied to out-of-network healthcare services, with 136,784 between January and July. Georgetown University researchers recently took a closer look at the data, publishing their findings June 11 in Health Affairs. 
    • “They highlighted RP’s significant payment wins via the “independent dispute resolution” (IDR) process in 2024. In Q1, the practice earned a median prevailing offer at 631% of the qualifying payment amount—essentially, the median contracted rate for a service in the same geographic region. These wins continued in Q2, with a median at 610% of QPA.  
    • “These high numbers highlight the disconnect between the two sides as they debate what constitutes a reasonable payment for [out-of-network] services,” Jack Hoadley, PhD, research professor emeritus with Georgetown’s Center on Health Insurance Reforms, and co-authors explained. “Providers believe the high volume of IDR disputes reflects inadequate payment by plans, exacerbated by possible manipulation of the [qualifying payment amount]. Plans respond that their QPAs are accurate and that providers should be willing to accept payments that align closely with in-network rates.”P

From the Food and Drug Administration front,

  • The Wall Street Journal reports,
    • “Embracing artificial intelligence. Taking on companies that make ultra-processed foods. And offering a fast-track to approve drugs the Trump administration views as a priority.
    • “Welcome to the new Food and Drug Administration as envisioned by Dr. Marty Makary, who is leading the agency under Health Secretary Robert F. Kennedy Jr. Both men have said they want to overhaul the agency, citing what they see as the FDA’s reputation for coziness with pharmaceutical companies.
    • “Makary’s goal is “to deliver more transparency, unleash innovation, eliminate conflicts and lower drug pricing,” said Calley Means, a White House adviser and ally of Makary’s.
    • “The changes are coming so swiftly, and often without input from career scientists, that Makary faces declining staff morale threatening to stymie his efforts. He must also contend with the administration’s staff cuts at the FDA, which have been partly undone but shrank the workforce nonetheless. And critics say Makary is playing fast and loose with the FDA’s commitment to world-class science.”
  • Per an FDA news release,
    • “The U.S. Food and Drug Administration today announced its Commissioner’s National Priority Voucher (CNPV) program to enhance the health interests of Americans. The new voucher may be redeemed by drug developers to participate in a novel priority program by the FDA that shortens its review time from approximately 10-12 months to 1-2 months following a sponsor’s final drug application submission.
    • “The new CNPV process convenes experts from FDA offices for a team-based review rather than using the standard review system of a drug application being sent to numerous FDA offices. Clinical information will be reviewed by a multidisciplinary team of physicians and scientists who will pre-review the submitted information and convene for a 1-day “tumor board style” meeting.
    • “Using a common-sense approach, the national priority review program will allow companies to submit the lion’s share of the drug application before a clinical trial is complete so that we can reduce inefficiencies. The ultimate goal is to bring more cures and meaningful treatments to the American public,” said FDA Commissioner Marty Makary M.D., M.P.H. “As a surgical oncologist, we often made multidisciplinary decisions with a team of doctors on major life-and-death questions for patients, incorporating the latest medical studies in a 1-day tumor board-style discussion. This voucher harnesses that model to deliver timely decisions for drug developers.”  
  • Per Modern Healthcare,
    • “Taiwanese surgical robotics company Brain Navi Biotechnology said Tuesday the Food and Drug Administration approved its NaoTrac neurosurgical robot.
    • “It’s designed to assist with brain tumor biopsies, deep brain stimulation and other complex brain surgeries.”
  • Per Cardiovascular Business,
    • “Inquis Medical, a California-based medtech company focused on peripheral vascular treatments, has received U.S. Food and Drug Administration (FDA) clearance for its Aventus Thrombectomy System to be used to treat pulmonary embolism (PE).
    • “The Aventus Thrombectomy System, a next-generation mechanical thrombectomy device, was previously cleared to target blood clots in a patient’s peripheral arteries. This new expanded clearance paves the way for PE patients to be treated using the same technology.”
  • Per MedTech Dive,
    • “Zyno Medical has recalled infusion pumps that shipped with software that had not undergone verification and validation testing, the Food and Drug Administration said Monday.
    • “The company released the Z-800 pumps with incorrect software versions. The software created a risk of incorrect air-in-line detection and audio alarms that could cause serious harm.
    • “Zyno has not reported any serious injuries or deaths. The recall, which the FDA assigned to Class I, started eight months after Zyno removed Z-800 pumps from use over another software issue.”

From the State law front,

  • Healthcare Dive reports,
    • “Iowa passed a law last week that places limits on pharmacy benefit managers, joining a growing number of states cracking down on the drug middlemen in an effort to constrain rising prescription drug costs and protect rural pharmacies. 
    • “The legislation includes numerous provisions aimed at tamping down on PBMs’ “outsized control” over the pharmaceutical supply chain, Gov. Kim Reynolds said in a statement. That includes preventing PBMs from steering patients to particular pharmacies, equalizing reimbursement between pharmacies and reforming how PBMs are paid.
    • “However, some experts have raised concerns that the law could lead to higher costs for health plans and patients.”

From the judicial front,

  • Bloomberg Law reports,
    • “The FDA lawfully determined that Novo Nordisk A/S’s Ozempic drug shortage ended and that drug compounders can’t keep making copies of the weight loss medicine, a federal judge ruled. 
    • “Judge Mark T. Pittman for the US District Court for the Northern District of Texas agreed with the Food and Drug Administration that it lawfully removed semaglutide from the drug shortage list last year, granting on June 13 the agency’s motion for summary judgment against compounders. 
    • “The opinion is currently sealed but will eventually be redacted, according to the court’s docket.”
    • The case number is 4:25-cv-00174.

From the public health and medical research front,

  • Cardiovascular Business reports,
    • “Mayo Clinic in Rochester, Minnesota, is the No. 1 heart hospital in the United States, according to a data-based ranking published by Newsweek. Cleveland Clinic and its Miller Family Heart, Vascular & Thoracic Institute came in at No. 2, followed by Massachusetts General Hospital/the Corrigan Minehan Heart Center at No. 3, NYU Langone Hospitals – Tisch Hospital at No. 4 and Stanford Health Care/Stanford Hospital at No. 5.
    • “The ranking is part of a new America’s Best Hospitals for Specialize Care 2025 report.
    • “Newsweek and Statista partnered on the list, naming their Top 200 Hospitals for Cardiac Care. While 45% of each facility’s overall score was determined by a variety of hospital quality metrics, another 35% was determined by survey responses from U.S. healthcare professionals collected in early 2025. In addition, 15% of the overall scores was determined by patient satisfaction surveys, and the final 5% was based on Statista’s PROMs Implementation Survey.“
  • Per Health Day,
    •  “Rheumatoid arthritis (RA) has steadily increased around the world during the past three decades, a new AI-powered study reports.
    • “The autoimmune disease affected 17.9 million people worldwide in 2021, a 13% increase from 1990, researchers reported today in the Annals of the Rheumatic Diseases.
    • “Results indicate that the global burden of RA has been vastly underestimated, researchers concluded.
    • “Further, the research team projects that rheumatoid arthritis will continue to increase unless steps are taken to prevent it or treat existing cases.”
  • and
    • “A new breakthrough can help people with schizophrenia keep up with their psychiatric meds, researchers said.
    • “A pill taken just once a week, gradually releasing medicine from within the stomach, can greatly simplify the drug schedule faced by schizophrenia patients, researchers reported June 10 in the journal The Lancet.
    • “The newly developed pill maintains consistent levels of the psychiatric drug risperidone in patient’s bodies, and controlled their symptoms just as well as daily doses, results showed.
    • “We’ve converted something that has to be taken once a day to once a week, orally, using a technology that can be adapted for a variety of medications,” researcher Giovanni Traverso, an associate professor of mechanical engineering at MIT, said in a news release.”
  • Per Beckers Hospital Review,
    • “A study found that a once-daily pill called obicetrapib significantly lowered LDL cholesterol in patients at high risk for heart disease. 
    • ‘The clinical trial, published May 7 in The New England Journal of Medicine, enrolled 2,500 participants with either a history of atherosclerotic cardiovascular disease or familial hypercholesterolemia, all of which were already taking the maximum tolerated doses of other cholesterol-lowering drugs. 
    • “After 84 days, those taking NewAmsterdam Pharma’s obicetrapib saw their LDL levels drop nearly 30% while the placebo group experienced a slight increase. The cholesterol-lowering effect was consistent across the treatment group and the rate of side effects was similar among the two groups.”
  • MedPage Today discusses “What the MAHA Report Gets Right, and Wrong, on Nutrition. Time will tell the impact of ensuing policies on health.”
  • and lets us know
    • “A rheumatology trainee who went on TikTok to find information on her own condition may have uncovered a novel and possibly tectonic approach to treating fibromyalgia, her presentation here suggested.
    • “That experience led to an analysis of the massive TriNetX medical records database, which indicated that fibromyalgia patients who used glucagon-like peptide-1 (GLP-1) receptor agonist drugs were less likely to use opioids and to report pain, fatigue, and malaise compared with propensity-matched non-users, according to Nouran Eshak, MBChB, of the Mayo Clinic in Scottsdale, Arizona.
    • “The findings were strong enough, Eshak told attendees at the European Alliance of Associations for Rheumatology annual meeting, that clinicians should “consider using GLP-1 agonists in fibromyalgia patients when comorbidities such as obesity, diabetes, or sleep apnea are present.” Those are approved indications for such agents, and therefore patients would face fewer barriers to access.
    • “Still, these findings are no substitute for prospective data, such as from randomized trials, Eshak stressed.”
  • The NIH’s Reseach Matters covers the following topics this week — “Y chromosome loss and cancer | Cysteine and weight loss | Treating malaria in mosquitoes.”
  • Per Medscape,
    • “When canagliflozin (Invokana) was approved in 2013, the SGLT2 inhibitor was touted as a first in a new medication class that was, at the time, the only oral, once-daily medication to reduce blood glucose as well as body weight and systolic blood pressure.
    • “Since then, additional SGLT2 inhibitors have been approved (dapagliflozin, empagliflozin, bexagliflozin, and ertugliflozin), and the indications for prescribing the medications have expanded.
    • “The medications have gone from targeting glucose-lowering to also providing cardiac protection, including for diabetes-free patients with heart failure.
    • “Next, experts said, discussions will focus on other decisions, such as when and whether to prescribe the SGLT2 inhibitors with GLP-1 receptor agonists for the best outcomes.”

