FEHBlog

Cybersecurity Saturday

David Ermer–Cybersecurity, Generative AI–

From the cybersecurity policy and law enforcement front,

  • Cybersecurity Dive reports,
    • “U.S. government officials said critical infrastructure operators should be on alert for Iranian cyberattacks.
    • “In a threat advisory published Monday [June 30], multiple agencies said Iran might target U.S. firms “for near-term cyber operations” due to “the current geopolitical environment” — a reference to the Trump administration joining Israel’s aerial campaign against Iran’s nuclear program and related assets.
    • “Defense contractors, especially firms that have relationships with Israeli companies, are likely at heightened risk of targeting, according to the advisory.”
  • and
    • “The Department of Justice on Monday [June 30] announced a series of actions as part of an investigation into the North Korean government’s deployment of its citizens abroad to pose as IT workers and illicitly earn money for the regime.
    • “Newly unsealed charging documents describe two separate schemes to trick U.S. companies into hiring people who funneled their paychecks to the North Korean government and exploited their access to the companies’ networks to steal sensitive information and cryptocurrency.
    • “Law enforcement officials, who have repeatedly issued alerts about Pyongyang’s IT worker schemes, warned U.S. businesses on Monday to carefully screen their remote employees to avoid falling victim to similar ruses.
  • Cyberscoop tells us,
    • “The Chinese hackers behind the massive telecommunications sector breach are “largely contained” and “dormant” in the networks, “locked into the location they’re in” and “not actively infiltrating information,” the top FBI cyber official told CyberScoop.
    • “But Brett Leatherman, new leader of the FBI Cyber division, said in a recent interview that doesn’t mean the hackers, known as Salt Typhoon, no longer pose a threat.
    • “While there’s been some debate about whether Salt Typhoon should be getting more attention than fellow Chinese hackers Volt Typhoon — whom federal officials have said are prepositioned in U.S. critical infrastructure, poised for destructive action in the event of a conflict with the United States — Leatherman said the groups aren’t as different as some think.
    • “Salt Typhoon, even though it was [an] espionage campaign, had access to telecommunications infrastructure,” he said. “You can pivot from access in support of espionage to access in support of destructive action.”
  • and
    • “Federal authorities levied sanctions Tuesday on Aeza Group, a bulletproof hosting service provider based in Russia, for allegedly supporting a broad swath of ransomware, malware and infostealer operators.
    • “Aeza Group has provided servers and specialized infrastructure to the Meduza, RedLine and Lumma infostealer operators, BianLian ransomware and BlackSprut, a Russian marketplace for illicit drugs, according to the Treasury Department’s Office of Foreign Assets Control. Lumma infected about 10 million systems before it was dismantled through a coordinated global takedown in May.
    • “The Treasury Department’s action against Aeza Group follows a wave of cybercrime crackdowns across the globe. Prolific cybercriminals have been arrested, and infostealers, malware loaders, counter antivirus and crypting services, cybercrime marketplaces, ransomware infrastructure and DDoS-for-hire operations have all been seized, taken offline or severely disrupted by global coordinated campaigns since May.
    • “Officials accused Aeza Group of helping cybercriminals target U.S. defense companies and technology vendors.”

From the cybersecurity breaches and vulnerabilities front,

  • Cybersecurity Dive informs us,
    • “Australian carrier Qantas said hackers who breached one of its call centers stole a significant quantity of customer data.
    • “The airline said on its website that it detected unusual activity on Monday [June 30] on a third-party platform that one of its call centers used. The airline took immediate action and was able to contain the attack, which it blamed on a criminal hacker.
    • “Qantas said it is investigating the extent of the intrusion but warned that the hackers accessed a “significant” amount of customer data, including names, addresses, phone numbers, dates of birth and frequent-flyer numbers. 
    • “The breach did not compromise any credit card details, personal financial information or passport information, Qantas said, because those are stored in a separate system. The intrusion also did not expect login information for customers’ frequent-flyer accounts.
    • “Qantas said it was working with government authorities, including the Australian Cyber Security Centre and the National Cyber Security Coordinator, as well as independent forensic experts to investigate the breach.
    • “All of Qantas’ systems are now secure and the airline is operating normally, according to the company. It said it was in the process of contacting customers to alert them to the incident.” 
  • Per Security Week,
    • “Missouri healthcare provider Esse Health is notifying over 263,000 people that their personal information was stolen in a disruptive April 2025 cyberattack.
    • “The incident was discovered on April 21 and impacted the organization’s access to the electronic medical record system, while also taking down its phone system.
    • “By May 13, the healthcare provider had restored certain systems and was able to fulfill scheduled appointments or procedures. The phone systems were restored in early June, along with other primary patient-facing network systems, the organization said in an incident notice.
    • “On June 20, Esse Health said its investigation into the attack determined that a threat actor breached its network on April 21 and stole files containing personal information.
    • “The exfiltrated data included names, addresses, dates of birth, Social Security numbers, medical record numbers, patient account numbers, health information, and health insurance details.”
  • and
    • “Benefits and payroll solutions firm Kelly & Associates Insurance Group (dba Kelly Benefits) has informed authorities that a recent data breach impacts more than 550,000 people.
    • “The company revealed in April that hackers had gained access to its systems in December 2024, and an investigation had shown that the threat actor managed to steal files storing personal information.
    • “The incident resulted in the theft of information such as name, date of birth, Social Security number, tax ID number, medical information, health insurance information, and financial account information. 
    • “Kelly Benefits is notifying impacted individuals on behalf of more than 40 affected customers, including Aetna Life Insurance Company, Amergis, Beam Benefits, Beltway Companies, CareFirst, The Guardian Life Insurance Company of America, Fidelity Building Services Group, Intercon Truck of Baltimore, Humana Insurance ACE, Merritt Group, Publishers Circulation Fulfilment, Quantum Real Estate Management, United Healthcare, and Transforming Lives.
    • “Data breach reports submitted by Kelly Benefits to the Maine Attorney General’s Office since early April show that the number of impacted individuals has steadily increased as the company’s investigation progressed.” 
  • The Center for Medicare and Medicaid Services announced on June 30,
    • The Centers for Medicare & Medicaid Services (CMS) is notifying Medicare beneficiaries whose personal information may have been involved in a data incident affecting Medicare.gov accounts. CMS identified suspicious activity related to unauthorized creation of certain beneficiary online accounts using personal information obtained from unknown external sources. CMS takes this situation very seriously. The safeguarding and security of personally identifiable information is of the utmost importance to CMS. 
    • Following detection of the incident, CMS worked quickly to deactivate affected accounts, assess the scope and impact of the compromise, and mitigate the effects on impacted individuals. CMS is working closely with appropriate parties to investigate this situation.
    • Approximately 103,000 beneficiaries may have been impacted. Notifications to affected individuals are being mailed, informing them of the incident, outlining steps being taken to protect their information, and providing guidance on actions they may wish to take. 
  • The Cybersecurity and Infrastructure Security Agency added five known exploited vulnerabilities to its catalog this week.
  • Dark Reading warns
    • “While browser extensions add useful functionality to Web browsers, such as blocking ads, managing passwords, and taking notes, they also increase the organization’s security and privacy risks.
    • “Browser extensions require certain levels of permissions that are attractive to attackers. Some extensions need access to the user’s location, browsing history, or the user’s clipboard to see what data the user has copied. Some extensions go further, requesting access to nearly all of the data stored on the user’s computer as well as the data accessed while visiting different websites. Attackers can exploit extensions with these heightened permissions to access potentially sensitive information, such as Web traffic, saved credentials, and session cookies.
    • “Even extensions with relatively modest permissions can manipulate those permissions to obtain access to the inner workings of every Web page displayed on a user’s screen, warns LayerX CEO and co-founder Or Eshed. LayerX research shows that 53% of enterprise users have installed extensions labeled with “high” or “critical” permissions scope. This is why browser extensions are a prime avenue for exploitation by threat actors, he adds.  
    • “[Attackers] can use it to copy or rewrite data or exploit Web page permissions for even more access,” Eshed says.”
  • Security Week adds,
    • A vulnerability in the Forminator WordPress plugin could allow attackers to take over more than 400,000 impacted websites.
    • A popular form builder plugin with more than 600,000 active installations, Forminator supports the creation of various types of forms, including contact and payment forms, polls, and more.
    • The WordPress plugin was found vulnerable to CVE-2025-6463 (CVSS score of 8.8), an arbitrary file deletion flaw that exists because file paths are not sufficiently validated in a function used to delete a form submission’s uploaded files.

From the ransomware front,

  • Bleeping Computer reports,
    • “The Hunters International Ransomware-as-a-Service (RaaS) operation announced today that it has officially closed down its operations and will offer free decryptors to help victims recover their data without paying a ransom.
    • “After careful consideration and in light of recent developments, we have decided to close the Hunters International project. This decision was not made lightly, and we recognize the impact it has on the organizations we have interacted with,” the cybercrime gang says in a statement published on its dark web leak earlier today.
    • “As a gesture of goodwill and to assist those affected by our previous activities, we are offering free decryption software to all companies that have been impacted by our ransomware. Our goal is to ensure that you can recover your encrypted data without the burden of paying ransoms.” * * *
    • “Threat intelligence firm Group-IB also revealed in April that Hunters International was rebranding with plans to focus on data theft and extortion-only attacks and had launched a new extortion-only operation known as “World Leaks.”
  • Security Week advises,
    • The key tool for surviving ransomware, or any attack scenario, is an IR plan. But an IR plan is only worthwhile if it’s comprehensive, current, and tested. IR plans are not “best practices”, nor singular documents stored in a safe place. They are living resources that require attention and maintenance. In this way, the proof of an IR plan’s efficacy is in that organizational muscle memory – most effectively trained through Tabletop exercises.  So, what are the primary “muscles,” and the repetitive “exercises” in which you can train an organization to respond decisively, immediately, confidently, and automatically.”
      • Plan your workout
      • Warm up
      • Train, recover, repeat
      • Measure your gains 

From the cybersecurity defenses and business front,

  • Withum offers guidance on how to align your firm’s cybersecurity practices with Labor Department best practices for ERISA plan fiduciaries.
  • Per Security Week,
    • Cloudflare has reversed its block on AI-crawling from optional to default, allowing finer grained crawling but only with agreement from all parties concerned.
    • LLMs are what they learn. From their inception the biggest source of learning has been the internet, so there has been a natural tendency for AI developers to scrape the internet as widely as possible.
    • Cloudflare has now introduced an option for their customers to accept or reject website scraping by AI vendors. Hitherto, internet scraping has been a major part of gathering training data for large LLM (gen-AI) developers; but the process has raised questions and objections over legality, copyright infringement, and accuracy.
  • Dark Reading lets us know,
    • “How businesses can align cyber defenses with real threats. Companies that understand the motivations of their attackers and position themselves ahead of the competition will be in the best place to protect their business operations, brand reputation, and their bottom line.”
  • and
    • “One year after a buggy CrowdStrike update knocked IT systems offline, organizations seeking to strike the right balance between security and productivity have viewed the incident as a learning opportunity.
    • “The cost of the CrowdStrike outage was estimated at $5.4 billion, affecting payment systems, airline reservations, and a variety of other industries. The impact of the outage highlights why many operational technology (OT) teams are as sensitive to patches and other updates in their critical infrastructure, as they are highly averse to outages that can happen if such updates are defective.
    • “But when balancing security and productivity, it is imperative not to view the CrowdStrike outage as a reason to forgo patching completely. The ever-growing volume of vulnerabilities and threats requires organizations to remain resilient and anti-fragile — that is, to have the ability to proactively respond to issues and continuously improve.”
  • Per Security Week,
    • “LevelBlue announced on Tuesday [July 1] that it’s acquiring managed detection and response (MDR) services company Trustwave from The Chertoff Group’s MC² Security Fund.
    • “LevelBlue, formerly known as AT&T Cybersecurity, was launched in May 2024 as a joint venture between WillJam Ventures and AT&T. 
    • “The company’s acquisition of Trustwave comes shortly after it announced plans to buy Aon’s cybersecurity consulting business. The deals are part of a plan to become the largest pure-play managed security services provider (MSSP). 
    • “Once the acquisition has been completed, LevelBlue’s expertise in strategic risk management and cybersecurity infrastructure will be integrated with Trustwave’s platform and MDR service.”
  • Here’s a link to Dark Reading’s CISO Corner.

Thursday report

David Ermer–Congress, FDA, Government Contracting, Medical / Rx research, U.S. Healthcare–

Note to readers: There will be no Friday report this week due to the Fourth of July holiday. Happy Independence Day!

From Washington, DC

  • The Wall Street Journal reports,
    • “The House narrowly passed Republicans’ sprawling tax-and-spending bill, delivering a major second-term victory for President Trump and again demonstrating his power to keep GOP lawmakers in line. 
    • “The 218-214 vote Thursday sends the measure to Trump’s desk, ahead of the July 4 target he set for Congress to finish the legislation that cuts taxes, boosts border security and lowers social safety-net spending. Trump and GOP leaders muscled the bill through the House after an all-night session, despite many lawmakers’ misgivings about the version the Senate passed 51-50 earlier this week.
    • “Two Republicans—Thomas Massie of Kentucky and Brian Fitzpatrick of Pennsylvania—voted with all Democrats against the “one big, beautiful bill.” The vote followed a long day of negotiations with conservative and moderate holdouts, as Trump and Speaker Mike Johnson (R., La.) eventually swayed enough members to prevail.
    • “We’ve had spirited debates, we’ve had months of deliberations, and now we are finally ready to fulfill our promise to the American people,” Johnson said.”
  • The Akin Gump law firm offers a summary of the key tax and healthcare provisions of the One Big Beautiful bill.
  • Govexec tells us,
    • “A postal advocacy group is asking the U.S. Postal Service to pause a planned July 13 increase in the price of stamps until after the new postmaster general begins his tenure. 
    • “Keep US Posted, a nonprofit advocacy group that represents consumers, nonprofits and newspapers, among other entities, in a July 3 letter backed a freeze on mailing rates until Waste Management CEO and FedEx board member David Steiner takes the helm of USPS, which is slated for the day after stamps increase to 78 cents. 
    • “We believe it is counterproductive for another postage surge to take place immediately before you undertake leadership of the Postal Service, as it will deprive you of the ability to thoroughly assess, and potentially rectify, one of the most destructive policies in [former Postmaster General Louis] DeJoy’s Delivering for America plan,” wrote former Rep. Kevin Yoder, R-Kan., the executive director of Keep US Posted.” 
  • Bloomberg Law informs us,
    • “The Department of Labor’s federal contractor watchdog will resume action on complaints under regulations prohibiting bias against veterans and disabled workers. 
    • ‘Labor Secretary Lori Chavez-DeRemer lifted a hold on the Office of Federal Contract Compliance Programs’ enforcement work that had been in place since January, the agency said Wednesday. 
    • “The agency’s enforcement of Section 503 of the Rehabilitation Act and the Vietnam Veterans Readjustment Act were paused after President Donald Trump rescinded the decades-old executive order that gave the agency authority to police and audit race and sex bias at companies that do business with the government. 
    • “Enforcement of Section 503 and VEVRAA regulations was not upended by the Trump order since those OFCCP duties were statutorily established.
    • “Chavez-DeRemer said Section 503 and VEVRAA complaints that were held up during the period of abeyance will resume processing immediately and complaints filed during the pause will move forward normally.”
  • Per MedPage Today,
    • The FDA cleared an artificial intelligence (AI)-powered wristband (Felix NeuroAI) to treat upper-limb functional limitations in adults with essential tremor, device maker Fasikl announcedopens in a new tab or window.
    • The noninvasive, wearable peripheral nerve stimulator connects to a cloud-based AI platform and incorporates patient recordings to continuously adjust settings, allowing therapy to be personalized.
    • Essential tremor is one of the most common types of movement disorders, affecting approximately 7 million people in the U.S.

