Cybersecurity Saturday

Cybersecurity Saturday

From the cybersecurity policy and law enforcement front,

  • NextGov/FCW tells us,
    • “The Senate confirmed Sean Cairncross to serve as national cyber director in a 59-35 vote on Saturday night [August 2], making him the first Senate-approved cybersecurity official of President Donald Trump’s second term.
    • “Cairncross is a former Republican National Committee official and was CEO of the Millennium Challenge Corporation agency during Trump’s first term. As national cyber director, he will be tasked with overseeing an office first stood up under the Biden administration, which serves as the key White House cyber policy interlocutor across federal agencies and Capitol Hill.” 
  • Cyberscoop adds,
    • “Sean Cairncross took his post this week as national cyber director at what many agree is a “pivotal” time for the office, giving him a chance to shape its future role in the bureaucracy, tackle difficult policy issues, shore up industry relations and take on key threats.
    • “The former White House official, Republican National Committee leader and head of a federal foreign aid agency became just the third Senate-confirmed national cyber director at an office (ONCD) that’s only four years old. He’s the first person President Donald Trump has assigned to the position after the legislation establishing it became law at the end of his first term.”
  • Cybersecurity Dive informs us,
    • “The Cybersecurity and Infrastructure Security Agency [CISA] has continued its work to protect federal networks and support critical infrastructure providers despite massive job cuts and resource constraints, two senior CISA officials said during the Black Hat USA cybersecurity conference here Thursday.
    • “We are not retreating, we’re advancing in a new direction,” CISA CIO Robert Costello said during a panel discussion.
    • “Chris Butera, the acting head of CISA’s Cybersecurity Division, added that, while the agency “did lose people” to the Trump administration’s downsizing program — roughly a third of its employees — CISA still has “a very talented workforce.” He cited the agency’s around-the-clock response to major vulnerabilities in Microsoft SharePoint as an example of CISA’s continued capacity.”
  • and
    • “The U.S. government is still pushing agencies to adopt zero-trust network designs, continuing a project that gained steam during the Biden administration, a senior cybersecurity policy official said on Wednesday.
    • “It must continue to move forward,” Michael Duffy, the acting federal chief information security officer, said during a panel at the Black Hat cybersecurity conference. “That architectural side of it is very important for us to get right as we integrate new technologies [like] artificial intelligence into the ways we operate.”
    • “Zero-trust networking emphasizes the concept of throwing up hurdles to hackers who penetrate a computer system, limiting the damage they can do by sealing off parts of the network and requiring strict user authentication.”
  • Per Dark Reading,
    • “As the Department of Defense (DoD) continues to make deeper strides in implementing its Cybersecurity Maturity Model Certification (currently CMMC 2.0), we find ourselves at the cusp of what feels like its next iteration, CMMC 3.0, marking the next evolution in its efforts to strengthen cybersecurity across the defense industrial base (DIB). While the updated framework builds on the structure of CMMC 2.0, this new update would include clearer expectations and stricter enforcement, particularly for organizations handling controlled unclassified information (CUI). The DoD’s message is clear: Reducing risk and enhancing resilience are now mission-critical for any company supporting national defense.”
  • Cybersecurity Dive adds,
    • “The Chinese government has such vast hacking resources that it’s targeting tiny companies in the U.S. defense industrial base that never imagined they would end up on Beijing’s radar, a National Security Agency official said here Wednesday.
    • “China’s hacking resources outnumber those of the U.S. and [its] allies combined, and China has stolen more corporate data from the United States than any other nation in the world,” Bailey Bickley, chief of DIB defense at the NSA’s Cybersecurity Collaboration Center, said during a session at the Black Hat USA cybersecurity conference.
    • “Although best known for its intelligence-collection role, the NSA is also responsible for helping defense contractors safeguard their systems. Recently, the agency has been doing that through free security services — including classified information sharing and a protective DNS offering — from the Cybersecurity Collaboration Center.
    • “When we engage with small companies” in the defense industrial base, “they often think that what they do is not important enough to be targeted” by China, Bickley said. “But when you have the significant resources like that to conduct mass scanning and mass exploitation, there is no company and no target too small.”
  • and
    • “The Defense Advanced Research Projects Agency on Friday [August 8] unveiled the winners of a competition to spur the development of artificial intelligence tools designed to autonomously find and fix software vulnerabilities.
    • “Team Atlanta, Trail of Bits and Theori claimed the top three spots in DARPA’s AI Cyber Challenge, agency officials said at the DEF CON cybersecurity conference here. They will receive prizes of $4 million, $3 million and $1.5 million, respectively.
    • “All seven finalist teams will open source their AI tools so that the entire world can use them. Four of the tools debuted on Friday, while the remaining three will be released in the next few weeks.’
  • Cyberscoop reports,
    • “BlackSuit’s technical infrastructure was seized in a globally coordinated takedown operation last month that authorities touted as a significant blow in the fight against cybercrime. The ransomware group’s leak site has displayed a seizure notice since July 24.
    • “The takedown followed a long investigation, which allowed authorities to confiscate “considerable amounts of data,” and identify 184 victims, German officials said in a news release last week. The group’s total extortion demands surpassed $500 million by August 2024, with demands typically in the range of $1 million to $10 million, the Cybersecurity and Infrastructure Security Agency said in an advisory last year. 
    • “U.S. authorities were heavily involved in the operation, but have yet to share details about the investigation or its results. BlackSuit’s extortion site was seized by the Department of Homeland Security’s Homeland Security Investigation department, a unit of U.S. Immigration and Customs Enforcement. 
    • “A spokesperson for ICE told CyberScoop the Justice Department has been waiting for court documents to be unsealed before releasing any information about the law enforcement action dubbed “Operation Checkmate.” The FBI, Secret Service, Europol and cyber authorities from the United Kingdom, Germany, France, Ireland, Ukraine, Lithuania and Romania-based cybersecurity firm Bitdefender were also involved in the operation.” 
  • Dark Reading relates,
    • “Two senior executives and founders of the Samourai Wallet cryptocurrency mixer have pleaded guilty to charges involving washing more than $200 million for cybercriminals and other nefarious types.
    • “CEO Keonne Rodriguez and chief technology officer William Lonergan Hill admitted to operating a money-transmitting business that handled criminal proceeds. They have pleaded guilty to conspiracy and face a maximum sentence of five years in prison in addition to the fine.
    • “The US Department of Justice first arrested Rodriguez and Hill in April of last year on two counts of conspiracy: operating an unlicensed money-transmitting business and money laundering, the latter of which carries a maximum sentence of 20 years.”

From the cybersecurity breaches and vulnerabilities front,

  • FedScoop reports,
    • “The U.S. judiciary announced plans to increase security for sensitive information on its case management system following what it described as “recent escalated cyberattacks of a sophisticated and persistent nature.”
    • “In a Thursday [August 7] statement, the federal judiciary said it’s “taking additional steps to strengthen protections for” that information. It also said it’s “further enhancing security of the system and to block future attacks, and it is prioritizing working with courts to mitigate the impact on litigants.”
    • “The statement from the third branch comes one day after a Politico report revealed that its case filing system had recently been breached. That report cited unnamed sources who were concerned that the identities of confidential court informants may have been compromised.”
  • Cyberscoop tells us,
    • “Federal cyber authorities issued an alert Wednesday evening about a high-severity vulnerability affecting on-premises Microsoft Exchange servers shortly after a researcher presented findings of the defect at Black Hat. 
    • “Microsoft also issued an advisory about the vulnerability — CVE-2025-53786 — and said it’s not aware of exploitation in the wild. 
    • “While the public disclosure and advisories about the defect came late in the day amid one of the largest cybersecurity conferences, Tom Gallagher, VP of engineering at Microsoft Security Response Center, told CyberScoop the timing was coordinated for release following Mollema’s presentation.
    • “Gallagher stressed that exploitation requires an attacker to achieve administrative access to an on-premises Exchange server in a hybrid environment.” 
  • and
    • “SonicWall warned customers to disable encryption services on Gen 7 firewalls in the wake of an active attack spree targeting a yet-to-be identified vulnerability affecting a critical firewall service. Attacks have increased notably since Friday, the company said in a blog post.
    • “Threat hunters and incident responders from Arctic Wolf, Google and Huntress have observed a wave of ransomware attacks beginning as early as July 15. Mounting evidence points to a zero-day vulnerability affecting the secure sockets layer (SSL) VPN protocol as the initial attack vector.
    • “A financially motivated threat actor is actively compromising victim environments and deploying Akira ransomware,” Charles Carmakal, CTO at Mandiant Consulting, said in a LinkedIn post Tuesday. “The speed and scale of the compromises suggests a potential zero-day vulnerability in SonicWall Gen 7 firewalls.”
    • “SonicWall said an ongoing investigation has yet to determine if the attacks involve a previously disclosed vulnerability or a zero-day. “If a new vulnerability is confirmed, we will release updated firmware and guidance as quickly as possible,” Bret Fitzgerald, senior director of global communications at SonicWall, told CyberScoop.”
  • Per Bleeping Computer,
    • “Trend Micro has warned customers to immediately secure their systems against an actively exploited remote code execution vulnerability in its Apex One endpoint security platform.
    • Apex One is an endpoint security platform designed to automatically detect and respond to threats, including malicious tools, malware, and vulnerabilities.
    • “This critical security flaw (tracked as CVE-2025-54948 and CVE-2025-54987 depending on the CPU architecture) is due to a command injection weakness in the Apex One Management Console (on-premise) that enables pre-authenticated attackers to execute arbitrary code remotely on systems running unpatched software.
    • “Trend Micro has yet to issue security updates to patch this actively exploited vulnerability, but it has released a mitigation tool that provides short-term mitigation against exploitation attempts.”
  • and
    • “A recently fixed WinRAR vulnerability tracked as CVE-2025-8088 was exploited as a zero-day in phishing attacks to install the RomCom malware.
    • “The flaw is a directory traversal vulnerability that was fixed in WinRAR 7.13, which allows specially crafted archives to extract files into a file path selected by the attacker.
    • “When extracting a file, previous versions of WinRAR, Windows versions of RAR, UnRAR, portable UnRAR source code and UnRAR.dll can be tricked into using a path, defined in a specially crafted archive, instead of user specified path,” reads the WinRAR 7.13 changelog.”
  • CISA added three known exploited vulnerabilities to its catalog this week.
  • Per SC Media,
    • “Dormant service accounts with privileges were found in more than 70% of enterprise environments according to new research released by BeyondTrust on Aug. 4 at BlackHat in Las Vegas.
    • “The researchers also reported that overly permissive Entra Service Principals create direct pathways to Global Admin privileges, exposing entire Microsoft 365 environments to potential takeover.
    • “According to BeyondTrust, credentials reused across multiple service accounts by human administrators can also let a single compromised password hack numerous non-human accounts.”
    • “Our data shows that many organizations lack the complete story when it comes to their identity attack surface,” said Marc Maiffret, chief technology officer at BeyondTrust. “For many, overlooked hygiene issues silently open the door to attackers. And with the rise of Agentic AI, the stakes have never been higher, especially as most organizations lack visibility into how compromised accounts can be leveraged to seize control of application secrets, which often carry elevated privileges.”
  • Security Week points out,
    • “Five vulnerabilities in the ControlVault3 firmware and the associated Windows APIs expose millions of Dell laptops to persistent implants and Windows login bypasses via physical access, Cisco Talos reports.
    • “The issues, tracked as CVE-2025-24311, CVE-2025-25215, CVE-2025-24922, CVE-2025-25050, and CVE-2025-24919, were initially disclosed on June 13, when Dell announced that patches for them were rolled out for over 100 Dell Pro, Latitude, and Precision models.
    • “The affected component, ControlVault3 (and the ControlVault3+ iteration), is a hardware-based system meant to securely store passwords, biometric information, and security codes.”