From the U.S. healthcare business front,

  • BioPharma Dive reports,
    • “Eli Lilly agreed to buy Verve Therapeutics for $1 billion, betting on the promise of one-and-done gene therapies to treat cardiovascular disease. 
    • “The deal announced Tuesday offers Verve stockholders $10.50 a share, plus a contingent value right worth another $3 a share. The non-tradeable CVR would pay out if the company’s experimental VERVE-102 treatment advances enough to dose a patient in a Phase 3 trial within 10 years of the transaction’s closing.
    • “Verve CEO Sekar Kathiresan and other top stockholders have already agreed to tender shares that represent about 17.8% of Verve’s outstanding stock and the gene editing company’s board recommends that all investors agree to the tender offer, Lilly said. A second-step merger will follow if needed. The companies expect to complete the transaction in the third quarter.”
  • The Wall Street Journal reports,
    • “Dozens of companies have pledged to build more manufacturing in the U.S. since President Trump took office. Generic drugmakers aren’t among them. 
    • “And they have no plans to change that anytime soon.
    • “Makers of generics—cheaper copies that make up 90% of Americans’ prescription medications—say further domestic investment is too risky in such a low-margin and unpredictable business, unless the government helps to steady the sector. 
    • “Drugmakers want more clarity from the Trump administration on the potential pharmaceutical tariffs, which some companies warn could lead them to close U.S. plants altogether. 
    • “Where’s the incentive?” said Richard Saynor, chief executive officer of Sandoz, whose U.S. slate of roughly 150 generic drugs range from blood thinners to antipsychotics. “You sell a packet of antibiotics more cheaply than a packet of M&M’s. That’s offensive, and we lose money doing that.”
  • and
    • “Fresenius Medical Care could end up benefiting from blockbuster obesity drugs, according to its chief executive, contrary to concerns that such treatments could be negative for the dialysis specialist.
    • “I believe [the effect] is neutral to positive, not negative,” Fresenius Medical Care’s Chief Executive Helen Giza said in an interview.
    • “Ozempic and others in the class of drugs known as GLP-1 have shown promise in clinical trials beyond their most common uses for diabetes and weight loss to treat heart, kidney and liver diseases, among a growing list of conditions. As signs of their potential emerged, investors raced to look for winners and losers.”
  • Per STAT News,
    • “A central theme in Humana’s plan for boosting Medicare Advantage profitability in the future is a strategy its peers have relied on for over a decade: coaxing members in for their annual wellness visits.”
  • Per Fierce Healthcare,
    • “Lark Health is rolling out a new, artificial-intelligence-enabled platform to manage the costs related to GLP-1s, and it has tapped a former insurance industry executive to lead the charge.
    • “Matthew Gibbs, who previously served as chief pharmacy officer at Blue Shield of California, will join Lark as president. In that role, he will spearhead the launch of LarkVantage, a platform designed to mitigate the challenges associated with utilization reviews for GLP-1s.”
  • Reuters informs us,
    • “Eli Lilly (LLY.N) will ship the two highest doses of its popular weight-loss drug Zepbound to cash-paying customers on its website starting early August, the U.S. drugmaker said on Monday.
    • “With the addition of the 12.5 milligrams and 15 mg doses, all approved doses of Zepbound will be available on the website in single-dose vials for $499 per month or less, regardless of insurance status, the company said.
    • “Lilly and rival Novo Nordisk (NOVOb.CO), opens new tab started offering vials at discounted prices on their respective websites to expand access and stave off competition from compounded versions or cheaper copies of their weight-loss drugs.
    • “The LillyDirect website was launched last year to help patients directly order some drugs.”

Monday report

David Ermer–CDC, CMS, Congress, FDA, Medical / Rx research, U.S. Healthcare, Uncategorized–
Photo by Sven Read on Unsplash

From Washington, DC

  • Per a Senate news release,
    • “U.S. Senate Finance Committee Chairman Mike Crapo (R-Idaho) today released legislative text within the Finance Committee’s jurisdiction for inclusion in Senate Republicans’ budget reconciliation bill.” * * *
    • “Click HERE to view bill text.
    • “Click HERE for a section-by-section.
    • “Click HERE for a bill overview.”
  • STAT News adds,
    • “To help pay for President Trump’s tax cuts, the Senate is clamping down on tactics that states use to boost federal Medicaid funding, according to legislation released by the Senate Finance Committee on Monday.
    • “The text includes harsher restrictions on Medicaid provider taxes than a version of the bill recently passed by the House. It also places stricter limits on programs that states use to boost Medicaid funding to health care providers, known as State directed payments.
    • “The Finance Committee, led by Sen. Mike Crapo (R-Idaho), is responsible for the largest portion of the budget reconciliation bill that Republicans are using to make good on Trump’s promise to extend expiring tax cuts and create new ones. The House passed its version of the One Big Beautiful Bill last month, and Senate Republicans are now negotiating it.”
  • The American Hospital Association News tells us,
    • “The Centers for Medicare & Medicaid Services June 13 announced it approved state plan amendments to expand Medicaid access to care for tribal communities in six states: Minnesota, New Mexico, Oregon, South Dakota, Washington and Wyoming. The approvals allow the Indian Health Service and tribal clinics to provide Medicaid clinic services in homes, schools and other community locations.” 

From the judicial front,

  • Bloomberg Law informs us,
    • “Eli Lilly & Co. and health tech company Kalderos Inc. are seeking to revive lawsuits in the DC Circuit after a federal judge ruled a US health agency acted lawfully when it didn’t approve drugmaker proposals to discount medicines through a rebate model.
    • “The notices to appeal the order were filed Thursday in the US Court of Appeals for the District of Columbia Circuit after a lower court ruled May 15 found the Health Resources and Services Administration didn’t act illegally when it denied drugmaker bids to discount medicines through a rebate model rather than up front to covered entities under the federal 340B Drug Pricing Program.”
  • MedTech Dive lets us know,
    • “When the deadline to appeal the court decision that blocked the Food and Drug Administration’s final rule regulating laboratory developed tests as medical devices slipped by in May without a word from the agency, industry groups were relieved that the plan they sued to stop was dead.
    • “The U.S. District Court for the Eastern District of Texas found the FDA’s attempt to expand jurisdiction over LDTs exceeded its statutory authority. Yet regulatory experts think the agency may still see room to assert authority over LDTs in other ways. A recent warning letter to a diagnostics company points to one avenue the agency could take, attorneys said.”
  • The Wall Street Journal reports,
    • “All 55 attorneys general signed onto a $7.4 billion settlement with Purdue Pharma and the Sackler family for their role in the opioid crisis.
    • “The attorneys general, who represent all eligible U.S. states and territories, finished signing the settlement on Monday after it was reached in principle in January.
    • “The deal ends the Sacklers’ control of Purdue, bars them from selling opioids in the U.S. and delivers funding across the country to support opioid-addiction treatment and prevention.
    • “The settlement requires resolution of legal claims by state and local governments. The local government sign-on process will be contingent on bankruptcy-court approval, according to several attorneys general.
    • “The Sackler family has told the attorneys general it plans to proceed with the settlement.”

