FEHBlog

Tuesday report

David Ermer–Agentic & Generative AI, CDC, CMS, Congress, FDA, Medical / Rx research, Medicare, Mental health care, NIH, Rx coverage, U.S. Healthcare–

Simplicity is a virtue

From Washington, DC

  • Roll Call reports,
    • “Sen. Darline Graham took the oath of office Tuesday to fill the vacancy left by the unexpected death of her older brother, four-term Republican Sen. Lindsey Graham. The late Graham died Saturday night at age of 71 of an aortic dissection, according to preliminary findings by the D.C. medical examiner.”
  • and
    • “Speaker Mike Johnson narrowly freed the floor from another standstill Tuesday — but it’s not clear how long the good feeling will last.
    • “The House adopted a rule for floor debate in a 215-211 vote after GOP leaders won over key holdouts by promising a markup of border security legislation before the August recess and taking steps to graft a voter ID bill onto a spending measure.
    • “With such a slim majority, leadership can only afford to lose a few Republican votes for party-line measures.”
  • Per a Centers for Medicare and Medicaid Services news release,
    • “The Centers for Medicare & Medicaid Services (CMS) is proposing transformational reforms to Medicare’s physician payment and value-based care programs that would expand accountable care, modernize physician payment, reduce administrative burden, and help shift the healthcare system’s focus from treating illness to preventing it.
    • “The proposals would make Medicare accountable care organizations (ACOs) easier to join and more rewarding to participate in, transition clinicians away from traditional Merit-based Incentive Payment System (MIPS) reporting toward more meaningful value-based care pathways, and update physician payment policies to better reflect modern clinical practice. Together, these reforms would strengthen primary care, improve patient outcomes, and support Medicare’s long-term sustainability.
    • “We’re proposing some of the most significant Medicare reforms in recent years to strengthen primary care, expand accountable care, and modernize physician payment,” said CMS Administrator Dr. Mehmet Oz. “These changes would make it easier for clinicians to focus on prevention, improve coordination for patients, and ensure Medicare rewards better outcomes rather than more services.” * * *
    • “To view the CY 2027 Physician Fee Schedule proposed rule, please visit: https://www.federalregister.gov/public-inspection/current
    • “To view the related Quality Payment Program fact sheet, please visit: https://d2g5m5leph8kam.cloudfront.net/s3fs/s3fs-public/2026-06/2027-qpp-proposed-rule-factsheet.pdf
    • “For a fact sheet on the CY 2027 Physician Fee Schedule proposed rule, please visit: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2027-medicare-physician-fee-schedule-proposed-rule
    • “For a fact sheet on the proposed Medicare Shared Savings Program changes in the CY 2027 PFS proposed rule, please visit: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2027-medicare-physician-fee-schedule-proposed-rule-cms-1848-p-medicare-shared“
  • Radiology Business adds,
    • “Physicians with greater clinical knowledge are less likely to order low-value imaging and other unnecessary healthcare services, according to new research published Monday. 
    • “These wasteful tests and treatments—such as imaging for an uncomplicated headache, which provides no benefit to the patient—continue plague the U.S. healthcare system. Each year, the country spends an estimated $100 billion on low-value services, experts write in JAMA Internal Medicine. 
    • “Researchers recently aimed to better understand how higher physician knowledge might help to curb healthcare waste.  They utilized the American Board of Internal Medicine’s Longitudinal Knowledge Assessment to measure clinician know-how, matching it against IM’s ordering of 25 different low-value services including medical imaging. 
    • “Lead author Jonathan L. Vandergrift, MS, and colleagues found a clear connection, with high-knowledge docs less likely to order unnecessary scans.”
    • “These findings suggest an important question for further study: If those who scored lower in the first year increase their knowledge, and therefore their score, over time, will they then order fewer low-value services?” Vandergrift, a senior health services researcher at the ABIM, said in a news announcement July 13. “We hope to learn more about whether the healthcare system may cut unnecessary costs through education and assessments that steer clinicians toward higher-value care that provides the most benefit to patients.”
       
  • The American Hospital Association relates,
    • “The Health Resources and Services Administration announced that 340B covered entities purchased $100 billion in outpatient drugs under the federal 340B Drug Pricing Program in calendar year 2025. This represents an approximate 22% increase from CY 2024, which had sales of about $81.4 billion. HRSA partly attributed the growth to increased shifts from inpatient to outpatient care, a rise in innovative therapies and increases in drug pricing. Of the $100 billion in CY 2025 sales, 340B hospitals accounted for nearly 87%, or about $87 billion.”
  • Per a Government Accountability Office news release,
    • “In recent years, Medicare’s spending on hospice has nearly doubled. We looked at this spending and found that the way Medicare pays for hospice care could be costing taxpayers billions more than it should. 
    • “Today’s WatchBlog post looks at our new report about inefficiencies in Medicare’s payments.”

From the Food and Drug Administration front,

  • Beckers Hospital Review reports,
    • “The FDA has approved Sanofi’s subcutaneous Sarclisa Escena in combination with standard-of-care regimens for patients with multiple myeloma across all existing indications of the intravenous formulation, making it the first anticancer treatment administered through an on-body injector.
    • “Sarclisa Escena is administered through Sanofi’s on-body injector and is the first multiple myeloma treatment in the U.S. available through both an on-body injector and manual subcutaneous administration, according to a July 10 news release.”
  • Cure relates,
    • “The Food and Drug Administration (FDA) on July 14, 2026, granted traditional approval to Retevmo (selpercatinib) for adults and children 2 years of age and older with locally advanced or metastatic solid tumors that carry a RET gene fusion, as identified by an FDA-approved test.
    • “To be eligible, patients must have seen their cancer progress on or after prior systemic treatment, or have no satisfactory alternative treatment options available.
    • “The approval marks an upgrade from the accelerated approval Retevmo previously received for this indication — first for adult patients in 2022 and later extended to pediatric patients ages 2 and older in 2024. Traditional approval is granted when a drug’s clinical benefit has been confirmed through additional clinical evidence.”
  • MedTech Dive reports,
    • “Medtronic is removing from the market certain lots of a catheter used to place pulmonary valves, the Food and Drug Administration said in a Monday recall notice.
    • “The affected devices have an increased risk that the distal tip may detach from the delivery catheter system, requiring another procedure to remove the tip. As of May 14, Medtronic had not reported any serious injuries or deaths associated with the issue, according to the FDA notice.
    • “A Medtronic spokesperson said in an emailed statement to MedTech Dive that the problem is limited to certain delivery systems and does not involve the valve itself. Medtronic has resolved the underlying manufacturing problem, so future shipments will not be affected by the recall, the spokesperson wrote.”

From the judicial front,

  • Healthcare Dive reports,
    • “CVS Health’s Caremark has reached a settlement with the Federal Trade Commission requiring notable changes to the pharmacy benefit manager’s business practices, including that Caremark prefer the lowest-cost drugs on its standard formularies and pass through savings negotiated with drugmakers to clients.
    • “The settlement announced by the FTC on Tuesday puts to bed regulators’ allegations that Caremark preferred more expensive versions of insulin in order to increase its rebates, driving up prices for the lifesaving diabetes drug. The FTC lodged the suit against Caremark, along with fellow PBM giants Express Scripts and Optum Rx, in 2024.
    • “Express Scripts settled with the FTC in February while Optum Rx is still finalizing an agreement with the antitrust agency.”
    • “The terms of CVS’ settlement are very similar to those secured with Express Scripts. The deal prevents the drug middleman from discriminating against cheaper drugs in its standard formularies for commercial clients, and requires it to provide a standard offering to plan sponsors that doesn’t include rebates.
    • “It requires Caremark to include any purchases a patient makes through TrumpRx, President Donald Trump’s online drug marketplace, towards the deductible in certain health plans, once regulatory changes make that possible. The settlement also includes a number of transparency provisions.
    • However, the CVS deal includes a new wrinkle meant to assuage concerns that the healthcare behemoth leverages its market power to prevent independent pharmacies from working with rival pharmacy hubs, third-party companies that provide a range of digital pharmacy services.
    • “The settlement prevents CVS from foreclosing hub service providers [FEHBlog provided link], and will create a monitor to ensure its compliance, according to the FTC.”
  • Modern Healthcare reports,
    • “The U.S. Justice Department (DOJ) sent civil investigative demands to lawyers in private litigation against Claritev [formerly known as Multiplan], escalating its antitrust probe.
    • A federal judge in June 2025 rejected Claritev’s bid to dismiss the private suits, keeping the cases alive.
    • The DOJ also has a separate ongoing antitrust investigation into one of Claritev’s major insurer clients.
  • Reuters relates,
    • “A coalition of public health organizations, pediatricians and parents sued the U.S. Food and Drug Administration on Tuesday, challenging a ​new policy that allow some manufacturers to sell vapes and ‌nicotine without the legally required license.
    • “The lawsuit, filed in U.S. District Court in Maryland, targets FDA guidance issued in May. The guidance states the agency would ​not prioritize enforcement against certain unauthorized e-cigarettes and nicotine pouch ​products if the companies have marketing applications under review.”

From the public health and medical / Rx research front,

  • The Wall Street Journal reports,
    • “Michigan state health officials are narrowing in on lettuce as a possible culprit in the rapidly expanding explosive-diarrhea outbreak, though federal authorities say they are still working to confirm a specific food source as the cause.
    • “Donald Prater, the Food and Drug Administration’s acting deputy commissioner for food, said lettuce is one of multiple produce items under investigation as officials race to identify the outbreak’s origins.
    • “Top health officials in Michigan said bagged, prewashed salad kits could be a particular risk, based on the state’s review of cases.
    • “The early signals are telling us that lettuce does seem to be implicated,” said Dr. Natasha Bagdasarian, the state’s chief medical executive.
    • “Michigan is the hardest hit by the cyclospora parasite, with more than 3,300 cases as of Tuesday, more than double the number on Friday.”
  • The American Hospital Association News adds,
    • “The Centers for Disease Control and Prevention July 14 released an advisory on the growing cyclosporiasis cases across the U.S. The advisory said that the agency received reports of 1,645 confirmed domestic cases across 34 states and is aware of more than 5,100 cases that require further analysis for confirmation. The CDC said that of 1,645 case-patients with available information, 9% (141) were hospitalized and no patients have died. The advisory includes recommendations for clinicians on how to diagnose and treat patients with cyclosporiasis, and for facilities on how to disinfect healthcare settings. The CDC is working with the Food and Drug Administration and state and local health departments to identify the cause of the illness. The CDC said that because cyclosporiasis is often underdiagnosed and underreported, the actual total of illnesses is likely higher than what has been reported.”
  • Healio relates,
    • “Alcohol consumption and smoking were identified as the two strongest common risk factors for breast cancer and atrial fibrillation globally, according to data published in the Journal of the American Heart Association.
    • “Reducing alcohol intake and smoking behaviors to the level at which risk is smallest, nearly one-third of breast cancer cases and 12% of AF cases could be prevented, the researchers wrote.
    • “One of the most surprising aspects of our findings was how common both breast cancer and atrial fibrillation/flutter diagnoses were among women ages 55 and older in high-income regions, which highlights the influence of lifestyle,” Shu Wang, MD, PhD, director of the Breast Disease Center at Peking University People’s Hospital in Beijing, said in a press release. “This is the first study combining global data with machine learning to show the relationship between the conditions, their location across the world and the shared risk factors of these two conditions.”
  • STAT News adds,
    • “STAT’s interviews with more than 100 experts — including current and former government officials, doctors, public health advocates, substance use researchers, people in recovery, and addiction treatment leaders — identified a dozen ways the U.S. could chip away at its alcohol epidemic.” Here are the first six:
      • Screen early and often
      • “Add ‘nudges’ to health system
        • “Health systems can do their part to boost screening and treatment by adding alcohol questionnaires, including the well-validated and quick AUDIT-C test, to clinician workflows.”
      • “Get creative with funding
        • “STAT’s reporting finds that fixing the country’s alcohol epidemic will require smarter investments and clear guidance from federal health officials.”
      • “Get the word out
        • “HHS could also reinvest in public messaging about the health risks of alcohol, such as the defunct “Drink Less, Be Your Best” campaign.” 
      • “Overhaul payment 
        • “In the clinic, payment continues to be a barrier to detection and treatment of alcohol-related problems. While health care reforms in the past two decades have boosted reimbursement for mental health treatment, including substance use disorder work, physicians say parity is still not enforced well enough.”
      • “Dive into data
        • “Even without spending more on alcohol interventions, the country could use information it already has, plus a bit of cleverness, to tackle the issue.” 
  • The National Institutes of Health’s Research Matters covers the following topics in its latest post:
    • “Brain-computer device helps man speak
      • “A man unable to talk due to paralysis successfully used a brain-computer interface system at his home to speak.
      • “This technology could become a practical communication tool for people who can’t talk because of problems with their muscles.”
    • “Sleep and exercise may reduce mutation-driven inflammation 
      • “Lifestyle factors may reduce inflammation caused by some mutations in blood stem cells, according to an analysis of human and mouse data.
      • “The results suggest improving sleep and exercise may curb the health consequences of this inflammation.”
    • “Fructose and glucose trigger different brain responses
      • “Scientists found the sugars glucose and fructose affect hunger-controlling brain cells and food preferences in mice differently.
      • “The study suggests that similar nutrients can signal to the brain through distinct pathways and have different effects on appetite.”
  • MedCity News explains
    • “How AI Can Support Better Mental Health Outcomes — With Humans at the Center.
      • “Mental health care does not need to become less human to become more effective. The most effective (and responsible) path forward is one built on partnership.”
  • Genetic Engineering and Biotechnology News tells us,
    • “Researchers at University College London (UCL) Great Ormond Street Hospital for Children (GOSH) have built a new lab model of infant lungs to show why respiratory syncytial virus (RSV) makes infants so much sicker than adults, and to allow them to test new treatments. The miniature model of a baby’s airways was created using pediatric airway cells, blood vessel cells, and neutrophils (a type of white blood cell that acts as the immune system’s primary response to infection).
    • “Studies using the new model suggest that future therapies for RSV should target both the virus and its immune response to ensure babies get the best possible outcomes. Research lead Claire Smith, PhD, at UCL Great Ormond Street Institute of Child Health, said, “This model allows us to watch early immune responses unfold and study them in a human setting that reflects the infant airway. That’s something animal models often struggle to capture, especially when it comes to age-specific effects.
    • “Senior and corresponding author Smith and colleagues reported on their findings in Nature Communications in a paper titled “Neutrophil myeloperoxidase as a functional biomarker for RSV severity: implications for in vitro therapeutic screening.” In their report they concluded, “These findings identify neutrophil–epithelial interactions as a useful target for intervention and support the use of physiologically relevant human models to accelerate the development of therapies that limit immunopathology while preserving antiviral defense.”
  • BioPharma Dive informs us
    • “Detailed findings from a closely watched clinical trial hint that a new kind of drug may offer similar benefits as approved medicines in early Alzheimer’s disease, a result that could boost the outlook for a long-studied but unproven area of scientific research.
    • “The mid-stage “Celia” trial explored whether a Biogen drug codenamed BIIB080 would be any better than a placebo at slowing the mental or functional decline of Alzheimer’s patients showing early signs of cognitive impairment. Unlike in-use therapies such as Eli Lilly’s Kisunla and Biogen and Eisai’s Leqembi, which target harmful “amyloid” proteins, BIIB080 works by gumming up the genetic instructions cells use to create another Alzheimer’s-linked protein called tau.”
  • Fierce Pharma adds,
    • “Huyabio has scored a win in the largest oncology study it has undertaken in its 22 years, as its oral histone deacetylase (HDAC) inhibitor HBI-8000 has succeeded in combination with Bristol Myers Squibb’s Opdivo in a phase 3 trial of patients with advanced skin cancer.
    • “The study, which included 404 melanoma patients across 15 countries, achieved its primary endpoint, as the combo produced a clinically meaningful improvement in progression-free survival. 
    • “Those who received HBI-8000 plus Opdivo remained alive and without their disease worsening for a median of 11.7 months, compared to a median of 7.4 months for those who were given Opdivo plus placebo. The 58% improvement was deemed statistically significant.”  

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

  • The Wall Street Journal reports,
    • “HCA Healthcare lowered its 2026 financial guidance following payer mix shifts due to health insurance exchanges.
    • “The company said the payer mix shift was driven by an increase in uninsured patients who had lost coverage on health insurance exchanges.
    • “HCA estimated that the payer mix shift had an unfavorable impact on income before income taxes of about $400 million during the second quarter.” * * *
    • “The company said it anticipates adjusted Ebitda for the second quarter of roughly $4.03 billion, and revenue for the three months of about $20.23 billion. That compared with $3.85 billion and $18.61 billion a year earlier, and is below the $4.47 billion and $19.47 billion in revenue that analysts polled by FactSet had penciled in.” * * *
    • “The company said it did see positive factors during the quarter, including growth in admissions, equivalent admissions and emergency room visits, increased benefit from Medicaid Supplemental Payment Programs and improved expense trends.”
  • Beckers Hospital Review relates,
    • “Madison, Wis.-based UW Health has reached an agreement with Marshfield Medical Center-Beaver Dam (Wis.) to bring the medical center into the health system.
    • “The hospital is part of Marshfield (Wis.) Clinic Health System, which merged with Sioux Falls, S.D.-based Sanford Health in January 2025 to create a 56-hospital, nonprofit integrated system that operates as Sanford Health. 
    • “Marshfield Medical Center-Beaver Dam is an integrated medical campus that comprises a hospital, skilled nursing facility and independent senior living apartments. The hospital also runs two assisted living facilities and primary care clinics, according to a July 13 UW Health news release shared with Becker’s.” 
  • and
    • “Little Rock, Ark.-based Baptist Health acquired Magnolia (Ark.) Regional Medical Center on July 12. 
    • “With the close of the acquisition, the 25-bed facility has been rebranded as Baptist Health Medical Center-Magnolia. 
    • “Magnolia became Baptist Health’s 14th hospital and the second acquired in less than one month. On June 14, Baptist completed its acquisition of South Arkansas Regional Hospital, a 151-bed hospital based in El Dorado. 
    • “Baptist Health signed a definitive agreement to acquire the Magnolia hospital in April.” 
  • Fierce Healthcare tells us,
    • “The American Medical Association (AMA) announced Tuesday a new interoperability initiative aimed at supporting electronic prior authorizations by better connecting clinical terminology to its Current Procedural Terminology (CPT) administrative coding.
    • “The professional association said Tuesday it will be developing and deploying SNOMED CT— a structured set of descriptive terms that serve as a shared medical vocabulary for computer systems—to CPT terminology mappings. Doing so will ultimately create a foundation for “scalable automation” to streamline workflows, improve data exchange and foster more efficient and quicker prior authorization outcomes, AMA said.
    • “Moreover, it aligns with the upcoming Jan. 1, 2027 Centers for Medicare & Medicaid Services (CMS) FHIR-based prior authorization compliance deadline.”
  • Fierce Pharma informs us,
    • “Nearly a decade after spinning out its Chinese research hub to form Dizal Pharmaceutical, AstraZeneca is paying up to $1.5 billion to buy a piece of the pipeline, securing exclusive global rights for the biotech’s oral EGFR lung cancer drug Zegfrovy (sunvozertinib).
    • “The total deal value is split between $600 million in upfront payment, up to $400 million in development milestones and another $500 million tied to certain sales milestones, according to a disclosure (Chinese, PDF) to the Shanghai Stock Exchange. Dizal is also entitled to tiered, up to low-double-digit royalties based on Zegfrovy’s global sales.
    • “The deal comes about a month after Dizal detailed positive phase 3 data for Zegfrovy in first-line non-small cell lung cancer with EGFR exon 20 insertion mutations at the 2026 American Society of Clinical Oncology annual meeting.
    • “In the global Wu-Kong28 trial, Zegfrovy significantly reduced the risk of disease progression or death by 35% compared with platinum-based chemotherapy.” 
  • and
    • “Insulet’s wearable insulin patch Omnipod may be able to seamlessly control insulin delivery for patients with diabetes, but it can’t fill all mental health-related treatment gaps on its own. To broaden its network of personalized care offerings, the company is teaming up with mental health platform Calm to roll out a host of holistic “Mind in Range” resources. 
    • “Insulet and Calm’s free-to-access mindfulness tools, launched Tuesday, July 14, are specifically tailored to the diabetes community and include short meditations, a breathing exercise and a new Calm Sleep Story narrated by fashion model Lila Moss, a diabetes patient and advocate. The collaboration marks Calm’s first integrated content partnership with a medtech company and aims to “normalize conversations” around mental health care in diabetes management, while also making mindfulness “simple and accessible,” Insulet explained in a release.” 
  • Beckers Hospital Review points out,
    • “Amazon Pharmacy is collaborating with eNavvi, a digital prescribing platform, to integrate real-time medication pricing, availability and home delivery options into clinicians’ e-prescribing workflow. 
    • “The integration gives clinicians visibility into medication costs by comparing cash prices with estimated insurance copays while automatically applying eligible manufacturer discounts, according to a July 14 news release. It also provides real-time inventory information and delivery estimates, allowing providers to make prescribing decisions based on medication availability and delivery timelines.
    • “The move builds on Amazon Pharmacy’s ongoing delivery expansion, which is on track to reach 4,500 U.S. cities and towns by the end of 2026. The company has also leaned into GLP-1 access, expanding Zepbound KwikPen availability through same-day delivery earlier this year. 
  • Beckers Health IT lets us know,
    • “OpenEvidence outperformed Claude Opus 4.8, Gemini 3.1 Pro and GPT-5.5 on real-world clinical questions in a new physician-graded study, contradicting a June Nature Medicine paper that foundgeneral-purpose AI models beat specialized clinical tools.
    • “The study, posted June 27 as a preprint on arXiv, has not yet been peer-reviewed. It had 149 practicing physicians across 36 states rate AI answers to 620 real point-of-care questions drawn from OpenEvidence’s platform, plus 187 questions from the HealthBench benchmark, judging responses on accuracy, clinical utility, source quality, verifiability and completeness.
    • “OpenEvidence posted positive win margins on all five dimensions, with differences ranging from 25 to 39 percentage points over the three general-purpose models. Claude Opus 4.8 and Gemini 3.1 Pro scored near parity with each other, while GPT-5.5 recorded the lowest win rates on every axis.”
    • “The results stood in contrast to a Nature Medicine study published June 12, which found GPT-5.2, Gemini 3.1 Pro and Claude Opus 4.6 outperformed OpenEvidence and Wolters Kluwer’s UpToDate Expert AI. OpenEvidence has since asked Nature Medicine to retract that study, alleging flawed methods; the journal has pointed the company to its formal rebuttal process instead. * * *
    • “The competing results leave hospital and health system leaders with conflicting independent evidence on how general-purpose AI models compare with specialized clinical decision support tools as adoption of both accelerates.”