From the ransomware front,

  • Bleeping Computer reports,
    • “Ransomware gangs have recently joined ongoing attacks targeting a Microsoft SharePoint vulnerability chain, part of a broader exploitation campaign that has already led to the breach of at least 148 organizations worldwide.
    • “Security researchers at Palo Alto Networks’ Unit 42 have discovered a 4L4MD4R ransomware variant, based on open-source Mauri870 code, while analyzing incidents involving this SharePoint exploit chain (dubbed “ToolShell”).
    • “The ransomware was detected on July 27 after discovering a malware loader that downloads and executes the ransomware from theinnovationfactory[.]it (145.239.97[.]206).
    • “The loader was spotted following a failed exploitation attempt that revealed malicious PowerShell commands designed to disable security monitoring on the targeted device.
    • “Analysis of the 4L4MD4R payload revealed that it is UPX-packed and written in GoLang. Upon execution, the sample decrypts an AES-encrypted payload in memory, allocates memory to load the decrypted PE file, and creates a new thread to execute it,” Unit 42 said.”
  • and
    • “A new Endpoint Detection and Response (EDR) killer that is considered to be the evolution of ‘EDRKillShifter,’ developed by RansomHub, has been observed in attacks by eight different ransomware gangs.
    • “Such tools help ransomware operators turn off security products on breached systems so they can deploy payloads, escalate privileges, attempt lateral movement, and ultimately encrypt devices on the network without being detected. 
    • “According to Sophos security researchers, the new tool, which wasn’t given a specific name, is used by RansomHub, Blacksuit, Medusa, Qilin, Dragonforce, Crytox, Lynx, and INC.”
  • CISA issued an Analysis report about Exploitation of SharePoint Vulnerabilities on August 6.
  • InfoSecurity Magazine explains how ransomware actors have expanded tactics beyond encryption and exfiltration.
  • Halcyon warns us,
    • “Ransomware remains one of the most destructive and expensive threats facing organizations today. With average ransom demands hitting $3.5M, victims are forced into high-stakes decisions under intense pressure: pay up or risk catastrophic disruption. 
    • “Nearly half of all targeted organizations end up paying, even after negotiations. The impact doesn’t end with encryption: recovery takes weeks, services stall, regulators circle, and trust erodes. Ransomware isn’t just a cybersecurity problem; it’s a full-blown operational crisis.  
    • “The Halcyon team of ransomware experts has put together this extortion group power rankings guide as a quick reference for the extortion threat landscape based on data from throughout Q2-2025, which can be reviewed along with earlier reports here: Power Rankings: Ransomware Malicious Quartile.”
  • MSPP Alert adds,
    • “Ransomware doesn’t play fair—and now, neither are the defenders. Sophos and Halcyon are teaming up with a direct integration that goes far beyond traditional intel feeds or industry sharing forums. This partnership isn’t about exchanging threat data after the fact. It’s about coordinating active defenses in real time, within live customer environments.
    • “What makes this different? According to Simon Reed, Chief Research and Scientific Officer at Sophos, it’s not just another “threat feed” dropped into a dashboard. “Sophos and Halcyon’s approach to threat intelligence sharing shifts the status quo from out-of-context threat intelligence (which is still hugely useful as an industry standard approach) to sharing coordinated, real-time defense that meets attackers head-on,” he told MSSP Alert.
    • “Instead of piecing together siloed signals, both companies are now synchronizing responses against a common adversary.”

From the cybersecurity business and reporting front,

  • Dark Reading reports,
    • “It was a memorable Black Hat 2025 USA for the founders of Prime Security, the winners of this year’s Startup Spotlight competition.
    • “The Startup Spotlight Competition is a pitch competition for cybersecurity startup companies to present their products and solutions in front of a live audience at Black Hat. In the first phase of the competition, startups of all stripes submitted a pitch describing the company and the products and solutions. A panel of judges reviewed submissions for the competition, looking for companies that fit the bill of “most innovative emerging companies in cybersecurity,” before narrowing down to four: FireTail, Keep Aware, Prime Security, and Twine Security. 
    • “Representatives from each of the four companies pitched their companies and products for the final time to a panel of judges at the Black Hat USA conference in Las Vegas, in a Shark Tank-style competition. While the judges deliberated on the winner, the audience also voted on their favorite. Prime Security won both the judges’ votes as well as the audience’s.”
  • Here is a link to Dark Reading’s round up of Black Hat conference news.
  • Also per Dark Reading,
    • “Investing in building a human-centric defense involves a combination of adaptive security awareness training, a vigilant and skeptical culture, and the deployment of layered technical controls.”
  • and
    • “Data Dump from APT Actor Yields Clues to Attacker Capabilities. The tranche of information includes data on recent campaigns, attack tools, compromised credentials, and command files used by a threat actor believed to be acting on behalf of China or North Korea.”

Door prize from the artificial intelligence front

  • Per Security Week,
    • “Red Teams Jailbreak GPT-5 With Ease, Warn It’s ‘Nearly Unusable’ for Enterprise
    • “Researchers demonstrate how multi-turn “storytelling” attacks bypass prompt-level filters, exposing systemic weaknesses in GPT-5’s defenses.”

Thursday report

From Washington, DC,

  • MedPage Today tells us,
    • “HHS Secretary Robert F. Kennedy Jr. last month quietly endorsed recommendations from his handpicked vaccine advisors that everyone in the U.S. ages 6 months and older receive a flu shot for the upcoming season.” * * *
    • “ACIP reaffirms the recommendations for routine annual influenza vaccination of all persons aged ≥6 months who do not have contraindications for the 2025-2026 season,” the ACIP page states. “With no current CDC Director and pending confirmation of a new CDC Director, this recommendation was adopted by the HHS Secretary on July 22, 2025, and is now an official recommendation of the CDC.”
    • “A new CDC director, Susan Monarez, PhD, is now in place. * * *
    • “Another ACIP recommendation from the June meeting earned an endorsement Aug. 4 from Monarez. ACIP called for infants younger than 8 months who were born during or entering their first respiratory syncytial virus (RSV) season who are not protected by maternal vaccination to receive one dose of clesrovimab (Enflonsia)opens in a new tab or window. The monoclonal antibody joins a similar long-acting shot, nirsevimab (Beyfortus),opens in a new tab or window as an option for this population.”
  • Beckers Hospital Reviews lets us know six things about the tariffs that took effect today.
  • Federal News Network informs us,
    • “The Postal Service’s board of governors is urging its regulator not to put limits on its ability to set higher mail prices, after posting another multibillion-dollar quarterly net loss.
    • “USPS posted a $3.1 billion net loss for the third quarter of fiscal 2025 — a greater loss than the $2.5 billion net loss it saw for the same period last year.
    • “But Postmaster General David Steiner said USPS is “on the right path,” under a 10-year reform plan launched by his predecessor, former Postmaster General Louis DeJoy.
    • “The strategy is sound. Now we have to execute,” Steiner said during a public meeting of the USPS Board of Governors on Thursday. “But we can’t execute unless all of our team is working together. We all need to be rowing the oars in the same direction.”
  • Healthcare Dive relates,
    • “Amwell has extended a contract with the Defense Health Agency to support virtual care at the military health system, one of the company’s most significant growth initiatives, for another year, the telehealth vendor said Tuesday. 
    • “However, the deal cut out deployments for Amwell’s behavioral health and automated care programs “due to budget restrictions being broadly enforced by the Department of Defense,” CEO Ido Schoenberg said during a second quarter earnings call on Tuesday. 
    • “The contract change led the telehealth firm to revise its guidance for 2025. Amwell now expects revenue from $245 million to $250 million this year, down from its previous outlook of $250 million to $260 million.”

From the Food and Drug Administration front,

  • The American Hospital Association News reports,
    • “The Food and Drug Administration Aug. 7 announced a new program to help improve the domestic pharmaceutical supply chain by increasing regulatory predictability and facilitating the construction of drug manufacturing facilities in the U.S. The program, called FDA PreCheck, was created in response to a May 5 executive order, “Regulatory Relief to Promote Domestic Production of Critical Medicines,” which directs the FDA to streamline and accelerate the development of domestic pharmaceutical manufacturing by eliminating unnecessary or duplicative regulations and improving inspection processes. 
    • “The program consists of a two-phase approach to facilitate new manufacturing facilities. The first provides manufacturers with more frequent FDA communication during stages such as facility design, construction and pre-production. The second focuses on streamlining development of the chemistry, manufacturing and controls section of the drug application through pre-application meetings and early feedback.” 
  • Per BioPharma Dive,
    • “The Food and Drug Administration on Thursday lifted its recommendation to pause use of Valenva’s chikungunya vaccine Ixchiq in older adults but added new warnings about the shot’s risks and limited who is eligible to receive it.
    • “The FDA’s action follows a similar move by the European Medicines Agency, which had paused use along similar lines as the FDA. However, the U.S. regulator’s changes to Ixchiq’s labeling appear likely to curtail how broadly its used in the future.
    • “Vaccination with Ixchiq is not advisable for most U.S. travelers. For most U.S. travelers, the risk of exposure to chikungunya is low,” the updated label says.”
  • Per MedTech Dive,
    • “Tandem Diabetes Care flagged a problem with certain t:slim X2 insulin pumps where a wiring issue with certain devices’ speakers can cause them to malfunction and stop delivering insulin. 
    • “Tandem said it has received reports of 700 adverse events and 59 injuries. There have been no reports of death. The problem, if not addressed, presents the risk of hyperglycemia in people with diabetes. The company said in a Thursday announcement that it has also alerted the Food and Drug Administration and regulators outside of the U.S. 
    • “The company sent a letter to customers in July. The FDA has not yet posted the device correction in its recall database.”
  • Fierce Pharma adds,
    • “When Jazz Pharmaceuticals’ incoming CEO Renee Gala takes the reins at the drugmaker next week, she’ll have a brand-new launch to manage.
    • “Wednesday, the FDA approved Jazz’s Modeyso (dordaviprone) for patients ages 1 and older with H3 K27M-mutant diffuse midline glioma who have progressive disease following prior therapy. The drug, picked up in the company’s $935 million buyout of Chimerix earlier this year, is the first systemic therapy for those with the aggressive brain cancer.”