From the public health and medical research front,

  • The Washington Post reports,
    • “Around 1 in 7 U.S. adults who smoke might have some degree of disability, according to a study published in the journal Tobacco Control.
    • “The researchers used data from the 2019-2023 National Health Interview Survey (NHIS) for about 150,000 people. During that period, 14.1 percent of adults who currently smoked had a disability, and estimates for any kind of disability were significantly higher for current or former adult smokers.
    • “The study looked at different kinds of disabilities and found that the prevalence of vision, hearing, mobility and cognitive disability was two to 2.4 times higher among those who currently smoked. About 16.5 percent of women who smoke and 12.1 percent of men who smoke have a disability, the study says. The study also looked at race and ethnicity, finding that 19 percent of non-Hispanic smokers had a disability vs. 11 percent of Hispanic smokers.”
  • The American Medical Association lets us know what doctors wish their patients knew about tendinitis.
  • STAT News relates,
    • To Rebecca Stone, the single most important fact about ovarian cancer is that it’s usually a misnomer. The most common kind — responsible for 70% of cases and 90% of deaths — often has its silent beginnings not in the ovary, but in the fallopian tube. This isn’t just an interesting factoid; as a gynecologic oncologist at Johns Hopkins, Stone sees it as a reason to evangelize. There’s no way to screen for so-called ovarian cancer, no colonoscopy, mammogram, or Pap smear equivalent. It’s typically found late, once it’s already spread. The treatments are middling at best. Among the best tools is surgical prevention: If someone doesn’t want more kids, and is considering another abdominal surgery, a surgeon can offer to take the tubes out.
    • Opportunistic salpingectomy, it’s called. “Somebody says, ‘Can I get my tubes tied?’ And I will say, ‘Well, actually, we don’t tie tubes anymore, we remove them,’” said Greg Marchand, an OB-GYN in Mesa, Ariz. There are exceptions, but generally, since the American College of Obstetricians and Gynecologists recommended offering it in 2015, he’s gone with salpingectomy.
  • It is odd that the article does not mention FDA Administrator Dr. Marty Makary who discusses this issue in his recent book Blind Spots.
  • Health Day tells us,
    • “Brain changes in sleepless teens could make them more likely to be impulsive and aggressive, a new study says.
    • “Teenagers with less sleep had lower connectivity between the parts of the brain that play a critical role in decision making, self-reflection and information processing, researchers reported June 13 in the journal Brain and Behavior.
    • “Problems in these parts of the brain are also linked to mental illnesses like depression, ADHD and schizophrenia, researchers said.
    • “Sleep isn’t just good for children. It helps keep their mental health intact and helps them regulate their emotions,” senior researcher Assaf Oshri, director of the University of Georgia Center for Developmental Science, said in a news release.”
  • and
    • “Struggling to get a good night’s sleep? A new study suggests that a natural solution might be found right in your fridge: fruits and veggies.
    • “Researchers from the University of Chicago and Columbia University found that eating more fruits, vegetables and whole grains during the day may lead to better sleep that same night.
    • “Dietary modifications could be a new, natural and cost-effective approach to achieve better sleep,” study co-author Dr. Esra Tasali, director of the UChicago Sleep Center, said in a news release.
    • “The study — published June 11 in the journal Sleep Health — is one of the first to show that what you eat during the day may affect your sleep that very night, researchers said.”
  • Per HR Executive,
    • “While it may seem surprising—given the ongoing push by many American workers to stay remote or hybrid post-pandemic—many workers are craving support and connection, as the nation’s loneliness crisis rises. Recent research identified loneliness as a significant and emerging threat to workers’ mental and physical health. And, experts say, it can have widespread effects on the workplace.
    • “In its survey, Loneliness in America 2025, Cigna found that 52% of U.S. workers report feeling lonely. The resulting impact on business is both profound and measurable, according to the Evernorth Research Institute, the research arm of Evernorth, Cigna’s health services business.
    • “Among other concerning results, the research found that lonely employees are more likely to miss work, disengage while at work and/or leave their jobs altogether. This is creating ripple effects that cost employers in productivity, morale and talent retention, researchers wrote.’
  • Per BioPharma Dive,
    • “Roche will advance an experimental Parkinson’s disease drug with a mixed track record into late-stage development, announcing Mondaythat it is “encouraged by the efficacy signals” the medicine displayed in earlier testing despite missing its main objectives in two clinical trials.
    • “The Swiss drugmaker and partner Prothena said continued study of trial enrollees suggested that the antibody drug, known as prasinezumab, delayed progression of symptoms like tremors or joint stiffness in people with early-stage disease.
    • “Roche and Prothena have been developing prasinezumab for more than a decade, having first initiated trials shortly after signing a partnership deal in 2013. The drug targets alpha-synuclein, a protein that can misfold and build up in the brains of Parkinson’s patients, and that’s been the focus of an array of drug programs. Study results have largely disappointed, however.”
  • Per Fierce Pharma,
    • “Roche and AbbVie have once again come up short in their attempt to gain an additional indication for their blockbuster blood cancer treatment Venclexta.
    • “A phase 3 trial of the therapy in previously untreated patients with higher-risk myelodysplastic syndromes (MDS) did not achieve its primary endpoint of overall survival, the companies said Monday. In the global study of approximately 500 patients, the combination of Venclexta plus the chemotherapy azacitidine was pitted against placebo plus azacitidine.
    • “The companies said they will present full data from the trial at an upcoming medical meeting.”

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • “Health systems are expanding their ambulatory surgery center networks in a bid to lower costs and manage overcrowded operating rooms.
    • “ASCs can provide a more convenient, lower-cost alternative for lucrative procedures like knee replacements and cataract surgeries. Health system executives say the transition of many services from hospitals to surgery centers is inevitable. Advancing technology, shifting regulations, patient preference and pressure from insurers and lawmakers to reduce hospital costs will make sure of that, they said.”
  • and
    • “Welsh, Carson, Anderson & Stowe made an unspecified investment in Constitution Surgery Alliance, an ambulatory surgery center operator with growth plans.
    • “The private equity firm will help fund a national expansion of the company, which manages 16 facilities in five states, according to a Monday news release.”
  • EXL offers payers a white paper titled “Embrace the new era of Utilization Management: Modernizing ineffective approaches with advanced technology.” Check it out.
  • On a related note, Beckers Hospital Review points out,
    • “As hospitals and health systems face increasing pressure to maintain margins and secure sustainable reimbursement, a growing number of leaders are turning to an old business truth: What gets measured, gets managed.
    • “Payer “scorecards” are gaining traction as hospitals seek to hold insurers accountable, reduce administrative friction and strengthen their negotiating position. By systematically tracking performance metrics such as denial rates, response times and contract compliance, providers aim to shift the balance at the negotiating table.
    • “I often emphasize to my clients that data is their greatest leverage,” Brad Gingerich, vice president of payer strategy at Ensemble Health Partners, said during an episode of the Becker’s Healthcare Podcast. “One of the most important steps is proactively holding payers accountable. The moment a payer fails to meet its contractual KPIs, we flag it immediately — whether through formal demand letters or direct discussions.” 
  • Beckers Hospital Review also informs us,
    • “Total prescription dispensing revenue at U.S. retail pharmacies hit $683 billion in 2024, marking a 9% increase from the previous year, according to a June 16 post from the Drug Channels Institute.
    • “The institute calculated estimated total prescription revenue for the 15 largest pharmacy companies in the U.S. based on 2024 calendar year data. COVID-19 vaccine revenue was excluded from the analysis.
    • “Collectively, the top 15 pharmacy companies accounted for about three-fourths of overall dispensing revenue from retail, mail-order, long-term care and specialty pharmacies. Nearly half of that revenue came from CVS Health, Walgreens Boots Alliance, Cigna and UnitedHealth Group. Elevance Health made the list for the first time after acquiring several pharmacy firms in 2024, including Kroger Specialty Pharmacy. 
    • “GLP-1s were the main driver of revenue increases last year, accounting for more than 80% of the overall growth.”
  • Per Fierce Pharma,
    • “Neurology specialist Supernus Pharmaceuticals will snap up Sage Therapeutics, which was once valued at more than $9 billion, for $561 million up front, with the hope that it can help transform a newly launched treatment for postpartum depression (PPD) into the indication’s standard of care.
    • “The buyout of Massachusetts-based Sage comes after a takeover bid, earlier this year by Biogen, which offered $7.22 per share for the struggling, 15-year-old biotech. 
    • “Six months later, Supernus got the job done with an offer of $8.50 per share, plus a contingent value right (CVR) worth $3.50 per share if a set of milestones are achieved, which would bump up the value of the deal to $795 million.”

Weekend Update

David Ermer–CDC, CMS, Congress, Medical / Rx research, Obesity, SCOTUS, U.S. Healthcare–

Happy belated Flay Day!

From Washington, DC

  • The Daily Caller explains,
    • The Senate’s confirmation of Trump nominees as of June 5 outpaced the Biden administration by 16 nominees and the first Trump administration by 33 nominees, according to information compiled by the Senate GOP leadership-aligned Senate Republicans Communications Center (SRCC).
    • Still, nearly 100 nominees are awaiting floor consideration, according to the Senate executive calendar.
    • The backlog is due in part to Senate Democrats placing blanket holds on hundreds of Trump nominees, requiring the Senate to use finite floor time to confirm each civilian nominee individually through multiple roll call votes. As a result, nearly 60% of the votes taken in the Senate during the 119th Congress have been related to nominations, according to the SRCC.
  • Roll Call summarizes other Senate work during this short workweek here.
  • The Supreme Court will be issuing opinions on Wednesday June 18 this week.
  • Tammy Flanagan, writing in Govexec, asks “Think you’re ready to tap your TSP? Here’s what you might be missing. Before touching your Thrift Savings Plan funds, make sure you understand the rules—and the risks—you might not have planned for.”