Monday report

David Ermer–Agentic & Generative AI, CDC, CMS, Congress, FDA, Medical / Rx research, Medicare, No Surprises Act, Obesity, Rx coverage, U.S. Healthcare–

Simplicity is a virtue.

From Washington, DC,

  • The Wall Street Journal reports,
    • “South Carolina Gov. Henry McMaster named Darline Graham Nordone, the sister of the late Sen. Lindsey Graham of South Carolina, to serve as an interim replacement in the Senate in the aftermath of the longtime lawmaker’s death. 
    • “President Trump had told McMaster, a Republican, that an appointment of Graham Nordone “would be a fabulous tribute to Lindsey, who loved her dearly!” Graham Nordone will serve out the remainder of her late brother’s term, which ends in early January.
    • “McMaster said Graham “took care of his little sister in years long departed. It’s my honor to ask his little sister, Darline Graham, to finish his work for him now.”
    • “Graham Nordone said, “Lindsey has always been there for me, and now I will be there for him.”
  • Fierce Healthcare relates,
    • “Insurers expect to issue $759.2 million in medical loss ratio rebates this year, according to a new analysis.
    • “The report is based on data reported by payers to states and compiled by analytics firm Mark Farrah Associates. An analysis of the data from KFF projects that total rebates paid out since their 2012 launch will rise to $15.1 billion after 2026 payments are made later this year.” * * *
    • “The estimated 2026 rebate tally is the lowest since 2018, when insurers paid $706.7 million in rebates, according to the KFF report. Rebate payments peaked in 2020 at $2.5 billion.” * * *
    • “The average simple loss ratio—which does not account for taxes or quality improvements like the MLR used to calculate rebates—was 93% in 2025, meaning plans spent 93% of their premium income on claims on average.” 
  • Healthcare Dive tells us,
    • “The oversight office of the HHS said it generated about $5.6 billion in monetary impact from fighting fraud, waste and abuse in federal health programs between October and March.
    • “The HHS Office of Inspector General also said it kicked over 1,200 people and entities off federal programs and pursued enforcement actions against people accused of running sham hospices and requesting improper Medicaid payments for autism behavioral therapy services, among others.
    • “The updates, part of a report compiled every six months for Congress, outlined the Trump administration’s healthcare enforcement priorities, adding that the HHS would focus on rooting out fraud in Medicaid and Medicare Advantage.”
  • Gilsbar, an insurance brokerage, offers information about recent revisions to the IRS Form 720 which is used to pay the annual PCORI fee.

From the Food and Drug Administration front,

  • Psychdelic Alpha reports,
    • “This morning, FDA issued its final guidance on psychedelic clinical investigations and announced a September public hearing “on the potential future therapeutic use of psychedelic drugs” and an associated request for comments. (We provided a detailed breakdown of the final guidance, as well as coverage of the planned hearing, in our Pα+ article: FDA Issues Final Psychedelics Guidance, Schedules September Hearing on the Future of Psychedelic Therapies.)
    • “Then, this afternoon, HHS and VA announced that they have entered into a five-year Memorandum of Understanding (MOU) “to strengthen collaboration on the research, clinical development, and responsible deployment to veterans suffering from serious mental health conditions of potential future rapid-acting psychedelic drug products if approved by the Food & Drug Administration.”
  • The Pharmacy Times relates,
    • “The FDA approved a new starting dosage regimen for the subcutaneous formulation of lecanemab-irmb (Leqembi; Eisai, Biogen), marking the first time patients can begin treatment with home administration either by themselves or by their caregiver,
    • “Lecanemab is an amyloid beta-directed antibody that targets and removes beta-amyloid from the brain. There is no evidence that lecanemab restores or reverses lost memories or cognitive function, but it is proven to reduce both cognitive and functional decline in patients, according to the Alzheimer’s Association.” 
  • Fierce Pharma tells us,
    • “In what GSK says represents a potential way to transform treatment for patients with certain types of rectal cancer, the company’s Jemperli has met the main goal of a phase 2 trial, teeing up an application with the FDA.
    • “Interim results from the phase 2 AZUR-1 study showed a “meaningful and sustained” clinical complete response rate for Jemperli at 12 months in stage 2/3 mismatch repair deficient/microsatellite instability-high (dMMR/MSI-H) locally advanced rectal cancer, GSK said Monday.
    • ‘Without going into specifics, GSK said its PD-1 inhibitor showed a “substantial improvement” compared to historical experience with existing treatment options. The company now plans to share the data with global health authorities, including with the FDA under an accelerated approval pathway.”  

No Surprises Act news

  • Benefits Pro reports,
    • “Federal regulators today [July 10] said they are setting up a renewal process for the organizations that help health care providers and health care payers resolve No Surprises Act billing disputes.
    • One part of the new recertification process for the No Surprises Act “independent dispute resolution entities” could involve assessments of IDR entities’ fairness.
    • “Something officials may consider when looking at an recertification application is the ability of the IDR entity to “provide rationales for payment determinations meeting regulatory requirements,” according to a new set of answers to frequently asked questions about the IDR entity recertification process.
    • “Application reviewers will also look at an entity’s ability to handle a high volume of dispute assignments quickly and the entity’s ability to handle cases “accurately in accordance with statutory and regulatory timelines,” officials say.” * * *
    • “Regulators will post a list of the entities seeking recertification each week.”
  • Fierce Healthcare relates,
    • “A payer-backed group has launched a campaign challenging a bill that would build on the No Surprises Act.
    • “The Coalition Against Surprise Medical Billing (CASMB) announced on Monday that its “six-figure” campaign urges lawmakers to reject the No Surprises Act Enforcement Act, or H.R. 4710. This legislation, they argue, would “reward the actors misusing the [independent dispute resolution] process.” * * *
    • “The ad says that the No Surprises Act was passed “with good intentions,” but that Congress should focus future efforts on closing loopholes that allow for IDR abuse.”

From the judicial front,

  • The Wall Street Journal reports,
    • “A federal appeals court revived more than 500 lawsuits that allege Tylenol and generic acetaminophen can cause attention-deficit hyperactivity disorder or autism if taken during pregnancy.
    • “The Second U.S. Circuit Court of Appeals in Manhattan ruled that a trial judge had erred by excluding expert medical witnesses, offered by the plaintiffs, who were expected to testify that there was a link between Tylenol use during pregnancy and neurodevelopmental disorders such as autism and ADHD. The 3-0 decision sends the case back to the lower court for further proceedings.”
  • Healthcare Dive relates,
    • “More insurers are filing lawsuits in an attempt to hike their Medicare Advantage quality scores after a court decision earlier this year exposed federal regulators to a new line of legal attacks.
    • “SCAN Health Plan and Alignment Healthcare both sued the CMS in D.C. district court last week, arguing regulators robbed them of higher star ratings in the privatized Medicare program.” * * *
    • “The lawsuits from SCAN and Alignment — which are both represented by the law firm Latham & Watkins — allude to larger calls for reform and cite MedPAC’s censure of the star ratings system.
    • “The Star Ratings program went off the rails years ago,” reads SCAN’s complaint. “The system is undeniably broken.”
  • Beckers Payer Issues tells us,
    • “A federal judge has dismissed with prejudice a lawsuit from Blue Cross Blue Shield of Georgia that accused medical billing company HaloMD and two physician groups of conspiring to defraud the insurer through the No Surprises Act’s arbitration process.
    • “The insurer, part of Elevance Health, alleged in May 2025 that HaloMD, Sound Physicians Emergency Medicine of Georgia and Hospitalist Medicine Physicians of Georgia submitted false attestations of dispute eligibility, flooded the independent dispute resolution system with large volumes of ineligible disputes using AI to overwhelm program safeguards, and submitted inflated payment offers, including some that exceeded the providers’ own billed charges.
    • “In his July 10 decision, Judge Thomas Thrash Jr. wrote that the court lacked jurisdiction over most of the counts and ruled that the racketeering, state-law, ERISA and deceptive trade practice claims were “collateral attacks” on the arbitration determinations. 
    • “It is highly improbable to infer from these facts that there is a vast conspiracy of providers and IDREs that have conspired to defraud the Plaintiff of millions of dollars in thousands of NSA IDR proceedings over many years,” Judge Thrash wrote. “It is highly plausible to infer that the Plaintiff engages in a consistent practice of submitting lowball offers to out-of-network providers in an effort to maximize its profits.”

From the public health and medical / Rx research front,

  • Healio reports,
    • “There are now cyclosporiasis cases in more than half of U.S. states. 
    • “The outbreak will eventually “burn” itself out even if a source is not found, an expert said.” * * *
    • “For insight into the current surge, Healio checked in with David O. Freedman, MD, FIDSA, professor emeritus of infectious diseases at the University of Alabama at Birmingham.
      • “Healio: Are all the cyclosporiasis warnings warranted or is this outbreak overhyped? 
      • “Freedman: On a national basis, for healthy people, the odds of any illness are still relatively low. Hospitalization, if ill, is extremely rare in normal hosts and care is noninvasive, involving mostly intravenous fluids and initiation of the antibiotic course. No deaths have occurred to date.
      • “The word outbreak refers to rates of illness above a normal year. On a national basis the annual average number of cases is about 3,000, which we have not reached yet, although official reports take several weeks to catch up with individual cases submitted. This is partly due to diminished CDC capacity at the national level. A small number of individual states, notably Michigan, are now reporting case numbers at the outbreak level.
      • “Healio: Can you explain why it is so important to find a source for the outbreak?
      • “Freedman: It is likely that only a portion of the total cases are the result of a single source contamination event at a farm, processing plant or distribution center. The rest of the cases will be due to the dozens of small contamination events that occur each summer in the U.S.
      • “Finding one or a few major contamination events will greatly diminish subsequent case numbers. However, it is important to remember that the incubation period from ingestion to illness is 1 to 2 weeks, so even after identification of a source, the process of withdrawing the product from the supply chain, educating the public to avoid products already in homes and waiting for incubating cases to manifest will take several weeks.
      • “Healio: Do you feel the outbreak will only continue to spread until a source for it is identified? 
      • “Freedman: Not necessarily. Outbreaks like this tend to burn themselves out as shown by the baseline seasonality that runs from May to August. Contaminated products that entered the processing chain early in the season may have been grown under different circumstances than products entering later in the season.”
  • Bloomberg Law reports
    • “New York City officials identified dozens of buildings with Legionnaires’ bacteria in Manhattan’s Upper East Side, closing in on the source of an outbreak that has infected at least 46 people and hospitalized 22.
    • “The New York City Health Department tested the cooling towers of 183 buildings in neighborhoods encompassed by three zip codes — 10028, 10128 and 10075 — that are among the city’s wealthiest and most densely populated. Of the 31 with signs of bacterial contamination, 19 already have been cleaned, officials said on a call with reporters Friday. The remainder are set to be cleaned by Saturday [July 11].
    • “Officials sought to reassure those who live in or have visited the area in recent weeks, pointing out that they would have already been exposed to the bacteria and noting that most people don’t fall ill from it.
    • “It’s safe for folks to drink water, to bathe to shower to cook and to use their air conditioner,” NYC Health Commissioner Alister Martin said.”
  • Health Day tells us,
    • “U.S. Sen. Lindsey Graham, 71, died Saturday of an aortic dissection, a sudden tear in the body’s main artery
    • “The condition is often fatal; about half of patients reach the hospital, and roughly half of those survive
    • “High blood pressure is the leading risk factor, and sudden severe chest or back pain is the key warning sign.”
  • and
    • “Weight-loss meds are transforming obesity treatment.
    • “But when it comes to heart health, exercise may still be the game changer.
    • “The study shows that while medication supports weight maintenance, it is exercise — with or without medication — that improves vascular health,” said researcher Signe Torekov, a professor of biomedical sciences at the University of Copenhagen in Denmark.”
  • MedPage Today adds,
    • “A network meta-analysis backed weight-loss benefits with several GLP-1 receptor agonists, with less certainty for newer-generation agents.
    • “Two GLP-1 drugs were also associated with reduced heart failure risk, while subcutaneous semaglutide stood alone in being tied to a reduced risk of all-cause mortality and myocardial infarction.
    • “The evidence was less certain for a reduction in kidney failure or an improvement in quality of life beyond a subjective threshold.”
  • STAT News informs us,
    • “Health secretary Robert F. Kennedy Jr. is pressing forward with his effort to help Americans stop taking psychiatric drugs, a medical practice known as deprescribing.
    • “Earlier this month, dozens of mental health professionals met with federal health officials to map out forthcoming clinical guidance they hope will help providers instruct patients on how to come off of antidepressant medications. While the Department of Health and Human Services has discussed plans to hold such a meeting, the outlines of the discussion haven’t been reported.
    • “During those talks, they reviewed guidance from European nations and worked on recommendations for nonmedication-based options for patients to address their mental health, such as therapy. A senior HHS official said they discussed gaps in the research around deprescribing SSRIs, including the side effects a person may experience, which vary depending on the drug and how long the person was on it, and how to recognize the difference between those side effects and a return of a patient’s depressive symptoms.”
  • MedPage adds,
    • “Modifiable dementia risk factors varied widely from country to country and a one-size-fits-all approach to dementia prevention will not work everywhere, data from 14 countries and regions showed.
    • “Both differences and similarities emerged in a global analysis of risks for 214,000 older adults, reported Emma Nichols, PhD, of the University of Southern California in Los Angeles, at the Alzheimer’s Association International Conference.
    • “Low education was a prevalent dementia risk factor for 85.6% of people in China compared with 12.0% of Americans, Nichols said. Obesity was a risk factor for 44.9% of older adults in the U.S., but only 13.3% of people in India.
    • “Despite differences in prevalence, similar factors — like cardiovascular risks (high cholesterol, hypertension, and diabetes) or risky behaviors (smoking and drinking) — tended to cluster together. Poor hearing, poor vision, and low education also co-occurred frequently.
    • “Risk factors often overlapped, with more than 50% of individuals having at least two risk factors, Nichols pointed out. In 11 countries and regions, the prevalence of at least four risk factors exceeded 20%.
    • “The findings were published in Lancet Healthy Longevity.
  • The CDC posted updated Core Elements of Outpatient Antibiotic Stewardship.
    • “Outpatient antibiotic stewardship programs promote appropriate antibiotic use to improve patient care and help combat antimicrobial resistance.
    • “The Core Elements of Outpatient Antibiotic Stewardship Programs provides a framework to improve antibiotic use and guide stewardship efforts for health systems, outpatient facilities, and prescribing clinicians.
    • “The guidance includes an assessment tool for evaluating stewardship efforts, a resource for measuring antibiotic use, and fact sheets that tailor stewardship strategies to specific outpatient settings.”
  • Per Health Day,
    • “Half as many young adults are misusing Adderall, Ritalin and other ADHD medications these days to help them remain alert at study or work, a new evidence review says.
    • “Misuse of ADHD stimulant meds among adults under 30 fell from 7.5% in 2016 to 3.7% in 2023, researchers report in the Journal of Clinical Psychopharmacology.
    • “We found a rapid drop in misuse of these medications, largely driven by a decline in Adderall misuse among young adults,” lead researcher Margaret Maglione said in a news release. She’s a project leader with the Southern California Evidence Review Center at the Keck School of Medicine of USC.”
  • Per MedTech Dive,
    • “Freenome said its updated blood-based colorectal cancer screening test met its primary and secondary endpoints in a pivotal validation study. Called SimpleScreen CRC, the new test showed improvement over an earlier version, particularly in detecting precancerous lesions. 
    • “Abbott, which inked a collaboration agreement with Freenome last August to bring SimpleScreen CRC to market, will commercialize the test when it gains Food and Drug Administration approval, Freenome said Thursday.
    • “The latest study results set up Abbott to be the dominant player in colorectal cancer screening, Evercore ISI analysts said in a note to clients.”

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

  • Healthcare Dive reports,
    • “Hospital dealmaking remained hot during the second quarter of 2026, extending a merger and acquisition rebound that has lately seen more mid-to-large independent systems in pursuit of financial security and growth, according to a new report. 
    • “Healthcare advisory firm Kaufman Hall, in its latest quarterly M&A report, tallied 18 new hospital transaction announcements from April through June. That’s well ahead of the eight logged during the same window last year, and comfortably above the average posted by the sector across the 2020s. 
    • “Total transacted revenue was $7.7 billion for the most recent quarter, which the firm noted was a major rebound from the $1.4 billion a year prior but falls well short of most prior years.” * * *
    • “Joining the M&A report was new hospital operating data from May suggesting a slight downturn in margins both month-to-month and compared to last year.
    • “Among the 1,300 hospitals Kaufman Hall taps for its monthly sector benchmarks, the firm reported a calendar year-to-date operating margin index of 2.9%, and a single-month operating margin index of 2.7% (both including health system allocations for the cost of shared services).
    • “The former of those reflects a 6% pullback from April’s data, and a 4% dip from May a year prior. The latter, year-to-date margin is a 5% decline from the preceding year as of the same point.” 
  • The American Hospital Association relates,
    • AHA Chair Marc Boom, M.D., presented three AHA awards during the 2026 Leadership Summit, recognizing hospitals and health systems for innovation, advancing health and excellence. See the news releases for more details on the winners and honorees.  
      • The 2026 Foster G. McGaw Prize for Excellence in Community Service, recognizing healthcare organizations for commitment to community service through programs that make communities healthier and more vital, was presented to Sky Lakes Medical Center in Klamath Falls, Ore.  
      • The 2026 Quest for Quality Prize, honoring hospitals and health systems that exemplify excellence in delivering high-quality, safe and patient-centered care, was presented to the Ralph H. Johnson VA Health System in Charlotte, N.C. 
      • The 2026 Circle of Life Award, recognizing outstanding programs in palliative and end-of-life care, was presented to Erie County Medical Center of Buffalo, N.Y., and the Geriatrics and Extended Care Hospice and Palliative Medicine Team of Orlando VA Health Care System in Orlando, Fla. 
  • Beckers Payer Issues tells us,
    • “Rejections of initial brand-name prescription attempts increased from 24.3% in 2018 to 40.7% in 2024, according to a July 9 JAMA study.
    • “Researchers from Baltimore-based Johns Hopkins Bloomberg School of Public Health and the American Enterprise Institute led the study. Looking across various types of coverage, they reviewed 1.17 million people’s pharmacy claims data for more than 2 million prescription attempts for brand-name drugs that lack generic alternatives. 
    • Here are six other things to know from the study:
      • 1. Overall, between 2018 and 2024, 32% of initial fill attempts were rejected.
      • 2. Of that share, the rejected molecule was ultimately filled within 90 days in 38.6% of cases, and a different drug in the same therapeutic class was filled for 13%. However, 48.4% had no medication filled in the same therapeutic class within that window.
      • 3. For those who ultimately received the same molecule or a therapeutic substitute, treatment was delayed an average of 12.2 days after that initial rejection.
      • 4. While 68% of the requests were paid after the initial fill attempt, 14.8% were rejected due to a formulary exclusion and 17.2% due to required prior authorization or step therapy.
      • 5. Rejections were steepest among exchange and Medicaid managed care plans, at 48.7% and 49.8%, respectively.
      • 6. Rejection rates were lower among Medicare plans.
  • Beckers Health IT informs us
    • “Technology services company UST is integrating Anthropic’s Claude into CarePath, a platform providers and payers use to run claims processing, care management and member services.
    • “Claude connects CarePath directly to underlying claims and care systems, turning fragmented health data into recommended next steps for care teams, per a July 9 Anthropic news release. Every action Claude recommends routes to a person for approval before it reaches a member, and the integration operates within the data controls healthcare requires.” * * *
    • “The company [UST] is betting that pairing Claude’s reasoning capabilities with human-approval workflows can move AI-led decisions out of pilot programs and into the production systems regulated industries depend on.”
  • Fierce Healthcare points out,
    • “Venture capital funding for digital health startups is on an upswing, fueled by an AI-powered rebound following a post-pandemic reset in 2023.
    • “Digital health companies raised $7.4 billion in the first half of 2026, up $1 billion compared to the first half of 2026 ($6.4 billion raised), according to Rock Health’s analysis of digital health deals in the first half of 2026. There were 244 deals in H1 2026. Investors poured $3.2 billion into the sector in Q2, just shy of Q1’s $4.2 billion.
    • “Building on trends from last year and into Q1 this year, capital is concentrating among a small number of megadeals as venture capital investors place their bets on innovative digital health companies, Rock Health researchers Ashwini Nagappan, Jason Lei and Maddie Knowles wrote.”