From the judicial front,

  • Healthcare Dive reports,
    • “UnitedHealth and Amedisys have agreed to a settlement with the Department of Justice, clearing the path for their $3.3 billion merger to go through.
    • The settlement, filed with the Maryland district court on Thursday, requires UnitedHealth and Amedisys to divest certain businesses in order to placate the DOJ’s concerns that the merger is anticompetitive. Amedisys has also agreed to pay a $1.1 million civil penalty to the U.S. for not fully complying with regulators during the merger review process.
    • “Regulators’ tentative greenlight of the multibillion-dollar deal is a win for UnitedHealth, which originally proposed plans to acquire the home health and hospice provider in 2023. However, the merger has been tied up in litigation after the DOJ and four states sued to block it in November.”
  • Per Fierce Healthcare,
    • “The drug price negotiation program has withstood another procedural effort in striking down one of the Inflation Reduction Act’s most significant provisions.
    • “In the U.S. Court of Appeals for the 6th Circuit, a panel of judges upheld (PDF) a lower court’s decision to dismiss the lawsuit.
    • “A judge dismissed the lawsuit last year, saying most of the plaintiffs lacked standing to bring the case, but the U.S. Chamber of Commerce was able to file a new suit. The U.S. Chamber could now appeal to the Supreme Court, reported The Hill.”
  • The Hill adds,
    • “Federal judges in Texas and Connecticut on Thursday ruled against arguments challenging the constitutionality of the Medicare Drug Price Negotiation Program, delivering two more blows to the pharmaceutical industry this week after an appeals court upheld the dismissal of a similar case.
    • “In Connecticut, the U.S. 2nd Circuit Court of Appeals upheld (PDF) a decision granted by U.S. District Judge Michael P. Shea last year against pharmaceutical company Boehringer Ingelheim. The company’s diabetes medication Jardiance was among the first 10 drugs chosen for Medicare negotiations, and two more of its products were chosen for the following round of negotiations.”
    • “In Texas, U.S. District Judge David Alan Ezra dismissed the lawsuit brought forward by the trade group PhRMA with prejudice, closing the case.”

From the public health and medical research,

  • The Wall Street Journal reports,
    • “Ultraprocessed foods make up the majority of calories Americans are eating, according to a report released Thursday by the federal government. But there are signs this consumption might be declining.
    • “Sandwiches, baked goods, salty snacks and other ultraprocessed foods accounted for 55% of the calories Americans age 1 and older consumed from August 2021 to August 2023, according to the Centers for Disease Control and Prevention’s National Center for Health Statistics study. 
    • “That proportion is getting smaller. For adults, the mean percentage of calories consumed from ultraprocessed foods fell 3 percentage points to 53% since 2018 and for children and teens, it fell nearly 4 percentage points to 61.9%, the report found.
    • “Statistically, the decline is significant,” said Anne Williams, a senior service fellow at the CDC and lead author of the report. For adults consuming around 2,000 calories a day, the drop between the 2017 to 2018 figures and the latest report translates to around 60 fewer calories a day coming from ultraprocessed foods on average, said Williams.
    • “Ultraprocessed foods have been linked to an array of health issues, including obesity, Type 2 diabetes, cancer, cardiovascular disease and depression. There isn’t a set definition for ultraprocessed foods but researchers consider them foods made with ingredients not normally found in a home kitchen, including high-fructose corn syrup and emulsifiers such as soy lecithin.”
  • MedPage Today adds,
    • “Eating French fries multiple times a week was associated with a higher risk of type 2 diabetes, though this wasn’t the case for baked, boiled, or mashed potatoes, researchers said.
    • “For every increment of three servings weekly of French fries, the rate of type 2 diabetes increased by 20% (95% CI 1.12-1.28), and for every increment of three servings weekly of total potato, the rate increased by 5% (95% CI 1.02-1.08), reported Walter Willett, MD, of the Harvard T.H. Chan School of Public Health in Boston, and colleagues.
    • “However, consumption of combined baked, boiled, or mashed potatoes was not significantly associated with risk of type 2 diabetes (pooled HR 1.01, 95% CI 0.98-1.05), they noted in The BMJ.
    • “Importantly, our substitution analysis showed that replacing all forms of potatoes — especially fries — with whole grains was linked to a lower risk of type 2 diabetes, whereas swapping them for white rice was associated with the opposite effect,” co-author Seyed Mohammad Mousavi, PhD, also of the Harvard T.H. Chan School of Public Health, told MedPage Today. “This reinforces that it’s not just about the potato itself, it’s about how it’s prepared and what foods it’s replacing in the diet.”
  • Genetic Engineering and BioTechnology News reports,
    • “Parkinson’s disease (PD) is the second-most common neurodegenerative disorder after Alzheimer’s and is caused by the degeneration of dopamine-producing neurons in the brain, leading to motor dysfunction, such as tremors and slowed movements.  
    • “Vamsi Mootha, MD, institute member at the Broad Institute, explains that a striking epidemiological association exists between heavy smoking and lowered PD risk. As smoking causes elevated carbon monoxide exposure which disrupts oxygen delivery by hemoglobin, he speculates that a low oxygen state in the brain may offer an unexpected protective mechanism against this incurable neurological disease that affects more than 10 million people worldwide. 
    • “In a new study published in Nature Neuroscience titled, “Hypoxia ameliorates neurodegeneration and movement disorder in a mouse model of Parkinson’s disease,” Mootha’s lab has now shown that low oxygen environments, similar to the thin air found at Mont Blanc, which reaches an elevation of approximately 16,000 feet, can successfully recover neuron function and alleviate motor symptoms in mice with Parkinson’s-like disease.:
    • * * * “The fact that we actually saw some reversal of neurological damage is really exciting,” said Mootha in a public release. “It tells us that there is a window during which some neurons are dysfunctional but not yet dead—and that we can restore their function if we intervene early enough.”
  • Health Day relates,
    • “Vaccination with the updated COVID-19 mRNA vaccine containing the severe acute respiratory syndrome coronavirus-2 Omicron JN.1 lineage [the fall 2024 vaccine] was not associated with an increased risk for 29 adverse events, according to a study published online July 28 in JAMA Network Open.
    • “Niklas Worm Andersson, M.D., Ph.D., from Statens Serum Institut in Copenhagen, Denmark, and colleagues examined the association between vaccination with JN.1-containing vaccines and the risk for 29 serious adverse events adapted from prioritized lists of adverse events of special interest to COVID-19 vaccines. Outcome rates during the first 28 days after JN.1-containing vaccine administration (i.e., the risk period) were compared to outcome rates during the remaining period.”
  • Per MedPage Today,
    • “Superagers — a group of adults over age 80 with the memory capacity of much younger people — maintained good brain morphology, tended to be gregarious, and appeared to be resistant to neurofibrillary degeneration and resilient to its consequences, more than two decades of research showed.
    • “In contrast to neurotypical peers who had age-related brain shrinkage, this group had a region in the cingulate gyrus that was thicker than younger adults, reported Sandra Weintraub, PhD, of Northwestern University Feinberg School of Medicine in Chicago, and colleagues.
    • “Superagers also had fewer Alzheimer’s-related brain changes, greater size of entorhinal neurons, fewer inflammatory microglia in white matter, better preserved cholinergic innervation, and a greater density of evolutionarily progressive von Economo neurons, Weintraub and colleagues wrote in a perspective piece in Alzheimer’s & Dementia.
    • “No particular lifestyle was conducive to superaging, the researchers said. Some superagers appeared to follow all conceivable recommendations for a healthy life. Others did not eat well, enjoyed smoking and drinking, shunned exercise, suffered stressful life situations, and did not sleep well.
    • “Superagers also did not seem to be medically healthier than their peers and took similar medications as they did. However, the superager group was notably sociable, relishing extracurricular activities. Compared with their cognitively average peers, they rated their relationships with others more positively. On a self-reported questionnaire of personality traits, they tended to endorse high levels of extraversion.
    • “It wasn’t the social and lifestyles aspects of superaging that surprised the researchers; it was “really what we’ve found in their brains that’s been so earth-shattering for us,” Weintraub said in a statement.”

From the healthcare artificial intelligence front,

  • Fierce Healthcare informs us,
    • “OpenAI released its most advanced reasoning model, GPT-5, which it touts as its most useful model for healthcare.
    • “The application of ChatGPT for healthcare played a leading role in the company’s Summer Update meeting on Thursday, during which it did live demos of the upgraded model. 
    • “Sam Altman, CEO of OpenAI, said health is one of the top reasons consumers use ChatGPT, saying it “empowers you to be more in control of your healthcare journey.” The company prioritized improving its healthcare features for this version of the product, Altman said. 
    • “GPT-5 will be available on the free version of the ChatGPT app, which means more consumers could start to rely on the product for assistance in making treatment decisions, understanding test results and determining what questions they should ask their doctors in the clinic.” 
  • Beckers Health IT points out,
    • “Oakland, Calif.-based Kaiser Permanente has been experimenting with AI in its patient portal, increasing patient engagement and experience in the process.
    • “The health system’s Southern California Permanente Medical Group, headquartered in Pasadena, launched the Kaiser Permanente Intelligent Navigator for its 4.9 million patients in October. The platform allows patients to chat with AI via a text box to book appointments and connect with the care they need.
    • “Care is local, but at the same time it’s virtual and it’s become a global commodity,” Khang Nguyen, MD, assistant executive medical director for care transformation at Southern California Permanente Medical Group and chief medical officer of care navigation for the Permanente Federation, told Becker’s. “So patients are really expecting artificial intelligence to support healthcare in a way that is supporting other industries, in the sense that people are able to describe what they want versus being given choices.” * * *
    • “In a study that evaluated nearly 3 million patient encounters using the AI between October and March, the tool detected urgent medical issues with 97.7% accuracy and recommended appropriate care paths with 88.9% accuracy. Patients successfully booked appointments more than half the time, compared to the industry average of 30%. The portal’s patient satisfaction scores went up by about 9%.”