From the public health and medical research front.

  • STAT News reports,
    • “Sarepta Therapeutics said Sunday that it was halting shipments of its Duchenne muscular dystrophy gene therapy for patients who can no longer walk, following the death of a second [male] person who received the treatment.
    • “Sarepta disclosed the first patient death — a 16-year-old boy — in March. Both occurred from acute liver failure, a side effect that has been seen with other gene therapies. The company said both patients were non-ambulatory, meaning their disease had progressed to the point they relied on a wheelchair. Most children with Duchenne lose the ability to walk by adolescence.
    • “The company said early Sunday it was working with experts to come up with an enhanced immunosuppressive regimen that could make the therapy, called Elevidys, safer for non-ambulatory patients. It said it would talk with the Food and Drug Administration about the the proposed regimen. 
    • “Sarepta also said it was pausing dosing in an ongoing clinical trial of Elevidys, called ENVISION, that’s focused on older ambulatory and non-ambulatory patients.” 
  • Per Fortune Well,
    • “Researchers at the University of California San Francisco have identified the U.S. regions, as defined by the Centers for Disease Control and Prevention, where dementia occurs most often.
    • “The large and comprehensive study, published in JAMA Neurology, examined data on more than 12.6 million veterans 65 and older enrolled in the Veterans Health Administration system; only 2% were women. 
    • “Researchers found the highest incidence in the Southeast (North Carolina, South Carolina, Georgia, Florida) and the lowest in the Mid-Atlantic states (Delaware, Maryland, Pennsylvania, Virginia, West Virginia, New Jersey, Washington D.C.).” 
  • The Washington Post informs us,
    • A common genetic variant is linked to a doubled dementia risk for older men, a recent analysis in Neurology suggests.
    • The study used data from Aspirin in Reducing Events in the Elderly (ASPREE), which followed elderly patients in the United States and Australia with no history of cardiovascular disease, dementia or cognitive decline between 2010 and 2017.
    • Researchers focused on 12,174 Australians of European ancestry over age 70, and looked for variants in the HFE gene. The gene is critical to regulating the body’s iron levels, and variants are common among people of European descent.
    • Those who carry two copies of the p.C282Y variant in the HFE gene can develop hemochromatosis, a condition that causes iron overload in the body, and resulting conditions such as liver cirrhosis, liver cancer, frailty, arthritis and dementia.
    • One in 3 people carry a gene variant called H63D, and 1 in 36 carry two copies, John Olynyk, a professor at the Curtin Medical Research Institute in Perth, Australia, says in a news release about the new study.
    • “Having just one copy of this gene variant does not impact someone’s health or increase their risk of dementia. However, we found having two copies of the variant more than doubled the risk of dementia in [previously healthy] men, but not women,” Olynyk says.
  • NPR offers “Advice for trying GLP-1 drugs for weight loss from a doctor who’s been there.”
  • The New York Times reports,
    • “Many older people embrace vaccines. Research is proving them right.
    • “Newer formulations are even more effective at preventing illnesses that commonly afflict seniors — perhaps even dementia.”
  • and
    • “Many Falls Are Preventable. These Tips Can Help. Small changes and good habits make a difference.”
  • The Wall Street Journal reports,
    • When Officer Chelsea Johnston came across a wanted felon one evening in May, Johnston jerked her cruiser in front of him, sprinted after him and tackled him to the ground. Still catching her breath, Johnston motioned for someone to step out of the cruiser: Joy Bogese.
    • “Thank God,” the man said. “It’s you.” 
    • Bogese, who served time for financial crimes that fed a heroin addiction, now spends many of her evenings in a police cruiser as a recovery specialist helping people with addiction get into treatment. The man asked Bogese to help him get into a drug-treatment program at the local jail, where Bogese occasionally facilitates groups. 
    • She is part of a growing effort in Chesterfield County’s [Virginia] fight against addiction. In this county of nearly 400,000, overdose deaths have dropped by half in a single year—about double the decline of the rest of the country—to levels seen before the crisis began in 2015.
    • The precipitous drops have astounded public officials and health-policy experts, who have traveled across the country in an attempt to learn the formula and replicate it. Governors, members of Congress and sheriffs from as far away as Alaska have all come through, along with an acting U.S. drug czar.
  • Per Medscape,
    • “A prospective study found that increased consumption of olive oil was associated with a reduced risk for breast cancer, particularly oestrogen receptor–negative (ER−) and human epidermal growth factor receptor 2–negative (HER2−) breast cancers. A systematic review revealed that case-control studies more frequently reported this protective association, whereas prospective studies did not report any association.”

From the U.S. healthcare business front,

  • Kauffman Hall points out,
    • Mehmet Oz, MD, the new CMS Administrator, in a Senate confirmation hearing, expressed support for exploring multi-year products for Medicare Advantage. While his remarks were made in the context of avoiding unnecessary member churn and associated elevated broker commissions, there are much broader ramifications of transitioning from single-year to multi-year health plan products. His remarks have sparked interest in the industry to explore this idea further.” * * *
    • “Multi-year health plan products have the potential to change a lot about how healthcare business models work today. Given the inherent complexity, it is likely to be a slow journey towards the destination. Even so, incumbent health insurers and risk-bearing providers would be well-advised to start strategizing and building / experimenting with prototypes to manage their risk of being disrupted by multi-year-native health plan innovators. The new administration has already shown that it can move with alacrity and is not afraid to be disruptive in the process. The shift to multi-year plans could come sooner than expected. Or it may not. But in any case, it is better to be prepared.”
  • The FEHB Program was offered on a multi-year basis for two years in the 1980’s although an Open Season was held between the two years in which there were no benefit changes.
  • The Washington Post reports, “Nurse practitioners step in as geriatrician ranks shrink. Nurse practitioners are not trying to replace doctors — they’re trying to meet patients’ needs, wherever those patients are, an expert said.”
  • Per MedTech Dive,
    • “Chris Scoggins is taking the helm of Abbott’s diabetes business at a busy time for the company and the diabetes tech industry. Scoggins was promoted to Abbott’s executive vice president of diabetes care in December. Since then, Abbbott has collaborated with insulin pump firms Tandem Diabetes Care and Sequel Med Tech to integrate its planned glucose-ketone sensor with their devices. 
    • “Scoggins spoke with MedTech Dive about the company’s strategic approach ahead of the American Diabetes Association’s Scientific Sessions in June.”
    • The article includes the interview.

Cybersecurity Saturday

David Ermer–Cybersecurity, Generative AI–

From the cybersecurity and law enforcement front,

  • Cyberscoop reports,
    • “A House panel approved a fiscal 2026 funding bill Monday [June 9, 2025] that would cut the Cybersecurity and Infrastructure Security Agency by $135 million from fiscal 2025, significantly less than the Trump administration’s proposed $495 million.
    • “The chairman of the House Appropriations Subcommittee on Homeland Security, Rep. Mark Amodei, said the annual Department of Homeland Security funding measure “responsibly trimmed” the CISA budget. But Illinois Rep. Lauren Underwood, the top Democrat on his panel, said the legislation “fails to address the catastrophic cybersecurity threats facing our critical infrastructure.”
    • “The subcommittee approved the bill by a vote of 8-4.
    • “CISA would get $2.7 billion under the measure, according to a committee fact sheet, or $134.8 million less than the prior year.
    • “While the full committee chairman Tom Cole, R-Okla., said “the bill provides critical support for cybersecurity technology,” Republicans also criticized the agency’s past work.”
  • and
    • “A familiar face is being promoted from within to lead the FBI’s Cyber division.
    • “In a LinkedIn post Sunday [June 8, 2025], Brett Leatherman said that FBI Director Kash Patel had selected him as assistant director and lead official for the FBI’s primary division for investigating cybercrimes.  The role is prominent in national security, espionage and counterintelligence investigations.” * * *
    • “Leatherman takes over the reins from Bryan Vorndran, who led the bureau’s Cyber Division from 2021 until this past spring when he left the federal government to take a job as Microsoft’s deputy chief information security officer.”  
  • The National Institute of Standards and Technology (NIST) illustrates “19 Ways to Build Zero Trust Architectures.”
    • “The traditional approach to cybersecurity, built around the idea of solely securing a perimeter, has given way to the zero-trust approach of continuously evaluating and verifying requests for access.
    • “Zero trust architectures can help organizations protect far-flung digital resources from cyberattacks, but building and implementing the right architectures can be a complex undertaking.
    • “New NIST guidance offers 19 example zero trust architectures using off-the-shelf commercial technologies, giving organizations valuable starting points for building their own architectures.”
  • Cyberscoop points out,
    • “Federal authorities on Wednesday [June 11, 2025] announced the seizure of about 145 domains and cryptocurrency funds linked to BidenCash, a cybercrime marketplace for stolen credit cards, compromised credentials and other personal information. 
    • “BidenCash was used by more than 117,000 customers, resulting in the trafficking of more than 15 million credit card numbers and personally identifiable information, the Justice Department said. Administrators of the cybercrime platform, which charged a per-transaction fee, generated more than $17 million in illicit revenue since its formation in March 2022, authorities said.
    • “Domains associated with BidenCash now redirect to a server controlled by U.S. law enforcement and display seizure notices. The U.S. Attorney’s Office for the Eastern District of Virginia, which is leading the case, said it seized cryptocurrency funds the BidenCash marketplace used to receive illicit proceeds from its operations.
    • “Authorities did not disclose the value of those seized cryptocurrency funds or identify the physical location of the administrators and infrastructure used by BidenCash. The U.S. Attorney’s Office for the Eastern District of Virginia did not immediately respond to questions.” 
  • Cybersecurity Dive adds,
    • “An international law enforcement operation has dismantled the computer infrastructure powering multiple strains of information-stealer malware.
    • “As part of “Operation Secure,” authorities in 26 Asian countries “worked to locate servers, map physical networks and execute targeted takedowns,” Interpol said in a statement. Law enforcement agencies worked with cybersecurity firms Group-IB, Kaspersky and Trend Micro to prepare assessments of their targets and shared that information with “cyber teams across Asia,” according to Interpol, resulting in “in the takedown of 79 percent of identified suspicious IP addresses.”