Weekend update

David Ermer–Agentic & Generative AI, Congress, Medicare, Obesity, U.S. Healthcare–

Simplicity is a virtue.

“National Simplicity Day on July 12 honors transcendentalist Henry David Thoreau, a man who advocated a life of simplicity. A man of many talents and skills, Thoreau was a supporter of living the simple life and encouraging others to do the same.”

Clarity Benefit Solutions offers the following pledge; “I pledge to make a conscious effort to simplify the administration, service, and user experience for benefits this year because I believe in the value and power of simplicity in a complicated world. Let’s let simplicity be our new normal.”

OPM should make good on this pledge by adopting the June 2026 recommendations that the AFHO trade association offered.

From Washington, DC,

  • Roll Call discusses this week’s anticipated events on Capitol Hill.
  • 24 Wall St reminds FEHB annuitants,
    • Skipping [Medicare] Part D for two years locks in a permanent 24% monthly surcharge worth roughly $113 annually on top of any plan premium.
    • The surcharge grows every year because it tracks the national base premium, which jumped 6% in 2026 alone, compounding lifetime costs into the thousands.
    • A 63-day gap without creditable coverage triggers the penalty even with no medications, making enrollment in the cheapest Part D plan the only sure defense.

From the U.S. public health and medical / Rx research front.

  • The Cleveland Clinic Newsletter tells us,
    • “As thousands of the world’s leading Alzheimer’s researchers, clinicians, and policymakers convene this week in London for the Alzheimer’s Association International Conference 2026, we have an opportunity to change the course of history for women’s health by focusing on women’s brains.
    • “For too long, women’s health has been compartmentalized into reproductive health, breast cancer, heart health and bone health. Missing from the conversation has been a focus on the organ that regulates every part of a woman’s body: the brain. That must end. Women’s health is brain health, and brain health is the core of women’s health.
    • “Women make up nearly two-thirds of those diagnosed with Alzheimer’s. Women are also far more likely to provide the unpaid care that keeps families and care systems from collapse. Yet women’s brains remain largely under-studied, under-discussed, and underprioritized in research, risk reduction and care.”
    • “The world can no longer afford to ignore [these issues].”
  • Onco Daily relates.
    • ‘Breast cancer incidence is increasing rapidly among Asian American, Native Hawaiian, and Pacific Islander women in the United States, with especially concerning trends in early-onset disease, distant-stage diagnosis, and aggressive molecular subtypes.
    • “A new population-based study published in JAMA Network Open examined invasive breast cancer incidence trends from 2000 to 2022 across disaggregated Asian American, Native Hawaiian, and Pacific Islander ethnic groups.
    • “The study included 148,608 Asian American, Native Hawaiian, and Pacific Islander females diagnosed with invasive breast cancer using National Cancer Institute SEER Program data from 14 US states.
    • “The findings challenge the older assumption that breast cancer incidence is uniformly lower among Asian American populations. They also show why grouping Asian American, Native Hawaiian, and Pacific Islander communities into one category can hide important differences in risk, stage, and subtype.”
  • The American Heart Association informs us,
    • “Gum disease bacteria may spur calcium buildup in the heart’s aortic valve, leading to a common and serious heart valve disease, according to preliminary, independent research presented at the American Heart Association’s Basic Cardiovascular Sciences Scientific Sessions 2026. The meeting, in Boston, July 13-16, 2026, is one of the largest meetings globally dedicated to fundamental and translational research in cardiovascular science.
    • “According to the American Heart Association, calcific aortic valve stenosis (CAVS) occurs when the aortic valve thickens and calcifies, restricting blood flow from the heart to the rest of the body. In early stages, there may be no symptoms; however, as the condition progresses, it can cause fatigue, chest pain, shortness of breath, fainting, heart failure and sometimes premature death. Standard treatment for severe CAVS is valve replacement surgery.
    • “This study identifies a potential biological pathway linking chronic oral gum disease and infection to calcific aortic valve stenosis.” * * *
    • “The American Heart Association’s Healthy Smiles, Healthy Hearts™ initiative provides dental care teams with professional education highlighting the connection between oral health and heart health, a standard blood pressure screening and referral guide for patients in dental settings, and educational materials for patients to help improve both their oral and heart health.
    • “The study has limitations because its findings have not been confirmed in people. The researchers have started a clinical study to further evaluate the link between gum disease and CAVS.”
  • U.S. Medicine points out,
    • “A top priority for researchers who study aging is how to identify and treat frailty, even though there are no established therapeutic interventions for the condition.
    • “That’s why a new study of U.S. veterans is considered so important. It found that initiation of statins was associated with a significantly lower risk of incident frailty or death among the older participants, including those who were pre-frail at baseline.
    • “There are currently no approved medications specifically to prevent frailty,” explained lead author Saadia Qazi, DO, MPH, MSc, a cardiologist at the VA Boston Healthcare System and in the Division of Aging in Mass General Brigham’s Department of Medicine. “Our findings suggest that statins may offer an important opportunity to reduce the risk of frailty and help people preserve their health and independence as they age.”

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

  • Out of the Beltway informs us, “The Economist surveys recent research and concludes, “An ageing society might not cost too much.”
    • “Spending on health care depends on how much it costs to provide and how much treatment is needed. Generally, the former has increased over time. Economists attribute this to Baumol’s cost disease, diagnosed by William Baumol, an American economist. Technologically intensive sectors (think of manufacturing or software development) get more productive. Labour-intensive service sectors do not. A doctor’s consultation takes roughly as long as it did a century ago. Yet physicians’ pay must match increases in faster-growing skilled industries, or all the doctors will go to work in tech. (Baumol pointed out that a string quartet still took 45 minutes to perform a Schubert work,but was paid vastly more than when the composer was alive.) […]
    • “Two new papers from the National Bureau of Economic Research, a repository of economic thought, suggest that the vision of health care gobbling up tax revenues may not come to pass. In the first, David Cutler and Lev Klarnet, both of Harvard University, observe that in 2024 America spent $1trn less on health care than official forecasts from 2010. The second is by Liran Einav, of Stanford University, and Amy Finkelstein, of the Massachusetts Institute of Technology (MIT). Using a survey of users of Medicare, America’s system of health insurance for the old, they find that, whereas expected lifetime spending on Social Security (ie, pensions) rose by 14% between 1993 and 2017, the expected cost of Medicare increased by only 6%. That is partly because elderly Americans have been collecting their pensions for longer but spending less time seriously ill.
    • “The papers point to improvements on both sides of the equation. Start with the cost of providing health care in hospitals. Messrs Cutler and Klarnet point out that, between 2000 and 2010, it consistently rose by around 2.3 percentage points above inflation—but that later something changed. Between 2011 and 2024 hospital costs rose by only 0.5 percentage points more than overall prices. Technology has played a role. Technological improvements in health care come in two types: some are adopted because economies get richer and can afford to treat new things; others make it cheaper to provide the same outcomes. For much of the past century, the first type dominated the second. Now, it seems the second type has taken over. Baumol’s cost disease turned out to be curable.”
  • McKinsey and Co. considers that “The consumer is changing fast. Four trends—the tech-driven path to purchase, the health revolution, the experience economy, and the resourceful consumer—will redefine the sector. Will brands keep up?”
  • MedCity News notes that “Healthcare and AI are in Need of Relationship Counseling.”
    • “Performing well in controlled settings is only part of the picture, the harder question is whether AI is being integrated into clinical workflows in ways that keep responsibility, authority, and accountability properly aligned.”
  • The Wall Street Journal reports.
    • “Eating-disorder therapists say patients are increasingly using chatbots for diet and exercise advice, sometimes challenging professional guidance.
    • “Therapists warn that chatbot advice delivered without clinical context can be dangerous and delay vital treatment for eating disorders.
    • “AI companies say they are working to improve how their models recognize and respond to signs of disordered eating.’

Notable Death

  • The Frederick (MD) News Post reports,
    • “Martha Lillard had just turned 5 when she was diagnosed with polio and depended on an iron lung to live. She died June 26 in Oklahoma, the last U.S. polio patient who used the machine, her sister said. She was 78.
    • “They told her she wasn’t supposed to live past 20 years old,” Lillard’s younger sister, Cindy McVey, told The Associated Press on Friday. “She had the enthusiasm and the drive to continue living and make the best of her life.” * * *
    • “McVey described her sister as artistic and creative. She wrote poems and composed songs. She wrote her own obituary, which is now posted online by a funeral home. She described being a Humane Society volunteer. “She was an avid Beagle lover and assisted in animal rescue as a cross poster on Facebook,” Lillard wrote.”
  • RIP


Cybersecurity Saturday

David Ermer–Agentic & Generative AI, Cybersecurity–

From the renewed war with Iran front,

  • Dark Reading offers an opinion piece explaining that “Iran’s Cyber Crosshairs Focus Beyond Critical Infrastructure.”
    • “Obscurity isn’t a defense. If your company has any Internet-facing vulnerability, you’re at risk from multiple threats.” * * *
    • “The groups behind recent attacks, including Handala, Ababil of Minab, and others operating within Iran’s cyber-influence ecosystem, cloak themselves in the mask of cyber activism, or “hacktivism.” They are largely opportunistic. They aren’t specifically hunting targets; they are on “Shodan Safaris” hunting easily exploited vulnerabilities or insecure systems. A law firm or logistics hub with an exposed programmable logic controller or an unpatched VPN is an easy, appealing target.
    • “Many companies don’t realize how much of their infrastructure is externally accessible, or how little it takes to exploit what’s exposed. Handala, which the US Justice Department has attributed to Iran’s Ministry of Intelligence and Security, remotely wiped over 200,000 hosts in an attack on Stryker, a medical device manufacturer, in March. The incident disrupted manufacturing and impacted their first-quarter earnings. More recently, Ababil of Minab compromised Vyncs, a GPS tracking platform used across the logistics sector, taking systems offline and defacing its website. In the Stryker incident, the attack was likely made possible through credentials stolen via commodity malware and provided for sale via illicit channels — emphasizing the opportunistic nature of these events.”
  • Security Week adds,
    • “An Iran-linked advanced persistent threat (APT) actor has been using a modular command-and-control (C&C) framework in recent attacks targeting organizations in Israel, Check Point reports.
    • “Tracked as Cavern Manticore, the APT focuses on government entities and IT providers, and appears linked to Iran’s MOIS (Ministry of Intelligence and Security), with possible ties to the OilRig subgroup Lyceum (also known as Hexane and SiameseKitten).
    • ‘Cavern Manticore’s C&C framework includes an adaptable toolset built using .NET, with various compilation formats used across components, used as an anti-analysis layer.”

From the Project Glasswing front,

  • Crypto Briefing reports,
    • “The U.S. government has begun utilizing AI technology developed by Anthropic to identify vulnerabilities in its software systems. This initiative, part of Project Glasswing, leverages Anthropic’s Mythos model to detect bugs within hours, a significant improvement over traditional methods. Despite previous concerns over security risks associated with the Mythos model, its deployment underscores the government’s commitment to strengthening cybersecurity measures. The move is seen as a strategic effort to protect critical infrastructure and enhance national security.”
  • Bleeping Computer adds,
    • Microsoft says Windows users should expect to see an increase in security updates as the company increasingly relies on artificial intelligence to discover vulnerabilities in its codebase.
    • In a blog post published today, Microsoft said advances in AI have significantly accelerated vulnerability discovery, allowing engineers to identify more security issues before they can be exploited in zero-day attacks.
    • “The pace of vulnerability discovery is changing with advances in AI making it possible to find more issues, faster, across more code, with new mechanisms that can accelerate both discovery and analysis,”  Microsoft said. * * *
    • “This announcement comes two days [July 8] after Reuters reported that the U.S. Cybersecurity and Infrastructure Security Agency (CISA) has begun using Anthropic’s Fable AI model to scan government software for vulnerabilities that cybercriminals or foreign intelligence services could exploit.
    • “According to the report, the AI-assisted code audits have already uncovered numerous vulnerabilities, though officials did not disclose how many or provide details on their severity.”
  • SC Media lets us know “what our industry learned the past 90 days since the Mythos announcement.”
    • “For years, security leaders have discussed the possibility that AI would eventually accelerate offensive cyber operations. Mythos transformed that discussion from a future-looking hypothesis into an immediate operational concern.
    • “Over the past three months, the industry has begun adjusting to a new reality. We no longer view AI simply as a productivity tool that helps developers write code or assists analysts with investigations. It’s emerged as a force multiplier for vulnerability discovery, capable of identifying weaknesses at a pace that challenges traditional security workflows. As the time between vulnerability discovery and exploitation shrinks, organizations are now forced to rethink long-standing assumptions about patch management, vulnerability prioritization, and cyber defense.
    • “This shift extends well beyond one AI model or one vendor. Whether organizations use commercial frontier models, open-weight alternatives, or internally developed AI systems, the underlying trend remains the same: AI has dramatically compressed the window defenders have to identify, validate, and remediate software flaws before attackers can weaponize them. In many ways, the security industry has entered an era in which the speed of decision-making may become just as important as the quality of detection.”

From the cybersecurity policy and law enforcement front,

  • On July 3, the Office of Management and Budget’s Office for Information and Regulatory Affairs posted the federal government’s 2026 unified regulatory agenda.
    • Fierce Healthcare tells us,
      • “Federal regulators have delayed a major overhaul of the Health Insurance Portability and Accountability Act (HIPAA) Security Rule, pushing back final action on the rule by a year.
      • “The Department of Health and Human Services (HHS) had proposed a May 2026 release for a final rule that makes significant changes to the HIPAA Security Rule and marks the first major update to the 23-year-old rule in more than 10 years.
      • “The U.S. Office of Management and Budget (OMB) website was updated and indicates that the final rule was pushed back to July 2027.”
    • Federal News Network lets us know,
      • “[The unified agenda] shows that the Cybersecurity and Infrastructure Security Agency expects to issue a final rule for the Cyber Incident Reporting for Critical Infrastructure Act in September 2026. Earlier this summer, CISA held a series of townhalls to get some final feedback on the regulations.” * * *
      • “Meanwhile, the Unified Agenda also shows that a federal contracting rule that standardizes cybersecurity requirements for unclassified IT systems will also be finalized in September 2026.
      • “The rule “will ensure federal information systems are better positioned to protect from cybersecurity threats by standardizing common cybersecurity contractual requirements across agencies for unclassified federal information systems,” according to the regulatory preview.
      • “And another federal contracting rule on “cyber threat and incident reporting and information sharing” is also projected to be finalized in September, the Unified Agenda shows.
      • “Both the CUI rule and the incident reporting rule have been long anticipated, with proposed rules dating back to 2023. They each represent landmark rules for the government contracting community, which is also grappling with the roll out of the Defense Department’s Cybersecurity Maturity Model Certification (CMMC) requirements.
      • “The CMMC regulations went into effect late last year, but DoD has been slowly ramping up the requirements for third-party audits. This November, however, the requirement for a third-party CMMC assessment is expected to become standard in all applicable contracts.
      • “DoD also expects to shortly issue more details on how the cybersecurity standards that underpin CMMC will be updated.
      • “The Unified Agenda shows that this month, DoD will adopt an interim final rule for the CMMC program that details the deadline for shifting to the National Institute of Standards and Technology Special Publication 800-171 Revision 3. Currently, CMMC assessments are tied to Revision 2 of the NIST standards.”
  • Fedscoop informs us,
    • “Greg Barbaccia is stepping down as federal CIO and leaving government at the end of August, he said in an email to the CIO Council Tuesday [June 7, 026].
    • “I’m writing to share that I’ve made the difficult decision to leave government, and my time as Federal CIO is coming to an end,” Barbaccia wrote to CIOs on the council in his email, obtained by FedScoop. 
    • “Barbaccia, who joined the Trump administration as its top IT official in January 2025, said his last day in the role will be Aug. 31.
    • “Barbaccia’s departure comes just months after he brought on former Department of Education CIO Thomas Flagg to be his deputy. Flagg would be the default acting official with Barbaccia’s departure, a government chief information officer told FedScoop on the condition of anonymity to be more candid.”
  • Cyberscoop observes,
    • “The AI-focused executive order President Donald Trump signed last monthgave the Treasury Department, the National Security Agency, and the Cybersecurity and Infrastructure Security Agency (CISA) 30 days to establish a new “AI cybersecurity clearinghouse.” The deadline passed last week.
    • “The clearinghouse is meant to coordinate the scanning, discovery, and validation of software vulnerabilities in critical infrastructure, and then prioritize how those vulnerabilities get patched and distributed.
    • “It’s the right problem to solve. The question now is whether what is created will actually solve it.”
  • and
    • “A major credential leak spurred the Cybersecurity and Infrastructure Security Agency to strengthen protections for its sensitive materials, improve how researchers can report agency vulnerabilities and develop plans for similar incidents, the agency said in a forensic report released Thursday.
    • The blog post outlines CISA’s response to the leak that the researcher who discovered it in May called one of the worst he had ever seen, which also drew congressional scrutiny.”
  • Cyberscoop adds,
    • “”A former ransomware negotiator for DigitalMint was sentenced to 70 months in jail for deceiving his employer’s clients and conspiring with ransomware affiliates to extort a combined $75.3 million from five U.S. companies he was entrusted to aid during their moments of extreme crisis, the Justice Department said Thursday. 
    • Angelo John Martino III shared confidential information he gained from his work as a ransomware negotiator, including victim organizations’ negotiating positions and insurance policy limits, to extract the maximum payment for himself and other BlackCat affiliates he colluded with in backchannels.”
  • and
    • “An Armenian national who was extradited from Ukraine to the United States last year pleaded guilty to participating in a series of attacks in 2019 and 2020 involving Ryuk ransomware, the Justice Department said Thursday.
    • “Karen Serobovich Vardanyan pleaded guilty to computer fraud and conspiracy to commit fraud and extortion. He agreed to pay nearly $1.2 million million in restitution and faces up to 15 years in jail.
    • “The 34-year-old admitted to participating in cybercrime from November 2019 to April 2020 when he and his co-conspirators deployed Ryuk ransomware against three U.S.-based organizations while living in Ukraine and Russia.”