From the public health and medical research front,

  • Health Day warns,
    • “Tens of thousands of people suffer needless heart attacks and strokes every year because they aren’t taking cholesterol-lowering drugs, a new study says.
    • “More than 39,000 deaths, nearly 100,000 non-fatal heart attacks and up to 65,000 strokes in the U.S. could be prevented if people eligible for statins and other cholesterol-lowering drugs were taking them, researchers reported June 30 in the Journal of General Internal Medicine.
    • “Nearly half of Americans (47%) who’ve never had a heart attack or stroke are eligible to take statins under U.S. guidelines, researchers found.
    • But fewer than a quarter (23%) of them have been prescribed the life-saving drugs, results show.
    • “A substantial number of heart attack or stroke survivors also aren’t taking the drugs, even though all are eligible for them under U.S. guidelines, researchers said.
    • “These results add to a growing body of evidence that there are important shortcomings in the quality of care for common and costly chronic diseases such as high cholesterol, and that addressing those shortcomings would yield major public health benefits,” lead researcher Dr. Caleb Alexander, a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, said in a news release.”
  • The New York Times reports,
    • “Screening can be a powerful weapon against cancer, helping catch some tumors months, or even years, before a person would feel sick enough to see a doctor.
    • “There are many different types of cancer, but the U.S. Preventive Services Task Force, a group of independent medical experts, only recommends regular screening for four types: lung, breast, colorectal and cervical. For this quartet, the task force has found that regular screening can save lives without exposing too many people to false alarms, additional testing or unnecessary treatments.
    • “Screening is on the front lines of reducing deaths from cancer,” said Robert Smith, an epidemiologist at the American Cancer Society.” * * *
    • “For some cancer types like skin, oral and bladder, there’s not enough evidence to recommend one way or another. In other cases — like ovarian, pancreatic, testicular, and thyroid cancers — the task force has found that screening people without symptoms can lead to too many false positives and complications without reducing people’s risk of death.
    • “For that reason, the task force recommends against screening older men for prostate cancer but says that men ages 55 to 69 should talk with their doctor to discuss the harms and benefits. Most prostate cancers grow so slowly that they would never be an issue, Dr. Reid said. While screening can find these tumors, it risks a cascade of unnecessary treatments and complications, such as rectal bleeding and impotence.
    • “Sometimes, the treatment is worse than having the cancer,” Dr. Reid said.”
  • and
    • “Drinking is harmful to your health at any age. But as you get older, the risks become greater — even with the same amount of drinks.
    • “Alcohol affects “virtually every organ system in the body,” including the muscles and blood vessels, digestive system, heart and brain, said Sara Jo Nixon, the director of the Center for Addiction Research & Education at the University of Florida. “It particularly impacts older adults, because there’s already some decline or impact in those areas.”
    • “There’s a whole different set” of health risk factors for older drinkers, said Paul Sacco, a professor of social work at the University of Maryland, Baltimore who studies substance use and aging. People might not realize that the drinks they used to tolerate well are now affecting their brains and bodies differently, he said.” * * *
    • “Drinking alcohol can increase the risk of developing chronic conditions like dementia, diabetes, cancer, hypertension and heart disease. But it can also worsen outcomes for the majority of older adults already living with chronic disease, said Aryn Phillips, an assistant professor of health policy and administration at the University of Illinois Chicago who studies alcohol and aging. * * *
    • “If you’re not currently drinking, don’t start,” Dr. Phillips said. And if you do drink, be honest with your doctor about your consumption, and do it in a safe environment, knowing that your tolerance may not be what it used to be, she added.
    • “The answer doesn’t have to be abstinence,” Dr. Nixon said. But healthy aging “probably does not include multiple drinks a day for most people.”
  • Gastroenterology Advisor lets us know, “Development of gallstones and metabolic disorders, including obesity, metabolic dysfunction-associated steatotic liver disease (MASLD), diabetes, and hypertension, are related, according to study results published in Journal of Digestive Diseases.”
    • “The study authors noted, “[W]e revealed a significant increase in the prevalence of gallstone disease in the United States over the past years, which was potentially linked to a rising occurrence of metabolic disorders.” However, they concluded, “Further studies are necessary to evaluate the causal relationship and the underlying mechanisms involved in these conditions.”

From the U.S. healthcare business front,

  • The Wall Street Journal reports,
    • The [One Big Beautiful] bill reduces the power of states to boost Medicaid payments to hospitals. 
    • States have increasingly imposed taxes on hospitals to trigger Medicaid matching funds from the federal government. Hospitals would typically balk at such levies, but in this case hospitals typically get back more money than they pay out in the form of higher payment rates.
    • The megabill reduces the maximum tax rate from 6% of hospitals’ net patient revenue to 3.5% in the 40 states that have expanded Medicaid under the Affordable Care Act. Nonexpansion states will have their state “provider taxes” frozen in place at the time the bill is signed.
  • This is excerpted from a Journal article about corporate winners and losers from enactment of the One Big Beautiful bill.
  • The Journal also discusses “what Trump’s Megabill means for you. How parents, retirees, tipped workers, Medicaid recipients and more will be affected.”
  • Per Beckers Hospital Review,
    • “Hospital and health system margins have stabilized for the moment, but a variety of factors could change that in coming months.
    • “Data from Strata Decision Technology, which gathers information monthly from more than 1,600 hospitals, found health system operating margins were around 1% for the fifth consecutive month in May while hospital margins grew by less than 1%. Hospitals in the West and Midwest reported slight margin declines while hospitals in the South reported 3.6 percentage points gained in average margins; hospitals in the Northeast reported 1.3 percentage point gains.
    • “Hospital size matters as well. Hospitals with 300-499 beds reported average margin increase of 2.6 percentage points while larger hospitals of 500 beds or more reported a 2.6 percentage point average margin decrease in May. The average margin for hospitals with less than 25 beds dropped 3.3 percentage points.
    • “Gross hospital revenue grew consistently as well, but gains were offset by increased expenses. Overall expenses were up nationwide year over year, driven by higher drug costs. Average total drug expenses increased 8.7% over the last year. Month over month, drug expenses jumped 0.7% while other non-labor expenses decreased slightly.”
  • and
    • lists the 18 hospital and emergency department closures in 2025 about which Beckers has reported. Most recently,
      • “St. Louis-based St. Luke’s Des Peres Hospital, a 143-bed acute care facility, will close on Aug. 1 due to low utilization and increased financial pressures.
      • “Stilwell (Okla.) Memorial Hospital and its clinic shuttered, ABC affiliate KTUL reported June 21. An employee told the news outlet the hospital will close June 27 and the clinic will shut down 30 days later.”

Midweek report

David Ermer–CDC, CMS, Congress, Medical / Rx research, Medicare, NIH, OPM, U.S. Healthcare–

From Washington, DC,

  • The Wall Street Journal reports,
    • “House Republican leaders worked to win over GOP critics of President Trump’s sprawling domestic-policy bill (Senate amendment to H.R. 1) headed into crucial votes expected later Wednesday.
    • “Dozens of lawmakers had raised complaints about the revised “big, beautiful bill,” which passed the Senate a day earlier, with fiscal hawks wanting deeper spending reductions and moderates worried about cuts to the social safety net. 
    • “I feel very positive about the progress,” said House Speaker Mike Johnson (R., La.), who has been meeting with lawmakers all day. “I feel good about where we are and where we’re headed,” he said.” 
  • P.S. The Wall Street Journal reports Thursday morning that the bill cleared another procedural hurdle, passing H.R. Res. 566 which creates a rule for House consideration of H.R. 1. The House now can hold a final vote on the bill on Thursday.
  • Per a Senate news release,
    • “On Wednesday, July 9, the Senate Health, Education, Labor, and Pensions (HELP) Committee will hold a hearing to examine the future of health care, and how to improve cybersecurity to better protect Americans’ health privacy. This hearing will take place directly after the Committee vote on the nomination of Susan Monarez to be Director of the Centers for Disease Control and Prevention.“
  • Govexec reports,
    • Across the federal government, tens of thousands of blue-collar federal employees are still waiting on their 2025 pay raise, all because of Defense Secretary Pete Hegseth’s purge of advisory committees as the Pentagon.
    • For most federal employees, receiving their share of the (mostly) annual across-the-board pay increase is a simple process. The president issues an alternative pay plan—to avoid massive automatic increases due to the Federal Pay Comparability Act—or Congress stipulates in appropriations legislation how it would override the president, and then the Office of Personnel Management publishes new pay tables in time for the first full pay period in January.
    • Raises for blue collar federal workers, hired under the Federal Wage System, are based on an extrapolation of those pay raises along with a series of wage surveys conducted by the Department of Defense Wage Committee. The committee then votes to implement wages region by region over the course of the year.
    • But in March, Hegseth issued a memo instructing all advisory committees within the Defense Department to halt operations for a 45-day review to “ensure that the department’s advisory committee efforts align with our most pressing strategic priorities.” At the conclusion of that six-week period, Hegseth purged all the members of the Pentagon’s advisory panels and ordered the recommendation of new members within 30 days.
    • As a result, the wage committee, whose members are required by federal regulations to consist of three agency officials and two union leaders, has been unable to meet. According to data provided by the Defense Civilian Personnel Advisory Service and the American Federation of Government Employees, the panel’s shuttering has stalled pay raises for blue collar feds in 87 of the 248 local wage areas, or roughly 60,000 workers.
  • and
    • “The Office of Personnel Management has started to go down a different path than the one it started on in early May when they attempted a sole-source human resources management software contract with Workday.
    • “OPM announced its intentions to award that contract to Workday on May 2 and then cancelled it within the following week. Industry backlash ensued after the initial decision on the sole-source contract, which was set up to help OPM meet the Trump administration’s July 15 deadline for having a new HR system in place.
    • “OPM now appears to be starting on a more traditional procurement process and has scheduled an industry engagement event for July 9-10, according to a Tuesday Sam.gov notice.
    • “The government is now looking at the end of 2028 as its target date to have a new HR management system scaled across all agencies, the notice says.”
  • The American Hospital Association News tells us,
    • “The Departments of Justice and Health and Human Services today announced the creation of the DOJ-HHS False Claims Act Working Group to combat health care fraud. The group will be jointly led by the HHS General Counsel and the Deputy Assistant Attorney General of the DOJ’s Commercial Litigation Branch and include participants from the Office of Counsel to the HHS Office of Inspector General, DOJ’s Civil Division, the Centers for Medicare & Medicaid Services’ Center for Program Integrity and designees representing U.S. Attorneys’ Offices.
    • “The working group’s priority areas for enforcement include Medicare Advantage; drug, device or biologics pricing; barriers to patient access to care; kickbacks related to drugs, medical devices, durable medical equipment, and other products paid for by federal health care programs; materially defective medical devices impacting patient safety; and manipulation of electronic health records systems to drive inappropriate usage of Medicare-covered products and services. The working group is encouraging whistleblowers to identify and report violations of the FCA related to those priority enforcement areas.”
  • Healthcare Dive adds,
    • “The HHS wants to move oversight of 340B from the Health Resources and Services Administration to the CMS, a move that could prove negative for the the two-thirds of U.S. hospitals that rely 340B to fund patient services, cover uncompensated care and, in some cases, keep their doors open.
    • “The potential change is putting providers on edge. And covered entities are right to be worried, given the CMS’ bellicose history with the program, according to experts.
    • “This could be truly devastating for some of these covered entity providers,” said Sarah Bowman, a principal with public accounting firm PYA who advises hospitals and health systems on 340B compliance.
    • “But increased scrutiny of how 340B dollars are being generated and used is probably a good thing, especially amid mounting evidence of fraud and abuse in the drug discount program.”

From the Food and Drug Administration front,

  • The Wall Street Journal reports,
    • “Regeneron Pharmaceuticals has won Food and Drug Administration accelerated approval of its Lynozyfic treatment for certain patients with the blood cancer multiple myeloma.
    • “Regeneron on Wednesday said the FDA green light covers Lynozyfic in adults with relapsed or refractory multiple myeloma who have received at least four prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent and an anti-CD38 monoclonal antibody.”
  • Cardiovascular Business informs us,
    • “The U.S. Food and Drug Administration (FDA) is alerting the public about a new safety issue associated with Johnson & Johnson MedTech’s Automated Impella Controller (AIC). The device displays patient data when the company’s line of Impella heart pumps are being used to provide mechanical circulatory support. 
    • “Johnson & Johnson MedTech has received reports of the AIC not detecting the heart pumps when they are connected. If the connection fails without the user noticing immediately, the FDA said it “may result in inadequate hemodynamic support.” 
    • “Patients in cardiogenic shock are at increased risk, as prolonged episodes of inadequate support may not be well tolerated and may lead to life-threatening injuries,” the agency warned in a new advisory.
    • “The issue can occur with all versions of the Impella technology. As of June 13, three patient deaths have been linked to this connection issue. 
    • “Johnson & Johnson MedTech sent a letter to all affected customers, highlighting the importance of keeping a backup AIC on hand. The company also provided specific details about what to look for during console-to-console transfers and the start of each case.” 
  • The AHA News adds,
    • The Food and Drug Administration has issued early alerts for certain Spectrum infusion pumps from Baxter and Abiomed Automated Impella Controllers. The agency said the affected infusion pumps may have an incorrect version of software, while the Abiomed product may not detect an Impella pump when connected.
  • BioPharma Dive calls attention to five FDA decisions to watch out for in the third quarter of 2025. “The agency is set to decide by September on new therapies for Duchenne cardiomyopathy, multiple myeloma and spinal muscular atrophy.”

From the judicial front,

  • Fierce Healthcare reports,
    • “Doctors for America, the Main Street Alliance and three cities have sued the Centers for Medicare & Medicaid Services (CMS) [in Baltimore, Maryland federal court] over a recent Affordable Care Act (ACA) final rule the agency said will help counter improper enrollments.
    • “The plaintiff cities named in the lawsuit are Baltimore, Chicago and Columbus.
    • “The groups and cities say the regulation will cause upward of 1.8 million Americans to lose coverage in 2026, leading to downstream raised premiums and out-of-pocket costs.”
  • MedTech Dive relates,
    • “A bankruptcy judge approved the sale of 23andMe to a nonprofit led by Anne Wojcicki, co-founder and former CEO of the genetic testing company. 
    • “U.S. Bankruptcy Judge Brian Walsh issued an order on June 27 approving the sale to the nonprofit TTAM Research Institute, adding that all objections to the sale are denied unless otherwise noted. In June, TTAM won a bid to buy the company for $305 million.
    • “States that have filed privacy objections, saying the sale does not comply with their state’s privacy laws, have until July 7 to be granted a stay to appeal the case, Walsh ruled.  California, Kentucky, Tennessee, Texas and Utah have said that the proposed sale would violate their genetic privacy statutes because 23andMe does not propose to seek opt-in consent from every customer in their states.”