From the cybersecurity vulnerabilities and breaches front,

  • The Wall Street Journal reports,
    • “Supermarket shelves are emptying out at some stores around the country, after a cyberattack hit a major distributor to Whole Foods Market and other chains.
    • “United Natural Foods said it detected unauthorized activity on its systems last week and took certain ones offline proactively.
    • “Disruptions to its operations have followed, United Natural said. Stores around the country have reported being unable to place orders. The company has told suppliers that it hopes to restore normal operations by Sunday, according to a notice viewed by The Wall Street Journal.” 
  • CISA added four known exploited vulnerabilities to its catalog this week.
    • June 9, 2025
      • “CVE-2025-32433 Erlang Erlang/OTP SSH Server Missing Authentication for Critical Function Vulnerability 
      • “CVE-2024-42009 RoundCube Webmail Cross-Site Scripting Vulnerability” 
        • The Hacker News discusses these KVEs here.
    • June 10, 2025
      • “CVE-2025-24016 Wazuh Server Deserialization of Untrusted Data Vulnerability
      • “CVE-2025-33053 Web Distributed Authoring and Versioning (WebDAV) External Control of File Name or Path Vulnerability”
        • Akamai discusses the “Wasuh Server” KVE here.
        • Security Week discusses the WebDAV KVE here.
  • Cybersecurity Dive adds,
    • “Government agencies are operating with massive amounts of “security debt” — meaning unresolved vulnerabilities — putting them and the public at increased risk of falling victim to hackers, according to a Veracode report released Wednesday [June 11, 2025]. 
    • “Roughly 80% of government agencies have software vulnerabilities that have gone unaddressed for at least a year, and roughly 55% of them have long-standing software flaws that place them at even greater risk, the report found.
    • “Veracode’s research shows that it takes government agencies an average of 315 days to resolve half of their software vulnerabilities, compared to the combined public- and private-sector average of 252 days.
    • “But companies and agencies alike are falling short of the necessary investments and procedures to address insecure software, according to Veracode.”
  • Dark Reading warns
    • “Secure Shell (SSH) keys are the backbone of secure remote access. They are everywhere, powering DevOps pipelines, enabling server management, and automating everything from deployments to patching. But despite their ubiquity, SSH keys often remain a blind spot in enterprise security. Why? Because unlike passwords, they don’t expire. They are easy to create, hard to track, and alarmingly simple to forget.
    • “In large enterprises, it is not uncommon to find hundreds of thousands or even millions of unmanaged SSH keys. Many of these grant access to sensitive systems but lack clear ownership or life-cycle oversight, turning what should be a secure authentication method into a major risk factor.
    • “If your organization cannot answer “Who can log in to what, using which key?” you are flying blind.”
  • Security Week notes,
    • “More than 40,000 security cameras worldwide are exposed to the internet, cybersecurity firm Bitsight warns.
    • “Operating over HTTP or RTSP (Real-Time Streaming Protocol), the cameras expose their live feed to anyone knowing their IP addresses, directly from the web browser, which makes them unintended tools for cyberattacks, espionage, extortion, and stalking, the company says.
    • “The HTTP-based cameras rely on standard web technologies for video transmission and control and are typically found in homes and small offices.
    • “Of the more than 40,000 cameras exposing their live feed, more than 14,000 are in the US, with Japan ranking second, at roughly 7,000 devices. Austria, Czechia, and South Korea have roughly 2,000 exposed cameras each, while Germany, Italy, and Russia have roughly 1,000 each.
    • “In the US, most of the exposed cameras are in California and Texas, followed by Georgia, New York, and Missouri. Massachusetts and Florida have high concentrations of exposed cameras as well.” * * *
    • “To keep these security cameras protected, users should secure their internet connections, replace default credentials, disable remote access if not needed, keep the devices always updated, and monitor them for unusual login attempts.”
  • and
    • “Trend Micro has released patches for ten vulnerabilities in Apex Central and Endpoint Encryption (TMEE) PolicyServer, including critical-severity flaws leading to remote code execution (RCE).
    • “The update for Apex Central resolves two critical bugs leading to RCE, tracked as CVE-2025-49219 and CVE-2025-49220 (CVSS score of 9.8). The security defects are similar, but were discovered in different methods, the company says.
    • “Both vulnerabilities are described as an insecure deserialization operation that could allow remote attackers to execute arbitrary code on affected installations, without authentication.
    • “Endpoint Encryption PolicyServer received fixes for eight flaws, including four critical and four high-severity defects.”
  • Per Bleeping Computer,
    • “Cloudflare has confirmed that the massive service outage yesterday was not caused by a security incident, and no data has been lost.
    • “The issue has been largely mitigated. It started 17:52 UTC yesterday [June 12, 2025] when the Workers KV (Key-Value) system went completely offline, causing widespread service losses across multiple edge computing and AI services.
    • “Workers KV is a globally distributed, consistent key-value store used by Cloudflare Workers, the company’s serverless computing platform. It is a fundamental piece in many Cloudflare services, and a failure can cause cascading issues across many components.”
    • “The disruption also impacted other services used by millions, most notably the Google Cloud Platform.”

From the ransomware front,

  • The HIPAA Journal informs us,
    • “It has taken three weeks, but Kettering Health has confirmed that it has resumed normal operations for key services following its May 20, 2025, Interlock ransomware attack. Kettering Health has been releasing regular updates on the progress being made restoring its systems, confirming that the core components of its Epic EHR system were restored on the morning on June 2, 2025, which allowed patient data to be entered, and the backlog of data recorded on paper to start to be entered into patient records.
    • “Interlock’s access to its network and system was immediately terminated when the attack was discovered, and Kettering Health confirmed on June 5, 2025, that all of the ransomware group’s tools and persistence mechanisms had been eradicated from its systems. Kettering Health also confirmed that all systems were fully up to date with the latest versions of software installed and patches applied, and security enhancements had been implemented, including network segmentation, enhanced monitoring, and updated access controls. Kettering Health said it is confident that its cybersecurity framework and employee security training are sufficient to mitigate future risks.”
  • Cybersecurity Dive reports,
    • “Ransomware gangs have exploited a vulnerability in the SimpleHelp remote support program to breach customers of a utility billing software vendor, the Cybersecurity and Infrastructure Security Agency (CISA) warned on Thursday [June 12, 2025].
    • “The government advisory follows an earlier warning from CISA and the FBI that hackers associated with the Play ransomware gang had been targeting critical infrastructure organizations using the flaw in SimpleHelp’s remote management software.
    • “The new CISA alert highlights the risks of vendors not verifying the security of their software before providing it to customers.” * * *
    • “In its Thursday alert, CISA said the breach of the utility payment vendor reflected a “broader pattern” of such attacks.
    • “The agency urged “software vendors, downstream customers, and end users to immediately implement the Mitigations listed in this advisory based on confirmed compromise or risk of compromise.” 
    • “Vendors should isolate vulnerable SimpleHelp instances, update the software and warn customers, according to CISA, while customers should determine whether they are running the SimpleHelp endpoint service, isolate and update those systems and follow SimpleHelp’s additional guidance.’
  • Per Bleeping Computer,
    • “Fog ransomware hackers are using an uncommon toolset, which includes open-source pentesting utilities and a legitimate employee monitoring software called Syteca.
    • “The Fog ransomware operation was first observed last year in May leveraging compromised VPN credentials to access victims’ networks.
    • ‘Post-compromise, they used “pass-the-hash” attacks to gain admin privileges, disabled Windows Defender, and encrypted all files, including virtual machine storage.
    • “Later, the threat group was observed exploiting n-day flaws impacting Veeam Backup & Replication (VBR) servers, as well as SonicWall SSL VPN endpoints.”