From the cybersecurity breaches and vulnerabilities front,

  • Dark Reading reports,
    • “In February, a ransomware attack against the University of Mississippi Medical Center disrupted operations for more than two weeks. In March, a cyberattack on German medical-billing provider Unimed, which services 95% of the nation’s university hospitals and more than half of large clinics, resulted in the theft of sensitive health data for tens of thousands of patients.
    • “In the first half of 2026, cyberattacks on the healthcare sector jumped 14%, slightly more than the overall increase of 11% across all industries, according to data from technology research firm Comparitech. While healthcare providers — such as hospitals and doctors’ offices — saw a moderate rise in attacks, healthcare businesses suffered a significant increase of 35% compared with the second half of 2025 and 110% compared with the same six months from the previous year.
    • “Much of the shift in focus is likely because attackers have recognized that compromising a single provider can provide access to multiple hospitals, says Rebecca Moody, head of data research at Comparitech.”
  • Cybersecurity Dive relates,
    • “A threat actor claims to have stolen a vast trove of sensitive data from the consulting giant Accenture in a recent cyberattack.
    • “The compromised data includes source code, Microsoft Azure personal access tokens, RSA encryption keys and SSH keys, a hacker calling themselves “888” said in a dark-web post shared by Bleeping Computer.
    • “The actor says they hacked roughly 35GB of data from Accenture during the intrusion, which occurred in early July.
    • “Accenture downplayed the incident in a statement to Cybersecurity Dive.
    • “We are aware of this isolated matter and we have remediated its source,” spokesperson Peter Soh said. “There is no impact to Accenture operations and service delivery.”
    • “The stolen data could put Accenture and its clients at significant risk of further attacks. “Source code can help attackers understand internal application logic, identify weak implementation patterns, and search for hardcoded secrets or exploitable paths in custom systems,” the threat intelligence firm SOCRadar said in an analysis of the incident. Meanwhile, the exposed access keys could let hackers roam freely through code repositories and cloud storage services.”
  • and
    • “AssuranceAmerica, a closely held provider of auto and renters insurance, was the target of a cyberattack earlier this year that impacted more than 6.9 million customers, according to state regulatory filings. 
    • “The Atlanta-based firm said the incident was detected on March 17, stemming from an attack that targeted one of its employees a day earlier, according to a filing with the California Attorney General’s office. 
    • “An investigation found an unauthorized party gained access to the company’s IT department and copied a number of data files. The company said it notified law enforcement about the attack. 
    • “According to a filing with the Maine Attorney General’s office, the breach involved more than 6.9 million people. This included nearly 880 people within the state of Maine. The Maine AG discontinued posting new notices on its public site in June after its breach reporting system was the target of an attack.”
  • and
    • “An initial access broker weaponized a critical vulnerability known as CitrixBleed 2 in a series of attacks during the first half of 2026 across multiple organizations, according to a report released Thursday [July 9] by the security company Huntress. 
    • “After exploiting the vulnerability, the hackers escalated privileges, created rogue local administrator accounts and established persistence with legitimate remote access tools, including ScreenConnect and Zoho Assist. 
    • “About a half-dozen cases between January and June followed a consistent playbook. In the most advanced case, the attackers deployed DragonForce ransomware, Huntress researchers said.”
  • Healthcare Dive adds,
    • “AdaptHealth disclosed last week that a recent cyberattack resulted in patient data being stolen.
    • “A threat actor gained unauthorized access to company systems through a social engineering attack and exfiltrated data, including certain personally identifiable information, protected health information of patients and stored password files associated with insurance billing, according to a July 2 filing with the Securities and Exchange Commission.
    • “Based on information obtained to date, AdaptHealth believes that the threat actor gained unauthorized access to certain cloud-based business applications, including internal patient management systems and document storage platforms. The company also confirmed that certain external electronic health record system portals were accessed.”
  • CISA added six known exploited vulnerabilities to its catalog this week.
    • July 7, 2026 (two releases; “Per BOD 26-04, federal agencies are required to patch all four security weaknesses by July 10.”)
      • CVE-2026-48282 Adobe ColdFusion Path Traversal Vulnerability
      • CVE-2026-48908 JoomShaper SP Page Builder Unrestricted Upload of File with Dangerous Type Vulnerability
      • CVE-2026-55255 Langflow Authorization Bypass Through User-Controlled Key Vulnerability  
      • CVE-2026-56290 Joomlack Page Builder Improper Access Control Vulnerability
        • Security Week discusses these KVEs here.
    • July 10, 2026
      • CVE-2026-48939 iCagenda Unrestricted Upload of File with Dangerous Type Vulnerability
      • CVE-2026-56291 Balbooa Forms Unrestricted Upload of File with Dangerous Type Vulnerability
        • Mallory discusses these KVEs here.
  • Dark Reading adds,
    • “Microsoft has tackled yet another zero-day vulnerability published by a disgruntled security researcher with a vendetta against the software giant.
    • “On Wednesday, Microsoft issued an out-of-band patch for RoguePlanet, an elevation-of-privilege vulnerability in Windows Defender, tracked as CVE-2026-50656. The high-severity flaw, which received a 7.8 CVSS score from Microsoft, could allow an attacker to escalate privileges on a Windows device from a basic user to the highest SYSTEM-level access, which would give them complete control over the device.” * * *
      “Despite a public exploit being available for RoguePlanet, it’s unclear if the vulnerability has been exploited in the wild. Microsoft’s updated advisory states the flaw has not been exploited, and CISA has not added CVE-2026-50656 to its Known Exploited Vulnerabilities (KEV) catalog. Qualys, meanwhile, published a threat report on June 18 stating that RoguePlanet has been “exploited in attacks,” though no details were provided.”
  • Security Week relates,
    • “Organizations across multiple sectors have been targeted in a vishing campaign aimed at harvesting Microsoft 365 credentials, Okta warns.
    • “The campaign started in April and has involved voice calls directing the victims to fake Microsoft Entra ID login pages under the pretense that they need to register a new passkey.
    • “Tracked as O-UNC-066 and also known as CL-CRI-1147 and Pink, the hacking group has been targeting automotive, aviation, construction, food and beverage, healthcare, and technology organizations, mainly for data extortion.
    • “As part of the observed attacks, the threat actor has been registering domains incorporating the word ‘passkey’, and has been directing victims to pages that closely mirror the Microsoft passkey enrollment process.
    • “It appears engineered to convince a targeted user they are in the process of enrolling a passkey with Microsoft, while the threat actor simultaneously registers their own passkey in the targeted user’s Microsoft account,” Okta says.”
  • and
    • “A critical prompt injection vulnerability in GitHub Agentic Workflows could allow unauthenticated attackers to leak private repository data, Noma Labs warns.
    • “GitHub Agentic Workflows allows users to write workflows in natural language using markdown files that an AI agent will use as GitHub Actions, thus automating the interaction with code repositories.
    • “Because of the security defect, named GitLost, unauthenticated attackers can hide indirect prompts in crafted GitHub Issues posted on the public repositories of an organization that also maintains private repositories, and the AI agent will follow the instructions.”

From the ransomware front,

  • Cybersecurity Dive reports,
    • “Ransomware activity grew slightly between the first and second quarters of 2026 but significantly year over year, and there were more hacker groups active during April, May and June than in any previous quarter, researchers said on Thursday [July 9].
    • “Cybercrime actors claimed breaches of 2,279 victims in Q2 2026, a 7% increase over Q1 2026 but a 43% year-over-year increase compared with Q2 2025, GuidePoint Security said in a quarterly report.
    • “The Qilin ransomware gang led the quarter, accounting for 13% of attacks, but the relatively new group The Gentlemen has grown quickly and now accounts for almost as much activity, GuidePoint said.” * * *
    • “Qilin, The Gentlemen, Akira and DragonForce compromise what GuidePoint calls the “four-headed monster” of high-volume ransomware groups. The lack of a “singular monolithic figure” could make the ransomware community more resilient to law-enforcement takedowns, the security firm said, because there are now “multiple franchises poised to absorb displaced affiliates if another were to disappear overnight.”
  • Tech Crunch relates,
    • “Last week, researchers at cloud security firm Sysdig said they’d documented the first known case of “agentic ransomware.” It was an extortion operation, dubbed JadePuffer, in which an AI agent — not a human — handled the technical execution of a real-world cyberattack from start to finish. The agent broke into a vulnerable server, stole credentials, moved through the target’s network, encrypted files, and even wrote its own ransom note, adapting to obstacles along the way like a human hacker would. Coverage of the operation described it as run “without any human oversight,” with “no human at the keyboard.”
    • “That’s not quite the full picture. In an interview on Monday with CyberScoop, Sysdig’s Michael Clark, the company’s senior director of threat research, clarified that a human was still very much involved — just not in the technical execution. “A human still set up and pointed the operation and provisioned the infrastructure behind it, the command-and-control server, the staging server used for the stolen data and chose a victim,” Clark said. The credentials used to break into the victim’s database, he added, weren’t harvested by the AI agent itself; someone obtained them separately, through a prior compromise, and handed them to the operation.
    • “None of this contradicts Sysdig’s original claim, and the technical details of the attack remain notable on their own — wild, even. The agent got in through a known bug in Langflow, a popular open source tool for building LLM apps, then moved on to a production MySQL server and exploited another known flaw to gain admin access. It encrypted over 1,300 configuration records and not only left behind a ransom note that it wrote itself but it left a Bitcoin address where the ransom could be sent. Sysdig hasn’t disclosed who was targeted.”
  • Dark Reading tells us,
    • “A newly rebranded ransomware outfit is sneaking malware into American organizations using a malicious yet Microsoft-approved driver.
    • “Researchers at Symantec recently observed a cyberattack from a group known as “Hyadina.” Hyadina is a 4-year-old ransomware-as-a-service (RaaS) operation with a new locker, “GodDamn,” an iteration on its previous lockers, “Beast” and “Monster.” It typically attacks American organizations, and it also has a distinct distaste for former Soviet countries. Its targets have spanned sectors that include healthcare, manufacturing, education, and wherever else it finds opportunity.
    • In a recent case against an unidentified organization, Hyadina used a smorgasbord of dual-use hacking tools, including legitimate remote monitoring and management (RMM) software, and more than a dozen penetration testing programs. The real kicker, though, was a malicious program with kernel access on Windows, capable of killing any and all processes, including security software.

From the cybersecurity business and defenses front,

  • Cybersecurity Dive reports,
    • “U.S. companies are merging cyber risk issues into their overall enterprise risk strategy, at a time when AI adoption and business resilience are leading to significant shifts in business priorities, according to a report released Tuesday [July 7] by Information Services Group, a technology research and advisory firm.
    • “Cybersecurity is increasingly seen as a business-critical concern, as companies accelerate their adoption of agentic AI and transform much of their technology and data infrastructure to hybrid or multicloud environments. 
    • “Enterprise leaders are closely integrating cyber spending decisions with overall IT strategy. In addition, C-suite and board members are taking greater accountability for business continuity, financial exposure and regulatory compliance.”
  • Info-Security Magazine relates,
    • “Chris Betz has officially taken the helm as the new CISO of Google Cloud. Transitioning from his previous role as Google’s VP of infrastructure security, Betz is stepping up to lead the company’s security posture at a critical turning point in the industry.
    • “In his very first interview since assuming the CISO title [which is found in the article], he shared his vision on the role generative AI will play in defending global enterprises.
    • “Coinciding with his transition, Betz published a key blog post on the Google Cloud blog titled Cloud CISO Perspectives: The 4 lessons that guided AI threat defense. In the article, he lays out Google’s playbook for using AI to defend against AI, advocating for a multi-model approach, robust security harnesses and the irreplaceable value of human expertise in modern cyber defense.”
  • Tech Target offers “a roadmap to zero trust maturity.”
    • “Transforming an organization to take on a zero-trust posture is no small affair. A phased, thoughtful approach can bolster security while supporting business outcomes.”
    • “Zero trust is not a product, control or single technology deployment; it’s a strategic architecture and operating model designed to reduce risk and improve the security posture of organizations that have traditional, perimeter-based security models. Perimeter-based models — which assume clearly defined “inside” and “outside” boundaries — fail to address modern threats because they were designed for a world that no longer exists.
    • “Zero trust relies on three foundational principles:
      • “Explicit verification. Every access request is authenticated and authorized using components such as user identity, device health, location and behavior.
      • “Least-privilege access enforcement. Users and devices receive only the minimum access required, and only for as long as needed.
      • “Assume breach. Security operates under the assumption that attackers are already present, with controls designed to limit access and damage.”
  • and sugggests an approach for “evaluating secure enterprise browsers vs. security plugins
    • “Malicious actors have long targeted and exploited browser vulnerabilities. The widespread adoption of AI increases the risk, forcing CISOs to reevaluate browser security options.” * * *
    • “In this moment of renewed attention to browser security and the risks of it failing, CISOs face two options for improving browser security: deploying secure enterprise browsers and deploying browser security plugins.”
  • Here is a link to Dark Reading’s CISO Corner.

Friday report

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

Simplicity is a virtue.

From Washington, DC

  • Federal News Network reports
    • “Federal retirement processing times are slowing down. During June, it took the Office of Personnel Management an average of 108 days to process a retirement claim, according to the agency’s latest data release. Processing times for digital-only applications averaged 96 days. That’s a full 30 days longer than the previous month’s average. But at the same time, OPM’s retirement claim inventory in June was the lowest it’s been all year, coming in at just under 34,000 pending applications. OPM received close to 9,000 new claims last month and processed nearly 13,000.(June 2026 retirement processing statistics – Office of Personnel Management)
  • FEHBlog observation: It’s hardly surprising that a slow down occurred during last month’s big processing system change.
  • Federal News Network adds
    • “There’s room for improvement in the Office of Personnel Management’s efforts to prevent improper retirement payments. OPM’s use of manual processes and delays in payment suspensions are hampering the ability to mitigate improper retirement payments. A recent report from OPM’s inspector general office recommends that the agency tighten its timeline and transition to digital tools to help identify and prevent overpayments or underpayments to federal retirees. Officials in OPM’s retirement services division say discussions are ongoing to automate various surveys and projects associated with improper payment prevention.(Evaluation of OPM Retirement Services’ efforts to identify and prevent improper payments – OPM Office of Inspector General)”
  • The American Hospital Asssociation News relates,
    • “The Health Resources and Services Administration has announced new funding available to healthcare providers in rural areas through the Small Health Care Provider Quality Improvement Program. Up to 20 grantees may be awarded up to $250,000 each to providers, such as critical access hospitals, rural health clinics or networks of small rural providers, to build programs that collect and use clinical data and evidence-based approaches to improve healthcare quality, particularly focused on improving chronic disease outcomes. The grant also is intended to be used to strengthen the skills and collaboration of the billing and coding staff in coordination with the front-line clinical staff. Applications must be submitted by Aug. 6, 2026.”
  • Fierce Healthcare informs us,
    • “Participants in the ACO REACH program generated nearly $1 billion in savings in 2024, according to new performance data from the Trump administration.
    • “The Centers for Medicare & Medicaid Services released its latest look at program performance on Thursday, which found $988.3 million in net savings for the federal government from the accountable care program. Gross savings, before accounting for benchmark discounts and shared savings arrangements, were $2.5 billion, according to the report.
    • “Net shared savings payments to the ACOs totaled $1.5 billion, for a shared savings rate of 4.2%.
    • Most of the 115 ACOs participating in REACH for 2024 earned shared savings, according to the report. Just 19 ACOs, or 17%, posted a net loss, while 96 organizations, or 83%, earned savings.
    • The participating ACOs also generally maintained high performance on quality, CMS said, with 49 organizations qualifying for the high performance pool that allows them to earn additional financial benefits. This pool was first offered for the 2023 program year, CMS said.
    • The ACO REACH model is set to conclude at the end of 2026, and the Center for Medicare and Medicaid Innovation will transition to a new model called Long-Term Enhanced ACO Design (LEAD) beginning on Jan. 1.

From the Food and Drug Administration front,

  • The American Hospital Association News reports,
    • “The Food and Drug Administration July 10 released a proposed rule that would modernize drug establishment registration requirements, with implications for pharmaceutical manufacturers and health systems that depend on a stable medication supply chain. The proposal would create a streamlined registration process for distributed manufacturing operations that use a “hub-and-spoke” model, allowing qualifying networks to register as a single establishment rather than registering each manufacturing unit separately.
    • “The rule would also clarify registration and drug listing requirements for certain foreign manufacturers, including facilities that produce active pharmaceutical ingredients destined for the U.S. market through intermediary facilities. FDA officials said the change would improve visibility into upstream supply chains and strengthen the agency’s ability to identify and respond to potential safety and quality concerns.”
  • Fierce Pharma informs us,
    • “The increasingly more popular combination of Padcev and Keytruda has expanded its bladder cancer territory once again.
    • “Thanks to an FDA nod on July 10, Padcev and Keytruda have become the first muscle-invasive bladder cancer (MIBC) treatment that does not require considerations over the patient’s eligibility for cisplatin-based chemotherapy. 
    • “The latest go-ahead allows the combo as neoadjuvant treatment before surgery, followed as adjuvant treatment after surgical removal of the bladder in MIBC, building on a previous perioperative indication that was limited to cisplatin-ineligible patients. 
    • “The inclusive MIBC label adds to the Padcev-Keytruda combo’s well-established profile in metastatic bladder cancer. It arrives more than a month earlier than the FDA’s target decision date of Aug. 17 under an already accelerated priority review timeline. “
  • and
    • “The third time is not the charm for Hengrui Pharma and Elevar Therapeutics’ star-crossed combination of camrelizumab and rivoceranib at the FDA.
    • “U.S. regulators have declined to approve the anti-PD-1/VEGFR combo for a third time as a first-line treatment for liver cancer, Hengrui and Elevar’s parent company, HLB Group, said in separate announcements Friday.
    • “The problem, again, is manufacturing. Only this time, the complete response letter (CRL) stemmed from deficiencies the FDA had identified in April at the plant producing rivoceranib, also known as apatinib, unlike the previous two rejections, which centered on Hengrui’s camrelizumab facility, according to the Chinese pharma. The rivoceranib manufacturer had passed an inspection by EU authorities in 2025, it noted.
    • “Still, three CRLs do not necessarily mean three strikes and you’re out for Hengrui and Elevar.”