From the public health and medical research front,

  • The University of Minnesota’s CIDRAP points out,
    • “In its weekly update today, the US Centers for Disease Control and Prevention (CDC) reported 40 more measles cases today, boosting the number of infections this year to 1,267, which is just 8 shy of passing the total in 2019, which was the highest since the disease was eliminated in the country in 2000.
    • “Though the large outbreak in West Texas has slowed substantially, the number of smaller outbreaks and travel-related cases continues to grow. The CDC this week reported 4 more outbreaks, raising the national total to 27. So far this year, 88% of confirmed cases have been linked to outbreaks. For comparison, the United States had 16 outbreaks for all of 2024.”
  • Per Health Day,
    • “The COVID-19 pandemic took a toll on Americans’ guts, researchers report.
    • “Gut disorders like irritable bowel syndrome (IBS) increased significantly during the COVID-19 pandemic, a new study says.
    • “Rates of IBS nearly doubled among U.S. adults, rising from around 6% in May 2020 to about 11% in May 2022, results show.
    • “Other gut health problems like constipation also increased, researchers report in the journal Neurogastroenterology & Motility.”
  • Per an NIH news release,
    • “Scientists at the National Institutes of Health (NIH) and their colleagues at the University of California, San Diego, have found that fine-particulate air pollution, which includes pollution from vehicles and industry, was strongly associated with increased genomic changes in lung cancer tumors among people who have never smoked. By assembling the largest-ever whole-genome analysis of lung cancer in individuals who have never smoked, researchers were able to link air pollution exposure to increased cancer-driving and cancer-promoting genetic mutations. This could potentially lead to more prevention strategies for never-smokers.
    • “Researchers analyzed lung tumors from 871 never-smoker patients across 28 geographic locations worldwide as part of the Sherlock-Lung study. They found associations between air pollution exposure and changes in the TP53 gene, and other genetic mutational signatures previously associated with tobacco smoking. They also observed a relationship between air pollution and shorter telomeres, which are sections of DNA found at the end of chromosomes. Telomeres shorten naturally with age and shorter telomeres are related to cells inability to continue to replicate. However, scientists found fine particulate air pollution was linked to premature shortening of telomeres.
    • “Prior genomic studies of lung cancer have focused on tobacco smokers, leaving a significant gap in our understanding of how lung cancer develops in people who have never used tobacco. By beginning to uncover the mechanisms through which tissues acquire cancer-causing or cancer-promoting mutations following environmental exposures, this study helps scientists better understand the primary drivers of lung cancer in this population—which represents up to 25% of all lung cancer cases globally.
    • “Interestingly, the researchers found that while exposure to secondhand smoke was associated with slightly higher mutation burdens and shorter telomeres, compared to tumors in patients who were not exposed, it did not lead to an increase in cancer-driving mutations or mutational signatures. This suggests that secondhand smoke may have a lower overall ability to cause genetic mutations, known as mutagenicity, compared to air pollution.
    • This work was led by researchers at NIH’s National Cancer Institute and the University of California, San Diego, and published in Nature on July 2, 2025.”
  • Per STAT News,
    • “An experimental psychedelic therapy from the U.K. company Beckley Psytech significantly reduced symptoms of treatment-resistant depression in a mid-stage trial, newly released data show, raising expectations for a class of drugs racing toward potential approval by U.S. regulators. 
    • “Companies like Beckley, Atai Life Sciences, and Compass Pathways — the first two are in the process of merging — are now vying to bring psychedelic therapies to market at a time when the regulatory and political climate seems to be shifting. The industry has backing from members in both parties, and several psychedelics-friendly figures have been appointed to policy roles under health secretary Robert F. Kennedy Jr.”
    • “In a Phase 2b clinical trial, Beckley’s compound, BPL-003 — an intranasal formulation of mebufotenin, a short-acting compound related to the psychedelic DMT — led to a reduction of 12.1 and 11.1 points on a standard clinical measure of depression called the MADRS scale at day 29, depending on dose. That compares to a 5.8 reduction in the low-dose comparator group, meeting the trial’s primary and key secondary endpoints. There were 193 participants in the study.
    • “This is good news for the field,” said Boris Heifets, an anesthesiologist at Stanford University who studies psychedelic drugs but is not involved with Beckley. “The market may react — people want a miracle, where a single dose is going to undo years of bad living and mood disorders and trauma. That’s unlikely. … [This] suggests moderate efficacy, sustained improvement, and safety.” 
  • BioPharma Dive discusses, “Sodium channel blockers for pain: New opportunities after Vertex’s ‘watershed’ moment. The success of Vertex’s opioid alternative Journavx could aid a group of biotechs that aim to take a similar development path with NaV1.8 and NaV1.7 inhibitors.”
    • “In January, the Food and Drug Administration approved this molecule [Nav1.8], known commercially as Journavx, as a treatment for the sharp, short-lived “acute” pain felt after an accident or surgery. Ken Harrison, a senior partner at Novo Holdings, said a core reason his firm decided to back SiteOne was that Vertex had established these drugs can be successfully studied and brought to market.
    • “While Journavx has so far proven remarkably safe and absent of addictive properties, doctors remain torn about how useful it will ultimately be for patients. At its best, the drug looks to be only as potent as a weak opioid. At least 5,800 Journavx prescriptions were written during the third week of June; millions more will need to come for it to meet Wall Street’s blockbuster forecasts.
    • “Still, TD Cowen analysts recently described the drug’s approval as a “watershed moment that could pave the way for a new era of non-opioid pain treatments.” Indeed, SiteOne and at least 10 other developers want to follow in Vertex’s footsteps with their own medicines that stopper either the “NaV1.8” sodium ion channel, as Journavx does, or a close cousin, “NaV1.7.”
  • Drug Topics adds,
    • ‘Interventions targeted at inappropriate prescribing can be implemented to safely reduce the number of medications that are prescribed to older adults in primary care settings, according to results of a review in JAMA Network Open. Investigators said future studies should evaluate interventions using standardized criteria and reports on potential harm.” * * *
    • “One intervention could include medication reviews, which can be incorporated as usual care. In one study, investigators implemented MedReviewRx, an application that analyzes a person’s medications and medical conditions to produce a report that simplifies the regimen and enhances safety. Deprescribing interventions, which consists of identifying and discontinuing drugs when the harms outweigh the benefits, is another method that can be effective.”
    • “Community pharmacists are aptly positioned to lead deprescribing efforts. Deprescribing is reliant on individual patients, so pharmacist-led deprescribing can help to reduce the number of medications in an effective way, as pharmacists are the medication experts. Future research should utilize pharmacists’ knowledge to improve health outcomes, especially for older patients and deprescribing efforts.”

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • “Value-based care platform Astrana Health acquired some of Prospect Health’s assets Tuesday for $708 million.
    • “The deal includes Prospect Health Plan, Prospect Medical Groups, management services organization Prospect Medical Systems, pharmacy RightRx and Foothill Regional Medical Center in Tustin, California. 
    • “Astrana announced in November it would acquire Prospect Health’s assets for $745 million. Astrana said the lower purchase price announced this week reflects its “commitment to disciplined capital deployment,” but the company is still confident in Prospect’s potential value, according to a Wednesday news release.”
  • Per Fierce Healthcare,
    • “Private equity investor Nordic Capital has acquired healthcare data analytics company Arcadia. Nordic will become the company’s majority owner, which marks an exit for former investor Peloton Equity.
    • “Financial details of the deal were not disclosed.
    • “Arcadia offers a healthcare data platform that integrates data from across the industry and uses artificial intelligence, advanced analytics and performance benchmarks to help insurers and healthcare organizations improve outcomes and quality and save money.” * * *
    • “Nordic Capital’s investment is a powerful endorsement of the strength of Arcadia’s platform and confidence in our ability to deliver value by improving outcomes and reducing costs,” said Michael Meucci, president and CEO of Arcadia, in a statement. “This milestone marks a new phase of growth for Arcadia, grounded in the same mission, but with even stronger backing to scale smarter, invest faster, and accelerate innovation to meet the growing demand for data-driven intelligence in healthcare.”
    • “Arcadia works with national and regional health systems and payers, along with governmental organizations, including Aetna, Highmark Blue Cross Blue Shield, Intermountain Health, Ochsner Health, and the State of California. Arcadia’s portfolio of provider, payer, government and life science customers totals nearly 200.”
  • and
    • “Cadence, a remote monitoring service provider, has stealthily created an advanced primary care business to help health systems provide better care with artificial intelligence and connected devices.
    • Reimbursement continues to decline for physicians, and primary care providers are among some of the lowest-paid providers in healthcare, according to the Assistant Secretary for Planning and Evaluation. Yet, the specialty is of immense import for identifying chronic diseases, annual wellness exams and treating mental health and substance use disorders. 
    • “The Centers for Medicare and Medicaid Services (CMS) has undertaken a variety of initiatives to enhance access to primary care, including through models at its innovation center. CMS took decisive action on the matter when it created the Advanced Primary Care Model (APCM) in November 2024, under its annual physician fee schedule (PFS). Payments for APCM went live on Jan. 1, 2025, with the aim of providing longitudinal primary care for Medicare beneficiaries.”
    • “The APCM model is an additional monthly bundled payment that promotes the ongoing relationship between primary care providers and patients. It pays for things like having 24/7 access to the provider’s team, coordinating care within a week of a hospital discharge, home visits, expanded hours and secure messaging options.”

Tuesday report

David Ermer–Congress, HSA, Medical / Rx research, NIH, Obesity, OPM, SCOTUS, SDOH, U.S. Healthcare–

From Washington, DC,

  • The Wall Street Journal reports,
    • “The Senate passed President Trump’s tax-and-spending bill [(HR 1)] by a 51-50 vote, with Vice president JD Vance breaking the tie.
    • The bill extends tax cuts, reduces Medicaid spending and increases funding for defense and border enforcement.
    • The House will now vote on the bill, facing internal GOP divisions over Medicaid changes and spending cuts.
  • House of Representatives will convene for legislative business at 9 am on Wednesday morning. The House Rules Committee met about the Senate amendment to HR 1 this afternoon.
  • Reuters tells us,
    • “President Donald Trump‘s administration on Tuesday reported having 2.3 million people on federal payrolls in March, almost unchanged from prior months despite the Republican’s efforts to shrink the size of government.
    • “The Office of Personnel Management, which functions as the HR department for the federal government, published figures on Tuesday on hiring and firing across thousands of government offices, with growth in some areas of government largely canceling out cuts elsewhere.
    • “Overall, the number of federal jobs – excluding postal workers and the military – was down about 23,000 from September, the last published report on overall staffing levels.
    • “To be sure, the numbers are only through March and Trump, who took office in January, has continued efforts to shrink the federal workforce. The administration has signed deals, for example, with at least 75,000 federal workers, agreeing to pay them for several months before they resign. A spokesperson at the Office of Personnel Management said hundreds of thousands of such workers will drop off federal payrolls in October.”
  • NextGov/FCW adds,
    • “The Office of Personnel Management plans to update FedScope, the government’s portal for statistics on the federal civilian workforce, it announced on Tuesday.
    • “In the coming months, OPM will launch a newly designed platform featuring interactive visuals, detailed datasets, and tools tailored to answer the most frequently asked questions about federal employment,” OPM said in a press release, previewing a fall 2025 update to the website. 
    • “A banner on the website also hints at more regular updates, saying that “beginning this fall, Federal Workforce Data will be routinely available in an easily accessible, reimagined format.”
  • Mercer conveniently summarizes the 2026 inflation-adjusted amounts for health savings accounts (HSAs), high-deductible health plans (HDHPs) and excepted-benefit health reimbursement arrangements (HRAs) along with the 2024 and 2025 figures.
  • The Justice Department and the Federal Trade Commission held listening sessions yesterday and today about lowering drug prices for Americans through competition.

From the judicial front,

  • The Washington Examiner informs us,
    • “The Supreme Court on Monday [June 30] wiped away a series of lower court decisions that favored transgender litigants, sending the cases back to the appellate level for reconsideration in light of the court’s recent ruling upholding a Tennessee ban on puberty blockers and hormone therapy for minors.
    • “The 6-3 decision in United States v. Skrmetti, handed down June 18, marked a major victory for state-level efforts to restrict transgender procedures for minors. The ruling has now prompted the justices to vacate multiple decisions from lower courts in cases involving health benefits and birth certificate policies for people who identify as transgender.
    • “In an order list issued Monday morning, the high court overturned appellate rulings that previously blocked state-level bans or coverage restrictions for transgender-related care in North Carolina, West Virginia, Idaho, and Oklahoma. The move means each case must now be reheard under the legal standard articulated in the Skrmetti ruling, which found no violation of the Constitution’s equal protection clause in a ban on medical treatments for minors who identify as transgender.
    • “The high court also declined to take up a separate appeal from Kentucky, where families challenged the state’s similar law banning transgender procedures for minors.”
  • The Court also denied reviewing two Flower court decisions holding that the Tennessee law did not violate the 14th Amendment’s due process of law clause.
    • S. Ct. Case No. 23-466 L. W., ET AL. V. SKRMETTI, JONATHAN, ET AL.
    • S. Ct. 23-492 DOE, JANE, ET AL. V. KENTUCKY
  • Fierce Healthcare lets us know,
    • “Mass layoffs and reorganization of the Department of Health and Human Services (HHS) stalled out in federal court, as a Rhode Island federal judge sided with a coalition of 19 state attorneys general against subagencies Tuesday.
    • “Filed in early May, the Democratic attorneys general argued recent actions signed off upon by HHS leadership were unconstitutional and illegal, reported Fierce Biotech. The judge agreed, granting a preliminary injunction to halt the changes. The government must file a status report by July 11.
    • “The Executive Branch does not have the authority to order, organize, or implement wholesale changes to the structure and function of the agencies created by Congress,” said U.S. District Judge Melissa Dubose, concluding her decision.”
  • Yesterday was the effective date of the Iowa PBM reform law.  Also, yesterday, a group of employers lead by the Iowa Association of Business and Industry obtained a temporary restraining order against this law, Dropbox link to TRO order.  A preliminary injunction hearing is set for July 14. Here’s a link to an MSN article on this decision.

From the public health and medical research front,

  • Prime Therapeutic relates,
    • Only 8% of individuals (or 1 in 12) initiating a glucagon-like peptide-1 (GLP-1) agonist drug for obesity without diabetes continued to do so at three years, according to the latest real-world research from pharmacy solutions partner Prime Therapeutics LLC (Prime). Meanwhile, individuals who took a high-potency GLP-1 drug approved for obesity — such as semaglutide (Wegovy®), which is now more commonly used to treat the condition — had greater persistence at 14% three years after initiating therapy. 
    • While overall persistence continues to decrease among those taking high-potency GLP-1 products after three years, persistence among those taking the drugs over a one-year period improved throughout the span of the study. For those initiating GLP-1 therapy in 2021, 33% were persistent, while in the first quarter of 2024, 63% of new initiators were persistent. This increase is believed to be largely attributed to resolving GLP-1 drug shortages in 2024.  * * *
    • “In addition to persistence and adherence insights, the Year-3 study found 38% of individuals switched GLP-1 products during the three years of study. The mean age of individuals within the same cohort is 47 years old and nearly 80% identified as female. 
    • “For additional information and study design details, refer to Prime’s Year-3 abstract.”
  • Axios adds based on a Fair Health study that “Women approaching menopause drive GLP-1 boom.”
  • Medscape points out,
    • “A report comparing childhood obesity prevalence before the COVID pandemic and since the height of the pandemic shows a dramatic rise in the numbers for Black children and Black adolescents with obesity. Findings were published in the Annals of Internal Medicine.
    • “Researchers, led by Michael Liu, MD, MPhil, with the Center for Outcomes Research at Beth Israel Deaconess Medical Center in Boston, found that overall, the prevalence of obesity didn’t change significantly. Prevalence was 20.3% from January 2011 to March 2020, when COVID shutdowns began, and rose to 22.0% from August 2021 to August 2023. But after accounting for secular trends, “no overall increase in obesity prevalence was seen during the pandemic relative to the pre-pandemic period (adjusted difference, 0.52 percentage points; 95% CI, 2.3-3.3 percentage points).
    • “Pandemic-related increases in obesity prevalence were observed only in Black children and adolescents, the authors wrote, for whom rates were 22.4% in the decade before the pandemic and 35% in the 2 years after the height of COVID.”
  • Per Health Day,
    • “Regular exercise can ease mood disorders in children and teens, offering an alternative to medications like antidepressants, a new evidence review has concluded.
    • “Both anxiety and depression decrease when kids take part in structured exercise programs, researchers reported June 26 in Journal of the American Academy of Child & Adolescent Psychiatry.
    • “Further, the review found that anxiety and depression symptoms are relieved by different types of workout regimens.
    • “Exercise is a low-cost, widely accessible strategy that could make a real difference to children’s mental health,” lead investigator Ben Singh, a research fellow with the University of South Australia, said in a news release.
    • “Importantly, exercise could help improve kids’ moods without resorting to drugs like antidepressants, researchers added.”
  • Per Infectious Diseases Advisor,
    • “Adults aged 50 to 64 years and younger adults with chronic conditions are at increased risk for influenza-associated hospitalization and death, but this risk could be mitigated through the use of recombinant influenza vaccines (RIV). These results were published in Clinical Infectious Diseases.”
  • Healio reports,
    • “Nearly three-quarters of infants were immunized against respiratory syncytial virus through maternal vaccination or nirsevimab during the first season those products were available, according to data from 10 U.S. health systems.
    • “The overall immunization coverage for infants across these health systems was higher than expected based on the limited data available from single state studies and surveys,” Stephanie A. Irving, MHS, research associate at the Kaiser Permanente Center for Health Research in Portland, Oregon, told Healio.”
  • MedPage Today notes,
    • “In a European study, higher consumption of fruits, vegetables, legumes, and potatoes was associated with a reduced risk of Crohn’s disease.
    • “High potato consumption, meanwhile, was tied to an increased risk of ulcerative colitis.
    • “The study findings may be especially relevant for children and other first-degree relatives of people with inflammatory bowel disease, researcher says.”
  • and
    • “More than half of 95 centenarians had a low amyloid load and 9% had no amyloid, autopsy data showed.
    • “A third of centenarians had a high amyloid load comparable to Alzheimer’s disease.
    • “Five centenarians maintained high cognitive performance despite a high amyloid load.”
  • NIH Research Matters covers the following topics this week: “Home test kits for cervical cancer | Education and mortality trends | Exercise and Alzheimer’s disease.”
  • CIGNA writes in LinkedIn about why it matters to close the women’s health gap in our country.
  • MedTech Dive reports on the scientific sessions at the American Diabetes Association’s conference held last month.