From the cybersecurity defenses front,

  • Cybersecurity Dive lets us know,
    • “The threat of cyberattacks represents the most serious challenge for businesses in the coming year, the advisory firm Kroll said in a report published Thursday [June 12, 2025].
    • “Roughly three-quarters of respondents said their cybersecurity and privacy concerns had increased over the past year, with nearly half citing malware and more than a third citing data extortion as specific fears.
    • “Kroll’s survey of 1,200 respondents from more than 20 countries, conducted in February, provides some measure of how businesses are thinking about and dealing with cyber worries as global tensions escalate.”
  • and
    • “Artificial intelligence is poised to transform the work of security operations centers, but experts say humans will always need to be involved in managing companies’ responses to cybersecurity incidents — as well as policing the autonomous systems that increasingly assist them.
    • “AI agents can automate many repetitive and complex SOC tasks, but for the foreseeable future, they will have significant limitations, including an inability to replicate unique human knowledge or understand bespoke network configurations, according to experts who presented here at the Gartner Security and Risk Management Summit.
    • “The promise of AI dominated this year’s Gartner conference, where experts shared how the technology could make cyber defenders’ jobs much easier, even if it has a long way to go before it can replace experienced humans in a SOC.
    • “As the speed, the sophistication, [and] the scale of the attacks [go] up, we can use agentic AI to help us tackle those challenges,” Hammad Rajjoub, director of technical product marketing at Microsoft, said during his presentation. “What’s better to defend at machine speed than AI itself?”
  • Dark Reading explains “Why CISOs Must Align Business Objectives & Cybersecurity. This alignment makes a successful CISO, but creating the same sentiment across business leadership creates a culture of commitment and greatly contributes to achieving goals.”
  • Here is a link to Dark Reading’s CISO Corner.

Friday report

David Ermer–ACA, CDC, Congress, COVID-19, FDA, Federal employment benefits, Medical / Rx research, Obesity, Telehealth–
Photo by Sincerely Media on Unsplash

From Washington, DC,

  • Govexec tells us,
    • “On Thursday night, the Senate Homeland Security and Governmental Affairs Committee published its portion of the budget reconciliation bill, which aims to cut federal spending to partially pay for tax cuts for the wealthy and increased immigration enforcement.
    • “Gone from the bill are House-passed provisions that would require all federal workers to contribute 4.4% of their basic pay toward the Federal Employees Retirement System, reduce their FERS benefit calculation from the average highest three years of salary to the highest five years, and eliminate the FERS supplement for employees who retire before Social Security kicks in at age 62.
    • “But in their place is a more draconian iteration of the controversial plan to force future federal workers to choose between a more expensive defined benefit annuity and at-will employment, meaning they can be fired “for good cause, bad cause, or no cause at all.” Under the Senate plan, all new federal hires would pay more than double toward FERS compared to feds hired after 2014—9.4% of their basic pay—and those who elect to accrue civil service protections would pay an additional 5 percentage points on top of that, or 14.4% of basic pay.”
  • Federal News Network adds,
    • “The Trump administration would proceed with plans to downsize the federal workforce and reorganize agencies with minimal interference from Congress, under a Senate committee’s proposal.
    • “The Senate Homeland Security and Governmental Affairs Committee, in its contribution to the budget reconciliation package, would allow the Trump administration to proceed with sweeping changes to the federal workforce — including those currently stalled by federal judges — without approval from Congress.
    • “The committee’s section of the “One Big, Beautiful Bill,” which passed the House last month, also sets aside $100 million for the Office of Management and Budget to oversee and implement the Trump administration’s reorganization plans over the next decade.”
  • Fierce Pharma lets us know,
    • “Independent Sens. Bernie Sanders of Vermont and Angus King of Maine have introduced a bill that would ban pharmaceutical companies from advertising directly to consumers.
    • “The End Prescription Drug Ads Now Act would prevent drugmakers from promoting prescription drugs through television, radio, print, digital platforms and social media.” * * *
    • “The proposal is likely to receive support from the Trump administration.” 
  • KFF released a report about “ACIP, CDC, and Insurance Coverage of Vaccines in the United States.”
  • The Sequoia Blog notes,
    • Recent guidance from the Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), and the United State Preventive Services Task Force (USPSTF) will impact coverage for women that must be provided by group health plans at no-cost, explained further [in the blog post].
  • Radiology Business adds,
    • “Radiology Partners was the No. 1 initiator of No Surprises Act payment disputes in the second half of 2024 with 136,784, according to new data released Wednesday. 
    • “The El Segundo, California-based industry giant accounted for about 15% of all disputes in Q4 of 2024 and 18% in Q3. HaloMD, a San Antonio, Texas, firm specializing in NSA dispute resolutions, was No. 2, initiating 134,318, followed by Knoxville, Tennessee, multispecialty group TeamHealth with 94,598. 
    • “In a summary document, the Centers for Medicare & Medicaid Services highlighted the “high volume of disputes” handled between July 1 and Dec. 31, 2024. Provider groups such as Rad Partners initiated a total of 853,374 disputes through the federal independent dispute resolution (IDR) portal, up 40% from the first half of 2024. Across all of last year, a small number of organizations were responsible for the majority of disputes, CMS noted.
    • “Many of the top initiating parties are (or are represented by) large practice management companies, medical practices or revenue cycle management companies representing hundreds of individual practices, providers or facilities,” the agency said May 28. “The top three initiating parties (Radiology Partners, HaloMD, and TeamHealth) represent thousands of clinicians across multiple states and accounted for approximately 43% of all disputes initiated in the last six months of 2024.”
  • STAT News points out,
    • “The links between ultra-processed food and higher risk of diabetes will be the focus of the first wave of health secretary Robert F. Kennedy Jr.’s national “Take Back Your Health” campaign, according to a notice posted on a government site for contractors.
    • “The notice invites public relations agencies to pitch strategies for the launch of the ad campaign, “a wake-up call to Americans that eating processed foods dramatically increases the risk of diabetes and chronic disease.”

From the Food and Drug Administration front,

  • Per Fierce Pharma,
    • “The FDA has approved Moderna’s mRESVIA for the prevention of lower respiratory tract disease caused by respiratory syncytial virus (RSV) in adults ages 18 to 59 who are at an increased risk for severe disease.
    • “Back in May, mRESVIA scored an FDA approval in adults 60 and older, becoming Moderna’s second commercial product behind the company’s first-generation COVID-19 shot, Spikevax.”
  • and
    • “Despite a recent rebuff from an FDA advisory committee, the first treatment for a specific and underserved cohort of U.S. bladder cancer patients has crossed the FDA finish line as UroGen Pharma’s Zusduri.
    • “The New Jersey-based pharma paired chemotherapy mitomycin with a sterile hydrogel using its sustained-release RTGel technology to create a localized therapy for potent tumor ablation of recurrent low-grade intermediate-risk non-muscle invasive bladder cancer (LG-IR-NMIBC). It’s a drug delivery combo familiar to UroGen from its 2020 approved Jelmyto, another hydrogel and mitomycin pairing formulated as a liquid solution made for delivery in the kidney’s pyelocalyceal system that is indicated for low-grade upper tract urothelial cancer.”
    • “In its phase 3 ENVISION trial, UroGen found that Zusduri could deliver a 78% complete response for patients with LG-IR-NMIBC at three months, with 79% of those patients still event-free 12 months later.”

From the judicial front,

  • The Wall Street Journal reports,
    • “Anne Wojcicki, the co-founder and former CEO of 23andMe, is poised to regain control of the DNA-testing company after a nonprofit she controls topped a prior bid.
    • “23andMe said Friday that a nonprofit backed by Wojcicki was the new buyer for the company’s assets, offering $305 million.
    • “Last month, 23andMe said Regeneron, a biotech based in Tarrytown, N.Y., had won the bidding during a bankruptcy auction to buy the company for $256 million. 
    • “The bidding reopened early this month, after Wojcicki, through her nonprofit, TTAM Research Institute, made the unsolicited offer. TTAM is an acronym that aligns with the first letters of 23andMe.
    • “Regeneron declined to make a bid that topped TTAM’s offer, which is being financed by Wojcicki and her affiliated entities, according to a court filing. The TTAM bid still needs to be approved by the court.”