From the public health and medical / Rx research front,

  • The Centers for Disease Control and Prevention announced today,
    • “As of July 10, 2026, the amount of acute respiratory illness causing people to seek health care is very low.
    • “RSV activity is very low in most areas of the country. Emergency department visits and hospitalizations for RSV are low but remain highest among infants and children younger than 4 years old.
    • “COVID-19 activity is low and stable nationally but is beginning to increase from low in a few areas of the country.
    • “Seasonal influenza activity is low.
    • “Parainfluenza (PIV), a respiratory virus that can cause illnesses such as croup, is elevated nationally. Rhinovirus/enterovirus (RV/EV), which often cause cold-like respiratory illness, are also elevated nationally but is going down. Whooping cough (pertussis) is still circulating.”
  • The University of Minnesota’s CIDRAP reports,
    • “The Centers for Disease Control and Prevention (CDC) confirmed 61 new US measles cases today and 2,231 for the year, as Virginia has become the country’s latest hot spot.
    • “Last year the CDC recorded 2,289 infections for the entire year, so the nation is just 58 cases short of that as we pass the midpoint of the year. The 2025 total was the most since 1991, and the United States is now on track to lose its measles elimination status that it gained in 2000.
    • “All but 13 of this year’s cases were locally acquired, with the rest related to travel outside the country. Of the total, 20% of infections are in children age 5 and under, and 70% involve kids and young adults to age 19. Six percent of patients have been hospitalized, compared with 11% in 2025. Among all measles patients, 93% are unvaccinated or have unknown vaccine status. 
    • “No measles deaths have been reported this year, compared with three in 2025.”
  • The American Hospital Association News relates,
    • “The Centers for Disease Control and Prevention has reported 843 cases of cyclosporiasis across 31 states, with 86 people hospitalized. State health departments are reporting higher case numbers than the CDC, which works to confirm the cases reported to it. Michigan has announced that it is investigating 1,562 cases, with 44 people hospitalized. No deaths have been reported, and investigators haven’t identified a source.”
  • The New York Times adds,
    • “How to Stay Safe From the Severe Stomach Bug That’s Going Around
      • “Cyclospora, a parasite that causes intestinal illness, is sickening many people across the United States. Health experts have tips for avoiding infection.”
      • “Past cyclospora outbreaks in the United States have mainly been linked to fresh produce, including raspberries, basil, cilantro, fruit mixes, snow peas, snap peas, lettuce and salad mixes. They have been caused by both imported and domestic fruits and vegetables and those prepared at home and in restaurants, said Donald Schaffner, chair of the food science department at Rutgers University.
      • “Because the cause of the recent infections is unknown, the best way to prevent illness is to follow standard hygiene and food safety practices, said Dr. Adam Ressler, an infectious disease physician with Michigan Medicine.
      • Always wash your hands with soap and water after using the bathroom and before preparing food, Dr. Moore said. Alcohol-based hand sanitizers do not kill cyclospora, he said, but soap and water does.
      • “Rinsing fruits and vegetables with water is always a good practice, Dr. Moore said. Some cyclospora may still cling to contaminated produce after rinsing, but it will reduce their numbers and in turn can reduce your risk of getting sick or make the illness less severe, he said.
      • “Cleaning produce with vinegar or other solutions is generally no more effective than doing so with running water, Dr. Schaffner said.”
  • Cardiovascular Business tells us,
    • “Data on the potential relationship between cannabis use and cardiovascular disease (CVD) remain mixed. Some studies have linked cannabis to an increased risk of heart attack and ischemic stroke, for example, but the current evidence is far from consistent. 
    • “With cannabis legalization skyrocketing in the United States, the team behind a new analysis in Trends in Cardiovascular Medicine hoped to explore the latest evidence and provide a fresh look at this important topic.[1]
    • “Compared with respiratory or psychiatric outcomes, the cardiovascular consequences of cannabis remain poorly established,” wrote first author Ahmed K. Mahmoud, MD, a cardiovascular health researcher with Mayo Clinic, and colleagues. “This highlights the urgent need for prospective studies and clinical trials to more clearly define cardiovascular risk.”
  • The University of Minnesota’s CIDRAP informs us,
    • “A new study finds that the antiviral drug Paxlovid can safely be used by children aged 6 and older.
    • “The study, published recently in Pediatrics, found Paxlovid, which combines the drugs nirmatrelvir and ritonavir, is safe for children who weigh at least 44 pounds who have mild to moderate COVID-19 but are at risk of developing severe disease.
    • “Paxlovid is approved by the US Food and Drug Administration in children at least 12 years old who weigh at least 88 pounds.
    • “The study included 75 children 6 to 17 years old who received at least one dose of Paxlovid. One group received a lower dose and the other a higher dose. 
    • “Researchers found that both doses were safe and well-tolerated, with no serious adverse events. In 90% of participants in both groups, blood concentrations of the drug reached levels that have been shown to have antiviral effects in adults.”
  • BioPharma Dive points out,
    • “An experimental drug GSK licensed from Hansoh Pharma has succeeded in a late-stage study in China, boosting the outlook for a therapy the British pharmaceutical company has already advanced into a series of large global trials. 
    • “GSK said Friday that the antibody-drug conjugate risvutatug rezetecan, or ris-rez, improved survival in people with advanced or relapsed small cell lung cancer when compared to standard treatment, meeting the trial’s main objective. The company didn’t provide specifics, but said that the drug was associated with “statistically significant and clinically meaningful improvements” in survival compared to that typical treatment, the chemotherapy topotecan. Riz-rez also produced “consistent benefits” across secondary study measures, including delaying tumor progression, according to GSK.” 

From the U.S. / worldwide healthcare business front,

  • The Wall Street Journal reports,
    • “Asset-management firm Apollo Global Management APO  agreed to buy a minority stake in Bayer’s BAYN  long-acting reversible contraceptives business for €3 billion, or $3.43 billion, the companies said.
    • “German pharmaceutical company Bayer said it secured €3 billion in equity capital, as part of an agreement with Apollo for its managed funds and affiliates to obtain a minority stake in a new entity. The newly established entity will hold Bayer’s long-acting reversible contraceptives business.
    • “Bayer will retain a majority stake in and full operational control over the business, it said.
    • “The long-acting contraceptives business focuses on methods that prevent pregnancy for a long period of time, such as the intrauterine device, according to Bayer’s website.”
  • Modern Healthcare relates,
    • “Health systems and insurers are trying to minimize poorly executed handoffs between post-acute facilities and home care providers that are costing them millions of dollars in hospital readmissions.
    • “CenterWell, Optum and Banner Health are using a combination of technology, staffing and their own post-acute operations to ensure patients receive timely and consistent care as they transition from skilled nursing facilities to home following a hospital stay.” 
  • Fierce Pharma tells us,
    • “The launch of Eli Lilly’s Foundayo remains “muted,” with weekly prescriptions flat over the last five weeks, analysts from Jefferies said in a July 10 note. The analysis is based on data collected by IQVIA.
    • “In the 13th week of Foundayo’s launch, IQVIA reported 19,550 prescriptions, down for the third straight week after peaking at Week 10 with 21,648 prescriptions. The figure also comes in significantly shy of the Week 13 launch of Novo’s Wegovy pill (more than 105K scripts) and Lilly’s injected obesity treatment Zepbound (59K), but ahead of Novo’s injected Wegovy (13K).
    • “Meanwhile, weekly scripts for Wegovy pill ticked slightly upward sequentially to about 153K, although they still lag behind the drug’s peak of more than 161K.
    • “Jefferies points out that CVS was the last of the big three PBMs to provide coverage of Foundayo, starting on June 1. By contrast, Wegovy had full coverage at the first week of its launch.
    • “While Jefferies’ $71 million quarterly sales projection for Foundayo sits significantly below Wall Street consensus of $130 million, the team still believes that the Lilly med can reach the consensus revenue estimate of $1.2 billion for 2026.”
  • Kaufmann Hall informs us,
    • “Most U.S. adults who use social media engage with health-related content, including sharing health information, according to a study published last month in JAMA. This includes joining online health communities and sharing personal or general health information, with more than one in five adults making health decisions based on what they see online. However, many adults also doubt the accuracy of health information on social platforms. This suggests a public health problem: social media has become a major health information channel, but one built for engagement rather than reliability. This comes as healthcare organizations explore “influencer engagement” as a way to introduce credible information into spaces where patients already are, and where trust is being shaped.”

Notable Death

  • The Wall Street Journal reports,
    • “For decades, oncologists blamed cancers of the mouth and throat on excessive use of tobacco or alcohol. It was typically an old man’s disease.
    • “Starting in the 1980s, they were shocked to see more of these so-called oropharyngeal cancers in people—often young or middle-aged men—who had little or no history of drinking or smoking. A few oncologists suggested those might be caused by the human papillomavirus, or HPV, just as cervical and some other cancers are. But most scoffed at that idea.
    • “In the late 1990s, Maura Gillison, a doctoral student at Johns Hopkins University who was then in her early 30s and little known in the field, sought to resolve the debate. She competed with other researchers for access to scarce tissue samples from human tumors and led a team analyzing them for clues. That work led to a 2000 article in the Journal of the National Cancer Institute demonstrating that HPV-related cases were very different from those related to tobacco or alcohol—and less deadly.”
    • “Gillison, who died June 21 at the age of 61, built on that work with more studies, describing how HPV-related cancers required different treatment—typically less aggressive than the intensive chemotherapy and radiation applied to many non-HPV cancers. These findings saved lives and spared patients from needless treatments and side effects, cancer specialists say.”
  • RIP

Thursday report

David Ermer–Agentic & Generative AI, CDC, CMS, FDA, Federal employment benefits, HIPAA Privacy and Security Rules, Medical / Rx research, Mental health care, Obesity, OPM, Patient safety, Rx coverage, U.S. Healthcare–

Simplicity is a virtue.

From Washington, DC

  • STAT News reports,
    • ‘ARPA-H, the U.S.’ “moonshot” agency for health research, announced Thursday that it will spend up to $160 million to push forward custom gene editing treatments for a spate of rare diseases. 
    • ‘The program, called THRIVE, will back seven different teams pursuing various groups of conditions affecting different organ systems. 
    • “Each team has a deadline of starting clinical trials by year three of the program, although some may start much sooner.” * * *
    • “Each of the groups will work with a partner, such as a biotech company or contract manufacturer, or multiple partners to assure they can manufacture the program to Food and Drug Administration standards.”
  • Beckers Hospital Review relates,
    • “Peptides have become one of the most closely watched regulatory questions in healthcare this summer, with a federal advisory committee vote set for July 23-24 that could reshape what’s legally available to prescribers, wellness clinics and patients nationwide.
    • “What are peptides?
      • Peptides are short chains of amino acids that often serve as signaling molecules for physiological functions in the body, including tissue repair, metabolism and inflammation. Some peptides, like insulin and semaglutide, the active ingredient in Ozempic and Wegovy, are FDA-approved drugs. Others — including BPC-157, TB-500 and a handful of others marketed for injury recovery, weight loss, sleep and anti-aging — have circulated for years through wellness clinics, medical spas and online retailers without ever being FDA-approved or added to the list of substances legally allowed in pharmacy compounding. 
      • “That distinction matters because of how compounding law works. Under Section 503A of the Food, Drug and Cosmetic Act, a licensed pharmacy can only compound a drug for an individual patient using a bulk substance if it’s FDA-approved, has a recognized USP monograph, or appears on the FDA’s 503A Bulks List. If a peptide isn’t on that list, pharmacies generally can’t legally compound it — which is exactly the question now in front of regulators. 
    • “The upcoming vote 
      • “The FDA’s Pharmacy Compounding Advisory Committee meets July 23-24 to decide whether seven peptides should be added to the 503A bulks list: BPC-157, KPV, TB-500 and MOTs-C, Emideltide (also called DSIP), Semax and Epitalon. The committee’s recommendation is non-binding, but the FDA has historically followed it.”
  • Tammy Flanagan, writing in Govexec, explains OPM’s new all-digital federal retirement benefit application process.
  • Per an HHS news release,
    • “President Donald J. Trump signed an Emergency Declaration for the Northern Mariana Islands and the Territory of Guam, and Secretary Robert F. Kennedy, Jr. has declared a public health emergency to address the consequences of Typhoon Bavi. Under these circumstances, the Secretary has also exercised the authority to waive sanctions and penalties against a covered hospital that does not comply with the following provisions of the HIPAA Privacy Rule:
      • the requirements to obtain a patient’s agreement to speak with family members or friends involved in the patient’s care. See 45 CFR 164.510(b).
      • the requirement to honor a request to opt out of the facility directory. See 45 CFR 164.510(a).
      • the requirement to distribute a notice of privacy practices. See 45 CFR 164.520.
      • the patient’s right to request privacy restrictions. See 45 CFR 164.522(a).
      • the patient’s right to request confidential communications. See 45 CFR 164.522(b).
    • “When the Secretary issues such a waiver, it only applies: (1) in the emergency area and for the emergency period identified in the public health emergency declaration; (2) to hospitals that have instituted a disaster protocol; and (3) for up to 72 hours from the time the hospital implements its disaster protocol. When the Presidential or Secretarial declaration terminates, a hospital must then comply with all the requirements of the Privacy Rule for any patient still under its care, even if 72 hours has not elapsed since implementation of its disaster protocol.”

From the Food and Drug Administration front,

  • USA Today reports,
    • “If headlines about heavy metals in tampons raised concerns, the Food and Drug Administration says there’s some reassuring news.
    • “A new agency study found trace amounts of metals including arsenic, cadmium and lead in tampons sold in the U.S., but concluded the levels released during use are too low to pose a health risk.
    • “The findings are the FDA’s latest response to a widely publicized 2024 study that detected metals in popular tampon brands and sparked questions about possible health effects. After analyzing 11 tampon products from six brands, FDA researchers found that while metals can be detected in the products, exposure during normal use remains far below levels considered harmful.”
  • MedTech Dive informs us,
    • “Johnson & Johnson has won Food and Drug Administration approval for a catheter that delivers radiofrequency and pulsed field energy to treat atrial fibrillation.
    • “The approval, which J&J disclosed Wednesday, covers the Dual Energy Thermocool Smarttouch SF Platform. J&J already had approval for a single, radiofrequency energy version of the device.
    • “Integrated into the company’s Carto mapping system, the dual-energy catheter is part of J&J’s push to leverage its electrophysiology strength to reverse market share losses triggered by PFA.”
  • The American Hospital Association News relates,
    • “The Food and Drug Administration has issued an early alert for specific lots of BD ChloraPrep Applicators by Medline because of a potential breach of sterility in the packaging, due to wrinkles in the paper lidding which may extend to the seal area. Medline has instructed impacted customers to remove the recalled convenience kits from where they are used or sold. The company said that other components within the convenience kits may still be used.” 
  • BioPharma Dive cautions,
    • “The regulatory gears in the U.S. are increasingly creaking under the weight of new, complex drug technologies and intensifying overseas clinical trials competition from countries like China and Australia.
    • “Now, the Department of Health and Human Services is making moves to speed early drug research under a new plan dubbed Operation Trialblazer. The blueprint, which involves initiatives at multiple federal agencies, including the Food and Drug Administration and the National Institutes of Health, focuses on modernizing regulations and processes, improving patient access and participation, and enhancing the use of data and technology to streamline the regulatory process.
    • “It’s the latest in a series of actions aimed at supporting drug research. But whether the new reforms will make a meaningful impact is an open question.” 

From the judicial front,

  • Fierce Healthcare reports,
    • “CVS Health and its embattled Omnicare unit have agreed to pay $440 million to the Department of Justice to satisfy a nearly $950 million judgment against the company as part of an ongoing fraud case.
    • “In April 2025, a federal jury ruled that Omnicare submitted more than 3.3 million fraudulent prescription claims between 2010 and 2018, earning $135.6 million in overpayments as a result. Then, in July 2025, a judge ordered Omnicare to pay $948.8 million in fees and damages as part of the case.
    • “In the new court docs, CVS said that it has agreed to make an initial $130 million payment within 14 days of the agreement’s effective date. The remaining $310 million must be paid out by March 15, 2028.
    • “The agreement with DOJ is contingent on the closure of Omnicare’s sale to GenieRx Holdings, according to the filing. As it navigated the legal fallout of the False Claims Act case, Omnicare filed for bankruptcy in September 2025, and CVS announced plans to sell to GenieRx in May of this year.”

From the public health and medical / Rx research front,

  • The Washington Post reports,
    • “Annual cancer cases are projected to rise considerably worldwide by 2050, according to a World Health Organization report on cancer published Wednesday. With its assessment, the United Nations body tempered optimism about improvements in cancer surveillance and treatment and warned that global health care inequities are driving further cases and deaths. 
    • “Around 20.6 million people were diagnosed with cancer in 2024, according to the findings. That number could reach 35 million a year by 2050.
    • “The new cases will disproportionately appear in lower-income countries with poorer access to cancer surveillance and treatment, according to the report.” * * *
    • “In the United States, the rate of new cases has generally been stable in recent years, according to the National Institutes of Health. The WHO report predicts that cancer rates will increase in all regions across the world, though the biggest increases are projected in Africa and the Eastern Mediterranean region.”
  • Health Day adds,
    • “More men die from cancer than women, and a new study suggests one potential reason why.
    • “Men are more likely than women to be diagnosed with advanced cancer that has spread to other parts of the body, researchers report in the July issue of the journal Cancer Epidemiology, Biomarkers & Prevention.
    • “That means their cancer is being detected too late, when it’s tougher to treat and more likely to be fatal, researchers said.
    • “We know that, overall, males are more likely than females to die from many types of cancer. We also know that cancer stage at diagnosis is a key predictor of cancer survival,” lead researcher Beth Maclin, a postdoctoral fellow at the National Cancer Institute in Bethesda, Maryland, said in a news release.” * * *
    • “My overall message is that everyone should go to the doctor regularly,” Maclin said. “Don’t delay seeing a doctor if you notice something has changed in your body.”
  • The AP relates,
    • “Nearly 1,000 people in Michigan have been diagnosed with a parasitic infection that can cause weeks of watery diarrhea, making it the largest such outbreak in state history and one of the nation’s largest in years.
    • “No deaths have been reported and the source of the cyclospora infections hasn’t been identified. Meanwhile, investigations into similar illnesses have been going on in 28 other states, including in Ohio, where people just across the Michigan border are also becoming sick.
    • “Michigan officials first announced the outbreak last week, when they were aware of more than 170 cases — all in the southeastern corner of the state — since June 22. Michigan usually identifies only about 50 cases each year.
    • “On Wednesday, the state reported the number had grown to 992, including about 40 hospitalizations. Just across the state line, Lucas County, Ohio, reported 306 cases as of Wednesday. Northwest Ohio has seen more than 500 cases.
    • “Cyclospora surges can be tricky to investigate, and food poisoning sources can be hard to establish. But “there is clearly a linked outbreak happening right now,” Dr. Natasha Bagdasarian, Michigan’s chief medical executive, told The Associated Press on Wednesday.”
  • MedPage Today tells us,
    • “Chronic kidney disease prevalence held steady at around 14.8% over the last decade, despite treatment advances.
    • “This translated to an estimated 36 million affected U.S. adults, based on national health survey data.
    • “The prevalence of diabetes-related chronic kidney disease increased during the period spanning 2013-2014 to 2021-2023.” * * *
    • “This means single-organ care is no longer enough, said [Sophie] Claudel [, MD]. Based on the data, a growing proportion of the population may be at risk for progressive cardiovascular-kidney-metabolic (CKM) syndrome.
  • Healio informs us,
    • “GLP-1s may prevent adverse outcomes in patients with peripheral artery disease and diabetes, according to data published in the Journal of the American Heart Association. 
    • “Researchers reported that GLP-1 receptor agonist use among patients with PAD and diabetes was associated with lower risk for mortality, hospitalization, revascularization and amputation compared with those prescribed metformin.
    • “Obesity and PAD, including chronic limb-threatening ischemia, are linked to increased inflammation, poor blood vessel function, insulin resistance, oxidative stress and faster hardening of the arteries,” Akiva Rosenzveig, MD, cardiology fellow at Cleveland Clinic, said in a press release. “These results indicate GLP-1 [receptor agonists] can help reduce inflammation, improve blood vessel function and manage blood sugar levels.”
  • Medscape adds,
    • “The FDA approved Zepbound (tirzepatide) in December 2024 for the treatment of moderate-to-severe obstructive sleep apnea (OSA) in patients with obesityafter research showed that the medication improved outcomes in these patients.
    • “Sleep apnea is among the most common sleep disorders. It occurs when the airways relax and block breathing during sleep. Patients may repeatedly stop breathing, leading to disrupted sleep, snoring, and excessive sleepiness during the day.
    • “Now new research has shown that certain patients seem to benefit more than others from the medication. Patients with the most severe sleep apnea along with those who are younger and have less severe obesity experienced nearly twice the reduction in symptoms compared to those who are older and have more severe obesity.”
  • Fierce Pharma points out,
    • “In a first for the neurotoxin market, Ipsen announced Thursday that its Dysport has hit the goals in two phase 3 trials for the prevention of both episodic and chronic migraines.
    • “While AbbVie’s market-leading Botox has been approved by the FDA to prevent headaches in patients with chronic migraine since 2010, Dysport is now the first botulinum toxin to also report positive phase 3 results in episodic migraine, according to Ipsen.
    • “The readouts come from studies in Ipsen’s Beond program, comprising 1,510 patients, split between C-Beond (chronic) and E-Beond (episodic). Both trials have met their primary endpoints, showing a statistically significant reduction in monthly migraine days versus placebo.
    • “Together, these findings position Dysport as a potential first-in-class treatment for a broad migraine population,” Ipsen’s global head of R&D, Christelle Huguet, Ph.D., said in a July 9 statement.
    • “Ipsen will review the full data and prepare for regulatory filings, including with the FDA, a company spokesperson told Fierce Pharma.” 
  • BioPharma Dive lets us know,
    • “A nucleic acid-based medicine from AstraZeneca and Ionis Pharmaceuticals missed its main objective in a big study of people with a deadly heart condition in a major setback with notable ramifications for multiple other drugmakers. 
    • “In a pair of statements, the companies said that when compared to a placebo in people with transthyretin-mediated amyloid cardiomyopathy, or ATTR-CM, their drug, eplontersen, didn’t significantly reduce the risk of death or recurrent cardiovascular events after 140 weeks. Eplontersen had no treatment effect among participants already receiving a commonly used “stabilizer” medication. A 29% risk reduction was observed in people who weren’t getting those drugs, AstraZeneca and Ionis said.
    • “The companies didn’t provide additional study details, only noting that the drug was “well tolerated” and showed positive signs on multiple other secondary study measures. Those specifics will be presented at a medical meeting in August. “
  • and
    • “Roche said Thursday it’s discontinuing two Ionis-partnered drugs for Huntington’s disease after clinical setbacks, with one missing its main trial goal and the other suspended because of a safety worry.
    • “A Phase 2 test of the antisense oligonucleotide tominersen “did not meet its efficacy objective” in spite of having a significant impact on biological disease signs, Roche said in a letter to patient groups. Meanwhile, enrollees in a Phase 1 trial of a drug codenamed RG6496 won’t receive a second dose because animal safety testing revealed that it “cannot be given chronically with repeated doses,” Roche said.
    • “The Swiss pharmaceutical giant had once before suspended a late-stage trial of tominersen because it didn’t appear to be helping patients. Roche forged ahead with a hypothesis that younger and less-advanced patients might benefit, but now that pathway has hit a dead end.”
  • Per Genetic Engineering and BioTechnology News,
    • “A landmark Phase I/II clinical study led by researchers at Skåne University Hospital and Lund University has shown that transplanting stem-cell-derived dopamine progenitor cells into the brain is feasible. Eight patients with Parkinson’s disease (PD) received transplants of STEM-PD, a cryopreserved, off-the-shelf dopaminergic progenitor product derived from human pluripotent stem cells. The three-year Phase I/II, open-label, multicenter, single-arm, dose-escalation study identified no serious side effects linked to the transplanted cells during the first year of follow‑up.
    • “The possibility of replacing dopamine neurons that are lost in Parkinson’s disease has been a long-standing goal in the field,” said Malin Parmar, professor of cellular neuroscience at Lund University, and lead of the STEM-PD program. “The findings represent an important milestone for regenerative medicine approaches in Parkinson’s disease and support continued clinical development of stem cell-based therapies.”
    • “Results from the study were reported by Parmar and colleagues in Nature Medicine. In their paper, titled “Human embryonic stem cell-derived dopaminergic cells for Parkinson’s disease: a Phase I/II open-label trial,” the team wrote, “In conclusion, particularly in the context of other recently published trials using human PS cell-derived dopaminergic cell therapies for PD, these findings further support the continued development of this therapeutic approach, including evaluation of the STEM-PD product in larger patient cohorts.”