From the U.S. healthcare business front,

  • STAT News reports,
    • “Centene has withdrawn its financial guidance for the rest of the year after receiving data that showed its health insurance members in Affordable Care Act plans are getting a lot more care than the company had anticipated.
    • “The company is also seeing a “step-up” in medical costs among its Medicaid enrollees. Centene’s stock plummeted 23% in after-hours trading Tuesday.”
    • “The surprise disclosure may be just the beginning of problems for Centene and other insurers that rely heavily on government health care enrollees. Centene gets a majority of its revenue from ACA and Medicaid plans. Despite Centene’s pleas to Republicans not to cut the taxpayer-funded programs, Republicans are advancing a bill that would result in the largest cut ever to Medicaid.” 
  • Healthcare Dive calls attention to “six ways employers can lower healthcare costs in 2025. ‘Employers have absorbed the majority of cost increases over the past four years, and they likely cannot continue to do so,’ one expert said” and provides an updated guide to top healthcare conferences in the second half of 2025.
  • MedCity News discusses “Innovative Strategies to Enhance Financial Predictability for Self-Funded Employers. Too often, the very systems meant to provide flexibility and control are undermined by delayed reimbursements, fragmented data, and a lack of transparency across the ecosystem. Solving this isn’t about tweaking the status quo, it requires a full redesign.”
  • Modern Healthcare tells us,
    • Ascension Health has sold four Michigan hospitals to Beacon Health System. 
    • The transaction closed Tuesday and includes four hospitals — Borgess Hospital in Kalamazoo, Borgess Allegan in Allegan, Borgess-Lee in Dowagiac and Borgess-Pipp in Plainwell — plus 35 outpatient clinics and an ambulatory surgery center, according to a Tuesday news release from Beacon. Beacon is rebranding the Ascension Southwest Michigan hospitals to Beacon Kalamazoo, Beacon Allegan, Beacon Dowagiac and Beacon Plainwell.
    • “The deal was announced in April. It brings more than 2,700 employees, including 259 providers, into the Beacon system, according to the release.
    • “South Bend, Indiana-based Beacon operates 11 hospitals, including the Ascension facilities, across northern Indiana and southwest Michigan. 
    • “Financial details of the deal were not disclosed.”
  • Per the American Journal of Managed Care,
    • “Prolonged ED stays and boarding times for older adults increased from 2017 to 2024, with academic hospitals experiencing the largest rise.
    • “The Age-Friendly Hospital Measure, effective 2025, aims to limit ED stays to under 8 hours and admissions within 3 hours.
    • “Epic Cosmos data analysis showed a significant increase in prolonged stays and boarding times, especially during the COVID-19 pandemic.
    • ‘Researchers suggest patient complexity, demand, and staffing shortages as potential drivers of increased ED stays and boarding times.”
  • Beckers Hospital Review lets us know “Physician compensation grew 4.9% in the last year, with a significant uptick for primary care physicians and specialists, according to the “AMGA 2025 Medical Group Compensation and Productivity Survey.”

Monday report

David Ermer–CMS, Congress, Medical / Rx research, Medicare, NIH, Obesity, Rx coverage, SCOTUS, Telehealth, U.S. Healthcare–

From Washington, DC.

  • The Wall Street Journal reports,
    • “Senate Republicans trudged through a marathon session Monday, aiming to pass the party’s “big, beautiful bill” and move the legislation one step further toward President Trump’s desk ahead of lawmakers’ self-imposed July 4 deadline.
    • “Voting on amendments and procedural motions started midmorning and dragged through the day as Republican leaders worked to find a balance of policies that could pass both the Senate and later the House. Trump spoke with congressional leaders by phone, and the White House said it was confident that the bill was on track even as its fate and final content remained uncertain.” * * *
    • “A final Senate vote could come late Monday or early Tuesday. If it passes, the measure would then move back to the House, where Republicans have a 220-212 majority. Moderate House Republicans argue that the Senate cut Medicaid too deeply. Others warn that the Senate is violating the House’s target that keeps tax cuts at most $2.5 trillion larger than spending cuts.” 
  • Modern Healthcare reports,
    • “Home health companies stand to lose more than $1 billion in Medicare payments under a proposed rule the Centers for Medicare and Medicaid Services published Monday.
    • “The proposed changes would represent a decrease of 6.4%, or $1.14 billion, in Medicare payments to home health agencies in 2026 compared with 2025, CMS said in a fact sheet.
    • “The proposed home health prospective payment system update includes a 2.4%, or $425 million, increase, which is offset by a 3.7%, or $655 million, decrease reflecting a proposed behavior adjustment required by statute. It also includes a 4.6%, or $815 million, decrease that reflects a proposed temporary adjustment and an estimated 0.5%, or $90 million, decrease based on a proposed update to the fixed dollar loss ratio.”
  • Per a CMS announcement,
    • “On June 30, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update payment rates and policies under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to Medicare beneficiaries on or after January 1, 2026. This proposed rule would also update the acute kidney injury (AKI) dialysis payment rate for renal dialysis services furnished by ESRD facilities for calendar year (CY) 2026 and proposes to update requirements for the ESRD Quality Incentive Program (QIP).
    • “For CY 2026, CMS is proposing to increase the ESRD PPS base rate to $281.06, which CMS expects would increase total payments to all ESRD facilities, both freestanding and hospital-based, by approximately 1.9%. The CY 2026 ESRD PPS proposed rule also includes a proposed payment adjustment for certain non-labor costs for ESRD facilities located in Alaska, Hawaii, and the United States (U.S.) Pacific Territories. 
    • “CMS is proposing shortening the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH CAHPS) survey to 39 questions, removing 23 questions, and eliminating three health equity reporting measures from the ESRD QIP. Additionally, CMS is seeking input on health IT use in dialysis facilities; and input on future measure concepts. CMS also is proposing the early termination of the ESRD Treatment Choices Model.”
  • The public comment deadline for both rules is sixty days after publication in the Federal Register.
  • Per another CMS announcement,
    • “The Justice Department today announced the results of its 2025 National Health Care Fraud Takedown, which resulted in criminal charges against 324 defendants, including 96 doctors, nurse practitioners, pharmacists, and other licensed medical professionals, in 50 federal districts and 12 State Attorneys General’s Offices across the United States, for their alleged participation in various health care fraud schemes involving over $14.6 billion in intended loss. The Takedown involved federal and state law enforcement agencies across the country and represents an unprecedented effort to combat health care fraud schemes that exploit patients and taxpayers.
    • “Demonstrating the significant return on investment that results from health care fraud enforcement efforts, the government seized over $245 million in cash, luxury vehicles, cryptocurrency, and other assets as part of the coordinated enforcement efforts. As part of the whole-of-government approach to combating health care fraud announced today, the Centers for Medicare and Medicaid Services (CMS) also announced that it successfully prevented over $4 billion from being paid in response to false and fraudulent claims and that it suspended or revoked the billing privileges of 205 providers in the months leading up to the Takedown. Civil charges against 20 defendants for $14.2 million in alleged fraud, as well as civil settlements with 106 defendants totaling $34.3 million, were also announced as part of the Takedown.
    • “Today’s Takedown was led and coordinated by the Health Care Fraud Unit of the Department of Justice Criminal Division’s Fraud Section and its core partners from U.S. Attorneys’ Offices, the Department of Health and Human Services Office of Inspector General (HHS-OIG), the Federal Bureau of Investigation (FBI), and the Drug Enforcement Administration (DEA). The cases were investigated by agents from HHS-OIG, FBI, DEA, and other federal and state law enforcement agencies. The cases are being prosecuted by Health Care Fraud Strike Force teams from the Criminal Division’s Fraud Section, 50 U.S. Attorneys’ Offices nationwide, and 12 State Attorneys General Offices.”
  • The Washington Post shares some details about the Takedown.
  • The GAO issued a report today titled “Highlights of a Forum: Reducing Spending and Enhancing Value in the U.S. Health Care System.”
    • “Health care spending per capita is higher in the U.S. than in any other high-income country. Yet, people living in the U.S. don’t live as long in comparison and are more likely to die of conditions that can be prevented or treated.
    • “To find ways to help address this disparity, we convened a forum in October 2024. Experts from government, academia, and industry identified changes to the health care system that could lower costs and improve patients’ outcomes. These include improving primary care, expanding the health care workforce, and reforming health care pricing and payments.”

From the judicial front,

  • The Supreme Court accepted the Solicitor General’s recommendation by declining to review a U.S. Court of Appeals for the 10th Circuit pro-ERISA preemption opinion captioned PCMA v Mulready (S. Ct. No 23-1213). What’s good for ERISA preemption is good for FEHB preemption.

From the public health and medical research front,

  • Health Day reports,
    • “A person’s body fat percentage provides a better estimate of their risk for early death than their body mass index (BMI), a new study says.
    • “People with a high body-fat percentage were 78% more likely to die within 15 years from any cause and 3.6 times more likely to die from heart disease, researchers reported June 24 in the Annals of Family Medicine.
    • “On the other hand, BMI — an estimate of body fat based on height and weight — was not associated with a statistically significant higher risk of death from any cause, researchers found.
    • “Waist circumference also proved to be more accurate than BMI in assessing the risks posed by excess weight, researchers added.
    • “This is a game changer for body composition assessment,” lead researcher Arch Mainous III, a professor of health services, management and policy at the University of Florida, said in a news release.”
  • The American Medical Association lets us know what doctors wish patients knew about cosmetic dermatology.
  • Endocrinology Advisor tells us, “Compared with self-monitoring, continuous glucose monitoring did not improve obstetric or neonatal outcomes among women with gestational diabetes.”
  • Per Medscape,
    • The American College of Gastroenterology (ACG) has issued updated guidance on the management of Crohn’s disease (CD) that reflects the surge in development of therapeutic options available since 2018, when the last guideline was published.
    • These newer treatment options include interleukin-23 (IL-23) blockers risankizumab, mirikizumab, and guselkumab; the anti-IL-12/23 agent ustekinumab; the Janus kinase inhibitor upadacitinib; and the anti-integrin vedolizumab.
    • The intent of the guideline is to suggest “preferable approaches” to CD management established through “interpretation and collation of scientifically valid research, derived from extensive review of published literature,” said the writing group, led by Gary Lichtenstein, MD, director, Inflammatory Bowel Disease Center, Hospital of the University of Pennsylvania, Philadelphia.
  • Per a National Institutes of Health press release,
    • “Scientists at the National Institutes of Health (NIH) have found that two common types of hormone therapy may alter breast cancer risk in women before age 55. Researchers discovered that women treated with unopposed estrogen hormone therapy (E-HT) were less likely to develop the disease than those who did not use hormone therapy. They also found that women treated with estrogen plus progestin hormone therapy (EP-HT) were more likely to develop breast cancer than women who did not use hormone therapy. Together, these results could help to guide clinical recommendations for hormone therapy use among younger women.
    • “The two hormone therapies analyzed in the study are often used to manage symptoms related to menopause or following hysterectomy (removal of uterus) or oophorectomy (removal of one or both ovaries). Unopposed estrogen therapy is recommended only for women who have had a hysterectomy because of its known association with uterine cancer risk.
    • “Hormone therapy can greatly improve the quality of life for women experiencing severe menopausal symptoms or those who have had surgeries that affect their hormone levels,” said lead author Katie O’Brien, Ph.D., of NIH’s National Institute of Environmental Health Sciences (NIEHS). “Our study provides greater understanding of the risks associated with different types of hormone therapy, which we hope will help patients and their doctors develop more informed treatment plans.”
  • The Wall Street Journal reports,
    • “Moderna said Monday its seasonal influenza vaccine candidate, mRNA-1010, showed superior efficacy in a Phase 3 study that compared it with a licensed standard-dose seasonal flu vaccine in adults aged 50 years and older.
    • “MRNA-1010 achieved the most stringent superiority criterion prespecified in the study protocol, with a relative vaccine efficacy of 26.6% in the overall study population, Moderna said.
    • “Subgroup analyses confirmed a consistently strong relative vaccine efficacy point estimate across age groups, risk factors and previous influenza vaccination status, it said. In participants aged 65 years and older, mRNA-1010 demonstrated a relative vaccine efficacy of 27.4%.
    • “The severity of this past flu season underscores the need for more effective vaccines,” Moderna Chief Executive Stephane Bancel said.”
  • BioPharma Dive points out the top 10 clinical trials to watch in the second half of 2025.
    • “Expected readouts in obesity, lung cancer and atopic dermatitis headline a series of study results that could give the biotechnology sector a boost in another down year.”

From the U.S. healthcare business front,

  • Beckers Payer Issues relates,
    • “Clear answers to questions are the top driver of members’ experience with their insurers, according to a report from Forrester. 
    • “The research firm scored insurers on the brand experience index, which measures customers’ and noncustomers’ brand perception, and customer experience index, which rates customer service and loyalty. 
    • “The health insurance industry had the lowest overall consumer ratings of the 10 industries studied by Forrester. 
    • “Based on consumer responses, Forrester rated answering questions with clear answers as the top driver of customer experience. Across the industry, 60% of consumers said their insurer answered questions clearly. CareFirst BlueCross BlueShield, the industry leader in this category, scored 71%. 
      • “Here are the five other key drivers of total experience for insurers, and insurers’ average scores, according to Forrester:
      • “Keeps personal and financial information secure: 54% 
      • “Helps manage care: 53% 
      • “Offers needed healthcare plans and services: 59% 
      • “Resolves problems on the first call: 56% 
      • “Has a website that meets customers’ needs: 58%” 
  • Modern Healthcare reports,
    • “OptumRx is removing prior authorization mandates for more drugs. 
    • “So far this year, the pharmacy benefit manager has eliminated reauthorizations for 140 medications patients use to treat chronic conditions, the UnitedHealth Group subsidiary said in a news release Monday. Insurance companies and PBMs require patients and clinicians to obtain reauthorizations for some drugs in cases of long-term safety concerns or potential dosing changes. Beginning Tuesday, OptumRx will cut prior authorizations for another 60 medications that treat seven chronic conditions, including HIV, high cholesterol, hypertension and and others. 
    • “Eliminating reauthorization requirements for established and effective treatments underscores our commitment to make these needed drugs more accessible, which also supports better health outcomes,” Dr. Sumit Dutta, chief medical officer, said in the release.”
  • OptumRx, writing in LinkedIn, discusses taking action against drug price hikes.
  • Healthcare IT News notes, “Taking a patient history upfront via telemedicine has been very fruitful for the high-demand specialty provider [the Kennedy-Krieger Institute]. By combining history via virtual care with a then more limited in-person visit, care can be delivered more efficiently to more patients.”
  • Per Beckers Hospital Review,
    • “Nearly 800 rural U.S. hospitals are at risk of closure due to financial problems, with about 40% of those hospitals at immediate risk of closure.
    • “The count is drawn from the Center for Healthcare Quality and Payment Reform’s most recent analysis, based on hospitals’ latest cost reports submitted to CMS and verified as current through June 2025. The analysis identifies two distinct tiers of rural hospital vulnerability: those at risk of closure and those facing an immediate risk of closure. * * *
    • [The article] includes a state-by-state listing of the number of rural hospitals at risk of closure in the next six to seven years and at immediate risk of closure over the next two to three years. 
  • BioPharma Dive reports,
    • “Abbvie has agreed to acquire cell therapy developer Capstan Therapeutics in a deal worth up to $2.1 billion, the companies announced Monday. 
    • “The acquisition will hand AbbVie access to technology developed by Capstan that uses small fatty spheres known as lipid nanoparticles to deliver into the body genetic instructions able to engineer specific cells. It’s an ambitious scientific approach that blends the science behind CAR-T cell therapy with that of messenger RNA vaccines.
    • “Capstan is a few weeks removed from dosing the first patient in a Phase 1 trial of its lead drug candidate, which it’s testing as treatment for B cell-mediated autoimmune diseases. Dubbed CPTX2309, the therapy is designed to reprogram immune T cells to target a protein called CD19 that’s commonly found on B cells.”