From the U.S. healthcare business front,

  • The Wall Street Journal reports,
    • Eli Lilly shares plunged about 14% in midday trading Thursday after the company reported less-than-stellar results of a new study of an experimental anti-obesity pill that is expected to become a blockbuster.
    • “The pill helped people lose up to about 12% of their body weight after more than a year of treatment. The results could clear the way for the shot alternative to be on the market next year, but the magnitude of weight loss fell short of Wall Street expectations.
    • “The drugmaker also raised its earnings outlook for the year after revenue surged in its latest quarter on continued demand for its weight-loss and diabetes treatments.”
    • “The Lilly pill, orforglipron, is expected to become a big seller if regulators approve it for sale. Morgan Stanley analysts had said that under their bull-case scenario, the drug’s use for both obesity and diabetes could generate annual sales of up to $40 billion by 2033.
    • “Yet the latest clinical-trial results may dent some of that enthusiasm. The magnitude of weight loss fell short of what some analysts were predicting: 13% to 15% or more. 
    • “The Lilly pill is one of two that could hit the market within the next year or so, ushering in a new chapter of the weight-loss drug boom. Novo Nordisk has applied for regulatory approval of an anti-obesity pill version of its Ozempic and Wegovy, which could become available by the end of this year.”
  • Modern Healthcare relates,
    • “Aetna will end nearly 90 Medicare Advantage plans across 34 states in 2026, the company notified third-party sellers this week.
    • “The CVS Health subsidiary’s financial performance has represented a bright spot in the Medicare Advantage market compared with competitors such as UnitedHealth Group. This month, CVS Health raised its annual earnings guidance amid a $2 billion turnaround plan. The company cut the second-most plans in 2025, after Humana.
    • “The majority of the Medicare Advantage plans Aetna plans to eliminate next year are PPOs. Beginning in September, Aetna will stop paying commissions to brokers that enroll new members in these plans, according to a notice the company distributed to brokers on Monday.”
  • and
    • “UPMC and GoHealth Urgent Care have rebranded 81 urgent care centers as part of a joint venture between the two organizations. 
    • “The centers span Pennsylvania and West Virginia and offer care for non-life-threatening ailments, including flu, fever, earaches, insect bites, sprains, simple fractures and cuts requiring stitches. They will also offer virtual care options and are staffed with UPMC clinicians, according to a Thursday news release.
    • “The centers were previously owned by UPMC, including sites it acquired last month from MedExpress, another urgent care provider. Financial details of the joint venture were not disclosed.” 
  • Beckers Payer Issues adds,
    • “As major insurers pull back on their Medicare Advantage offerings, health system-owned plans told Becker’s they’re eyeing an opportunity to regain ground ahead of the annual enrollment season.” * * *
    • “I do think it’s an opportunity. Over time, the playing field is going to level somewhat, which is going to be a challenge for the nationals. For the community health plans, I think it’s going to be a benefit,” Rob Hitchcock, president and CEO of Intermountain’s Select Health, said.
    • “What you want is a healthy mix. You do want the national players to be strong, but you also want the community health plans to be strong,” he added.
  • NFP, an Aon company, discusses pharmacy deserts.
    • “A pharmacy desert is more than just a rural problem. It’s any area, urban, suburban or rural, where people lack reasonable access to a pharmacy. That usually means:
      • “More than one mile away in urban areas.
      • “Two miles in suburban areas.
      • “10 miles in rural regions.
    • “However, distance isn’t the only factor. Even if a pharmacy technically exists nearby, lack of public transportation, limited hours or closures of independent stores can make access nearly impossible, particularly for lower-income communities or those with mobility challenges.” * * *
    • “Pharmacy deserts are growing, and they have real consequences for employee health, equity and cost. While benefit consultants cannot control the closures, clients can guide their employees toward solutions that help their people stay healthy and protected, no matter where they live.”

Tuesday report

From Washington, DC

  • The Wall Street Journal reports,
    • “Many seniors enjoy the perks that come with Medicare Advantage. But those extras—like dental coverage and free gym memberships—are being scaled back.
    • “Insurers are cutting benefits and exiting from unprofitable markets, and Wall Street is cheering them on. Once rewarded by investors for rapid expansion in the lucrative privatized Medicare program, companies are now being applauded for showing restraint amid rising medical costs and lower government payments.” * * *
    • “To be clear, major insurers aren’t exiting Medicare Advantage. Apart from Cigna, which sold its Medicare business last year, the big players are still betting on the program—some are likely to take advantage of the turmoil to increase their market share. And the market is arguably still well served and competitive, especially in densely populated areas. Even after some moderation last year, the average beneficiary this year had 42 plan options from which to choose, according to health-research nonprofit KFF. 
    • “As the industry pivots to leaner operations, Wall Street may regain confidence. But the era of red-hot Medicare Advantage growth is over, at least for now. While Democrats have led efforts to cut overpayments, Republicans also face mounting pressure to curb spending—especially after recent tax cuts, notes Deutsche’s [George] Hill. He warns that more regulatory shifts may be coming, including a potential overhaul of the star ratings system, which governs billions in bonus payments tied to plan quality and patient satisfaction.
    • “Until that picture clears, investors will continue to reward restraint and tightly managed risk. In today’s Medicare Advantage market, and across government insurance programs, growth is taking a back seat to profitability.
  • BiioPharma Dive tells us,
    • “The U.S. plans to put tariffs of up to 250% on pharmaceutical imports over the next year and a half, President Donald Trump said in a Tuesday interview with CNBC.
    • “Trump said he would put a “small tariff” on such imports initially but added that he would raise the duties to 150% and then 250% in “one and a half years maximum.” The president indicated that announcements of pharmaceutical tariffs, as well as duties on semiconductors, would be announced “within the next week or so.”
  • Per an HHS news release,
    • “The U.S. Department of Health and Human Services (HHS) today announced the beginning of a coordinated wind-down of its mRNA vaccine development activities under the Biomedical Advanced Research and Development Authority (BARDA), including the cancellation and de-scoping of various contracts and solicitations. The decision follows a comprehensive review of mRNA-related investments initiated during the COVID-19 public health emergency.
    • “We reviewed the science, listened to the experts, and acted,” said HHS Secretary Robert F. Kennedy, Jr. “BARDA is terminating 22 mRNA vaccine development investments because the data show these vaccines fail to protect effectively against upper respiratory infections like COVID and flu. We’re shifting that funding toward safer, broader vaccine platforms that remain effective even as viruses mutate.” * * *
    • “While some final-stage contracts (e.g., Arcturus and Amplitude) will be allowed to run their course to preserve prior taxpayer investment, no new mRNA-based projects will be initiated. HHS has also instructed its partner, Global Health Investment Corporation (GHIC), which manages BARDA Ventures, to cease all mRNA-based equity investments. In total, this affects 22 projects worth nearly $500 million. Other uses of mRNA technology within the department are not impacted by this announcement.” * * *
    • “The move signals a broader shift in federal vaccine development priorities. Going forward, BARDA will focus on platforms with stronger safety records and transparent clinical and manufacturing data practices. Technologies that were funded during the emergency phase but failed to meet current scientific standards will be phased out in favor of evidence-based, ethically grounded solutions – like whole-virus vaccines and novel platforms.”
  • Roll Call lets us know,
    • “The Trump administration is escalating its push against what has become a key part of the way states, localities and communities respond to the overdose epidemic: harm reduction. 
    • “A public health approach aimed at mitigating the negative health effects associated with drug use, harm reduction aims to prevent overdoses and infectious disease transmission.
    • “Methods can involve the use of opioid overdose reversal medications such as naloxone, providing sterile needles to limit the transmission of infectious diseases, test strips that detect fentanyl in drugs, and “safe consumption sites,” where people can use drugs under supervision in case they need intervention.” * * *
    • “In a “Dear Colleague” letter sent to states last week, Art Kleinschmidt, principal deputy assistant secretary at SAMHSA, said he doesn’t consider naloxone a harm reduction method and as such it would continue to be funded by the government. Kleinschmidt said test kits and other services can also be funded through grants.
    • “But the letter stated that federal funding can’t be used to “purchase pipes or other supplies for safer smoking kits nor syringes or needles used to inject illicit drugs” or “any other supplies to promote or facilitate drug use.” 
    • “Moving forward, SAMHSA funds will no longer be used to support poorly defined so-called “harm reduction” activities; rather, SAMHSA is providing guidance to state agency leadership and to grantees through new award terms and conditions that provide clarity on what supplies and services previously defined under the umbrella of harm reduction can be supported with SAMHSA funding,” Kleinschmidt wrote.” 