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

  • Healthcare Dive reports,
    • “CVS’ insurance division Aetna has a finally gotten a handle on medical spending after a turbulent few years, according to the healthcare giant’s chief executive.
    • “We’ve got, I think, our arms around how to project and predict where healthcare costs are going, and making sure we’re pricing our products accordingly,” CVS CEO David Joyner said at an event hosted by the Economic Club in Washington, D.C., on Thursday.
    • “Joyner’s comments — which come about a month before CVS is scheduled to report second quarter results — are likely a welcome signal for investors that Aetna can continue recent progress on controlling spending.” * * *
    • “The biggest challenge for CVS isn’t managing members’ costs: It’s policy uncertainty out of Washington, Joyner said.
    • “I spend a lot of my time, both at the federal level and in the states, trying to help educate and also describe what are the real drivers of healthcare costs, and then making sure that we play an active role to help with members of Congress,” the CEO said.”
  • Fierce Healthcare relates,
    • “UnitedHealthcare is rolling out a new benefit option aimed at making it easier for employers to offer more personalized wellness programs.
    • “Called Lifestyle Spending Accounts (LSAs), the benefit allows employers to offer a stipend that members can put toward wellness solutions. The LSAs are integrated with UnitedHealth’s UHC Store, which is a digital storefront where members can purchase select health and wellness programs at a discount.
    • “The accounts exist alongside health savings accounts or flexible spending accounts, allowing individuals to purchase health and wellness generally not available under HSAs or FSAs, UnitedHealthcare said.”
  • Benefits Pro tells us,
    • “Both the levels and growth of health care spending from 2005 to 2023 were greatest among Americans with the highest incomes, according to a new report in Health Affairs.
    • “Among the lowest income quintile, spending grew more rapidly just after 2014 but declined from 2018 to 2023. By contrast, spending in the highest income quintile grew more rapidly in recent years. As a result, the difference in age and health status-adjusted spending between the highest and lowest income quintiles declined after implementation of the Affordable Care Act subsidies but increased more recently. The adjusted per capita spending difference in 2023 was more than $4,700.
    • “If spending continues its most recent trajectory, that difference will continue to grow,” the report said. “These spending patterns were driven largely by outpatient and prescription drug spending, which tend to be more discretionary than inpatient and emergency department spending. Prescription drug spending showed a particularly pronounced recent divergence for the top income quintile. Recent spending growth was most evident in the population younger than age 65, which has more variation in insurance coverage, affecting both service use and prices.”
  • Psychology Today lets us know,
    • “Mental health leave [under federal and state leave acts] has sharply increased in the U.S. since the pandemic.
    • “Women, especially caregivers, account for the majority of mental health leaves.
    • “Access to mental health leave highlights structural inequalities in the workplace.
    • “Early, ongoing treatment with an established provider can support the mental health leave process.”
  • Per Smart Brief,
    • “Healthcare AI’s next challenge isn’t adoption. It’s reliability
    • “Healthcare has reached a point where the challenge with AI is not adoption but ensuring it is accountable and dependable post-deployment, writes Sina Bari, vice president of healthcare and life sciences AI at iMerit.”
  • Per MedTech Dive,
    • “Stereotaxis said Thursday it finalized the acquisition of French surgical robotics company Robocath.
    • “Announced in April, the deal is valued at up to $45 million and brings together two robot developers focused on endovascular interventions, which are performed inside blood vessels.
    • “Combining the companies’ expertise will speed development of next-generation robotic technologies for electrophysiology, interventional cardiology and neurointerventions, the companies said.”
  • Per Fierce Pharma,
    • “Unexpectedly catapulted into global fame as a COVID-19 vaccine maker, BioNTech is on the verge of returning to its oncology roots with potentially its first commercial cancer drug. Yet, to Chief Commercial Officer Annemarie Hanekamp, the upcoming launch is less of a standalone milestone than a strategic springboard for a far more critical pipeline product. 
    • “Backed by positive phase 2 data and an ongoing confirmatory phase 3 trial, BioNTech is readying its Duality Biologics-partnered antibody-drug conjugate (ADC) trastuzumab pamirtecan (T-Pam) for submission with the FDA for previously treated HER2-expressing endometrial cancer. 
    • “If approved, the drug will compete with AstraZeneca and Daiichi Sankyo’s blockbuster HER2 ADC, Enhertu, which boasts a pan-tumor indication. Challenging the market leader, however, is not BioNTech’s end goal for T-Pam.
    • “This is not about competing head to head with Enhertu and overtaking them,” Hanekamp said in a recent interview with Fierce Pharma. “We’re very realistic, and we know in the oncology space, first-mover advantage matters. They’ve been in the market for a while, it’s an amazing drug, and we don’t claim to be all that differentiated versus Enhertu.”
    • “Instead, Hanekamp views T-Pam as a “strategic launch,” an exercise to “run water through the pipes” and test BioNTech’s commercial infrastructure in oncology.”

Midweek report

David Ermer–ACA, Agentic & Generative AI, CDC, CMS, Congress, Electronic health records, FDA, Federal employment benefits, Medical / Rx research, Obesity, OPM, U.S. Healthcare–

Simplicity is a virtue.

From Washington, DC,

  • Per a Senate news release,
    • “On Wednesday, July 15, [beginning at 10 am ET], the U.S Senate Health, Education, Labor, and Pensions (HELP) Committee will hold a confirmation hearing on the nomination of Sean Kaufman to be Assistant Secretary for Preparedness and Response for the U.S. Department of Health and Human Services and Erica Schwartz to be Director of the Centers for Disease Control and Prevention.”
  • The Wall Street Journal reports,
    • “Rates for many Affordable Care Act plans rose by double digits this year. Insurers want to do the same next year.
    • “Some of the biggest Obamacare companies are seeking hefty premium increases for 2027, often for the second year in a row. In Washington state, Centene is asking for a 28% hike, after boosting rates by 35% in 2026. Blue Cross and Blue Shield of Illinois wants 15%—on top of a 28% increase this year.
    • “It is a stunning jump” when you add both years together, said Cynthia Cox, senior vice president at KFF, a health-research nonprofit. At the request of The Wall Street Journal, KFF analyzed the rate requests for the largest ACA plans by enrollment in 15 states where insurers’ 2027 filings have already become public, as well as the District of Columbia.” * * *
    • “KFF calculated the median increase across 77 publicly available ACA rate filings for 2027: 14%. For 2026, the median final rise across all ACA plans was 20%.   
    • “Insurers’ 2027 ACA rates have to be reviewed by regulators, and the premiums finalized in late summer might be different from these early requests.”
  • Beckers Payer Issues reports,
    • “CMS has rescinded a decade-old “fast-track” review process for certain Medicaid Section 1115 demonstration waiver extensions as the agency prepares to implement new federal budget neutrality requirements that take effect in 2027.
    • “The July 7 informational bulletin formally withdraws 2015 guidance that allowed eligible states to use an expedited review process when renewing some Section 1115 demonstrations.
    • “CMS said the change is necessary because new statutory requirements will require the agency’s chief actuary to certify that Medicaid demonstrations will not increase federal spending before they can be approved, renewed or amended beginning Jan. 1, 2027.” * * *
    • “CMS previously notified state Medicaid directors that it intends to propose new budget neutrality policies and expects to issue additional implementation guidance. The agency said it remains committed to working with states to support Medicaid and CHIP innovation while complying with the new statutory requirements.”
  • Federal News Network relates,
    • “The Trump administration is looking to tweak the rules for federal employees’ paid administrative leave. Recently proposed regulations from the Office of Personnel Management would give agencies more leeway to use paid leave, including during workforce reduction efforts. During 2025, agencies used administrative leave to implement the deferred resignation program, choosing to paying thousands of employees for several months not to work, in exchange for them agreeing to quit their jobs.”
  • and
    • Federal News Network interviews Tammy Flanagan about early retirement for federal law enforcement officers.
      • [I]n law enforcement, typically, you’ve got to retire by the time you’re 57. And sometimes that’s hard because they really love that career for the most part, and that’s their identity. So leaving that early sometimes can be a tough transition, not only financially, but also emotionally.
  • The American Hospital Association News informs us,
    • “The Department of Health and Human Services and the Centers for Medicare & Medicaid Services July 8 launched  a voluntary pledge that hospitals can sign related to their efforts on healthy food. Among other actions, the pledge asks that hospitals prioritize food options in alignment with the 2025-2030 Dietary Guidelines for Americans; ensure that inpatient meals meet individual nutritional needs; provide accessible nutrition education and resources to sustain healthy habits following discharge; and provide community-based nutrition programs to support healthier communities.” 

From the Food and Drug Administration front,

  • STAT News reports,
    • “The top contenders to lead the Food and Drug Administration have been sent to the White House for a final review and decision, according to a person familiar with the process.
    • “The finalists include Heidi Overton, a White House adviser; Jeffrey Vacirca, an oncologist and health system executive; and Stephen Ferrara, a health affairs official at the Defense Department.” * * *
    • “The advancement of the finalists suggests the highly anticipated decision is on the horizon, though the timing remains unclear.”
  • Politico discusses the FDA’s 2026 regulatory agenda which was released on July 3.

From the judicial front,

  • HealthExec reports,
    • “Once scheduled for the fall, the federal murder trial against the man accused of killing UnitedHealthcare CEO Brian Thompson will now begin in January, a judge determined last week.
    • “At the conclusion of a June 29 hearing, U.S. District Judge Margaret Garnett agreed with attorneys representing Luigi Mangione who argued the original date of Oct. 13 left little time to prepare a defense.
    • “A trial in New York on state charges of second-degree murder is set to begin first, with jury selection pegged for a Sept. 8 start date, followed by opening arguments on Oct. 13—the same day the federal trial was initially scheduled to begin. With it now pushed back, Mangione’s attorneys need only worry about the looming prospect their client could be spending the rest of his life in prison as a result of the first trial.”
  • Per a Justice Department news release
    • “The founder and former Chief Executive Officer (CEO) Ruthia He of Done Global Inc., a California-based digital mental health company, was sentenced today to six years in prison and a fine of $1 million for orchestrating a scheme that used her company’s technology platform, compensation structure, and clinical protocols to unlawfully distribute over 37 million pills of Adderall, defraud insurers of over $12 million, and obstruct the federal investigation that followed.”

From the public health and medical / Rx research front,

  • The Hill reports,
    • “As of Monday [July 6], the parasitic illness has spread to at least 18 states, with the most cases reported in Illinois, Michigan, New York and Texas.
    • “While exact numbers are unknown, the Michigan Department of Health and Human Services has reported 572 cases of cyclosporiasis as of July 4, and New York has reported more than 100. No exact numbers have been released for Illinois or Texas. Current figures are most likely an undercount, as most people who are sick don’t report it or go to a doctor unless it’s severe.
    • “Other states linked to the outbreak include Alaska, Colorado, Connecticut, Florida, Georgia, Louisiana, Massachusetts, New Jersey, North Carolina, Ohio, Pennsylvania, Tennessee, Virginia and Wisconsin.”
  • Health Day relates,
    • “Exercise can boost a smoker’s odds of successfully quitting, a new evidence review says.
    • “Smokers taking part in exercise programs were more likely to either quit or cut back on cigarettes, researchers reported recently in the Journal of Sport and Health Science.
    • “In fact, a single bout of exercise immediately reduces nicotine cravings for up to a half hour afterward, researchers found.
    • “Quitting smoking is one of the best things a person can do for their health, but it’s also one of the hardest,” lead investigator Ben Singh, a research fellow at Adelaide University in Australia, said in a news release.
    • “Many smokers want to quit, but the current approaches don’t work for everyone,” Singh said. “That’s why we need more strategies that people can incorporate into their daily lives at little or no cost.”
  • The New York Times discusses the medical problems created by parents refusing to protect their infants with an injection that resolves the Vitamin K deficiency with which all of us are born. It’s worth a read.
  • STAT News tells us,
    • “Could a lifesaving lung transplant strategy that contained the Covid-19 virus also save patients whose advanced lung cancer hasn’t spread? 
    • “That’s the question that inspired surgeons and oncologists at Northwestern Medicine to offer double lung transplants to patients who had run out of treatment options but whose late-stage cancer hadn’t left their lungs. People with late-stage lung cancer have not been transplant candidates before for two reasons: rates were high for cancer recurrence and low for survival.
    • “There are ethical considerations to weigh, too, when deciding how to allot donated organs.
    • “On Wednesday, the Northwestern team reported in JAMA that the 17 patients who received lung transplants after advanced but limited cancer fared better than 81 similar patients who continued standard immunotherapy, chemotherapy, or radiation treatments. Overall, the study followed 404 patients with end-stage pulmonary disease, including 98 with stage 4 lung cancer.
    • “After one year, through June 2025, all the lung cancer transplant patients had survived compared to 88% of patients transplanted without cancer. Among those 17 patients, by January 2026, there were four recurrences of cancer and two deaths unrelated to cancer — one from an infection and one from a blood clot. Among the 81 cancer patients getting standard care, 74 saw their cancers progress.”
  • Genetic Engineering and Biotechnology News informs us,
    • “It has long been known that brain gray matter plays a key role in multiple sclerosis (MS) disease progression and cognitive impairment, but because magnetic resonance imaging (MRI) has only been able to detect lesions in white matter, neither clinicians nor researchers have had a way to detect or monitor gray matter (cortical) lesions. And while many new drugs developed in the past decade can slow disease progression significantly, they primarily work on reducing white matter lesions.
    • “A University at Buffalo (UB)-led team now reports that it has found a way to use artificial intelligence to reveal these otherwise invisible cortical lesions by reviewing existing MRI scans. The researchers say the significance of finally being able to see what has been known as one of the most important indicators in MS disease progression cannot be overstated.”
  • Healio points out,
    • “Public health messaging had a longer-lasting impact on parents’ intent to vaccinate their children against HPV than AI chatbot interactions.
    • “Strategies to make both modalities more effective are needed.”
  • Per Fierce Healthcare,
    • “After thriving in the market for more than a decade as the only treatment for Dupuytren’s contracture and Peyronie’s disease, Keenova Therapeutics’ Xiaflex has excelled in a phase 3 trial that could set up the injectable biologic enzyme for approval in a third indication.
    • “The study of 436 patients with plantar fibromatosis achieved its primary endpoint, showing statistically significant and clinically meaningful reductions in pain versus placebo as measured by the Average Daily Pain Intensity on the Numeric Rating Scale (NRS).” * * *
    • “Plantar fibromatosis, which is also known as Ledderhose disease, causes lumps composed primarily of excess collagen to form in the connective tissue that supports the arch of the foot. It can cause pain, swelling, and difficulty walking. Based on claims data and projections, Keenova estimates that 300,000 people will see a healthcare provider for plantar fibromatosis in 2028.
    • “There is no medicine on the market specifically for plantar fibromatosis. Patients can get relief through radiation therapy or corticosteroid injections, with surgical interventions generally reserved as a last resort.” 
  • The Wall Street Journal reports,
    • “Some patients are using GLP-1 drugs to treat eating disorders like bulimia and binge-eating disorder.
    • “No major medical organization has endorsed GLP-1s for eating disorders, and drugmakers Novo Nordisk and Eli Lilly say they are not approved for this.
    • “Experts say widespread adoption is unlikely soon due to limited scientific data.”
  • Per MedTech Dive,
    • “Penumbra said Tuesday it has started a clinical trial that could support wider use of mechanical thrombectomy in a subset of stroke patients.
    • “The real-world prospective study is assessing Penumbra’s RED reperfusion catheter portfolio in patients with M2 occlusions.
    • “Penumbra, which Boston Scientific has agreed to buy for $14.5 billion, is assessing whether its computer-assisted vacuum thrombectomy and modulated aspiration tools improve outcomes.”

From the U.S. healthcare business front,

  • Healthcare Dive reports,
    • “A newly released audit of UnitedHealth’s home visits for Medicare seniors found little evidence to support accusations that the program, called HouseCalls, drums up extra patient diagnoses to inflate UnitedHealth’s reimbursement from the federal government.
    • “UnitedHealth argued that the results vindicate HouseCalls, which has faced scrutiny from regulators and lawmakers focused on combating profiteering in Medicare Advantage, Medicare’s privatized sister program.
    • “About 96.6% of diagnoses that UnitedHealth found during the home visits were backed up by patients’ health records, according to the audit released Tuesday from FTI Consulting, which used the same review process as the government.
    • “That leaves 3.4% of diagnoses unsupported by medical information — three times lower than the error rate found by the CMS in its most recent audit of data in the privatized Medicare program.
    • “UnitedHealth said it reviewed FTI’s findings and that the lion’s share of diagnoses unsupported by medical records were backed up by other information like paid claims.”
  • and
    • “Data from consumer wearables are valuable in clinical care, and many physicians are using the information in their practice — but widespread adoption is hindered by limited workflow integration and other barriers, according to a survey published Wednesday by the American Medical Association. 
    • “Eighty-six percent of U.S. physicians reported they at least sometimes reviewed data from their patients’ wearables, like information on heart physiology, oxygen and breathing, and sleep, according to the report, which also interviewed doctors from Canada, France, Germany, Spain and the U.K.
    • “But only 6% of doctors in the U.S. said wearable data was integrated into clinical workflows, like the ability to import information into electronic health records. “We have all this data that’s available, but it’s actually not actionable because we don’t have a way to get it into clinical workflow,” AMA CEO Dr. John Whyte said in an interview.”
  • Modern Healthcare relates,
    • “Health insurance companies and third-party vendors offer arrangements to mitigate the costs of cell and gene therapies to employers.
    • “More than three-quarters of employers see gene therapies as a major challenge, yet 35% lack financial protection, a survey found.
    • “The Food and Drug Administration has approved cell and gene therapies for conditions such as blood cancers and neurodegenerative diseases.”
  • MedCity News adds,
    • “In Oncology, the Cost Problem Goes Beyond Predictability.
    • “Healthcare does not lack the data needed to better understand oncology costs. What it does lack is a consistent way to connect clinical progression with financial impact in a time frame that aligns with strategic planning.”
  • Beckers Payer Issues tells us,
    • “Memorial Hermann Health System plans to shut down its commercial health insurance business.
    • “The wind-down affects the Houston-based system’s HMO, PPO, and self-funded products for employers. On its website, the system said it would be difficult to reach the scale needed to sustainably provide value to members moving forward. The closure notice does not include the system’s Medicare Advantage business.
    • “This decision was made following a careful and comprehensive assessment of system assets and resources, including an evaluation of existing opportunities and future challenges amid sustained pressures on health system-owned health plans,” the system wrote.
    • “Current coverage will remain in effect, and providers can continue treating members through each plan’s termination date, which will vary by employer group. Groups whose plan year is set to renew before Dec. 1 will have the option to enroll in one additional year of coverage before the full closure.”
  • and
    • “Josh Michelson started serving as executive vice president and chief strategy and innovation officer for The Cigna Group, according to a recent LinkedIn post.
    • “A Cigna website said Mr. Michelson is responsible for steering the company’s long-term strategic direction, corporate innovation and The Cigna Group Ventures, the company’s venture capital branch.
    • “He joined Cigna in 2020 and was most recently a senior vice president and chief strategy and transformation officer for the company.”
  • Beckers Health IT notes,
    • “[The major electronic health records company] Epic named four executives who will take on expanded responsibilities following President Sumit Rana’s departure, according to a statement from Founder and CEO Judy Faulkner shared with Becker’s.
    • “Ms. Faulkner said Seth Howard, Mark Lipsky, Erv Walter and Garrett Adams are among a small group of leaders who will be adding to their responsibilities as the company moves forward without Mr. Rana.
    • “The statement did not detail the additional responsibilities these individuals would be taking on.” * * *
    • “Mr. Rana’s departure leaves a notable gap at the top of the nation’s largest EHR vendor. He was widely viewed as a potential successor to Ms. Faulkner, who is 82.”
  • Per Cardiovascular Business,
    • “Novo Nordisk is now working with Vivani Medical, a California-based biopharmaceutical company, to evaluate the potential of a long-lasting semaglutide implant. This is a non-exclusive agreement between the two companies. 
    • “Novo Nordisk, one of the world’s largest pharmaceutical companies, sells semaglutide under the brand name Wegovy. Vivani is known for its drug implants, which are designed to help patients benefit from life-changing medications without ever needing to inject or ingest them. 
    • “The goal of this partnership is to reduce the risk of non-adherence and ensure patients taking semaglutide can receive the care their physicians have determined they need. The implant in question, currently known as NPM-139, is being developed to help patients with chronic weight management. It utilizes Vivani’s proprietary NanoPortal technology and could help patients receive the maximum benefits of treatment with just one or two treatments per year.
    • “Vivani is also preparing the launch of a new first-in-human clinical trial that would randomize certain patients to either undergo treatment with an NPM-139 implant or receive semaglutide injections.”
  • Per MedTech Dive,
    • “Resmed has agreed to sell its MatrixCare software business for $490 million to private equity firm Frazier Healthcare Partners. The deal is meant to sharpen Resmed’s focus on sleep and breathing health devices and connected, home-based care.
    • “Divesting MatrixCare enables Resmed to reallocate capital and resources toward higher-growth opportunities and expansion of its digital health ecosystem, the company said Tuesday.
    • “The cash transaction is expected to close in the first quarter of Resmed’s fiscal 2027, which ends in September.”