Weekend update

David Ermer–Congress, Medical / Rx research, Medicare, Mental health care–
  • From Washington, DC
  • The Wall Street Journal reports,
    • “The Senate geared up Sunday for an all-night session of debate and amendment votes on the GOP’s “big, beautiful bill” [HR 1], after Republicans narrowly advanced the measure in a 51-49 vote that set up more push-and-pull before final passage.
    • “The 940-page legislation is driving a wedge between the GOP’s two wings, just as the party is racing to pass the measure early this week. Centrists have raised concerns about cutting benefit programs and straining state budgets, while fiscal conservatives are pushing for even more cuts to rein in federal budget deficits. 
    • “Proponents maintain that the opportunity to pass President Trump’s core agenda items—and pressure from Trump on holdouts—would propel the package over the finish line in the Senate, where the GOP has a 53-47 majority. 
    • “It’s a big, beautiful bill if you believe in cutting people’s taxes, securing the border, having a strong military and controlling government spending,” Sen. Lindsey Graham (R., S.C.) said on the Senate floor Sunday. “The bottom line is, we’re about to make history,” he said.”
  • Here’s a link to the Journal’s explanation of the key provisions in the bill under Senate consideration. The Senate press gallery notes “The Senate will convene on Monday at 9:00 a.m. and begin the Vote-A-Rama on H.R. 1.” If the Senate passes the bill, then the Senate bill, which is based on the bill that the House passed in May, will go back to House for a vote. If the House approves the bill, then the bill will go to the President for signature into law.
  • Beckers Payer Issues calls attention to five Medicare Advantage bills pending in Congress.
  • The Wall Street Journal lets us know how “the Supreme Court dipped its toes into Trump 2.0” during its October 2024 term ended last Friday.

From the public health and medical research front,

  • Fortune Well reports,
    • For all of the advancement in treating stroke victims over the past couple of decades, some concerns have remained almost constant. In medicine, we like to say that “time is brain,” meaning that every moment a stroke goes untreated, the potential for long-term brain damage or death escalates. In fact, every minute that the brain goes without blood flow, the average patient loses around 1.9 million neurons and about a week of independent life, experts say.
    • “As the vast majority of strokes are ischemic, with a blood clot blocking the flow of oxygen to the brain, clearing that clot swiftly is critical. This is true whether the clot is small or large and regardless of its density—but reliably removing the densest clots via mechanical means has proved an elusive task.
    • “Though these concerns, time and density, are not necessarily linked, both matter—one reason, researchers suggest, that a newly developed technology from Stanford University holds the potential to reshape how stroke patients are treated.
    • “The device, called a milli-spinner, is a tiny, powerfully rotating hollow tube outfitted with fins and slits. In action, both lab and swine tests demonstrate the ability to dramatically compact and shrink the size of blood clots, making it easier to remove them quickly and effectively—often on the first try.
    • “This has the potential to be a game changer,” says Greg Albers, director of the Stanford University Stroke Center and a longtime expert in the field. “The results are likely to translate well to clinical trials.”
  • The New York Times tells us,
    • “Gary Sergott felt weary all the time. “I’d get tired, short of breath, a sort of malaise,” he said. He was cold even on warm days and looked pale with dark circles under his eyes.
    • “His malady was not mysterious. As a retired nurse-anesthetist, Mr. Sergott knew he had anemia, a deficiency of red blood cells. In his case, it was the consequence of a hereditary condition that caused almost daily nosebleeds and depleted his hemoglobin, the protein in red blood cells that delivers oxygen throughout the body.
    • “But in consulting doctors about his fatigue, he found that many didn’t know how to help. They advised Mr. Sergott, who lives in Westminster, Md., to take iron tablets, usually the first-line treatment for anemia.
    • “But like many older people, he found a daily regimen of four to six tablets hard to tolerate. Some patients taking iron complain of severe constipation or stomach cramps. Mr. Sergott felt “nauseated all the time.” And iron tablets don’t always work.
    • “After almost 15 years, he found a solution. Dr. Michael Auerbach, a hematologist and an oncologist who is the co-director of the Center for Cancer and Blood Disorders in Baltimore, suggested that Mr. Sergott receive iron intravenously instead of orally.
    • ‘Now Mr. Sergott, 78, gets an hourlong infusion when his hemoglobin levels and other markers show that he needs one, usually three times a year. “It’s like filling the gas tank,” he said. His symptoms recede, and “I feel great.”
    • “His story reflects, however, the frequent dismissal of a common condition, one that cannot only diminish older adults’ quality of life but lead to serious health consequences, including falls, fractures and hospital stays.”
  • The Washington Post informs us,
    • In her mid 70s, Argie, a widowed former teacher, began feeling poorly. She was tired. Her stomach hurt. Sometimes she got agitated. And she seemed forgetful.
    • Worried, her grown children urged the woman, who asked that only her first name be used for privacy reasons, to consult a memory specialist in Baltimore, not far from her home.
    • Argie’s cognitive powers, the doctor concluded, were reasonably good. But her medicine cabinet was a real hazard: She was taking 21 different prescription drugs, for diabetes, high blood pressure and her kidneys. After an assessment by a team that included a clinical pharmacy specialist well versed in drug interactions, she’s now down to eight.
    • “Every time I went in to a doctor, they gave me another pill,” Argie said. She’s now less confused. Less agitated. Less nauseated. She said cognitive challenges are manageable, and she’s more energetic and steadier on her feet.
    • “That overload of drugs, known as polypharmacy, can be dangerous at any age but it’s particularly hazardous for elderly people, who often have multiple health conditions and whose bodies may not handle meds the same way they did when they were younger, said Nicole Brandt, a leading expert on geriatric prescribing at the University of Maryland.”
  • Per Medscape,
    • “Posttraumatic headache (PTH) is frequently misdiagnosed and undertreated in nonspecialist settings, highlighting a critical gap in diagnostic accuracy, treatment access, and integrated care for this complex condition, new research showed. 
    • “Investigators found that patients with the condition are frequently misdiagnosed and undertreated in nonspecialist settings. Further, most are only correctly diagnosed with a migraine phenotype after evaluation by a headache specialist.
    • “A central message of our work is that the diagnosis of ‘headache’ is too often treated as a monolith — an endpoint rather than the beginning of a diagnostic journey,” study investigator Natalia Murinova, MD, clinical professor of neurology, and director of the headache clinic at the University of Washington (UW), Seattle, told Medscape Medical News.
    • “The results of the retrospective analysis were presented at the American Headache Society (AHS) Annual Meeting 2025.”

Cybersecurity Saturday

David Ermer–Cybersecurity, Generative AI–

From the cybersecurity policy and law enforcement front,

  • Federal News Network reports,
    • “House appropriators have advanced a homeland security spending bill that endorses many of the Trump administration’s budget proposals, while rejecting steep cuts to cybersecurity and artificial intelligence personnel.
    • “The fiscal 2026 homeland security appropriations measure includes $66.36 billion in discretionary spending. The GOP-led committee passed the bill Tuesday [June 24, 2025] on a 36-27 vote.
    • “The bill follows the broad contours of Trump administration policies by prioritizing funding for Customs and Border Protection and Immigration and Customs Enforcement. Appropriators are also expecting significant funding for the Department of Homeland Security to be included in the budget reconciliation bill.”
  • Cyberscoop tells us,
    • “With time running short before expiration of a cyber information-sharing law highly valued by the private sector, Congress is taking a look at the possibility of a short-term extension.
    • “The 2015 Cybersecurity Information Sharing Act, which provided legal safeguards for companies to share threat data, is due to sunset at the end of September, and Congress doesn’t tend to work much in August.
    • “A bipartisan pair of senators have introduced a bill to simply extend it for another 10 years. But a House bill is still in the works and might take a different approach that involves making changes to the law going forward, industry officials told CyberScoop on Wednesday. Getting competing proposals through both chambers, then settling differences and finalizing a bill to get to the president’s desk, could take significant time.
    • “There are other things that are being considered in the mix,” said John Miller, senior vice president of policy for trust, data and technology and general counsel at the Information Technology Industry Council. One would be attaching language to a continuing resolution funding measure that would extend the 2015 law for a short period of time.”
  • Cybersecurity Dive informs us,
    • “Federal officials and private-sector security leaders said Tuesday [June 24, 2025] that they are closely monitoring for cyberattacks related to the Iran conflict but thus far have not observed any significant activity. 
    • “The Department of Homeland Security warned Sunday that Iran-linked actors or hacktivist groups may launch attacks against U.S. critical infrastructure operators, citing a recent history of attacks against poorly configured water utilities and other systems. 
    • “An apparent truce announced late Monday by President Donald Trump appeared to lower international tensions, but officials remain on guard for any potential threat activity.
    • “The Cybersecurity and Infrastructure Security Agency (CISA) “is actively coordinating with government, industry, and international partners to share actionable intelligence and strengthen collective defense,” CISA spokesperson Marci McCarthy said in a statement. “There are currently no specific credible threats against the homeland.”
  • NextGov/FCW notes,
    • “Morgan Adamski is leaving her role as executive director of U.S. Cyber Command, handing the reins to Patrick Ware.
    • “After 17 years of service at the National Security Agency, I’ve decided to turn the page to an exciting new chapter in my career. It has been an extraordinary journey contributing to the defense of our Nation and advancing the cybersecurity mission across the U.S. Government,” Adamski wrote in a LinkedIn post Friday [June 27, 2025].
    • “The number three spot in the combatant command is typically held by a civilian on detail from the National Security Agency.
    • “Though Adamski did not clarify where she would be headed next, she noted her commitment to ensuring there were cyber solutions on “both sides of the fence.”
  • CISA and the National Security Agency have released a report titled “Memory Safe Languages: Reducing Vulnerabilities in Modern Software Development.’
  • Per Cyberscoop,
    • Kai West, a prolific cybercriminal better known for operating under the moniker “IntelBroker,” was arrested in France earlier this year and faces federal charges for allegedly stealing data from more than 40 organizations during a two-year period, the Justice Department said Wednesday [June 25, 2025]. 
    • Federal prosecutors unsealed a four-count indictment charging West, a British national, with conspiracy to commit computer intrusions, accessing a protected computer to obtain information and wire fraud. The United States is seeking his extradition for the charges, which each carry maximum sentences of five to 20 years in prison. 

From the cybersecurity breaches and vulnerabilities front,

  • Beckers Health IT identifies the top ten states for healthcare data breaches between February 2023 and April 2025.
  • CISA added three known exploited vulnerabilities to its catalog this week.
    • June 25, 2025
      • CVE-2024-54085 AMI MegaRAC SPx Authentication Bypass by Spoofing Vulnerability
        • Network World discusses this KVE here.
      • CVE-2024-0769 D-Link DIR-859 Router Path Traversal Vulnerability
        • Cybersecurity News discusses this KVE here.
      • CVE-2019-6693 Fortinet FortiOS Use of Hard-Coded Credentials Vulnerability
        • Cybersecurity News discusses this KVE here.
  • Cyberscoop reports,
    • Citrix on Wednesday [June 25, 2025] disclosed an actively exploited zero-day vulnerability affecting multiple versions of NetScaler products, an alarming development from a vendor that’s been widely targeted in previous attack sprees.
    • The zero-day (CVE-2025-6543) was disclosed by Citrix nine days after it issued a security bulletin for a pair of defects (CVE-2025-5777 and CVE-2025-5349) in the same products. All three vulnerabilities affect the company’s networking security appliance NetScaler ADC and its virtual private network NetScaler Gateway. 
    • “Exploits of CVE-2025-6543 on unmitigated appliances have been observed,” Citrix said in a security bulletin for the zero-day. Citrix did not respond to a request for comment. 
    • Citrix described the critical zero-day CVE-2025-6543, which has a base score of 9.2 on the CVSS scale, as a memory overflow defect that attackers can exploit for unintended control flow and denial of service. Exploitation can only occur if targeted NetScaler instances are configured as a gateway or an authentication, authorization and accounting (AAA) virtual server, according to Citrix.”
  • and
    • “The aviation industry has seemingly become the latest target of Scattered Spider, a sophisticated cybercriminal group that has shifted its focus from retail and insurance companies to airlines in what cybersecurity experts describe as a coordinated campaign against the sector.
    • “Hawaiian Airlines disclosed a cybersecurity incident Friday [June 27, 2025] affecting some of its IT systems while maintaining that flights continued operating safely and on schedule. The attack, first detected June 23, according to SEC filings, prompted the airline to engage federal authorities and cybersecurity experts for investigation and remediation efforts.
    • “Multiple incident responders have attributed the Hawaiian Airlines attack to Scattered Spider, also known as Muddled Libra or UNC3944. The assessment comes as cybersecurity firms Unit 42 and Mandiant issued warnings about the group’s apparent pivot to targeting aviation companies.
    • “Charles Carmakal, chief technology officer at Mandiant Consulting – Google Cloud, confirmed his company is “aware of multiple incidents in the airline and transportation sector which resemble the operations of UNC3944 or Scattered Spider.” The group has demonstrated a pattern of focusing intensively on single industries before moving to new sectors.”
  • Per Hacker News,
    • “Unknown threat actors have been distributing a trojanized version of SonicWall’s SSL VPN NetExtender application to steal credentials from unsuspecting users who may have installed it.
    • “NetExtender enables remote users to securely connect and run applications on the company network,” SonicWall researcher Sravan Ganachari said. “Users can upload and download files, access network drives, and use other resources as if they were on the local network.”
    • “The malicious payload delivered via the rogue VPN software has been code named SilentRoute by Microsoft, which detected the campaign along with the network security company.” * * *
    • “The development comes as G DATA detailed a threat activity cluster dubbed EvilConwi that involves bad actors abusing ConnectWise to embed malicious code using a technique called authenticode stuffing without invalidating the digital signature.
    • “The German cybersecurity company said it has observed a spike in attacks using this technique since March 2025. The infection chains primarily leverage phishing emails as an initial access vector or through bogus sites advertised as artificial intelligence (AI) tools on Facebook.”

From the ransomware front,

  • Bleeping Computer notes,
    • “Ahold Delhaize, one of the world’s largest food retail chains, is notifying over 2.2 million individuals that their personal, financial, and health information was stolen in a November ransomware attack that impacted its U.S. systems.
    • “The multinational retailer and wholesale company operates over 9,400 local stores across Europe, the United States, and Indonesia, employing more than 393,000 people and serving approximately 60 million customers each week in-store and online.” * * *
    • “In a Thursday filing with Maine’s Attorney General, the retail giant revealed that the attackers behind the November breach stole the data of 2,242,521 individuals after gaining access to the company’s internal U.S. business systems on November 6, 2024.”Mich
  • Michigan Health Watch adds,
  • Dark Reading reports,
    • “A newly discovered ransomware group dubbed “Dire Wolf” has already taken a bite out of 16 organizations globally since its emergence only last month, mainly across the technology and manufacturing sectors, researchers have found.
    • “The group uses a double extortion tactic with a monthlong turnaround time for paying ransom, and deploys custom encryptors tailored to specific victims, security firm Trustwave revealed in a blog post published June 24. Researchers from Trustwave SpiderLabs recently uncovered and observed a ransomware sample from the emerging threat group and gained insights on how it operates, they said.
    • “So far, the group’s victims have spanned 11 countries, with the US and Thailand reporting the highest numbers of attacks, followed by Taiwan. So far, five of the 16 victims listed on the group’s data leak site have data scheduled to be uploaded by the end of June, presumably because they didn’t pay the ransom, according to the post.”
  • Per Cybersecurity Dive,
    • “Only half of ransomware attacks on organizations this year have involved data encryption, once the attack’s defining feature, according to a Sophos report published on Tuesday [June 24, 2025].
    • “Both the average ransom demand and average ransom payment have dropped significantly over the past year (by 34% and 50%, respectively).
    • “Less than a third of respondents in the survey who paid a ransom said the amount matched the attackers’ initial demand, with 53% of victims paying less and 18% paying more.”