From the public health and medical research front,

  • The American Hospital Association News informs us,
    • “Patients in the hospital for surgeries had better outcomes in 2024 than they did in 2019, according to a new report released today by the AHA and Vizient. 
    • “The significant improvement aligned not only with better performance on patient safety metrics — such as reductions in infections and falls — but also with marked declines in three major surgical patient safety indicators: severe bleeding, sepsis and respiratory failure. * * *
    • “The new findings build on a report AHA released in collaboration with Vizient last year showing that hospitals and health systems performed better on key patient safety and quality measures in the first quarter of 2024 than they did before the COVID-19 pandemic. In fact, hospitals’ efforts to improve safety led to 200,000 Americans hospitalized between April 2023 and March 2024 surviving episodes of care they wouldn’t have in 2019.” 
  • MedPage Today reports,
    • “Unhealthy alcohol use is a leading cause of death and serious illness among U.S. adults.
    • “In new draft guidance, the USPSTF reaffirmed that all adults should be screened for unhealthy alcohol use and [newly] recommended brief behavioral counseling interventions when appropriate.
    • “The task force found insufficient evidence to make the same recommendation in adolescents.”
    • The public comment period ends on September 2, 2025.
  • Healio adds,
    • “Testing for hepatitis C virus infection every 6 to 12 months — or even more frequently — among people who inject drugs could be a beneficial, cost-effective strategy, according to a study published in JAMA Health Forum.
    • USPSTF recommends hepatitis c screening for adults aged 18 to 79 without known liver disease.
      • “Most adults need to be screened only once. Persons with continued risk for HCV infection (e.g., PWID) should be screened periodically. There is limited information about the specific screening interval that should occur in persons who continue to be at risk for new HCV infection or how pregnancy changes the need for additional screening.”
        • The JAMA Health Forum study fills in the screening interval information gap.
  • Per STAT News,
    • “Nathan Young, a community neurologist at the Mayo Clinic, recently saw a patient whose diagnosis he couldn’t quite nail down. Parkinson’s seemed a likely possibility, but Young was concerned she might instead have a rare neurological disorder called progressive supranuclear palsy, or PSP, which can progress much more rapidly. 
    • “I opened a can of worms,” said Young: He ordered a PET scan of the patient’s brain, but the radiology report only confused matters. Instead of ruling out PSP, it suggested yet a third diagnosis: Alzheimer’s. 
    • “Normally at this point, Young would call in other specialists as reinforcements, including Mayo’s renowned experts. But this time he had something different to help: a new AI tool called StateViewer.”
    • “Developed by Mayo’s Neurology AI program, StateViewer takes scans like the one Young ordered — they’re called FDG-PET scans, named for the radioactive tracer they use — and spits out a report of similar brains that have been scanned in Mayo’s clinical and research networks. The output: a differential diagnosis of nine potential types of dementia. In development over the last several years, StateViewer hit the rails at all three Mayo campuses four months ago, and it’s been run thousands of times on patients’ brain scans.”
  • and
    • “Vertex Pharmaceuticals said Monday afternoon that its next-generation non-opioid pain reliever failed to significantly outperform placebo in a Phase 2 trial.
    • “The experimental drug, codenamed VX-993, is similar to the company’s recently approved pill Journavx but could potentially be given at higher doses and formulated as an IV infusion. The hope is that it could thus provide superior relief or offer an alternative to IV opioids. But after Monday’s results, the company said it would discontinue efforts to develop the drug as a single-agent medicine for acute pain.”
    • “We do not plan to advance VX-993 as monotherapy in acute pain, because we do not expect that it will be superior to our [existing] NaV1.8 inhibitors,” said CEO Reshma Kewalramani during a Monday afternoon earnings call with investors, using a scientific shorthand for the class of drugs. She noted that the company will continue a trial testing the drug in patients with diabetes who have chronic nerve pain.”
  • Cardiovascular Business points out,
    • “A surgeon at Cleveland Clinic has performed the world’s first robotic-assisted heart surgery of its kind, using CardioPrecision’s CoreVista Robot Enabling Platform to implant Corcym’s Perceval Plus aortic heart valve through a small incision in the patient’s neck.
    • “The successful operation, known as AVATAR (Advanced Videoscopic Aortic valve surgery by Transcervical Approach using Robot assistance), was performed by Marijan Koprivanac, MD, a cardiovascular surgeon with Cleveland Clinic’s Heart, Vascular and Thoracic Institute. Other robotic techniques for aortic valve replacement have already been in use, including the robotic aortic valve replacement procedures developed at the WVU Heart and Vascular Institute, what sets this approach apart is the fact that everything is done through that small incision in the neck. 
    • “Combining the artificial heart valve with this new surgical technology means patients should experience less pain and time in the hospital following heart surgery,” Koprivanac said in a statement. “In fact, we believe that this may be one of the least invasive surgical heart valve replacement options now available.”
  • Per Genetic Engineering and Biotechnology News,
    • “Amyotrophic lateral sclerosis (ALS) is an incurable neurological disorder affecting motor neurons (MNs), which are nerve cells in the brain and spinal cord that control voluntary muscle movement and breathing. Many ALS clinical trials, including those testing promising drugs, have fallen short of expectations, commonly because the extent of the disease can vary, and not all patients respond the same way to medications.
    • “Scientists at Case Western Reserve University now report new insights into one type of ALS, that may point towards a therapeutic approach for different types of the disorder. The team studied inducible pluripotent stem cell (iPSC)-motor neurons (MNs) carrying the P56S mutation in a protein called vesicle-associated membrane protein-associated protein-B (VAPB), which is responsible for a familial form of ALS. Their findings provided evidence that the mutation activates integrated stress response (ISR) via mitochondrial dysfunction in motor neurons and also indicated that pharmacological inhibition of ISR using ISRIB helped to rescue ALS-associated phenotypes in both VAPB P56S and patient-derived IPSC-MNs.
    • “Although the research centered on this rare form type of ALS, the investigators are optimistic the positive results could provide clues for potentially treating the devastating disorder more broadly. Study lead Helen Cristina Miranda, PhD, an associate professor of genetics and genome sciences at Case Western Reserve’s School of Medicine, suggested, “This work could help lay the foundation for genetically informed clinical trials.”
    • “Miranda and colleagues reported on their study in EMBO Molecular Medicine, in a paper titled “Convergent activation of the integrated stress response and ER–mitochondria uncoupling in VAPB-associated ALS,” concluding, “This is the first study to mechanistically connect a known ALS mutation with ISR activation, highlighting the potential for mutation-specific therapeutic targeting and patient stratification in ISR-modulating clinical trials.”
  • The National Institutes of Health announced a “new study to test if mothers’ diet prevents early sign of food allergy in babies. NIH trial to assess if eating peanuts, eggs during pregnancy, breastfeeding protects infants.”
    • “The study, called Expecting Mother’s Study of Consumption or Avoidance of Peanut and Egg (ESCAPE), will be led by Kirsi Järvinen-Seppo, M.D., Ph.D., chief of Pediatric Allergy and Immunology and Founders’ Distinguished Professor in Pediatric Allergy at University of Rochester Medicine. Results are expected in 2029. 
    • “More information about the trial, including contacts for people who are interested in participating, is available at ClinicalTrials.gov under study identifier NCT06260956.”
  • NIH Research Matters covers the following topics this week: “Treating CoQ10 deficiency | Specialized blood vessels in organoids | Fat-fueled neurons.”
  • Beckers Hospital Review identifies “seven new drug shortages and discontinuations, according to drug supply databases from the FDA and the American Society of Health-System Pharmacists.” 
  • CIGNA, writing in LinkedIn, discusses the importance of access to mental health services.
    • “Virtual care appointments have emerged as a valuable tool in providing mental health services, particularly in remote or underserved areas. Connecting with mental health professionals via telephone, video calls, and even smart phone apps, make it easier to access care without the need for travel. Additionally, virtual care often reduces wait times, providing quicker access to necessary care.
    • “Community-based mental health programs are another effective approach. These programs use the strengths and resources of local communities to provide support and care. Community health workers, peer support groups, and local organizations can play a vital role in delivering mental health services and promoting mental well-being.
    • “Integrating mental health services into primary care is also promising. By training primary care providers to recognize and address mental health issues, individuals can receive holistic care that addresses both their physical and mental health needs. This integration can help improve overall health outcomes.”

From the U.S. healthcare business front,

  • BioPharma Dive reports,
    • “Pfizer and other large pharmaceutical companies are taking seriously President Donald Trump’s demand that drugmakers make more of their medicines available direct to consumers in the U.S. at lower cost, Pfizer CEO Albert Bourla said Tuesday.
    • “We have serious discussions in the industry,” Bourla told investors on a conference call Pfizer held to discuss its earnings for the second quarter. “I’m connected very often individually with all the major companies, and they are all ready to roll up their sleeves and execute something like that.”
  • MedTech Dive relates,
    • “Alcon has agreed to buy implantable lens maker STAAR Surgical for about $1.5 billion in total equity value, the companies said Tuesday.
    • “Alcon, which will purchase all outstanding shares of STAAR for $28 per share in cash, expects STAAR’s refractive surgery offerings to complement Alcon’s laser vision correction business.
    • “BTIG analyst Ryan Zimmerman said Alcon is getting “a solid deal” given STAAR’s setbacks in the China market. The company is betting on a recovery in China and the longer-term health of lens-based refractive surgery, said the analyst.”
  • Per Fierce Healthcare,
    • “Shares of Hims & Hers tumbled 12% in after-hours trading Monday after the company’s second-quarter revenue missed Wall Street analysts’ expectations.
    • “The company faces headwinds in its compounded GLP-1 drug business after pharma giant Novo Nordisk pulled the plug on a monthlong collaboration to make its weight loss drug Wegovy available on the telehealth company’s platform. The company had to off-board GLP-1 subscribers from the branded version of the drug, executives said.
    • “Hims & Hers continues to sell compounded semaglutide, the active ingredient in Novo’s Wegovy and Ozempic drugs, and these generic versions are more affordable than the branded drugs.
    • “Analysts, however, seem pleased by what they see as strong results and the online health and wellness company’s growth plans, including international expansion, new hormone health offerings and building out standalone lab testing.”
  • and
    • “Online therapy provider Talkspace continues to make big investments in artificial intelligence, seeing opportunities to improve the experience for patients and cut down on paperwork for providers.
    • “Talkspace connects people via an app with therapists who provide counseling remotely, either over the phone, by video chat or by text.
    • “The company is building out foundational large language models specifically for behavioral health using its internal, de-identified clinical data sets, as it claims to have the “largest behavioral health datasets in the industry,” consisting of millions of therapeutic interactions on the Talkspace platform over the past 12 years.
    • “Unlike existing, horizontal, general-purpose LLMs, we are working closely with mental health clinicians experienced with evidence-based therapeutic frameworks,” CEO Jon Cohen, M.D., told investors during the company’s second-quarter earnings call Tuesday. “Talkspace behavioral health LLMs are being developed specifically to understand the language complexity and workflows of mental health delivery. Once up and running, these behavioral health LLMs will be an integral part of how we provide higher-quality care to our Talkspace members.”
  • Modern Healthcare reports,
    • “Virtual behavioral health provider Cerebral announced Tuesday it had acquired Resilience Lab, which offers therapy and medication management through its online platform. The deal, which closed last week, includes Resilience’s clinician development program aimed at training and supporting early-career therapists. 
    • “The combined organization will be led by Cerebral CEO Brian Reinken under the Cerebral brand, with Resilence Lab Co-founder Marc Goldberg holding the president role, according to a spokesperson. Dr. Carl Marci will join the company as chief medical officer, and Resilience Lab Co-founder Christine Carville will serve as chief clinical officer. Cerebral representatives declined to disclose financial details of the deal.”
  • and
    • “Quest Diagnostics has completed its acquisition of some clinical testing assets from Spectra Laboratories, a subsidiary of dialysis company Fresenius Medical Care.
    • “Under the agreement, Quest will provide dialysis-related clinical testing to independent clinics formerly served by Spectra Laboratories.
    • “As part of a separate deal with Fresenius, Quest said in a Tuesday news release it expects to complete the acquisition of select dialysis-related water testing assets by the end of the year. It also said it plans to start providing comprehensive dialysis-related laboratory services for centers operated by Fresenius in the U.S. The transition of services is slated to be completed by early next year.”