Tuesday report

David Ermer–ACA, Agentic & Generative AI, CDC, CMS, Congress, FDA, Medical / Rx research, Medicare, Mental health care, Obesity, Patient safety, Rx coverage, U.S. Healthcare–

Simplicity is a virtue

From Washington, DC,

  • Roll Call reports,
    • “The sweltering Fourth of July weekend is over, but for both parties in House and Senate leadership, the heat is still cranked up.
    • “Both chambers are likely to return next Monday to the same sweat-inducing tangle of legislative problems that left them stumped as they headed out of town at the end of June.
    • “Speaker Mike Johnson, R-La., is looking for a solution so “irresistible” that his fellow Republicans will have to accept it — but the numbers are working against him.
    • “For one thing, August is fast approaching, leaving just a couple weeks in Washington before lawmakers depart for an even longer summer break. And as Senate Majority Leader John Thune, R-S.D., has said all along, mathematical realities can’t be changed in the Senate, even when it comes to the White House-backed voter ID bill dubbed the SAVE America Act.”
  • Beckers Hospital Review relates,
    • “CMS is proposing to create a new payment pathway for algorithm-driven diagnostic software, including AI tools, as part of its 2027 Hospital Outpatient Prospective Payment System and Ambulatory Surgery Center proposed rule, issued July 2. 
    • “The proposal marks CMS’ first attempt to build a standardized payment structure for what it calls “Software as a Medical Service” — clinical software that uses algorithms to analyze patient data and produce a diagnosis, risk score or treatment recommendation.”
  • and
    • “The planned July meeting for the U.S. Preventive Services Task Force has been postponed until late August, an HHS spokesperson told Becker’s.” * * *
    • “The HHS spokesperson said the July meeting was postponed due to an “unprecedented” number of nominations for task force membership, to allow more time for selection and onboarding of new members.”
  • Fierce Healthcare reports,
    • “The American Medical Association (AMA) updated maternity care coding Thursday, in what it says is the “most significant” move in decades to improve care delivery and data to advance maternal health.
    • “Beginning Jan. 1, 2027 (PDF), current procedural terminology (CPT) codes will reflect modern obstetric care, enable accurate and transparent reporting across the full pregnancy spectrum and create a data foundation for improved care throughout the entire patient journey.
    • ‘The update featured the deletion of 17 codes, the creation of six codes and the revision of six codes. It also includes new subsections, revised guidelines and relocation for some existing codes.
    • “Moreover, new CPT codes (PDF) will separately identify four phases of care: antepartum, labor management, delivery and postpartum.” * * *
    • “There is no expected impact on health plan benefits or an increase in cost-sharing, according to an AMA analysis using data from more than 650 physicians and certified nursing midwives.”
  • FEHBlog observation. We shall see.
  • KFF Health News explains how surprise Medicare Part D premiums can adversely affect Medicare Part D beneficiaries.

From the Food and Drug Administration front

  • Per a July 6, 2026, FDA announcement,
    • “The FDA and CDC, in collaboration with state and local partners, are investigating illnesses in a multistate outbreak of E. coli O145:H28 infections linked to frozen GreenWise brand-organic blueberries recalled by Frutas y Hortalizas del Sur S.A, of San Carlos, Chile.”
    • “Recalled frozen GreenWise-brand organic blueberries in 10-oz packages with printed lot code of 60401 and Best by Date of February 9, 2028.” * * *
    • “Recalled product was shipped to Publix retail stores throughout 8 states including Alabama, Florida, Georgia, Kentucky, North Carolina, South Carolina, Tennessee, and Virginia. Blueberries may have been distributed to other retailers, and FDA will update this advisory as more information becomes available.” 
  • Cardiovascular Business reports,
    • “Medtronic is recalling certain lots of the delivery catheter system for its Harmony Transcatheter Pulmonary Valve (TPV) System due to a significant safety risk. The U.S. Food and Drug Administration (FDA) has ruled this as a Class I recall, which means using the device could cause “serious adverse health consequences or death.”
    • “Medtronic initiated the recall after identifying an issue with the delivery system that could lead to distal tip detachment during implant procedures. More than 1,800 devices are included in this Class I recall.
    • ‘The Harmony TPV system is used to treat a native or surgically repaired right ventricular outflow tract (RVOT) in patients with severe pulmonary regurgitation. It has received FDA approval in addition to CE mark approval. Click here to read about a recent analysis of the device’s safety and effectiveness.”
  • Fierce Pharma relates,
    • “When Vera Therapeutics in-licensed atacicept from Merck KGaA about six years ago, patients with IgA nephropathy (IgAN) had no FDA-approved treatment options. Today, the dual-target drug has crossed the regulatory finish line but is entering a vastly different landscape as the sixth drug approved for the rare kidney disease.
    • “Atacicept, a recombinant fusion protein to be marketed under the brand name Trutakna, is now the first drug in the U.S. that inhibits both B-cell activating factor (BAFF) and A proliferation-inducing ligand (APRIL), two cytokines involved in B-cell survival and the production of autoantibodies associated with IgAN.” 

From the judicial front,

  • Per a June 25, 2026, Justice Department news release,
    • “Julianna C. Lung pleaded guilty in federal court today to health care fraud, admitting she marketed and sold hearing protection devices to United States Border Patrol agents, other federal employees, and their family members, then falsely billed insurance providers for what she claimed were medically-necessary hearing aids.
    • “According to her plea agreement, Lung submitted approximately 385 fraudulent claims to health insurance plans participating in the Federal Employees Health Benefits (FEHB) program. The claims falsely represented that beneficiaries suffered from hearing loss or tinnitus that required treatment.
    • “In reality, Lung told customers the devices were intended to protect their hearing—not treat a medical condition—and assured them their insurance would cover the cost for that purpose.
    • “As a result of the scheme, FEHB plans paid approximately $2,500 per device, totaling about $962,500 in fraudulent reimbursements.”

From the public health and medical / Rx research front,

  • Dr. Drew Altman, writing in KFF Health News, tells us,
    • Many of us in health care are deeply concerned about misinformation (and declining trust), so it seems important to underscore that while the American people may not always be as science-based as we might like them to be, they may also not be as anti-science as you may think they are—only a sliver of the public are hard-core refusniks who believe the lies, myths, misinformation or misbeliefs about vaccines. Occasionally, a lie breaks through when it’s amplified by someone influential and by the media. For example, 41% of the American people believed there were death panels in the ACA, but that’s the exception, not the norm.
    • In our most recent Tracking Poll on Health Information and Trust, we tested out who believed and didn’t believe each of four vaccine-related myths: “Getting the measles vaccine is more dangerous than becoming infected with measles;” “mRNA vaccines can change your DNA;” “measles, mumps, and rubella vaccines, also known as the MMR vaccines, have been proven to cause autism in children;” and, “more people have died from the COVID-19 vaccines than have died from the COVID-19 virus.” Here’s what stood out to me from these findings:
      The share of the public who believe these four myths is very small. Between 3% and 8% of the adult population believe these different vaccine myths are “definitely true.” By any standard, that’s a small, even tiny share of the overall adult population (for context, about a quarter of adults say they are MAGA). These are likely most of the folks you see in the spikes in social media engagement we sometimes observe when influencers or leaders like Secretary Kennedy amplify vaccine or
      other myths. 
    • Looked at another way, the hard-core group is even smaller: Just 1.3% believe all four false claims about vaccines are “definitely true.” 
    • By contrast, between 31% and 44% of the public think these claims are basically nonsense, meaning the share who don’t believe these things at all outnumber those who definitely do by almost 5-to-1 or more. That’s hardly the impression you get when you read reports about social media posts and views with characterizations like “engagement spiked” or “views tripled.” It’s important to track social media engagement to know how misinformation is spreading and who is spreading it, but it doesn’t give us a real picture of reach or impact. How many people believe it? How strongly? Who are they? Where did they get their information? Who do they trust and not trust when it comes to health information? That’s why we do our information and trust surveys. 
    • As I have written before and we have widely reported, most people are floundering around in a muddled middle uncertain what to believe. Take, for example, the slam dunk falsehood that “more people have died from the COVID-19 vaccines than from COVID-19 itself.” As you can see in the chart below, 53% of the American people are not certain about the answer to that question, with 34% saying that’s “probably false” and 19% “probably true,” Estimates are that the vaccine saved 2.5 million lives, and many more years of life. 
  • The Washington Post reports,
    • “The number of people injecting themselves with or taking an oral version of the new class of weight-loss drugs continues to rise dramatically.
    • “A Gallup poll released Tuesday based on a web survey of 5,065 U.S. adults says that 15 percent of U.S. adults reported using GLP-1 medications to lose weight at some point, while 11 percent say they currently are taking them.
    • “That’s up from a Gallup poll in 2024 that found 6 percent had ever taken them, and 3 percent were currently on the therapy.
    • “At the same time, respondents’ self-reported obesity rates have dipped, and diabetes rates have flattened. “The growing popularity of GLP-1 medications continues to point to broader health benefits for American adults as obesity levels curtail and the diabetes rate levels off after years of increases,” Gallup said.”
  • Beckers Payer Issues adds,
    • “The share of employers covering GLP-1s for both diabetes and weight loss has held steady at 36% year over year, according to a survey from the International Foundation of Employee Benefit Plans.
    • “The survey was conducted June 2 to June 12. The foundation represents more than 31,000 multiemployer, corporate and public sector members representing over 25 million lives.”
  • Radiology Business tells us,
    • “Experts are calling for greater integration of breast and lung cancer screening programs to help bolster monitoring for both diseases. 
    • “Researchers with Thomas Jefferson University, Philadelphia, made the case in a new analysis published July 3 by the Journal of the American College of Radiology. They noted that, despite the proven lifesaving benefits of mammography, completion rates remain as low as 55%, with worse screening adherence among socioeconomically disadvantaged patient populations. 
    • “Women eligible for lung cancer screening represent a unique population, they note, with elevated cancer risk and “substantial healthcare needs.” Previous studies have explored lung cancer screening among women already receiving mammography, but less is known about whether those actively engaged in LCS programs are up to date on their breast exams. 
    • “This represents an important gap in the literature because dual BCS/LCS-eligible women can be more efficiently identified from an [lung cancer screening] cohort than from a [breast cancer screening] cohort,” lead author Meghan Maceyko, MD, with the Department of Surgery at Thomas Jefferson, and colleagues wrote Friday. “Additionally, LCS participants may have access to highly structured LCS navigation pathways to facilitate BCS completion.”
  • The American Journal of Managed Care informs us,
    • “Adults with diabetes treated with insulin who were prescribed continuous glucose monitoring (CGM) by their primary care clinician were associated with meaningful and durable improvements in hemoglobin A1c (HbA1C), along with fewer hospitalizations and emergency department (ED) visits, according to a cohort study published in JAMA Network Open.”
      .
  • MedPage Today points out,
    • “Influenza vaccine effectiveness against death among U.S. kids and teens averaged 80% in recent years.
    • “Vaccine effectiveness against death was 77% among kids with underlying medical conditions and 87% among those without.
    • “The findings come against a backdrop of declining influenza vaccine uptake since 2021.”
  • and
    • “Roughly 22 high school students die each week from a fentanyl overdose.
    • “In a nationally representative survey study, less than half of 8th graders surveyed attributed great risk to experimental use of fentanyl.
    • “The study’s findings are a “call to action” to better educate children and teens about the synthetic opioid’s risks, a researcher said.”
  • Per Health Day,
    • “Artificial sweeteners may affect metabolism.
    • “Artificial and low-calorie sweeteners have been linked to higher fasting insulin, higher HbA1c and reduced insulin sensitivity.
    • “Alterations to the gut microbiome may help explain the observed metabolic changes.”
  • Cardiovascular Business notes,
    • “A polypill containing three different medications is associated with significant benefits for select heart failure patients, according to new findings published in Nature Medicine.[1]
    • “For the POLY-HF randomized trial, researchers explored data from 212 heart failure patients treated at two U.S. healthcare facilities. The median age was 54 years old, and 78% of patients were men. Nearly seven in 10 patients were either uninsured, or faced other barriers that can make it harder to receive optimal medical therapy.” * * *
    • “The study’s primary outcome, change in left ventricular ejection fraction after six months, was 3.3% higher for patients taking the polypill than it was for patients taking each medication separately. In addition, patients taking the polypill had a 60% lower rate of heart failure hospitalizations or ED visits.
    • “Adherence, evaluated by studying each participant’s blood for metoprolol and spironolactone, was also higher for patients taking the polypill than it was for patients taking each medication separately.”
  • Per STAT News,
    • “Compass Pathways said its investigational psilocybin treatment had lasting benefits on patients with severe depression out to six months.
    • “The biotech previously reported that 39% of patients who took two high doses in a Phase 3 trial achieved what Compass called a “clinically meaningful reduction” on a depression rating scale after six weeks. Today, it said that on average, those participants maintained the benefit through at least six months.
    • “In the trial, participants who didn’t achieve remission in the first six weeks were eligible to then get an additional dose. Compass said this morning that 28% of participants who had achieved a clinically meaningful response but not remission at six weeks did later go into remission after the additional dose. * * *
    • “Compass’ treatment is one of three psychedelic compounds the FDA has selected to review on an accelerated basis. It’s possible the drug could be approved as soon as this year.”

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

  • STAT New reports,
    • “It has never been more difficult for employers to offer health insurance for their workers. That’s especially true for America’s small businesses, the backbones of entire communities. More and more, they’re giving up entirely.
    • “America’s employer-based health insurance system — the dominant form of coverage for people younger than 65 — is crumbling. The percentage of working-age adults who get their health coverage from a job has declined from 67% in 1998 to about 60%. It’s also more expensive than ever.”
  • FEHBlog observation — To lower premiums, uncouple the employer market from the Affordable Care Act.
  • Modern Healthcare reports,
    • “Care navigators are helping health systems reduce unnecessary admissions and save money as chronically ill older adults and uninsured patients flood emergency departments. 
    • “Care navigators are typically nurses embedded in emergency departments who connect patients to less costly outpatient services to avoid hospitalizations. Providers, including St. Louis-based BJC Health System and Chicago-based Northwestern Medicine, have been growing care navigator programs.”
  • Healthcare Dive relates,
    • “Ascension has agreed to snap up a regional health system in a deal worth almost $1 billion as the Catholic nonprofit giant continues to beef up its portfolio.
    • “On Monday, Franklin, Tenn.-based Williamson Health announced it plans to sell to Ascension through the company’s Tennessee business Ascension Saint Thomas, after Williamson’s board voted unanimously in support of the change of ownership.
    • “The proposed transaction is still subject to approval by the Williamson County Board of Commissioners and other regulators. If the deal advances, the companies expect it to be finalized in 2027 or 2028.”
  • Beckers Hospital Review tells us,
    • “Jupiter (Fla.) Medical Center, an independent, nonprofit health system, broke ground June 24 on its second hospital, the “Jupiter Medical Center Neighborhood Hospital at The Health Park at Avenir.”
    • “The 53,000-square-foot facility will comprise 29 inpatient beds, four operating rooms, 24-hour emergency services, imaging services and a diagnostic laboratory, according to a news release. 
    • “Jupiter Medical Center Neighborhood Hospital at The Health Park at Avenir will be adjacent to a 47,000-square-foot, three-story medical office building for Jupiter Medical Center physicians. The building will feature cardiology, concierge medicine, gastroenterology, general surgery, primary care, pulmonary and orthopedics.
    • ‘Both the hospital and medical office building are expected to open in early 2028.” 
  • Fierce Healthcare informs us,
    • “Handspring Health offers a virtual mental health clinic for youth and families, purpose-built around evidence-based care and ongoing training and support for clinicians.
    • “The startup, which launched four years ago, picked up $19 million in series B funding to grow its clinician workforce, expand value-based care partnerships with payers and broaden its geographic reach.”
  • Fierce Pharma lets us know how “biosimilar experts size up US hurdles, opportunities ahead.”
  • Beckers Payers Issues explains “How 4 health plans are innovating with specialty pharmacy.”
  • MedCity News offers “The AI Playbook for Health Plans: 5 Steps for Leaders Who Don’t Know Where to Start.”
    • “It starts with a simple mindset shift, realizing that a successful AI journey begins with identifying a business problem, not with technology. The plans that make real progress embrace this mindset first then follow these five steps.” 

Monday report

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

Simplicity is a virtue.