From the cybersecurity defenses front,

  • Cyberscoop reports,
    • “When a faulty software update from cybersecurity firm CrowdStrike last year caused possibly the largest IT outage in history, Microsoft ended up taking much of the blame.
    • “CrowdStrike’s Falcon endpoint detection and response was on millions of Windows devices worldwide, and like most antivirus products that need broad access to different systems to do their job, the software had direct access to the Windows kernel.
    • “When CrowdStrike’s update crashed, so did millions of Windows-powered systems and devices around the world. A series of security announcements by Microsoft on Thursday [June 26, 2025] are designed to reduce the possibility of future third-party outages and other security threats that can take an organization’s IT out of commission for extended durations.
    • “Among those changes: antivirus software like the kind installed by CrowdStrike and other third-party cybersecurity will no longer have direct access to the Windows kernel. The company will be previewing a new endpoint security platform to vendors next month that requires security updates to go through layers of testing and review before they ship to Windows devices and systems worldwide.”
  • Per Cybersecurity Dive,
    • “Cybersecurity insurance premiums declined 2.3% year over year to roughly $7.1 billion in 2024, according to a new report released on Monday [June 23, 2025] by credit rating agency AM Best.
    • “Meanwhile, cyber insurance providers’ loss ratio — the proportion of premiums they use to pay out claims — remained below 50%, indicating that the market remains profitable.
    • “AM Best offered several possible explanations for the slight premium decline.”
  • and
    • “Two reports — one that KPMG released on Thursday and one that Thales released last month — illustrate how generative AI is raising security concerns for business leaders.
    • “Business leaders surveyed by KPMG reported prioritizing security oversight in their generative AI budgeting decisions, with 67% saying they plan to spend money on cyber and data security protections for their AI models. Fifty-two percent cited risk and compliance as a budgetary priority.
    • “Those spending decisions reflect corporate executives’ growing worries about AI security. ***
  • WEDI is offering a free healthcare cybersecurity webinar on June 15, 2025, at 1:00 pm ET.
  • The ISACA Blog considers Proactive Approaches to Identify Cyberthreats.
  • Here is a link to Dark Reading’s CISO Corner.

Friday report

David Ermer–CDC, CMS, Congress, COVID-19, Federal employment benefits, Medical / Rx research, SCOTUS, U.S. Healthcare–

From Washington, DC,

  • The Wall Street Journal reports,
    • “President Trump stuck to his July 4 deadline for Republicans’ tax-and-spending megabill while signaling there might be some wiggle room as GOP senators struggled to resolve disagreements over Medicaid cuts and other provisions.
    • “Senators said they were aiming for an initial procedural vote as early as noon Saturday, which would let them pass the bill sometime Sunday. Before that, they are aiming to release the final text of the bill and ensure that it can work procedurally in the fast-track process they are using for the party-line legislation.
    • “As of Friday afternoon, Senate Republicans were still negotiating details over the state and local tax deduction, considering a new proposal to set the cap at the House-preferred level of $40,000 for five years before it shrinks. They are also debating changes to Medicaid, including limits on state-financing mechanisms that could squeeze rural hospitals—and a rural-hospital fund to mitigate the effects of their plans. 
    • “Asked at a press conference if he was sticking with his Independence Day target, Trump said: “It’s not the end-all. It could go longer, but we’d like to get it done.”
  • Federal News Network tells us,
    • “A bipartisan bill to revise the rules for federal workers’ compensation cases unanimously advanced out of a House committee this week. The legislation would revise the Federal Employees’ Compensation Act to allow physician assistants and nurse practitioners to treat feds in workers’ compensation cases. A previous version of the bill passed the House in 2022, but did not clear the Senate. Cosponsors of the bill say they’re hopeful it will pass both chambers this Congress.”
  • Per a CMS news release,
    • “The Centers for Medicare & Medicaid Services (CMS) is announcing a new Innovation Center model aimed at helping ensure people with Original Medicare receive safe, effective, and necessary care. Through the Wasteful and Inappropriate Service Reduction (WISeR) Model, CMS will partner with companies specializing in enhanced technologies to test ways to provide an improved and expedited prior authorization process relative to Original Medicare’s existing processes, helping patients and providers avoid unnecessary or inappropriate care and safeguarding federal taxpayer dollars. This model builds on other changes being made to prior authorization as announced by the U.S. Department of Health and Human Services and CMS on Monday.” * * *
    • “To view the Model Overview fact sheet, visit: https://www.cms.gov/files/document/wiser- fact-sheet.pdf.
    • “For more information on the WISeR Model, visit: https://www.cms.gov/priorities/innovation/innovation-models/wiser.
    • “The WISeR Model can be seen on the Federal Register at: https://www.federalregister.gov/d/2025-12195.
  • Fierce Pharma informs us,
    • “Restricted availability under an FDA-mandated drug safety program has limited the reach of CAR-T cell therapies for certain blood cancers—until now.
    • “The FDA has removed the Risk Evaluation and Mitigation Strategies (REMS) requirements for currently approved BCMA- and CD19-directed CAR-T therapies, the agency said Thursday.
    • “Existing commercial CAR-T products, including Bristol Myers Squibb’s Abecma and Breyanzi, Gilead Sciences’ Yescarta and Tecartus, Johnson & Johnson and Legend Biotech’s Carvykti, and Novartis’ Kymriah, stand to benefit from the update. Autolus’ CD19 CAR-T Aucatzyl was approved in November for B-cell precursor acute lymphoblastic leukemia without a REMS requirement. The FDA’s website only has updated prescribing information for Carvykti as of publication time, but the agency’s announcement said the REMS requirements have been removed for all these drugs.” * * *
    • “These changes should facilitate patient access, particularly for those who do not live near centers of excellence where CAR-Ts are commonly administered,” Citi analysts wrote in a Friday note.”
  • Federal News Network notes,
    • “June 28th is National Insurance Awareness Day, offering a timely reminder for federal employees to reassess their current healthcare needs and determine whether their FEHB plan remains the best fit.
    • “It’s important to review your coverage outside of Open Season, know what to expect for 2026, and be aware of trusted resources that can help guide your decisions.”
    • The article shares information on these points.

From the judicial front,

  • The Supreme Court completed its October 2024 term today.
  • Roll Call reports,
    • The Supreme Court curtailed the power of district courts to issue “universal injunctions” in a decision Friday in the legal clash over the Trump administration’s push end birthright citizenship.
    • The 6-3 decision [liberals dissenting] found that most of those broad orders that stop government actions — and there have been dozens issued against the Trump administration this year — exceed the power Congress gave to federal district courts.
    • The decision sends litigation over the legality of President Donald Trump’s birthright citizenship effort back to the lower court and is likely to set off an avalanche of litigation in more than 100 lawsuits against Trump’s administrative actions.
  • The FEHBlog expects that plaintiffs will be converting their lawsuits to class actions.
  • Govexec adds,
    • “The Supreme Court on Friday limited individual judges’ capacity to strike down government policy on a nationwide basis, a decision with potentially far-reaching impacts on how federal agencies carry out their work. 
    • “The high court left in place some carve outs, however, including one that could—at least temporarily—protect a judge’s ruling that is currently blocking the Trump administration from carrying out widespread layoffs. While the Trump administration applauded the Supreme Court’s decision and lamented the influence that lower-level judges have exerted over the president’s control of the federal workforce, attorneys who helped bring the lawsuit forward suggested it did not apply to the order preventing large-scale reductions in force.” * * *
    • “The victory for federal employees, to the extent they can claim one after the Supreme Court’s decision, may be short lived. The administration has already appealed both RIF cases to the [Supreme Court], where it is now awaiting resolution. It has done so seeking emergency relief and a decision is expected any day.” 
       
  • The Wall Street Journal sums it up as follows:
    • The Supreme Court ruled against nationwide injunctions, limiting the scope of lower-court rulings against presidential policies.
    • The high court ruling might lead to more lawsuits against the administration, as individuals and groups must bring their own cases.
    • Lawyers are exploring class-action suits, and state attorneys general might gain influence challenging White House policies.
  • The American Hospital Association News relates,
    • “The Supreme Court today voted 6-3 [conservatives dissenting] to uphold an Affordable Care Act provision creating an independent task force charged with making recommendations of preventive services that insurers must cover at no cost. The ruling reverses a June 2024 decision by the U.S. Court of Appeals for the 5th Circuit, which partially affirmed a district court judgment that the U.S. Preventive Services Task Force, the group charged with determining coverage of certain preventative services, was unconstitutional.” 
    • The Court held that the USPSTF members, who are volunteers, are inferior officers of the United States, who can be appointed by someone other than the President, in this case, the HHS Secretary, without Senate confirmation.
    • The opinion helpfully preserves the ACA preventive care status quo.
  • KFF calls attention to legal issues that the Court’s opinion may not have resolved.
  • SCOTUSblog covers the other Supreme Court decisions issued today.
  • The AHA News also tells us,
    • “A U.S. District Court for the District of Columbia judge today ruled against Johnson and Johnson and sided with the Department of Health and Human Services and hospitals in a lawsuit brought by J&J challenging the government’s authority to reject J&J’s proposed 340B rebate model.  
    • “In sum, based on the plain and unambiguous language of the 340B statute, and supported by its purpose and history, HRSA has the authority to ‘provide’ for discounts, rebates, or both,” Judge Rudolph Contreras wrote. “This conclusion defeats J&J’s claim that HRSA lacked the authority to require prior approval of J&J’s rebate model.” 
    • “The AHA in a friend-of-the-court brief urged the court to uphold the government’s decision to reject J&J’s proposed 340B rebate model. Others joining the AHA in the filing were the Children’s Hospital Association, the Association of American Medical Colleges and America’s Essential Hospitals. 
    • “Earlier this year, a second district judge reached the same conclusion in cases brought by five other drug companies.”

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, emergency department visits and laboratory percent positivity are at very low levels.
    • “Influenza
    • “RSV
      • “RSV activity is very low.”
  • Per Health Day,
    • “Updated COVID-19 vaccines are keeping up with new coronavirus strains and remain effective for keeping people out of the hospital, a new study says.
    • “The study, which examined the effectiveness of the 2023-2024 COVID vaccines against the XBB and JN.1 Omicron variant waves, found that the updated shots caused:
      • “A 24% lower risk of ER and urgent care visits related to COVID.
      • “A 29% lower risk of hospitalization.
      • “A 48% lower risk of ICU admission or death in hospital.
    • “This protection stretched from a week after vaccination out to 299 days afterward, researchers reported June 25 in JAMA Network Open.
    • “Maximum protection came during the first two months after vaccination, reducing severe cases of COVID by up to 68%, results show.
    • “However, vaccine effectiveness waned over time, particularly beyond the six-month mark.”
  • The University of Minnesota’s CIDRAP reports,
    • “The US Centers for Disease Control and Prevention (CDC) is now updating its measles totals on Wednesdays, and on June 25 it reported 13 more cases, putting the national total at 1,227 in 37 states. The nation’s cases are just 48 cases shy of passing the record number of cases reported in the 2019 surge, which was the most since measles was eliminated in the United States in 2000.
    • “The number of outbreaks remained at 23, and 89% of the confirmed cases are linked to outbreaks. Of the confirmed case-patients this year, 95% were unvaccinated or have an unknown vaccination status. So far, 148 people have been hospitalized, and the number of deaths remains at 3.”
  • and
    • “The percentage of US adults reporting high confidence in the Centers for Disease Control and Prevention (CDC) fell from 82% in February 2020 to 56% in June 2022, along with decreasing trust in other US health institutions, according to a study yesterday in PLOS Global Public Health.
    • “For the study, researchers from the University of Texas Southwestern Medical Center in Dallas conducted four surveys from February 2020 to October 2024 that assessed Americans’ confidence in US health institutions including the CDC, National Institutes of Health (NIH), Department of Health and Human Services (HHS), state and local health departments, professional medical organizations, the White House, and their own doctor. Sample sizes were 718, 672, 856, and 828, respectively.
    • “All four surveys asked participants their perceptions of public health organizations and who they thought should lead the US response to infectious disease outbreaks. Surveys 1 and 2 also asked questions on the COVID-19 pandemic, while surveys 3 and 4 asked questions around the 2022 and 2024 mpox outbreaks.” * * *
    • “The rate of those expressing high confidence then rebounded only slightly, to 60%, in October 2024.” * * *
    • “In a press release from PLOS, which published the journal, first author Hannah Melchinger says, “We need to take this decline seriously if we want to preserve the credibility of these entities and their public health recommendations.”
  • Per MedPage Today,
    • “Maternal flu vaccination was associated with a reduced risk of influenza infection during infants’ first 6 months of life, an age when they are too young to be vaccinated, a cohort study of nearly a quarter-million women and their babies found.
    • “Flu vaccination during pregnancy was associated with an adjusted 44.4% (95% CI 31.4-54.9) reduction in the risk of infant influenza infection, with protection strongest during the infants’ first few months of life, reported researchers led by Ousseny Zerbo, PhD, of Kaiser Permanente Northern California (KPNC) in Oakland, in Obstetrics & Gynecology.”
  • Health Day notes,
    • “People living with an autoimmune disease are nearly twice as likely to suffer from mood problems like depression, anxiety or bipolar disorder, a new large-scale study says.
    • “The risk of mood disorders is 87% to 97% higher in people suffering from rheumatoid arthritis, inflammatory bowel disease, lupus, multiple sclerosis, psoriasis and Graves’ syndrome, researchers reported June 24 in the BMJ Mental Health.
    • “This risk remains higher even after accounting for other factors like age, income and family history of psychiatric disorders, researchers found.
    • “Together, these results support the hypothesis that exposure to chronic inflammation may be associated with a greater risk for affective disorders,” concluded the research team led by Arish Mudra Rakshasa-Loots with the University of Edinburgh Center for Clinical Brain Sciences in the U.K.”
  • UConn which the FEHBlog’s alma mater writes in Linked In,
    • “Millions of Americans suffer from osteoarthritis, a painful joint disease that wears down cartilage and can severely impact mobility. Pain medications only mask symptoms, and surgical option carry risks of infection and immune rejection.
    • “At the University of Connecticut, a research team led by Thanh Nguyen, associate professor of mechanical engineering and biomedical engineering, believes the future of joint repair might lie in a tiny electrical spark—and a simple injection.
    • “Backed by a $2.3M grant from the National Institutes of Health (NIH) and National Institute of Biomedical Imaging and Bioengineering (NIBIB), Nguyen and his team are developing an injectable hydrogel designed to stimulate cartilage regeneration in large animal models.
    • “With current treatments, we’re managing the pain, not healing the tissue,” says Nguyen. “We’re hoping that the body’s own mechanical movements—like walking—can generate tiny electrical signals that encourage cartilage to grow back.”

From the U.S. healthcare business front,

  • Beckers Hospital Review lets us know about nine major hospital construction projects unveiled or advanced this year and notes that “Eliminating a $45 out-of-pocket fee for 3D mammography, also called digital breast tomosynthesis, increased utilization of the procedure by 7.8%, according to a study published June 19 in the Journal of the American College of Radiology.” 
  • Per HealthLeaders,
    • “Hospital at Home, which aims to treat selected patients at home with a combination of virtual care, remote patient monitoring and daily in-person visits instead of keeping them in the hospital, took off during the pandemic, with support from a waiver that enabled health systems and hospitals following the CMS model to receive Medicare reimbursement. That waiver is due to expire in September, and while there’s a strong lobbying effort to make it permanent, many hospital executives have said the program has proven its value and will go on regardless.”
  • Fierce Pharma discusses expert views on the status of the compounding industry now that the shortage of Novo and Lilly GLP-1 drugs is over.
  • Healthcare Dive reports,
    • “Bipartisan policies in Congress meant to lower drug costs by targeting middlemen in the pharmaceutical supply chain are likely to run up against a fundamental issue: the three major pharmacy benefit managers’ chokehold on the U.S. drug market, experts said during a drug pricing transparency forum in Washington, D.C. this week.”
    • The FEHBlog thinks that this is Pharma distraction.