Cybersecurity Saturday

From the cybersecurity policy and law enforcement front,

  • Security Week tells us,
    • “Members of the Senate Homeland Security and Governmental Affairs Committee voted 9-6 [on July 31, 2025] to recommend Sean Plankey ’s nomination for director of the Cybersecurity and Infrastructure Security Agency, known as CISA, which sits under the Department of Homeland Security.”
  • Federal News Network informs us that a “new CISA guide helps agencies with next steps on zero trust.”
  • The American Hospital Association News points out,
    • “The FBI, Cybersecurity and Infrastructure Security Agency and international agencies July 29 released a joint advisory on recent tactics by the Scattered Spider cybercriminal group. The group, observed by federal agencies since November 2023, has members based in the U.S. and U.K. The group has targeted large companies and their IT help desks. Scattered Spider threat actors typically engage in data theft for extortion and also use ransomware variants once in a system to steal information, along with other tactics.  
    • “Scattered Spider often employs tactics like phishing, push bombing and subscriber identity module swap attacks to get credentials, bypass multifactor authentication and gain access to networks,” said Scott Gee, AHA deputy national advisor of cybersecurity and risk. “They have also impersonated company help desks to trick users into divulging credentials. These tactics serve as a reminder of the importance of training to recognize and stop these social engineering attacks. The fact that they are native English speakers can make their social engineering attacks more effective. There have been several arrests of group members recently, but their attacks persist, and their tactics are evolving to evade detection. They are currently targeting Snowflake data storage solutions and stealing customer information.”  
  • Cyberscoop reports,
    • “Federal analysts are still sizing up what the Chinese hackers known as Volt Typhoon, who penetrated U.S. critical infrastructure to maintain access within those networks, might have intended by setting up shop there, a Cybersecurity and Infrastructure Security Agency official said Thursday.
    • “We still don’t actually know what the result of that is going to be,” said Steve Casapulla, acting chief strategy officer at CISA. “They are in those systems. They are in those systems on the island of Guam, as has been talked about publicly. So what [are] the resulting impacts going to be from a threat perspective? That’s the stuff we’re looking really hard at.”
    • “Casapulla made his remarks at a Washington, D.C. event hosted by Auburn University’s McCrary Institute for Cyber and Critical Infrastructure Security.”
    • FEHBlog observation: Ruh roh! 
  • Per Cybersecurity Dive,
    • “The Department of Justice on Thursday announced a $9.8 million settlement with Illumina over allegations that the company sold genomic-sequencing systems with software vulnerabilities to federal agencies for multiple years.
    • “Between 2016 and 2023, the government said, the company sold the systems without having an adequate security program and knowingly failed to incorporate cybersecurity into its product design process.
    • “According to prosecutors’ complaint, Illumina is the dominant company in the global market, with a share of roughly 80%.
    • “Companies that sell products to the federal government will be held accountable for failing to adhere to cybersecurity standards and protecting against cybersecurity risks,” Assistant Attorney General Brett Shumate of the DOJ’s Civil Division said in a statement.”

From the cybersecurity vulnerabilities and breaches front,

  • Cyberscoop reports,
    • “Social engineering — an expanding variety of methods that attackers use to trick professionals to gain access to their organizations’ core data and systems — is now the top intrusion point globally, attracting an array of financially motivated and nation-state backed threat groups. 
    • “More than one-third (36%) of the incident response cases Palo Alto Networks’ Unit 42 worked on during the past year began with a social engineering tactic, the company said this week in its global incident response report
    • “Threat groups of assorted motivations and origins are fueling the rise of social engineering. Cybercrime collectives such as Scattered Spider and nation-state operatives, including North Korean technical specialists that have infiltrated the employee ranks at top global companies, have adopted social engineering as the primary hook into IT infrastructure and sensitive data.” 
  • and
    • “The average cost of a data breach for U.S. companies jumped 9% to an all-time high of $10.22 million in 2025, as the global average cost fell 9% to $4.44 million, IBM said in its 20th annual Cost of a Data Breach Report Wednesday [July 30].
    • While shorter investigations are pushing down costs globally, reflecting the first decline in five years, IBM found higher regulatory fines, along with detection and escalation costs, are driving up the ultimate recovery price in the United States. 
    • “This widening gap helps explain why U.S. organizations continue to face the highest breach costs globally, further compounded by more organizations in the U.S. reporting paying steeper regulatory fines,” Troy Bettencourt, global partner and head of IBM X-Force, said in an email.
    • “The report underscores that organizations face an uneven burden in the wake of data breaches, even as detection and containment times improve. On average, it took organizations 241 days to identify and contain a breach through the one-year period ending in February — a nine-year low, according to IBM.”
  • Cybersecurity Dive adds,
    • “A coalition of information-sharing groups urged their members on Wednesday [July 30] to take additional steps to mitigate potential attacks by the cybercrime gang Scattered Spider, which has spent recent months attacking the insurance, retail and airline industries. 
    • “Threat actors such as Scattered Spider are constantly innovating, so organizations must be diligent in continually monitoring their processes and identities to look for new exploits,” the group of information sharing and analysis centers (ISACs) — representing the financial services, food and agriculture, information technology, healthcare, aviation, automotive, retail, maritime and electricity sectors — said in a joint advisory.
    • Their warning came one day after the FBI and the Cybersecurity and Infrastructure Security Agency (CISA) warned that Scattered Spider had developed an evolving set of tactics to conduct social-engineering attacks on its targets.
    • The ISACs said they expect the group to continue to find new ways to evade existing security measures.
  • Bleeping Computer points out,
    • “Researchers have found that in roughly 80% of cases, spikes in malicious activity like network reconnaissance, targeted scanning, and brute-forcing attempts targeting edge networking devices are a precursor to the disclosure of new security vulnerabilities (CVEs) within six weeks.
    • “This has been discovered by threat monitoring firm GreyNoise, which reports these occurrences are not random, but are rather characterized by repeatable and statistically significant patterns.
    • “GreyNoise bases this on data from its ‘Global Observation Grid’ (GOG) collected since September 2024, applying objective statistical thresholds to avoid results-skewing cherry-picking.
    • “After removing noisy, ambiguous, and low-quality data, the firm ended up with 216 events that qualified as spike events, tied to eight enterprise edge vendors.
    • “Across all 216 spike events we studied, 50 percent were followed by a new CVE within three weeks, and 80 percent within six weeks,” explain the researchers.”
  • CISA added three known exploited vulnerabilities to its catalog this week.

From the ransomware front,

  • HIPAA Journal tells us,
    • “A new report from the cybersecurity firm Semperis suggests ransomware attacks have decreased year-over-year, albeit only slightly. The ransomware risk report indicates healthcare is still a major target for ransomware gangs, with 77% of healthcare organizations targeted with ransomware in the past 12 months. 53% of those attacks were successful.
    • “The report is based on a Censuswide survey of 1,500 IT and security professionals across multiple sectors. While attacks are down slightly, 60% of attacked healthcare organizations report suffering multiple attacks. In 30% of cases, they were attacked more than once in the same month, 35% were attacked in the same week, 14% were attacked multiple times on the same day, and 12% faced simultaneous attacks.
    • “A general trend in recent years, as reported by several firms, is fewer victims of ransomware attacks paying ransoms, although across all industry sectors in the U.S., 81% attacked companies paid the ransom, an increase from last year. Ransom payment was far less common in healthcare. According to Semperis, 53% of healthcare victims paid a ransom to either prevent the publication of stolen data, obtain decryption keys, or both. The ransom paid was less than $500,000 for 55% of companies, 39% paid between $500,000 and $1 million, and 5% paid more than $1 million.”
  • Cybersecurity Dive adds,
    • “Manufacturing, information technology and healthcare are top targets of cybercriminals, but ransomware attacks on the oil and gas industry increased dramatically between April 2024 and April 2025, spiking 935%, according to a new report from cybersecurity firm Zscaler.
    • “Oil and gas companies may be facing more attacks because their industrial control systems are increasingly automated and digitized, “expanding the sector’s attack surface,” Zscaler said.
    • “Half of all ransomware attacks listed on leak sites during the April-to-April survey period targeted the United States, and attacks on U.S. targets more than doubled, to 3,671, a figure that exceeds the combined number of ransomware events on the 14 other countries in the top 15 list.”
  • Cybersecurity Dive further reports,
    • “A recent wave of ransomware attacks targeting SonicWall firewall devices may be related to a zero-day vulnerability in the products, according to researchers.
    • “Anomalous firewall activity that began on July 15 and involved VPN access through SonicWall SSL VPNs morphed into intrusions the following week, researchers at Arctic Wolf said.
    • “This appears to be affecting SonicOS devices from what we’ve seen so far,” Stefan Hostetler, lead threat intelligence researcher at Arctic Wolf, told Cybersecurity Dive. “Our investigation is still preliminary, so I’m not able to offer much more detail yet.”
    • “Hackers deployed the Akira ransomware variant in hands-on-keyboard attacks after compromising SonicWall SSL VPNs, according to the researchers.”
  • and
    • “Researchers from Palo Alto Networks say they are investigating a ransomware attack related to the recently disclosed ToolShell vulnerabilities in Microsoft SharePoint
    • “The hackers left the victim a ransom note on Sunday [July 27] claiming they had encrypted files using the 4L4MD4R ransomware. The note warned that any attempt to decrypt the files would result in their deletion.
    • The hackers used PowerShell commands to disable real-time monitoring in Windows Defender, according to Palo Alto Networks researchers. The intruders also bypassed certificate validation.
    • Researchers from Palo Alto Networks say they are investigating a ransomware attack related to the recently disclosed ToolShell vulnerabilities in Microsoft SharePoint
    • The hackers left the victim a ransom note on Sunday claiming they had encrypted files using the 4L4MD4R ransomware. The note warned that any attempt to decrypt the files would result in their deletion.
    • The hackers used PowerShell commands to disable real-time monitoring in Windows Defender, according to Palo Alto Networks researchers. The intruders also bypassed certificate validation.
  • and
    • “Several major ransomware-as-a-service groups have stopped posting victims to popular leak sites, suggesting that the ecosystem is more dispersed than it used to be, according to a new report from Check Point Software Technologies.
    • “At the same time, many smaller groups that used to affiliate with larger players “are operating independently or seeking new partnerships,” Check Point said in its Thursday report.
    • “Established players are actively competing to recruit these ‘orphaned’ affiliates,” according to the report, which cited competition between prominent groups Qilin and DragonForce for affiliates of the now-defunct RansomHub.”
  • Per Bleeping Computer,
    • “A wave of data breaches impacting companies like Qantas, Allianz Life, LVMH, and Adidas has been linked to the ShinyHunters extortion group, which has been using voice phishing attacks to steal data from Salesforce CRM instances.
    • “In June, Google’s Threat Intelligence Group (GTIG) warned that threat actors tracked as UNC6040 were targeting Salesforce customers in social engineering attacks.
    • “In these attacks, the threat actors impersonated IT support staff in phone calls to targeted employees, attempting to persuade them into visiting Salesforce’s connected app setup page. On this page, they were told to enter a “connection code”, which linked a malicious version of Salesforce’s Data Loader OAuth app to the target’s Salesforce environment.”
  • SC Media tells us,
    • “Epsilon Red ransomware is being spread via a unique ClickFix lure that convinces victims to download and execute HTML Application files.
    • “The campaign impersonates widely used online services such as Twitch, Kick, Rumble, OnlyFans and the popular Discord Captcha Bot, CloudSEK reported recently.
    • “Like other sites using the ClickFix social-engineering method, these impersonation sites display a fake CAPTCHA prompt, but rather than having the victim copy and paste malicious commands, this version directs them to go to a different page to complete “extra verification steps.”
    • “These extra steps include pressing CTRL + S to save a file, renaming the file to verify.hta, opening the file with Microsoft HTML Application Host (mshta.exe), clicking “YES” if a popup appears and then entering a decoy “verification code” on the original CAPTCHA page. This last step is designed to trick the user into believing they have completed a legitimate verification process.”
  • Per InfoSecurity Magazine,
    • “A new ransomware operator called Chaos has launched a wave of intrusions impacting a wide range of sectors, Cisco Talos has reported.
    • “Victims have been predominantly based in the US, with some in the UK, New Zealand India, according to the actor’s data leak site.
    • “Targeting appears to be opportunistic and does not focus on any specific verticals. However, Chaos is focused on “big-game hunting” and uses double-extortion tactics.
    • “In one incident observed by Cisco, the group adopted a novel negotiation strategy, offering an extra ‘reward’ for making payment to the attackers, or additional ‘punishment’ for resisting demands, including the threat of a distributed denial-of-service (DDoS) attack.
    • “The Chaos ransomware actor is a recent and concerning addition to the evolving threat landscape, having shown minimal historical activity before the current wave of intrusions,” the researchers wrote in a blog dated July 24.”
  • Per Trend,
    • “Gunra ransomware’s Linux variant broadens the group’s attack surface, showing the new group’s intent to expand beyond its original scope. 
    • “The Linux variant shows notable features including running up to 100 encryption threads in parallel and supporting partial encryption. It also allows attackers to control how much of each file gets encrypted and allows for the option to keep RSA-encrypted keys in separate keystore files.
    • “Since its first observed activity in April 2025, Gunra ransomware has victimized enterprises from Brazil, Japan, Canada, Turkiye, South Korea, Taiwan, and the United States. Its victims include organizations from the manufacturing, healthcare, IT and agriculture sectors, as well as companies in law and consulting.” 