From the public health and medical research front,

  • The Centers for Disease Control and Prevention announced today,
    • Reported on Friday, June 13, 2025
    • Seasonal influenza activity is low. COVID-19 and RSV activity is very low.
    • COVID-19
      • COVID-19 wastewater activity, emergency department visits, and laboratory percent positivity are at very low levels.
    • Influenza
    • RSV
      • RSV activity is very low.
  • The University of Minnesota’s CIDRAP adds,
    • Dozens of medical and public health organizations have signed a letter urging insurers to continue covering COVID-19 vaccination in pregnant patients.
    • The letter from the American College of Obstetricians and Gynecologists is in response to the recent move by the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) to no longer recommend COVID-19 shots for healthy pregnant women.
  • and
    • “In its latest update on variant proportion estimates, the US Centers for Disease Control and Prevention (CDC) said the level of NB.1.8.1 viruses, recently added as a variant under monitoring (VUM) by the World Health Organization (WHO), has grown from 15% to 37% since late May, bringing it nearly even with LP.8.1, which has been dominant over the last few months.” * * *
    • “The CDC also reported a rise in XFG variant proportions, which rose from 6% to 8% over the same period. Both viruses are descendants of the JN.1 Omicron SARS-CoV-2 variant.”
  • and
    • “The US Centers for Disease Control and Prevention (CDC) today in its weekly measles update reported 29 more cases, bringing the national total to 1,197 cases and coming within 77 cases of matching the total from 2019, which was the most since the disease was eliminated from the country in 2000.
    • “So far, 35 states have reported cases, one more than a week ago, which likely reflects Arizona’s first cases of the year.
    • “Four more outbreaks were reported, bringing the national total to 21. For comparison, the CDC recorded 16 outbreaks for all of 2024. Of measles cases reported this year, 90% have been part of outbreaks. Last year, 69% of the illnesses were related to outbreaks.
    • “School-aged children are the most affected group (37%), followed closely by adults ages 20 and older (33%), and children younger than 5 years old (29%).”
  • The AHA New relates,
    • “The Centers for Disease Control and Prevention has added new resources for health care providers to its Be Ready for Measles Toolkit. They include a decision tree to help providers determine when to give measles, mumps and rubella vaccinations to adults; checklists for summer camps; and immunity records templates.” 
  • CBS News reports,
    • “The average age of moms giving birth in the U.S. continues to rise, hitting nearly 30 years old in 2023, according to a new report from the Centers for Disease Control and Prevention.
    • “In the report, published Friday by the CDC’s National Center for Health Statistics, researchers found the average age of all mothers giving birth in the United States increased from 28.7 years old in 2016 to 29.6 in 2023. For new first-time moms, average age also increased, from 26.6 in 2016 to 27.5 in 2023. The data was taken from the National Vital Statistics System, which includes all birth records in the country.” 
  • The New York Times reports, “In Some Ozempic Households, the Weight Loss Is Contagious. Patients taking the drugs are finding their families are benefiting, too.”
  • Managed Healthcare Executive adds,
    • “Glucagon-like peptide-1 receptor agonists (GLP-1RAs) — a class of drugs typically prescribed for type 2 diabetes and weight loss — may significantly reduce the risk of developing several common age-related eye diseases, including age-related macular degeneration (AMD) and glaucoma, according to a study published online earlier this year in Ophthalmology.
    • “The study, based on an analysis of electronic health records (EHRs) from older patients in the United States, revealed that GLP-1RAs were associated with lower rates of age-related macular degeneration, as well as primary open-angle glaucoma (POAG), when compared with other common medications such as metformin, insulin, statins and aspirin.”
  • Per MedPage Today,
    • Starting fecal immunochemical testing (FIT) at ages 40 to 49 was associated with reduced colorectal cancer (CRC) incidence and mortality compared with starting screening at age 50, a Taiwanese cohort study suggested.
    • Among over 263,000 participants, the incidence of CRC was 26.1 per 100,000 person-years for those who participated in early screening (at ages 40 to 49) versus 42.6 per 100,000 person-years for those who participated in regular screening (at age 50 and older), reported Tony Hsiu-Hsi Chen, PhD, of National Taiwan University in Taipei, and colleagues.
    • The mortality rate was 3.2 per 100,000 person-years for the early screening group compared with 7.4 per 100,000 person-years for the regular screening group, they noted in JAMA Oncology.
  • Per Health Day,
    • “A good number of people don’t know that high blood pressure is a silent killer, increasing a person’s heart risk with no obvious symptoms, a new poll has found.
    • “More than a third of Americans (37%) erroneously think high blood pressure always has noticeable symptoms like dizziness or shortness of breath, according to a survey by the University of Pennsylvania’s Annenberg Public Policy Center.
    • “In truth, high blood pressure usually has no signs or symptoms to indicate its presence, according to the U.S. Centers for Disease Control and Prevention (CDC).
    • “Likewise, nearly 4 in 10 people (39%) mistakenly believe that “feeling calm and relaxed” is an indication that blood pressure is normal, the poll shows.
    • “And very few people — only 13% — know the correct reading that reflects high blood pressure, 130/80, poll results show.
    • “Because controlling blood pressure reduces one’s risk of serious health problems, including heart attacks and strokes, correcting misperceptions about ways to identify it should be a public health priority,” Patrick Jamieson, director of the policy center’s Annenberg Health and Risk Communication Institute, said in a news release.”

From the healthcare business front,

  • The Wall Street Journal reports,
    • “AstraZeneca said it entered into a strategic research collaboration with China’s CSPC Pharmaceuticals, focused on artificial intelligence-driven research, valued at up to $5.33 billion.
    • “The partnership aims to advance the discovery and development of novel oral candidates, with the potential to treat diseases across multiple indications, the British pharmaceutical giant said Friday.
    • “Under the terms of the deal, CSPC will receive an upfront payment of $110 million. It is also eligible to receive up to $1.62 billion in potential development milestone payments and up to $3.6 billion in sales milestone payments, as well as potential single digit royalties based on annual net sales of the products.
    • “The British group will have rights to exercise options for exclusive licenses to develop and commercialize worldwide candidates identified under the agreement.
    • “The research will be carried out by CSPC and will utilize its AI-driven technology.
    • “The collaboration boosts AstraZeneca’s presence in China following the $2.5 billion investment in the country announced earlier this year, while it also strengthens its collaboration with the Chinese group.”
  • Modern Healthcare reports,
    • “Amazon is restructuring its healthcare division and another high-profile executive is departing the company.
    • “As part of the restructuring, Amazon’s Vice President of Health Partnerships and Marketing Aaron Martin is planning to leave the company later this summer after assisting with the transition, according to a person familiar with the situation.
    • “The moves were made to simplify the company’s structure, reduce layers and elevate tenured leaders across six teams, said Neil Lindsay, senior vice president at Amazon Health Services, in a statement on Friday. 
    • “Two of Amazon’s healthcare teams will focus on Amazon’s One Medical virtual and in-person care product, with one focused on clinical care delivery while the other is centered on operations and performance. The four other teams will focus on pharmacy, growth and network development, compliance as well as a segment focused on marketing and technology.”
  • Medscape tells us,
    • “Hospitals are struggling with long emergency room (ER) wait times, capacity issues, and staffing shortages. A growing number of patients with cellulitis, chronic obstructive pulmonary disorder, pneumonia, and other chronic conditions are being asked to skip hospital stays and return home.
    • “Hospital at Home models may be the answer. The explosion of Hospital at Home programs now makes it possible to provide acute level care at home. Today, 378 hospitals in 140 health systems and 39 states have been approved to provide healthcare at home. And a recent report found that 71% of health systems planned to launch Hospital at Home models.
    • “Digital care is the way of the future,” said Melissa Meier, MSN, RN, manager of Digital Care for OSF OnCall, the Digital Health Division for OSF HealthCare in Peoria, Illinois. “We’re always looking at ways to help reach more patients [and] always being on the cutting edge to reach our patients wherever they are is super important…[Hospital at Home] is certainly an answer for that.”
  • Per Beckers Hospital Review,
    • Becker’s has compiled a list of the hospitals with a CMS five-star rating for care transitions.
    • CMS’ “Patient survey (HCAHPS)-Hospital” database listed hospital ratings based on the Hospital Consumer Assessment of Healthcare Providers and Systems survey. This is a national, standardized survey of hospital patients about their experience during a recent inpatient hospital stay. The survey was completed between July 2023 and June 2024. The data was last updated April 30. 
    • [The article lists] the 195 hospitals by state with five-star care transition ratings.
  • Per BioPharma Dive,
    • “Quest Diagnostics has partnered with The University of Texas MD Anderson Cancer Center to develop a cancer risk blood test.
    • “The collaboration, which Quest disclosed Tuesday, builds on MD Anderson’s research into protein biomarkers that may indicate a patient is at high risk of cancer diagnosis in the coming years.
    • “MD Anderson’s approach is potentially a cheaper way than liquid biopsies to find patients who would benefit from conventional screening, according to the announcement. Quest is aiming to launch the test next year.”
  • and
    • “Novo Nordisk is planning Phase 3 clinical trials for a obesity drug combination called amycretin, adding another emerging weight-loss medicine to the list of prospects it has in advanced testing.
    • “The Danish drugmaker said Thursday the trials could begin in early 2026 and will test both an injectable and an oral formulation. In a Phase 2 trial, amycretin helped people with obesity lose up to 22% of their body weight over 36 weeks, topping Novo’s marketed medication Wegovy as well as Eli Lilly’s rival Zepbound.
    • “Amycretin targets GLP-1, as Wegovy does, but also a separate metabolic hormone called amylin that has drawn increasing interest from drugmakers. Earlier this week, shares of Metsera climbed by double digits after the biotechnology company reported promising Phase 1 data for an amylin-targeting agent.”