Thursday report

David Ermer–CDC, Congress, Federal employment benefits, Medical / Rx research, Obesity, OPM, SDOH, U.S. Healthcare–

From Washington, DC,

  • The Wall Street Journal reports,
    • “Several of Republicans’ largest proposed spending reductions can’t be done as written in the fast-track budget process they are using to advance their megabill, the Senate parliamentarian determined, dealing a setback to the GOP’s hopes of passing their plans quickly. 
    • “The ruling affects several of the largest and most controversial reductions in President Trump’s “one, big, beautiful bill,” and Republicans will likely be forced to drop or rewrite them. The changes could amount to hundreds of billions of dollars, making it harder for Republicans to hit their budget targets.
    • “But the ruling wasn’t the final word, and Senate Republicans said by Thursday afternoon that they thought some slight tweaks to the wording of some proposed Medicaid cuts would be enough to break the logjam.
    • “There are things that we can do, there are other ways of getting to that same outcome,” said Senate Majority Leader John Thune (R., S.D.). Sen. John Hoeven (R., N.D.) said that such a plan was already under way, and that Republicans expected to hear back soon from the parliamentarian. 
    • “We’ve proposed some things to the parliamentarian that we think can work,” Hoeven said.’
  • Fierce Pharma tells us,
    • “The CDC’s Advisory Committee on Immunization Practices (ACIP) has blessed Merck’s new respiratory syncytial virus (RSV) shot Enflonsia, but the decision was hardly resounding from Robert F. Kennedy Jr.’s newly formed panel of advisors.
    • “The ACIP signed off on recommending Merck’s newly approved monoclonal antibody by a vote of 5 to 2. The committee endorses one dose of Enflonsia to be given to infants younger than 8 months of age who are born during or entering their first RSV season and who are not already protected by a maternal vaccine.” * * *
    • “The new recommendation for Enflonsia, which was approved by the FDA just two weeks ago, matches that of Sanofi and AstraZeneca’s Beyfortus, which has been on the market for the last two years and generated sales of $1.8 billion in 2024.”
  • BioPharma Dive adds,
    • “Advisers to the Centers for Disease Control and Prevention recommended Thursday that influenza vaccines used in the coming flu season be free of the preservative thimerosal, addressing unproven fears the mercury-containing substance can lead to developmental disabilities.
    • “If confirmed by the CDC, the recommendation from the Advisory Committee on Immunizaiton Practices, or ACIP, would affect about 5% of flu shots administered in the U.S., distributed in multidose vials that necessitate the use of a preservative to prevent bacterial or fungal contamination. Only three such vaccines are approved for U.S. use, two from CSL and one from Sanofi.
    • “Meeting for the first time with members appointed by Health and Human Services Secretary Robert F. Kennedy Jr., ACIP also reviewed a change in its recommendations for measles vaccines, although it won’t vote on that proposal until a meeting later this year.”
  • The Wall Street Journal sums it up as follows:
    • “The Advisory Committee on Immunization Practices, or ACIP, was established in 1964 to offer the federal government advice on which vaccines Americans should get and when. After Kennedy dismissed its 17 members and picked new ones, the committee spent two days examining science’s weapons to combat flu, measles and other diseases—with a new emphasis on the risks of the weapons themselves.
    • “Vaccines are not all good or bad,” said the committee’s new chair, Martin Kulldorff, a former Harvard professor. “No questions should be off-limits.” * * *
    • “In a joint statement after the two-day session concluded Thursday, the committee said it had “no predetermined ideas and will make judgments as if we are treating our own families,” adding that “unbiased scientific thinking is fundamental to the committee’s charge.”
  • The Census Bureau informs us,
    • “The U.S. population age 65 and older rose by 3.1% (to 61.2 million) while the population under age 18 decreased by 0.2% (to 73.1 million) from 2023 to 2024, according to the Vintage 2024 Population Estimates released today by the U.S. Census Bureau.
    • “The data show the population continued to age, with the share of the population age 65 and older steadily increasing from 12.4% in 2004 to 18.0% in 2024, and the share of children declining from 25.0% to 21.5%.
    • “Ongoing growth among the older population, coupled with persistent annual declines in the population under age 18 has reduced the size difference between these two age groups from just over 20 million in 2020 to just below 12 million in 2024. From 2020 to 2024, the older population grew by 13.0%, significantly outpacing the 1.4% growth of working-age adults (ages 18 to 64), while the number of children declined by 1.7%.
    • “Children still outnumber older adults in the United States, despite a decline in births this decade,” said Lauren Bowers, chief of the Census Bureau’s Population Estimates Branch. “However, the gap is narrowing as baby boomers continue to age into their retirement years. In fact, the number of states and counties where older adults outnumber children is on the rise, especially in sparsely populated areas.”
  • Tammy Flanagan, writing in Govexec, offer guidance to those who are “Retired and confused about Medicare Part B. You’re not alone. From late penalties to premium reimbursements, here’s what every retired fed should understand about enrolling in Medicare Part B—and how it works with your FEHB plan.

From the judicial front,

  • The Supreme Court will complete issuing opinions from its October 2024 term tomorrow morning at 10 am.
  • Beckers Hospital Review relates,
    • “Several Iowa businesses and health plans are suing to block a new state law regulating pharmacy benefit managers, arguing it violates federal law and the Constitution, Iowa Capital Dispatch reported June 23. 
    • “The lawsuit, filed June 23 in the U.S. District Court for the Southern District of Iowa, challenges Senate File 383, a measure signed in early June by Gov. Kim Reynolds. The plaintiffs include the Iowa Association of Business and Industry, Des Moines Orthopaedic Surgeons PC, Iowa Springs Manufacturing & Sales Co., and health plans like the Iowa Bankers Benefit Plan and Iowa Laborers District Council Health and Welfare Fund. 
    • “While supporters said the provisions will help struggling pharmacies in many Iowa communities, the lawsuit argued the new law will “raise healthcare costs for businesses across the state — large and small — by tens of millions of dollars.” 
  • Bloomberg Law adds,
    • “Four lawsuits seeking to invalidate a first-of-its kind Arkansas law prohibiting companies that manage prescription drug benefits from acquiring pharmacies will be heard together in federal court, a judge ruled Tuesday.
    • “The order from Judge Brian S. Miller for the US District Court for the Eastern District of Arkansas grants an unopposed motion filed by the Arkansas attorney general’s office to consolidate the cases. The challenges were brought by pharmacy benefit managers Express Scripts, CVS Health Corp., and OptumRx, as well as the industry group Pharmaceutical Care Management Association.” * * *
    • “Miller ordered Tuesday that all future filings in the four cases be filed in the docket for Express Scripts’ lawsuit. The members of the Arkansas pharmacy board, who are represented by the state attorney general’s office, must file by July 11 a consolidated response to PBMs’ motion for a preliminary injunction on the law, according to the order. 
    • “The case is Express Scripts v. Richmond , E.D. Ark., No. 4:25-cv-00520, motions to consolidate granted 6/24/25.” 
  • Beckers Hospital Review lets us know about ten recent healthcare billing fraud cases.

From the public health and medical research front,

  • Fox Business reports,
    • Trader Joe’s said Friday [June 20] that a “single lot code” of the cheese curds have been recalled in response to the potential risk of Listeria monocytogenes contamination.
    • The recalled product was offered at some Trader Joe’s locations in Northern California as well as stores in the Nevada cities of Carson City, Reno and Sparks, according to a notice posted on the popular grocery store chain’s website. 
    • The stores in Northern California included those in Monterey, Fresno and “all locations North,” Trader Joe’s said. 
    • “The recalled cheese curds have a use-by date of “082925” on their container.” 
  • Beckers Hospital Review ranks states by opioid overdose deaths.
    • “West Virginia had the highest rate of fatal opioid overdoses of any state in 2023, according to a new analysis from KFF. 
    • “The analysis is based on finalized 2023 opioid overdose death totals from the CDC’s WONDER database, which uses ICD-10 codes to identify deaths where synthetic and prescription opioids are listed as a contributing cause.
    • “Becker’s calculated each state’s death rate per 100,000 residents using 2023 U.S. Census population estimates to enable fair comparisons across states.
    • “The national opioid overdose death rate was 23.69 per 100,000 residents in 2023.”
  • News Medical points out,
    • “Weight loss surgery has long been an effective treatment for the more than 40 percent of American adults struggling with obesity. Previous studies have shown that Black patients lose less weight overall following bariatric surgery compared to other racial groups, but less attention has been paid to the relationships between economic and social factors that may help explain differences in weight loss.
    • “New research led by NYU Langone Grossman School of Medicine found that Black patients who had a sleeve gastrectomy, the most common weight loss surgery, between 2017 and 2020 lost 6.2 percent less weight than their White counterparts, and 4.9 percent less than Hispanic patients, after one year. However, further analyses found that a lot more complexity and interplay between non-biological factors than previously known appear to impact weight loss surgery incomes.
    • “Published online in the journal Obesity, this is the first study to investigate the relationship between a variety of economic and social factors that include income, sleep disturbances and stress, and weight loss differences among racial groups, the study authors said.”
  • Per Health Day,
    • “Fitness trackers aren’t accurately assessing the physical activity of people with obesity, a new study argues.
    • “Differences in walking gait, speed, energy burn and other factors mean that folks with excess weight aren’t getting an accurate read from their devices, researchers wrote in the journal Scientific Reports.
    • “People with obesity could gain major health insights from activity trackers, but most current devices miss the mark,” senior researcher Nabil Alshurafa, an associate professor of behavioral medicine at Northwestern University Feinberg School of Medicine in Chicago, said in a news release.
    • “Alshurafa’s team has developed a new algorithm that enables smartwatches to more accurately monitor the calories burned by people with obesity, researchers said.
    • “Lab tests show that the new algorithm achieves over 95% accuracy in real-world situations, the study says.
    • “Without a validated algorithm for wrist devices, we’re still in the dark about exactly how much activity and energy people with obesity really get each day — slowing our ability to tailor interventions and improve health outcomes,” Alshurafa said.”
  • Per MedPage Today,
    • “AS01-adjuvanted RSV and shingles vaccines were tied to a lower dementia risk in older adults.
    • “Compared with flu vaccine recipients, those who had the AS01 RSV shot had 29% more dementia-free time over 18 months.
    • “No differences emerged between the two AS01 vaccines, implying the adjuvant may play a role.”

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • “The leader of UnitedHealth Group Inc.’s Optum Health care delivery unit has left the role, an early indication of management changes under Stephen Hemsley, UnitedHealth’s new chief executive officer.
    • “The division will now be led by Patrick Conway, who was recently promoted to CEO of the broader Optum division that includes Optum Health. Conway will add the title of Optum Health CEO, according to a company memo reviewed by Bloomberg News.
    • “Amar Desai had been CEO of Optum Health since 2023. He’ll become president of Optum integrated care and vice-chairman of Optum Health, according to the memo, and will continue to work with Conway and Hemsley.”
  • Healthcare Dive tells us,
    • “Declines in Walgreens’ front-of-store retail sales continued in Q3, falling 5.3% year over year, due largely to store closures and lower same-store sales. The drugstore retailer last year announced it would shutter 1,200 U.S. stores over three years.
    • “Weak sales in grocery and household, health and wellness, and beauty drove store comps down 2.4%. The international and U.S. healthcare segments fared better, helping drive a 7.2% overall Q3 sales increase to $39 billion.
    • “The drugstore retailer swung into the red with a net loss of $175 million, a decrease of $519 million compared to last year’s $344 million in net earnings.”
  • Per MedTech Dive,
    • “Johnson & Johnson has partnered with Nvidia and Amazon Web Services, or AWS, to support the use of artificial intelligence in surgery, the medtech company said Wednesday.
    • “The Polyphonic AI Fund for Surgery builds on J&J’s existing collaboration with Nvidia and creation of a digital platform for in-house and third-party surgical applications.
    • “Through the fund, J&J, Nvidia and AWS will evaluate, and support projects related to AI model development, data engineering and management, and AI governance.”
  • Per Tech Target,
    • The Lown Institute is recognizing 125 hospitals nationwide for their performance on health equity, value and outcomes, honoring these for this corporate social responsibility in healthcare.
    • “These hospitals show that no matter how tough the environment gets, putting patients and communities first is always possible,” Vikas Saini, M.D., president of the Lown Institute, said in a press release. “Those returning to the list prove that equitable, high-value care doesn’t have to be rare; it’s a standard that hospitals can uphold year after year.” * * *
    • “The top 10 acute care hospitals for health equity, value and outcomes include the following:
      • “Duke Regional Hospital (Durham, N.C.).
      • “Fort Loudoun Medical Center (Lenoir City, TN..).
      • “Baylor Scott & White Medical Center – Pflugerville (Pflugerville, TX.).
      • “Denver Health Main Campus (Denver, CO.).
      • ‘Methodist Medical Center (Oak Ridge, TN.).
      • “Prisma Health Baptist Hospital (Columbia, S.C.).
      • “TriStar Horizon Medical Center (Dickson, TN.).
      • “Sharon Hospital (Sharon, CT.).
      • “Inspira Medical Center Vineland (Vineland, N.J.).
      • “Southern California Hospital at Hollywood (Los Angeles, CA.).”
  • MedCity News reports,
    • “Novavax’s alliance with Sanofi came at an opportune time for the beleaguered vaccine developer. Its protein-based Covid-19 vaccine never reached the revenue highs achieved by the messenger RNA vaccines for the novel coronavirus. A corporate restructuring slashed headcount and R&D spending, but Novavax’s financial reports still flagged concerns about the company’s ability to continue.
    • “The Sanofi partnership(Opens in a new window) inked a little more than a year ago infused Novavax with $500 million up front, staving off the immediate financial worries. Starting this year, Sanofi will record sales of the Covid-19 shot vaccine Nuvaxovid, paying Novavax royalties on those sales. The deal is more than a financial lifeline. Beyond sharing in Nuvaxovid’s commercialization, Sanofi can research potential combinations of the Covid-19 shot with its own influenza vaccines. The pharmaceutical giant may also explore using Novavax’s adjuvant in its own vaccines. This agreement is a blueprint for the kinds of alliances Novavax is now pursuing, according to Ruxandra Draghia-Akli, executive vice president, head of research and development.
    • “It’s a multifaceted partnership and we thought that is a model, or maybe components of that model can be developed with other partners,” she said in an interview during the recent BIO International Convention in Boston.”
  • Per Fierce Pharma,
    • “After blueprinting an injectables facility in North Carolina in 2020, it didn’t take long for Eli Lilly to draw up designs for a second in the Tar Heel State.
    • “Following declines in the manufacturing, textiles and tobacco industries that once formed the core trades in the state, North Carolina has increasingly put its chips behind biotechnology. It’s a strategy that has attracted not only Lilly but myriad other pharma majors like Fujifilm Biosciences, Johnson & Johnson and Thermo Fisher Scientific.
    • “For Lilly, building a new parenteral products and devices facility in the city of Concord was a natural evolution following the decision to throw down $470 million on a similar injectables plant at North Carolina’s famed Research Triangle Park back in 2020.” * * *
    • “Together, Lilly’s two North Carolina facilities—which are used in part to make incretin medicines such as Zepbound and Mounjaro—are part of the drugmaker’s ongoing, multibillion-dollar investment in U.S. infrastructure. They also form part of a bulwark against the immense demand for Lilly’s dual GIP/GLP-1 products for diabetes and obesity.”
  • and
    • “Novo Nordisk continues to expand its partnerships with telehealth companies to broaden access to its blockbuster weight loss drug Wegovy.
    • “The pharma giant is now partnering with WeightWatchers to offer consumers access to Wegovy, using CenterWell Pharmacy to fulfill and deliver the medications. CenterWell is owned by Humana.
    • “WeightWatchers aims to provide patients with a more streamlined experience, along with convenient access to FDA-approved medication with the lifestyle support shown to improve outcomes, the company said in a press release.
    • “The partnership will start July 1.”