From the cybersecurity business and defenses front,

  • Cyberscoop reports,
    • “Palo Alto Networks has agreed to acquire identity security firm CyberArk for approximately $25 billion, marking the cybersecurity giant’s largest acquisition and its formal entry into the identity security market as the industry continues consolidating amid rising cyber threats.
    • “The transaction ranks among the largest technology acquisitions this year and underscores the market’s focus on identity security in an era of increasing artificial intelligence adoption.
    • “CyberArk, founded over two decades ago, specializes in privileged access management technology that helps organizations control and monitor access to critical systems and accounts. The company’s customers include major corporations such as Carnival Corp., Panasonic, and Aflac. Its technology addresses what security experts consider one of the most vulnerable aspects of enterprise security: managing privileged credentials for both human users and machine identities.
    • “The acquisition comes as cybersecurity companies face pressure to offer comprehensive solutions rather than point products, with customers seeking to streamline their vendor relationships following high-profile breaches. Recent cyberattacks, including Microsoft’s SharePoint vulnerabilities that affected over 100 organizations including U.S. government agencies, have heightened focus on identity protection and privileged access management.”
  • ISACA discusses “Defending Against Human-Operated Ransomware Attacks.”
  • Per a CISA news release,
    • “Today, the Cybersecurity and Infrastructure Security Agency (CISA) released an Eviction Strategies Tool, a no-cost resource designed to support cyber defenders in their efforts to respond to cyber incidents. CISA contracted with MITRE to develop this tool that enables cyber defenders to create tailored response plans and adversary eviction strategies within minutes. They will also be able to develop customized playbooks aimed at containing and evicting adversaries from compromised systems and networks.
    • “The tool includes COUN7ER, a database of atomic post-compromise countermeasures mapped to adversary tactics, techniques, and procedures (TTPs), and Cyber Eviction Strategies Playbook NextGen, a web-based application that matches incident findings with countermeasures obtained from COUN7ER. Together, these resources help defenders build systematic eviction plans with distinct countermeasures to thwart and evict unique intrusions.”
  • Dark Reading adds,
    • “The Cybersecurity and Infrastructure Security Agency (CISA), in collaboration with the Department of Energy’s Sandia National Laboratories, has released Thorium, an automated malware and forensic analysis platform, to help enterprise defenders quickly assess malware threats.” * * *
    • “Thorium is available from CISA’s official GitHub repository. Organizations interested in using it will need a deployed Kubernetes cluster, block store, and object store. A successful deployment requires familiarity with Docker containers and compute cluster management.
    • “By making this platform publicly available, we empower the broader cybersecurity community to use advanced tools for malware and forensic analysis,” said Jermaine Roebuck, CISA’s associate director for threat hunting, in a statement. “Scalable analysis of binaries and digital artifacts strengthens our ability to identify and fix vulnerabilities in software.”
  • Dark Reading offers Black Hat News. The Black Hat conference starts today in Las Vegas.

Tuesday report

From Washington, DC,

  • The Senate confirmed Susan Monarez to be Director of the Centers for Disease Control and Prevention today by a 51 to 47 vote. The AP adds,
    • “She holds a doctorate in microbiology and immunology from the University of Wisconsin and did postdoctoral research at Stanford University. Prior to the CDC, Monarez was largely known for her government roles in health technology and biosecurity.”
  • MedCity News tells us,
    • “On Thursday, a coalition of 28 healthcare organizations sent a letter to leaders in Congress calling on them to extend the Affordable Care Act enhanced premium tax credits, which are set to expire at the end of the year.
    • “The letter was addressed to John Thune, Senate majority leader; Chuck Schumer, Senate minority leader; Mike Johnson, speaker of the House; and Hakeem Jeffries, minority leader of the House. The letter was led by Keep Americans Covered and was signed by healthcare organizations including AHIP, Blue Cross Blue Shield Association, the American Medical Association, Kaiser Permanente, Families USA and more.” 
  • STAT News reports,
    • “Health secretary Robert F. Kennedy Jr. could “imminently” overhaul a key federal advisory panel that recommends which preventive services insurers must pay for, according to a person familiar with the plans. 
    • “The person said that federal health officials are actively vetting new members for the U.S. Preventive Services Task Force. David Mansdoerfer, an adviser to a Kennedy-aligned group of physicians, said he’s aware of people being considered for the panel, but declined to name them.” * * *
    • “Mansdoerfer added that the existing panel is “M.D. heavy” and a reconstituted panel is more likely to include “allied health professionals,” which are health care providers who aren’t nurses or physicians, like physical therapists and dietitians.” 
  • Following up on yesterday’s post about Medicare Part D, here is a link to the CMS guidance upon which the Wall Street Journal relied.
  • World at Work informs us,
    • “Health savings accounts (HSAs) have become a staple total rewards offering over the last decade, but a new study by the Employee Benefit Research Institute (EBRI) showed employees are still leaving the full value of these accounts on the table.
    • “The June 12 EBRI report pulled data from 14.5 million accountholders, containing more than $48 billion in total assets — roughly 40% of the entire HSA universe. The analysis revealed:
      • “Low balances. End-of-year balances increased in 2023 (the most recent analysis period) to $4,747 but are still modest compared with average out-of-pocket maximums for HSA-eligible health plans ($8,300 for individual coverage in 2025, $16,600 for family coverage)
      • Low contributions. Relative to 2022, average HSA contributions increased in 2023. However, after adjusting for inflation, both employer and employee contributions were higher in the 2010s. Also, notably, the average combined HSA contribution was $760 less than the statutory maximum contribution for individuals and $4,660 less than the statutory maximum contribution for accountholders with family coverage.
      • High withdrawals. More than half of accountholders withdrew funds, and the average distribution rose to $1,801.
      • “Low investment. Only 15% of accountholders invested in assets other than cash. 
    • EBRI found that, essentially, employees use HSAs as specialized checking accounts rather than investment accounts, and in doing so, miss out on the triple tax advantage available if they maximize contributions, minimize withdrawals and invest their balances.
    • “The good news is that, here we are 20-plus years after HSAs launched, and they’ve become pretty standard. They’re a typical plan offering from most employers of all sizes — not just large or small companies, or in certain industries,” said Alexander Domaszewicz, a principal and healthcare consultant at advisory firm Mercer. “If we live long enough, we’ll have healthcare expenses, and we want to be prepared for that. But while awareness and visibility of HSAs have grown, they’re still intimidating to folks.”
  • Beckers Payer Issues calls attention to recent No Surprises Act developments.
  • Federal News Network lets us know,
    • “The Trump administration is detailing how it expects agencies to recruit more political appointees through the new “Schedule G” hiring category, while also reminding agencies that all non-career hires must be approved by the White House.
    • “The Office of Personnel Management on Tuesday outlined how agencies should adopt the federal employment classification President Donald Trump created earlier this month. Generally, the new Schedule G broadens agencies’ options for hiring political appointees, beyond the avenues already available to presidential administrations for picking their own staff members.
    • “In its guidance on Trump’s new hiring authority, OPM said agencies will have to run any Schedule G hires they want make by the White House for review and approval.
    • “As a matter of practice,” OPM said, agencies will have to send all their political hires to their White House liaison — a position that coordinates with the White House on hiring and retention of political appointees — before agencies can advance any Schedule G appointments.”