From Washington, DC,

  • STAT News reports,
    • “Clinical trial policy got caught up in the Trump administration’s attack on policies related to diversity, equity, and inclusion. Republicans in Congress would like to change that. 
    • “Days after Trump took office, the Health and Human Services Department began purging all references to DEI from the websites of its agencies. Those efforts were supposed to target DEI initiatives focused on hiring practices, communications, and social issues.
    • “But supporters of clinical trial diversity say the policy has nothing to do with DEI in that sense. Instead, it aims to ensure that clinical trials enroll people who are similar to the patients who would use the drugs and medical devices being tested. 
    • “Congressional Republicans seem to agree. Last month, the Republican-controlled House passed a bill, mostly along party lines, to fund the Food and Drug Administration. It was accompanied by a report that, while not legally binding, tells agency officials what congressional appropriators expected of them. 
    • “A section of that bill deals with trial diversity.
    • “The Committee encourages FDA to continue to implement legislation and policies requiring study sponsors to submit a diversity action plan for phase 3 studies of new drugs,” the report states.”
  • MedPage Today relates,
    • “I still have hope,” said Peggy Tighe, legislative counsel for the Regulatory Relief Coalition, a group of physician specialty organizations advocating for regulatory burden reduction in Medicare, when she was asked about the Improving Seniors’ Timely Access to Care Actopens in a new tab or window, which was approved last weekopens in a new tab or window by the House Energy and Commerce Health Subcommittee.
    • “The measure, which seeks more transparency and accountability from Medicare Advantage plans on their prior authorization decisions, must still be approved by the full Ways & Means and House Energy & Commerce committees before it hits the House floor for a vote.
    • “What’s different this year is that there is much more limited committee time and House floor time because of the … drama on the House floor and the paucity of votes,” Tighe said in a phone interview with MedPage Today. “So with everything else going on, I still have hope that we could pass this bill out of Energy & Commerce and Ways & Means before the August recess, but every day that Congress gets canceled, it makes it more difficult to find that time to accomplish what I think should be a very easy goal of passing legislation that is zero cost and widely supported.”
  • Per a HHS news release,
    • “The Substance Abuse and Mental Health Services Administration (SAMHSA), a division within the U.S. Department of Health and Human Services (HHS), today announced more than $281 million in funding opportunities for 15 grant programs.
    • “The investments will advance President Trump’s Great American Recovery Initiative by expanding access to a wide range of behavioral health services, including substance use disorder treatment, overdose prevention and response, mental health and suicide prevention, trauma-informed care, integrated care, recovery supports, first responder training, privacy education and workforce development.”
  • The American Hospital Association tells us,
    • “The AHA today sent a letter to the Office of the United States Trade Representative to ask that medications, medical devices and other healthcare equipment and supplies be exempted from proposed duties on goods from other nations. While “America’s hospitals and health systems support the administration’s goal of strengthening domestic manufacturing for drugs, medical devices, PPE and other essential medical supplies,” the AHA noted, “the U.S. healthcare system relies significantly on international sources for many drugs, devices, supplies, equipment and other products needed to both care for patients and protect our healthcare workers.”
  • Federal News Network informs us,
    • “An overhaul to the federal workforce’s performance management system is now set in stone, following a final rule the Office of Personnel Management released this week.
    • “Going forward, agencies will be limited in the share of employees they can rate highly in performance reviews. OPM’s final regulations, which are scheduled to publish Tuesday to the Federal Register, remove a previous ban on using forced distribution in the government’s performance management system.
    • “The final rule marks the largest overhaul of the government’s performance management system in decades. Agencies will have to be in compliance with OPM’s changes by Jan. 1, 2027. Once effective, the changes to performance management will apply across virtually the entire federal workforce.
    • “These changes are necessary to promote a culture of accountability and excellence across the federal workforce — one that reflects both the government’s evolving operational demands and its longstanding commitment to a merit-based civil service,” OPM said in the final rule.”
  • Other health plan related highlights from last Friday’s unified regulatory agenda.
    • A proposed rule [RIN 0938-AV95, to be published in December 2026] would propose requirements under the Mental Health Parity and Addiction Equity Act (MHPAEA) to clarify plans’ and issuers’ obligations, promote compliance, and reduce burden.
    • A long term plan [RIN 0945-AA22] to modify the Security Standards for the Protection of Electronic Protected Health Information (the Security Rule) under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act). These modifications will improve cybersecurity in the health care sector by strengthening requirements for HIPAA regulated entities to safeguard electronic protected health information to prevent, detect, contain, mitigate, and recover from cybersecurity threats. A final rule is expected to be published in July 2027.

From the public health and medical / Rx research front

  • The Washington Post explains “Why U.S. measles outbreaks have grown harder to extinguish.”
    • The nation is already nearing last year’s record case total, and experts say the virus is forcing doctors to relearn a disease many thought had been consigned to history.”
  • Beckers Hospital Review tells us that “Clinical cases of the drug-resistant fungus Candida auris more than doubled in the U.S. from 2022 to 2024, highlighting ongoing transmission in healthcare settings, according to a CDC study published July 2.” 
    • “C. auris is frequently resistant to antifungal drugs, can persist on patients’ skin and surfaces, and spreads readily in healthcare settings. Bloodstream infections caused by the fungus are associated with high mortality.
    • “The CDC said sustained infection prevention and control measures, including transmission-based precautions, environmental disinfection and communication of patients’ Candida auris status during transfers, remain essential to limiting further spread.”
  • The AP informs us,
    • “Doctors and others are sounding an alarm: More U.S. children have been drowning in recent years.
    • “When drowning occurs, seconds matter,” said Dr. Rohit Shenoi, the lead author of a recent American Academy of Pediatrics warning. “Quick rescue and resuscitation can mean the difference between life, death and lifelong disability.”
    • “About 4,000 to 5,000 Americans drown each year. Most are adults who die in natural bodies of water, such as lakes, ponds or oceans.
    • “But statistically speaking, drowning is a much larger danger to children. It’s the No. 1 cause of death for kids ages 1 to 4, and one of the top killers of children ages 5 to 14. The drowning rate is higher for white kids in the younger group, but much higher for Black, American Indian and Alaska Native children in the older group.
    • “Drownings of very young children sometimes occur in bathtubs. But most, like Stewie Leonard’s, occur in swimming pools.”
  • The American Medical Association lets us know what doctors want their patients to know about sunburn.
    • “Sunburns cause lasting skin damage. Learn the difference from sun poisoning, how to prevent burns and treat symptoms safely, and when to seek medical care.”
  • Health Day points out,
    • “Many people with long COVID suffer from “brain fog,” finding it difficult to remember things, think on their feet or pay attention.
    • “But this symptom can be addressed by rehab, according to a new study.
    • “Ten weeks of cognitive rehabilitation helped long COVID patients lift much of their brain fog, allowing them to achieve goals they’d set in their work and home lives, researchers reported July 1 in JAMA Network Open.”
  • Beckers Hospital Review notes,
    • “Active drug shortages in the U.S. climbed to 223 in the first quarter of 2026, the second consecutive quarterly increase. Buried in that count are dozens of manufacturer-specific dates — extended-use deadlines, promised “next delivery” windows, backorder recovery targets — that pharmacy teams are tracking lot by lot. Several of those dates land this month.
    • “[The article identifies] six hospital-use drugs with a shortage-related deadline in July, according to the FDA’s drug shortage database and its list of extended use dates.”

From the U.S. healthcare business front,

  • Beckers Hospital Review discusses “Kaiser Permanente’s partnership strategy and what comes next” and identifies “15 maternity service closures in 2026.”
  • Fierce Healthcare reports,
    • “For a month now, weekly prescriptions for Eli Lilly’s Foundayo have been hovering at around 20,000. In other words, three months into its market debut, the non-peptide GLP-1 receptor agonist was still at the same script level that Novo Nordisk’s Wegovy pill had achieved in two to three weeks post-launch.
    • “For the week ended on June 26, Foundayo’s total scripts dipped about 4% sequentially to 19,830, according to IQVIA data cited by Jefferies. During the same period, scripts were also down about 2% for oral Wegovy, reaching about 149,000.
    • “In a July 4 report, Jefferies analysts modeled about $71 million in U.S. sales during Foundayo’s debut quarter from April to June, versus the team’s previous estimate of $85 million in a June 26 report. Wall Street’s consensus currently has the number at $130 million. To reach its estimate, Jefferies used an illustrative calculation based on the IQVIA data, with certain assumptions regarding pricing, dosing and stocking.
    • “While Lilly still lags Novo on the oral GLP-1 battlefield, the Indianapolis pharma has maintained a majority 59.5% share of the overall obesity market, according to IQVIA’s prescription data.” 
  • The Wall Street Journal informs us,
    • Vertex Pharmaceuticals VRTX has agreed to purchase Crinetics Pharmaceuticals CRNX for $10 billion, adding a biopharmaceutical company that specializes in treatments for endocrine diseases to its portfolio that mainly includes cystic fibrosis therapies.
    • Vertex, a Boston-based biotechnology company, said it would acquire Crinetics for $85 a share in cash. The company pegged the value at $8.8 billion when accounting for net estimated cash acquired.
  • and
    • Novartis NOVN said it agreed to pay up to $1.5 billion for Myricx Bio, in a bid to bolster its portfolio amid industry competition for oncology drugs.
    • “The Swiss pharmaceutical company said it would purchase the privately held U.K.-based biotechnology firm, which is developing a new class of antibody-drug conjugates. Myricx Bio’s approach delivers differentiated cancer-killing mechanisms directly to tumor cells, Novartis said.
    • “Novartis will pay $1.1 billion upfront, with up to $400 million in potential additional payments. The deal, expected to close in the second half of 2026, is subject to regulatory approvals. Myricx Bio has a pipeline of antibody-drug conjugates that show pre-clinical efficacy and tolerability across tumor-associated antigens and cancer cell types, it said.”
  • BioPharma Dive adds,
    • “Drug developers making new medicines to treat autoimmune conditions and cancer made up more than 40% of the venture funding rounds in the first half of 2026, BioPharma Dive data show.
    • “Of the more than $9 billion that poured into venture-backed biotechnology companies from 26 highly active investors tracked by BioPharma Dive, a little more than $3.9 billion went toward immune and cancer drugmakers. About $2.1 billion of that figure alone was dedicated to that former bucket, in which many startups are working on experimental therapies for conditions such as lupus, atopic dermatitis and inflammatory bowel disease. A handful are developing drugs in these two fields simultaneously (and have been included in the funding totals for each).
    • “While exits might be concentrated in other research areas like obesity and cardiometabolic disorders, venture funding is likely to continue pouring into cancer and immunology because of a lack of “a time-sensitive element,” said Ben Zercher, a senior analyst at PitchBook.”

Weekend Update

David Ermer–Congress, Mental health care, No Surprises Act, Obesity, OPM, U.S. Healthcare–

Simplicity is a virtue.

From Washington, DC,

  • Congress will be out of session this week following the semiquincential holiday.
  • STAT News reports,
    • “Dozens of congressional lawmakers are urging the Trump administration to force Eli Lilly to reinstate mandated price breaks to hospitals that participate in a federal drug discount program but have refused to provide the company with claims data.
    • “In a letter to Department of Health and Human Services Secretary Robert F. Kennedy Jr., the bipartisan group of lawmakers argued that Lilly is failing to comply with federal law by eliminating the price breaks. The drugmaker stopped offering discounts last month to reduce what it calls duplicate discounts paid to the hospitals.” * * *
    • “Congress did not authorize manufacturers to unilaterally impose additional reporting mandates or data-sharing requirements as a prerequisite for obtaining those discounts,” the lawmakers wrote. “Lilly’s actions effectively condition participation in the 340B program on compliance with manufacturer-imposed requirements that extend beyond the statutory framework established by Congress.”
  • On July 3, a federal holiday, the Office of Management and Budget’s Office of Information and Regulatory Affairs posted the “2026 Regulatory Plan and the Unified Agenda of Federal Regulatory and Deregulatory Actions,” which was historically known as the semi-annual regulatory agenda.
  • The Office of Personnel Management’s agenda includes the following FEHB / PSHB related rules:
    • “This proposed rule [RIN: 3206-AO45, projected to be published in September 2026] would implement section 9816 of the Internal Revenue Code of 1986, section 716 of the Employee Retirement Income Security Act of 1974 (ERISA), and section 2799A1 of the Public Health Service Act (PHS), as directed by section 111 of the No Surprises Act; and may include other provisions under the Consolidated Appropriations Act, 2021. Pursuant to 5 U.S.C. 8902(p), Federal Employees Health Benefits (FEHB) carriers must comply with Advanced Explanation of Benefits requirements in the same manner as those provisions apply to a group health plan or health insurance issuer offering group or individual health insurance coverage. This rule would also clarify that FEHB carriers must comply with the applicable Medicare limits set forth at 5 U.S.C. 8904(b) notwithstanding a payment determination calling for a payment in excess of those limits.”
    • “OPM is proposing new standards [RI: 3206-AO93, projected to be published in November 2026] to improve enrollment integrity and accuracy in Federal employee benefits programs, including the Federal Employees Health Benefits (FEHB) and Federal Employee Group Life Insurance Programs. This would include amendments to 5 CFR parts 870 and 890 to establish a new eligibility determination process for children who are age 26 and over and who are incapable of self-support (ISS). In addition, OPM will (1) allow employing offices to adjust enrollment type from Self and Family or Self plus one to Self Only if there is only one person covered by the enrollment and (2) prohibit ineligible family members from receiving a 31-day extension of coverage when their coverage is terminated due to a reduction in the enrollee’s enrollment type.”
    • This proposed rule RIN: 3206-AP13; projected to be published in July 2027) would implement section 108 of the No Surprises Act.” Section 108 requires the No Surprises Act regulators to promulgate a rule describing the requirements of Public Health Service Act Section 2706, which is the Affordable Care Act’s provider non-discrimination provision.
    • The Office of Personnel Management (OPM) is amending its regulations to implement the Administrative False Claims Act of 1986, as amended by the National Defense Authorization Act for Fiscal Year 2025 [RIN: 3206-AP00; projected to be published this month]. This proposed rule would revise the administrative procedures for imposing civil penalties and assessments against persons who make, submit, or present false claims and statements to OPM.
  • OPM’s announced in LinkedIn
    • “Fraud in federal healthcare programs isn’t a rounding error — it’s likely billions of dollars a year, and it’s now a White House priority.
    • “I’m hiring the engineering leader who’ll help make that fight real from the inside. U.S. Office of Personnel Management (OPM) is looking for a Division Chief to lead our Healthcare Engineering Division — working directly with the White House Task Force to Eliminate Fraud, chaired by Vice President Vance. This role owns the technical work behind better services and lower costs and leads the AI/ML systems, infrastructure, and full SDLC for programs touching millions of federal employees, retirees, and their families.
    • “GS-15 scope: $147,945–$197,200, budget authority over major IT investments, a team of engineers and data scientists reporting to you.
    • “If you want engineering work with real consequences, apply by July 8.”
  • FEHBlog observation – Since the late 1980s, OPM’s Inspector General has been fighting fraud, waste, and abuse “from the inside” with strong, effective support from the FEHB and PSHB carriers which hold the financial risk for their plans.
  • ACDIS tells us,
    • “CMS has published the fiscal year (FY) 2027 ICD-10-CM code set, including 190 new codes, 30 deleted codes, and four revised codes. These updates will become effective on October 1, 2026.
    • “Of the 190 new codes, 33 are related to continuing pregnancy after vanishing twin syndrome (category O31.4) and 17 codes related to the toxic effect of cycloparaffins (category T52.82).”

From the public health and medical / Rx research front,

  • The Wall Street Journal explains new developments in sunscreens sold in our country.
  • Healio reports,
    • “Adults with type 2 diabetes who were provided medically tailored healthy meals and lifestyle counseling for 6 months had a lower HbA1c than those who received a monthly food subsidy, researchers reported.
    • “Food insecurity is a common barrier to eating healthy meals for people with diabetes, according to Seth A. Berkowitz, MD, MPH, associate professor of medicine at University of North Carolina School of Medicine. In an open-label, parallel-group, randomized trial presented at the American Diabetes Association Scientific Sessions, Berkowitz and colleagues compared health outcomes among two nutritional interventions: medically tailored meals that were created and delivered directly to people’s homes, and subsidies where participants received money to purchase food themselves.”
  • and
    • “A single injection of sura-vec reduced the severity of nonproliferative diabetic retinopathy for up to 2 years, according to data presented at Optometry’s Meeting.
    • “Early intervention is essential to prevent progression to blinding complications, yet the burden of frequent intravitreal injections with current anti-VEGF therapies make long-term treatment difficult for many patients,” Steve Pakola, MD, chief medical officer at Regenxbio, told Healio. “We believe sura-vec has the potential to redefine the treatment paradigm by delivering sustained anti-VEGF expression through a one-time, in-office gene therapy, reducing treatment burden while helping preserve vision long-term.”
  • Health Day informs us,
    • “More than half the calories consumed by young kids in the U.S. come from ultra-processed foods.
    • “Now, a new study warns that those foods, including sugary cereals, packaged snacks, fast food and processed meats, may be linked to measurable differences in brain structure by age 6.
    • “A team at Children’s Hospital Los Angeles followed 144 Latino and Hispanic mother-child pairs from infancy through age 6, tracking kids’ diets over time and using MRI scans to measure brain structure.” * * *
    • “Our findings suggest that what children eat early in life may shape brain development in ways we’re just beginning to understand,” said senior author Michael Goran, director of the Nutrition and Obesity Program at the hospital’s Saban Research Institute. “Even without differences in cognitive performance, we’re seeing measurable changes in brain structure.”
    • “More work is needed to understand what these structural differences may mean for long-term health.”
  • and
    • “Here’s more pressure for harried mothers — a sluggish response to baby’s coos and babbles might increase their risk of childhood psychiatric problems.
    • “Moms who respond within one second of their baby’s vocalizations appear to lower the child’s risk of mental health problems by age 7, researchers reported July 1 in the journal PLOS One.
    • “Specifically, for every 10% increase in the likelihood of a mom responding within a second, the child’s odds of a later psychiatric diagnosis decreased by 17%, researchers found.
    • “The results “suggest a robust association between slow parental responses to their infants’ signals and later problems,” senior researcher Philip Wilson, an emeritus professor at the University of Aberdeen in the U.K., said in a news release.”

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

  • HealthExec reports,
    • “More than half of all patients taking GLP-1s such as semaglutide are using them to treat a diagnosed medical condition, signaling that the demand for the popular weight loss drugs may not be purely for vanity, a new study using payer claims data reveals.
    • “In its report, healthcare market research firm Trilliant Health was able to show that, while popular GLP-1 substances such as Ozempic, Zepbound and Wegovy may have been originally approved to manage blood sugar, their medical use has expanded significantly since the latter was given FDA approval for chronic weight management in 2021, spurring the modern trend.
    • “According to the data analyzed by Trilliant, the number of patients prescribed this class of pharmaceuticals has risen nearly 636% between 2018 and 2024, when the data cuts off. Notably, the first GLP-1 approved to be prescribed for weight management was Saxenda, given the greenlight in 2014 for adults.” * * *
    • “The most common indication for why patients were prescribed GLP-1s was obstructive sleep apnea, potentially directly related to obesity, coming in at 25.5% of scripts. The second highest medical condition was major depressive disorder, coming in at 18.2%.
    • “After that, chronic kidney disease was the most common reason for prescriptions at 10.6%, followed by fatty liver disease.
    • “Trilliant noted that conditions related to overeating specifically—binge eating—were the least common reason for patients to be given the drugs, coming in at only 0.5%.
    • “The firm added that, when considering that many patients were also prescribed GLP-1s for more than one medically valid condition, demand for the drugs will only grow, and payer plans should be prepared for the continued spike.” * * *
    • “The full report is available by clicking here.”
  • Medscape adds,
    • “Substance use disorders (SUDs) may become the next therapeutic target for GLP-1 receptor agonists (GLP-1s). Although the evidence remains preliminary, growing preclinical, observational, and early clinical data suggest these drugs may reduce the cravings that drive addiction.
    • “Interest has accelerated over the past few years, fueled by reports that patients taking semaglutide or tirzepatide for diabetes or obesity drink less alcohol, smoke fewer cigarettes, or experience fewer cravings. Those observations have prompted a wave of studies exploring whether these drugs could have a role in treating alcohol, nicotine, opioid, and other SUDs.
    • “More recently, large retrospective analyses have suggested that GLP-1s may be associated with lower rates of overdose, SUD-related mortality, and new-onset SUDs.
    • “At this point, however, much of the evidence comes from animal studies, observational research, and patient reports. Definitive answers will require randomized clinical trials. More than 30 studies are now investigating GLP-1s for alcohol, nicotine, opioid, cocaine, and methamphetamine use disorders, making addiction one of the fastest-growing areas of GLP-1 research.”
  • BioPharma Dive relates,
    • Celea Therapeutics, a biotechnology startup testing a next-generation treatment for idiopathic pulmonary fibrosis, said in a Thursday announcement it has brought in $180 million to continue its work.
    • Launched in 2025, the PureTech Health spinout is working on a medicine that it says is a retooled version of pirfenidone, also known as Roche’s Esbriet, a drug that slows the progression of scarring in the lungs.
    • The venture round was backed by RA Capital Management, Leaps by Bayer and PureTech, as well as two other unnamed funds. The proceeds from this fundraising will be used to launch its drug deupirfenidone into late-stage testing in the third quarter of 2026.
  • HR Dive tells us,
    • HR is still adapting to artificial intelligence rather than taking the lead on redesigning the workflow around AI, according to a report released by the Institute for Corporate Productivity (i4cp) Tuesday [June 30].
    • After surveying more than 1,300 business and HR leaders worldwide, i4cp researchers determined that even though workplaces are moving past “isolated AI use cases,” AI implementation is still a “series of disconnected experiments,” according to a Tuesday statement.
    • AI is increasing expectations for what HR practitioners are expected to bring to the table, but “most HR functions are still experimenting at the margins rather than redesigning how work actually gets done,” Katheryn Brekken, senior research analyst at i4cp, said in a statement.