Midweek report

David Ermer–CDC, Congress, FDA, Generative AI, Medical / Rx research, Medicare, Obesity, U.S. Healthcare–

From Washington, DC,

  • The Wall Street Journal reports,
    • “Senate Republican leaders kept pressing the gas pedal Wednesday to get their “one big, beautiful bill” passed by this weekend, even while hundreds of billions of dollars in crucial decisions are being negotiated, key senators are holding out, and some House lawmakers are crying foul.
    • “President Trump wants the legislation on his desk by July 4, and Republicans hope the megabill’s perceived inevitability overcomes any momentary implausibility. Senators aim to start votes as soon as Friday on the legislation, which would cut taxes, reduce spending on Medicaid and nutrition assistance, and boost spending on border security and national defense. The House could send the bill to Trump early next week. 
    • “For now, there aren’t enough votes for a bill that isn’t finished yet. 
    • “It is this mysterious process of trying to be able to move specific ideas through 53 other people and trying to be able to get ideas and opinions,” said Sen. James Lankford (R., Okla.). “And where do people land? It’s a moving target.”
    • “Senators aren’t quite ready to vote, and they expect to change the legislation in the days ahead. Several senators, including Josh Hawley (R., Mo.) and Dan Sullivan (R., Alaska), said they want to be able to review the whole bill before taking the first procedural step—a vote to open debate. 
    • “Our guys are all going to keep advocating for what they want, till the final minute, till we pass it,” said Sen. John Hoeven (R., N.D.) “That’s how it works.” 
  • and
    • “Health Secretary Robert F. Kennedy Jr.’s new panel of vaccine advisers will re-evaluate the recommended schedule for vaccines for children and teenagers, including for measles and hepatitis B, its new chairman said Wednesday.
    • “The new slate of advisers met for the first time Wednesday in Atlanta, kicking off a two-day meeting with an agenda partially set by political appointees. Meanwhile, on Capitol Hill, the nominee to lead the Centers for Disease Control and Prevention, Susan Monarez, told senators she believes vaccines save lives and there is no causal link between vaccines and autism.” * * *
    • “Monarez, if confirmed, would have the power to decide whether or not to adopt ACIP recommendations. Asked if she agreed with Kennedy’s decision to remove all members of the previous committee, Monarez responded “that the secretary had to make a decision related to ensuring that the ACIP could be supportive of restoring public trust in decision-making.”
    • “The vaccine advisory panel is set Thursday to hear a presentation on thimerosal, a preservative that antivaccine activists have often blamed for autism, from Lyn Redwood, a nurse practitioner who is president emerita of Children’s Health Defense, an antivaccine nonprofit previously helmed by Kennedy. Antivaccine activists have long claimed that thimerosal causes autism. Rates of the disorder have continued to climb even after thimerosal was removed from most vaccines in the early 2000s.”
  • Beckers Health IT tells us,
    • “Health and Human Services Secretary Robert F. Kennedy Jr. says he wants every American using a wearable health device within four years, Politico reported June 24.
    • “Speaking during a June 24 hearing of the House Energy and Commerce Health Subcommittee, Mr. Kennedy said the department is preparing “one of the biggest advertising campaigns in HHS history” to promote wearable technology.
    • “The devices are central to Mr. Kennedy’s “Make America Healthy Again” initiative. He told lawmakers that wearables give people a way to “take control of their own health.”
  • Govexec fills us in on what happened at yesterday’s House Oversight and Government Reform Subcommittee on Government Operations hearing titled “The Route Forward for the U.S. Postal Service: A View from Stakeholders.”
  • The American Hospital Association News informs us,
    • “The Administration for Strategic Preparedness and Response June 25 announced it conducted an exercise transporting simulated patients with high-consequence infectious diseases in a new portable biocontainment unit from Toronto to U.S. hospitals in the northeast and southeast. The hospitals are all Regional Emerging Special Pathogen Treatment Centers for highly infectious diseases. ASPR said the biocontainment unit is the first domestic resource for isolating and transporting patients with high-consequence infectious diseases, such as Ebola, across long distances to RESPTCs. The unit can be transported by air or by ground.”
  • CMS called attention to its Medicare website explaining how to get medical assistance in a disaster or emergency.

From the state and local government front,

  • Politico lets us know,
    • New York City Mayor Eric Adams announced [June 22] he will not move forward with a contentious effort to cut costs by shifting retired city workers to a Medicare Advantage plan, bringing a sudden end to a four-year saga.
    • “We have heard concerns from retirees about these potential changes at numerous older adult town halls and public events, and our administration remains focused on ensuring that New York City remains an affordable place to live,” Adams said in a statement Friday.
    • Just two days earlier, the state Court of Appeals ruled in City Hall’s favor in a lawsuit over the Medicare Advantage transition, handing Adams a rare win in the long legal battle to implement a plan he inherited from former Mayor Bill de Blasio.

From the Food and Drug Administration front,

  • STAT News reports,
    • Outgoing Food and Drug Administration regulator Jacqueline Corrigan-Curay acknowledged to staff [June 24] that much is still in flux at the agency, weeks before she retires.
    • “We are leaner and therefore we have to find ways to be efficient and do things in new ways,” she told staff, according to a recording of a town hall meeting obtained by STAT. 
    • She did not say who will be the next leader of the Center for Drug Evaluation and Research once she retires next month. Her retirement is the latest in a series of departures of senior officials at the FDA, who have either chosen to take early retirements, left for other jobs, or been forced out by political appointees.
    • “CDER has filled one leadership position, though. At the meeting, Corrigan-Curay introduced staff to the new deputy director of CDER, Mike Davis. Davis, a psychiatrist and pharmacologist, was most recently chief medical officer at the Usona Institute, a nonprofit organization developing psychedelic drugs for the treatment of depression and PTSD. He previously spent six years at the FDA as a clinical team leader in the psychiatry division.” 
  • Per BioPharma Dive,
    • “The Food and Drug Administration is investigating two deaths among [over 900] patients treated with Sarepta Therapeutics’ gene therapy Elevidys for Duchenne muscular dystrophy. Both patients died this year of acute liver failure after receiving Elevidys, with the second case reported earlier this month. The FDA said their deaths appear to be related to treatment and that it will evaluate “the need for further regulatory action.”
  • Per MedPage Today,
    • “The FDA said Wednesday it has expanded existing warnings on the two leading COVID-19 vaccines about a rare heart side effect mainly seen in young men.
    • “Myocarditis, a type of heart inflammation that is usually mild, emerged as a complication after the first shots became widely available in 2021. Prescribing information from both Pfizer and Moderna already advises doctors about the issue.
    • “In April, the FDA sent letters to both drugmakers asking them to update and expand the warnings to add more detail about the problem and to cover a larger group of patients. While the FDA can mandate label changes, the process is often more of a negotiation with companies.”

From the public health and medical research front,

  • The American Hospital Association News tells us,
    • “A study published June 25 by the Journal of the American Heart Association found that heart disease death rates fell 66% from 1970 to 2022. Deaths from heart attacks decreased 89% in that time span. The study attributed the declines to advancements in intervention and prevention efforts. Meanwhile, deaths from other types of heart disease, including arrhythmia, heart failure and hypertensive heart disease, increased by 81% during the same period. The study said the rising prevalence of obesity, diabetes, hypertension and physical inactivity have contributed to those causes.”
  • Cardiovascular Business adds,
    • “A team of surgeons with Baylor St. Luke’s Medical Center in Houston has made history, performing what is believed to be the first fully robotic heart transplant in the United States. 
    • “The procedure occurred in March 2025. Kenneth K. Liao, MD, PhD, chief of cardiothoracic transplantation and circulatory support at Baylor College of Medicine and chief of cardiothoracic transplantation and mechanical circulatory support at Baylor St. Luke’s Medical Center, and colleagues completed the transplant using an advanced Da Vinci surgical system. 
    • “The patient’s chest did not need to be opened all for the procedure—everything was done through small incisions.
    • “Opening the chest and spreading the breastbone can affect wound healing and delay rehabilitation and prolong the patient’s recovery, especially in heart transplant patients who take immunosuppressants,” Liao explained in a statement. “With the robotic approach, we preserve the integrity of the chest wall, which reduces the risk of infection and helps with early mobility, respiratory function and overall recovery.”
    • “The patient in question was a 45-year-old male who had been hospitalized with advanced heart failure for four months. He was discharged after being observed in the hospital for a month. There have been no complications.”
  • Per Medscape,
    • “The investigational non-peptide small-molecule oral GLP-1 agonist orforglipron significantly reduced A1c over 40 weeks in adults with early type 2 diabetes, according to the results of ACHIEVE-1 sponsored by Eli Lilly. 
    • “In the trial, orforglipron reduced A1c to the 6.5% range and produced clinically meaningful weight loss with a safety profile similar to that of other GLP-1 drugs. ACHIEVE-1 is the first of seven phase 3 studies of the safety and efficacy of the drug in over 6000 patients with type 2 diabetes and obesity,
    • “Orforglipron and other similar non-peptide small molecules “have the potential to be widely accepted as a much earlier therapy for type 2 diabetes,” Julio Rosenstock, MD, senior scientific advisor for Velocity Clinical Research and clinical professor of medicine at the University of Texas Southwestern Medical Center, Dallas, said at a press briefing here at the American Diabetes Association (ADA) 85th Scientific Sessions. The findings were simultaneously published in the New England Journal of Medicine.”
  • STAT New relates,
    • “A study tracking nearly 250,000 Swedish people using ADHD medication for 14 years found that these treatments can reduce risks of traffic crashes, injuries, and criminal behavior — and that conclusion remained true even as more girls, women, and adult men received a diagnosis.
    • “I wish we had access to this kind of data for the U.S.,” said Ryan Sultan, who was not part of the study and is a psychiatrist and professor at Columbia University Irving Medical Center where he specializes in ADHD. “Being able to follow them from birth means that their data is really, really powerful.”
    • “The study arrives as providers in the United States contend with twin realities: ADHD medication prescriptions are skyrocketing — largely thanks to telehealthand diminishing stigma — while medication shortages are imperiling people’s access to these critical treatments. Scientists are also learning more about how the condition interacts with other variables, such as how menstrual periods can affect symptoms and treatment. 
    • “We’re in a moment in U.S. society where … everyone and their grandmother are asking whether they have ADHD or not,” said Sultan. “It’s really interesting to be thinking about, when we’re expanding [access], who are we actually expanding it to, and who are we actually treating?”
  • Medical Economics points out,
    • “According to Dexcom’s 2025 State of Type 2 Report, most U.S. physicians now consider continuous glucose monitoring (CGM) one of the most impactful interventions for managing type 2 diabetes, surpassing even medications and lifestyle counseling in future importance.
    • “The findings are based on a national survey of 310 adults with type 2 diabetes and 111 U.S. health care professionals (HCPs), including primary care physicians, nurse educators and diabetes specialists.
    • “CGM adoption remains relatively low among patients — just 16% of U.S. adults with type 2 diabetes currently use the technology — but satisfaction among users is high. The vast majority report improved quality of life, reduced stress and better engagement with their glucose data. Physicians, meanwhile, see CGM as a key solution to longstanding pain points, including poor adherence, low health literacy and difficulty tracking glucose fluctuations outside clinic visits.
    • “The report highlights a disconnect between CGM’s perceived value and its real-world accessibility. Most patients cite cost or insurance coverage as the top reason for not trying it. Most physicians say they lack the tools to educate patients on its benefits. And nearly three-quarters of people with type 2 diabetes say they need better understanding of how diabetes technology can help them manage their condition.”
  • Per the American Journal of Managed Care,
    • The use of pre-exposure prophylaxis (PrEP) for prevention of HIV has helped to curb the spread of the virus nationally. Knowing how much PrEP is needed in certain areas can help to more specifically target vulnerable populations who need it more.
    • A model was developed that could estimate the need for PrEP, according to a study published in Annals of Epidemiology. Public health authorities can use this information to monitor progress and establish resource allocation.

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • “U.S. households, businesses and governments will spend $8.6 trillion on healthcare in 2033, when the sector will comprise just over one-fifth of gross domestic product, according to a federal report issued Wednesday.
    • “The Centers for Medicare and Medicaid Services Office of the Actuary attributes its forecast to factors such as a rapidly aging population and high demand for healthcare. The independent CMS division published its analysis in the journal Health Affairs.
    • “National health expenditures will increase 5.8% a year on average from 2024 to 2033, the actuaries predict. The healthcare spending trend is expected to continue outpacing economic growth, which the office projects will average 4.3% annually over the coming decade.”
  • Fierce Healthcare adds,
    • “In an uncertain policy and macroeconomic environment, healthcare finance leaders are concerned about what the future holds, a new report showed.
    • “Analysts at Deloitte surveyed 64 finance leaders, split evenly between executives from health systems and insurers, to capture what they view as the biggest challenges and opportunities coming down the pike. Most (84%) of those surveyed said they are worried about business conditions given the cloudy policy outlook, economic concerns and potential disruptions from tariffs and the supply chain.
    • “Over the past several years, workforce challenges, cost reductions and cybersecurity have all been top concerns for finance leaders in healthcare. However, this year’s survey found external factors taking on a much greater role.”
    • “Internal concerns like workforce challenges, cost reduction, and cybersecurity—once top priorities for healthcare chief financial officers in our previous surveys—seem to have become less urgent amid rising external factors, according to survey respondents,” the researchers said.”
  • Per a press release,
    • “Optum is accelerating the adoption of artificial intelligence (AI) for health care technology companies, providers and payers with the launch of the Optum AI Marketplace. The new marketplace is the only health care-specific AI digital platform of its kind, built by health care developers to simplify AI integration across clinical and administrative systems.
    • “Many emerging health care organizations want to modernize their systems but don’t have the time, resources, or infrastructure to build AI solutions on their own. The new marketplace addresses these gaps by offering a centralized, health care-specific ecosystem of curated solutions and APIs that are ready to implement, helping organizations streamline operations, reduce integration costs, and scale AI adoption.
    • “Optum brings decades of health care expertise and advanced data infrastructure to the AI Marketplace. This foundation ensures the platform is built for real-world health care needs and supports faster, more effective AI and API implementation. With more than 1.4 billion API transactions each year, the marketplace powers real-time insights and seamless integrations across the health care landscape.” * * *
    • Discover more at Optum AI Marketplace.
  • Per Beckers Hospital Review,
    • Overall demand for healthcare services is poised to continue its significant growth across various service lines over the next decade, with outpatient care expected to experience the highest growth rate and inpatient services seeing more moderate increases, according to Sg2’s 2025 Impact of Change Forecast published in June.
    • Sg2’s forecasting model integrates a broad range of factors, including national data, institutional data, and market trends. National population changes, epidemiological shifts, economic influences, policy developments and advances in technology were considered in the projections.
    • Sg2 used data from the HCUP National Inpatient Sample and CMS Limited Data Sets, alongside its own analysis of healthcare usage trends.
  • Per Beckers Payer Issues,
    • “Medicare Advantage enrollees experience longer hospital stays before being discharged to post-acute care settings compared to individuals enrolled in traditional Medicare, according to a June 2025 analysis by NORC at the University of Chicago.
    • “The analysis was commissioned by the Coalition to Strengthen America’s Healthcare, a group of more than 5,000 hospitals, businesses and hospital associations that includes the AHA and FAH. 
    • “The researchers found that while hospital discharges overall declined over the five-year study period, discharges to post-acute settings increased for MA enrollees and decreased slightly for traditional Medicare enrollees. At the same time, MA enrollees had longer hospital stays prior to post-acute discharge, with the gap widening over time.
    • “While the data is age-adjusted, the study did not control for clinical or demographic differences that could affect length of stay or discharge destination. Future research is recommended using tools like HCC risk scores and claims-based frailty index to better isolate coverage-related effects.”