Thursday report

David Ermer–ACA, Congress, FDA, Generative AI, Medical / Rx research, Patient safety, Telehealth, U.S. Healthcare–
Photo by Josh Mills on Unsplash

From Washington, DC

  • The Wall Street Journal reports
    • “House Republicans narrowly passed a $9.4 billion rescissions package that includes cuts to foreign aid as well as the entity that funds National Public Radio and the Public Broadcasting Service.
    • “The vote was 214-212, after some last-minute arm-twisting by GOP leaders convinced two Republicans to switch their votes to yes from no. All Democrats were opposed. The package now heads to the Senate, where it could face more scrutiny from Republicans.”
  • Beckers Payer Issues tells us,
    • “Proposed changes to Medicare Advantage are unlikely to be included in a final budget deal, The Hill reported June 11. 
    • “Senators had floated adding provisions of the No UPCODE Act, which targets overpayments in the program, to the massive federal budget bill. 
    • “Sen. Kevin Cramer, R-N.D., who first raised the idea of targeting MA savings in the bill, told The Hill the final legislation is unlikely to touch Medicare.”
  • STAT News informs us,
    • The Trump administration is pushing pharmaceutical companies to begin negotiations to bring their drug prices in line with what other countries pay — usually far less than Americans.
    • “Under President Trump’s direction, HHS is demanding that pharmaceutical companies end their obstruction and come to the table—just as they already do with nearly every other economically comparable nation—to negotiate fair, transparent pricing for Americans,” an agency spokesperson said in a statement to STAT, adding that the companies were “prevent[ing] progress of lowering prices for the American people.”
    • “The spokesperson did not immediately clarify how companies were preventing that progress. The administration’s statement comes after pharmaceutical executives said they were expecting more details about the kinds of drugs that would be up for negotiations and the price targets for them. 
    • ‘It also comes after a number of drug companies have met with the administration. At least three firms said this week that talks have not yet gotten into the details of pricing, instead mostly consisting of exchanging high-level ideas about the pharmaceutical market.”
  • The International Foundation of Employee Benefit Plans points out
    • The Internal Revenue Service (IRS) issued 2025 draft 1094-B, 1095-B, 1094-C, and 1095-C forms for use by employers, plan sponsors and group health insurers to report health coverage to plan members and the IRS.
  • Per MedTech Dive,
    • “Medtronic has recalled ventilators and asked customers to stop using the devices because of a fault linked to two serious injuries and one death, the company said Wednesday.
    • “Affected Newport HT70 and HT70 Plus ventilators can shut down during use or fail to effectively sound the shutdown alert alarm. The company also recalled certain related Newport service parts. There have been 63 medical device reports about the problem.
    • ‘The Food and Drug Administration said in a Class 1 recall database entry about the fault this week that 4,842 affected ventilators are in commerce worldwide.”

From the judicial front,

  • Bloomberg Law reports,
    • A trio of air ambulance providers lost [Dropbox link] an appeals court bid to overturn a decision in two surprise medical bill disputes, narrowing the legal path for physicians to challenge alleged malfeasance from health insurers in court.
    • The consolidated case revolves around two conflicting provisions of the No Surprises Act, which requires doctors and insurers to settle unexpected out-of-network bills via arbitration rather than balance billing the patient. 
    • The US Court of Appeals for the Fifth Circuit’s decision accompanies a separate ruling also issued [Dropbox link] Thursday in which the same panel of judges upheld a lower court’s decision, similarly, asserting that surprise billing arbitration disputes may not be addressed through litigation.
    • The Fifth Circuit sided against air ambulance companies Guardian Flight LLC, Reach Air Medical Services LLC, and Calstar Air Medical Services LLC in the consolidated case challenging Aetna Health Inc., Kaiser Foundation Health Plan Inc., and arbitrator Medical Evaluators of Texas ASO LLC over what the providers said were misrepresentations during the arbitration process. 
    • Judges Stuart Kyle Duncan, a Donald Trump appointee, Jerry E. Smith, a Ronald Reagan appointee, and Edith Brown Clement, a George H. W. Bush appointee, also reversed the lower court’s ruling in determining that MET was protected from litigation under the No Surprises Act.

From the public health and medical research front,

  • CBS News reports,
    • “Check your medicine cabinet — Zicam nasal swabs and Orajel baby teething swabs are being recalled due to potential microbial contamination, according to federal health officials.
    • “In an alert from the U.S. Food and Drug Administration, Church & Dwight Co., Inc., the brands’ manufacturer, voluntarily issued the recall after the potential contamination was discovered, which was identified as fungi in the cotton swab components of the products. 
    • “The recalled products include all lots of Zicam Cold Remedy Nasal Swabs (with UPC 732216301205), all lots of Zicam Nasal AllClear Swabs (UPC 732216301656) and all lots of Orajel Baby Teething Swabs (UPC 310310400002). All other Zicam and Orajel products are not affected by this recall, the FDA said.
    • “Consumers with any recalled products should stop using them immediately, the FDA advised.”
  • Health Imaging notes,
    • “New MRI data suggest that patients who weathered severe cases of COVID-19 may sustain long-lasting heart damage. 
    • “Specifically, researchers have uncovered evidence indicating patients who have been hospitalized with the virus may develop long-term left ventricular systolic dysfunction and coronary microvascular dysfunction. These findings were detailed this week in JAMA Network Open, where experts revealed the damage was evident on imaging nearly one year after patients had recovered from their initial infection. 
    • “In long COVID, or postacute sequelae of SARS-CoV-2 infection (PASC), patients commonly experience cardiopulmonary symptoms, including dyspnea, palpitations, chest pain, and fatigue, which impair quality of life and functional capacity,” Jannike Nickander, MD, PhD, with the department of clinical physiology at Karolinska University Hospital, in Sweden, and colleagues noted. “The underlying pathophysiological mechanisms are not fully understood but may stem from myocardial injury sustained during acute COVID-19 due to hypoxia, systemic hyperinflammation, hypercoagulability, and direct viral invasion of endothelial cells and cardiomyocytes.” 
  • Fierce Healthcare relates,
    • “Urine drug test (UDT) data can generate timely estimates of overdose deaths, a new study suggests. 
    • “The study, published in JAMA Network Open by specialty lab Millennium Health and The Ohio State University, aimed to determine whether UDT data could provide near real-time indications of overdose trends. Effective responses to the overdose crisis must be prompt, the study noted, which requires a timely evaluation of current trends. However, current publicly available data on fatal overdoses in the U.S. can lag by at least six months. 
    • “We were determined to close that gap,” Eric Dawson, vice president of clinical affairs at Millennium Health, told Fierce Healthcare. “We wanted to be able to tell people, here’s what’s happening today with overdoses—compared to here’s what you’re being told today happened six months ago.” 
  • The International Foundation of Employee Benefit Plans offers a new look at virtual care.
    • “What’s next for virtual care? One area of focus is the further development of hybrid solutions that offer virtual-first care coupled with in-person clinics. Many vendors are also introducing their own health plan and/or TPA for a virtual-first solution. These can be offered alongside traditional health plans (e.g., not necessarily as a full replacement offering). Supplemental and/or coordinating carrier care management is also an avenue explored by new digital health startups offering virtual care. Another trend influencing virtual care is the development of artificial intelligence (AI) as a tool and the related ability to become more predictive and proactive around population health management and outreach. It will be important, however, for employers to track how these virtual offerings impact quality outcomes, engagement and positive user experience.
    • “Overall, the opportunity is clear—Virtual care as a component of a broader health care system can provide convenient and efficient care while increasing access and lowering costs for employer populations. Integration with in-person care will always be important, but technological developments will pave the way to create a more seamless patient experience.”

From the U.S. healthcare business front,

  • BioPharma Dive reports,
    • “COVID vaccine maker BioNTech is buying rival CureVac, announcing Thursday an all-stock deal weeks before the two companies were due to face off in a German court over potentially billions of dollars worth of royalties related to intellectual property on messenger RNA drugs.
    • “Per deal terms, each CureVac share will be exchanged for about $5.46 worth of BioNTech’s U.S.-listed shares, valuing the company at $1.25 billion. Upon the deal’s close, CureVac shareholders will own between 4% and 6% of BioNTech.
    • “In the early days of the COVID-19 pandemic, BioNTech and CureVac were among the companies racing to develop the first coronavirus vaccines. BioNTech, however, partnered with Pfizer and won approval of the first COVID-19 shot, while CureVac’s program never made it to market. The two companies have since been embroiled in patent litigation.”
  • Per Healthcare Dive,
    • “Cigna unveiled a number of new digital tools on Thursday meant to improve customer experience with its health benefits portal, including a virtual assistant based on generative artificial intelligence.
    • “The rollout — part of the insurer’s larger push to make it easier for members to access and afford the benefits they’re due — also includes a new tool to match patients to in-network providers.
    • “Experts have raised concerns about rising adoption of AI in the healthcare sector due to the technology’s tendency to make mistakes. Cigna said its new features were developed with “rigorous” research and testing within an AI governance framework.”
  • and
    • “Mergers and acquisitions should play an “important role” in Teladoc’s future business strategy, the virtual care firm’s CEO said Wednesday. 
    • “We’re going to make investments not just for the short term, but things that we think are going to start to increase that [total addressable market], start to increase the scope and range of what we can do. And we think that’s the right place to deploy our capital,” CEO Chuck Divita said at the Goldman Sachs Global Healthcare Conference.
    • “The telehealth company has already completed two acquisitions this year, scooping up preventive care firm Catapult Health in February and virtual mental health provider UpLift last month.”
  • Beckers Hospital Review calls attention to “six hospital partnerships and proposed deals that were called off or unwound so far this year”