From the Food and Drug Administration front,

  • Bloomberg Law informs us,
    • “Vinay Prasad, a top regulator at the US Food and Drug Administration, has left the agency after a controversy over his handling of Sarepta Therapeutics Inc.’s gene therapy. 
    • “Dr. Prasad did not want to be a distraction to the great work of the FDA in the Trump administration and has decided to return to California and spend more time with his family,” Department of Health and Human Services spokesperson Andrew Nixon said in a written statement. 
    • “Prasad did not immediately respond to a request for comment about his departure.” 
  • The Washington Post reports,
    • “The Food and Drug Administration pushed Tuesday to restrict a synthetic opioid found in tablets, gummies and drinkable shots commonly sold in convenience stores.
    • “Health officials announced they will seek to add 7-OH — a potent substance synthesized from a compound in the kratom leaf — to the tier of controlled substances reserved for the most addictive drugs, such as heroin and LSD.
    • “The FDA, researchers and kratom companies have grown increasingly alarmed by the rise of 7-OH products they say are distinct from all-natural teas and powders derived from a leaf that grows on trees native to Southeast Asia.
    • “FDA Commissioner Marty Makary said at a news conference that the agency is not asking to restrict natural products made from kratom, which contains trace amount of the compound. In a report released Tuesday, the agency said it maintains concerns about kratom broadly but needed to act urgently on 7-OH because of its risk of sedation, nausea, breathing problems and addiction.”
  • From the judicial front,
    • Fierce Healthcare reports,
      • “A new law in Arkansas banning pharmacy benefit managers from owning pharmacies has been blocked by a federal judge, the latest development in one of the industry’s most-watched new pieces of legislation.
      • “Judge Brian Miller said the law may violate (PDF) the Commerce Clause in the constitution and is likely preempted by TRICARE, a health care program for military families. The state is barred from enforcing the law until final disposition, a ruling shows.
      • “Act 624 appears to overtly discriminate against plaintiffs as out of state companies and the state has failed to show that it has no other means to advance its interests,” said Miller, adding other enacted state laws already can properly restrict PBMs.
      • “Arkansas Attorney General Tim Griffin said he plans on appealing the decision, reported the Associated Press.
      • “We’re pleased with the Court’s decision to grant a preliminary injunction to stop the implementation of Act 624,” a CVS Health spokesperson said in a statement. “We continue to be focused on serving people in Arkansas and are actively looking to work together with the state to reduce drug prices and ensure access to pharmacies.”

From the public health and medical researach front,

  • KFF considers whether our country’s measles elimination status is at risk.
  • The Agency for Healthcare Research and Quality released a medical expenditures survey report titled “Healthcare Expenditures for Heart Disease among Adults Aged 18 and Older in the U.S. Civilian Noninstitutionalized Population, 2022.”
    • “In 2022, 7.8 percent of adults aged 18 and older were treated for heart disease, and men were more likely than women to have treated heart disease (8.4 % vs. 7.2%).
    • “Among age groups, the treated prevalence of heart disease was highest for those aged 65 and older (22.8%) compared to only 6.0 percent for adults aged 45-64, and 1.4 percent for adults ages 18-44.
    • “In 2022, healthcare expenditures to treat heart disease for adults in the US totaled $100.0 billion (with an average cost of $4,900 per adult with diagnosed and treated heart disease).
    • “The largest portion of heart disease expenditures were incurred through hospital inpatient stays (46.1%) and prescribed medications (20.5%).
    • “The majority of heart disease treatment costs were paid by Medicare (57.6%) and private insurance (24.2%).”
  • Per MedPage Today,
    • “The global incidence of liver cancer is projected to double by 2050.
    • “Sixty percent of liver cancers are preventable by controlling risk factors including hepatitis B and C, alcohol consumption, and MASLD.
    • “The Lancet Commission estimated that a 2-5% reduction in the age-standardized incidence rate of liver cancer could prevent up to 17.3 million new cases and save up to 15.1 million lives.”
  • Per Neurology Adviser,
    • “Urinary tract infections (UTIs) may be a trigger for myocardial infarction (MI) or stroke, with an increased risk for both within the first 7 days of infection, according to the findings of a study published in BMJ Open.”
    • “Growing evidence suggests that acute infection plays a role in the pathogenesis of cardiovascular disease.
    • “Researchers from Cardiff University in the United Kingdom conducted this self-controlled cases series using data from the Secure Anonymised Information Linkage (SAIL) Databank which houses nation-wide data from Wales. Patients (N=105,930) with MI (n=51,660) or stroke (n=58,150) between 2010 and 2020 were evaluated for general practitioner suspected or confirmed UTI before or after MI or stroke event. The peak risk period was defined as up to 90 days after UTI.
    • “The MI and stroke cohorts consisted of 63% and 49% men, with mean ages of 69 and 74 years for men and 77 and 79 years for women, respectively.”
  • STAT News reports,
    • “A major Alzheimer’s disease medical group is recommending that specialists may use certain blood tests to help diagnose patients with cognitive impairment in lieu of more complex and invasive tests, a move that could lead more people to get treated for the devastating disease.
    • “The Alzheimer’s Association, in its first clinical guidelines on blood biomarker testing, said Tuesday that tests that have over 90% sensitivity (ability to identify positive results) and 90% specificity (ability to identify negative results) can be used instead of current diagnostic methods like PET scans and cerebrospinal fluid tests.
    • “The group said that tests that have over 90% sensitivity and 75% specificity can be used to triage patients, meaning negative results rule can rule out Alzheimer’s with high probability but positive results should be confirmed with the standard diagnostic methods, given that these blood tests have a higher likelihood of false positives.
    • “The authors stressed that the guidelines should not be considered a substitute for a full clinical evaluation and that they apply only to people who are in the care of specialists and have already been confirmed to have cognitive impairment. The authors also noted that there’s wide variability in the blood tests on the market and that many do not meet the accuracy thresholds.”
  • Per Benefits Pro,
    • “Researchers at Cigna’s Evernorth Research Institute are seeing early signs that offering patients semaglutide and other GLP-1 agonists might cut the cost of managing mental health problems.
    • “Duy Do and two other Evernorth researchers found that using Ozempic or similar drugs to control blood sugar reduced use of office visits to treat depression by 13% and reduced use of office visits to treat anxiety by 15%.
    • “Use of GLP-1 agonists did not reduce use of emergency room visits or inpatient care for depression or anxiety, but the researchers say their work shows the need for understanding how GLP-1 agonist use affects people’s mental health and use of mental health services.
    • “Given the high economic burden of mental health disorders among patients with T2DM, further research is needed to confirm the clinical and cost-effectiveness of [GLP-1s] in reducing the overall health care burdens for this patient population,” Do and colleagues conclude.”

From the U.S. healthcare business front,

  • The Wall Street Journal reports,
    • “UnitedHealth Group anticipates its 2025 earnings to fall below expectations due to rising costs and operational issues.
    • “CEO Stephen Hemsley aims to restore UnitedHealth to high performance, projecting earnings growth for the coming year.
    • “UnitedHealth is facing industry upheaval with rising healthcare costs, government actions, and ongoing Justice Department probes.”
  • Modern Healthcare tells us,
    • “Humana is offering certain employees voluntary early retirement buyouts.
    • “Employees age 50 or older with at least three years of service are eligible for the program, although those working in certain business-critical areas will be ineligible, a company spokesperson said Tuesday. He said the window to apply for voluntary early retirement will be open for several weeks.
    • “The Louisville, Kentucky-based health insurer said the offers are part of ongoing evaluations Humana conducts to adjust staffing and drive organizational efficiency.”
  • Beckers Hospital Review lets us know,
    • U.S. News & World Report released its 2025-2026 Best Hospitals rankings and ratings July 29, which included its list of 504 Best Regional Hospitals across 49 states and 95 metropolitan areas.
    • “The latest edition of Best Hospitals, now in its 36th year, evaluated more than 4,400 hospitals on measures such as risk-adjusted mortality rates, preventable complications and level of nursing care.” 
    • The article lists the no. 1 ranked hospitals in each eligible state.
  • Cardiovascular Business points out the best heart hospitals according to U.S. News and World Report.
  • Fierce Healthcare informs us,
    • “Earlier this year, CVS Health announced that it would invest $20 billion in improving the consumer experience and making the healthcare journey simpler.
    • “Now, its health benefits arm, Aetna, is unveiling its new Care Paths program, which connects members who have certain health needs—launching with diabetes, joint health and maternity care—to a more personalized view of their benefits and more directly with the care team supporting them. The platform is powered by artificial intelligence and offers users individualized recommendations for health and wellness programs related to their conditions as well as care kits when available.
    • “The goal, the insurer said, is to make members’ interactions with their health plans feel less transactional and instead more holistic. Aetna offered an exclusive look at the new offering to Fierce Healthcare.”
  • and
    • Sword Health, a company that provides virtual physical therapy and mental health, is now offering an AI assistant for payers and providers to tackle operational and administrative tasks.
    • “The new AI division marks a notable expansion from the company’s core business of virtual care services like digital musculoskeletal care, pelvic health and movement health.
    • “The launch of the new division, called Sword Intelligence, marks a “pivotal evolution” in Sword Health’s strategy, according to the company.
    • “Sword Intelligence allows us to move beyond delivering care to our own members to enabling the entire healthcare industry to scale it efficiently and effectively,” Virgilio “V” Bento, founder and CEO of Sword Health, told Fierce Healthcare when reached via email.”
  • The Wall Street Journal further reports,
    • Merck & Co. said it is embarking on a multi-year cost-savings plan, which includes cuts to its workforce and real-estate footprint, as it looks to redirect resources toward new product launches.
    • “The plan comes as the drug company on Tuesday logged lower revenue and sales in its latest quarter and narrowed its full-year guidance.
    • “The company said it expects the plan to result in $3 billion in annual cost savings by the end of 2027, which it plans to reinvest to support new products as well as its pipeline across multiple therapeutic areas.
    • “As part of the cost-savings plan, Merck expects to eliminate certain administrative, sales and research-and-development positions.
    • “The company didn’t disclose how many workers would be affected but said it would continue to hire employees in new roles across strategic growth areas of its business.
    • “Merck said it also would reduce its global real-estate footprint and continue to optimize its manufacturing network.
    • “The company expects the workforce cuts and real-estate reductions to result in annual cost savings of about $1.7 billion, which would be substantially realized by the end of 2027.”
  • and
    • “Novo Nordisk shares plunged after losing its lead in the weight-loss drug market to competitors like Eli Lilly.
    • “The company lowered its 2025 sales growth forecast due to copycat versions of Wegovy and slower Ozempic sales.
    • “Maziar Mike Doustdar was named chief executive, effective Aug. 7, succeeding Lars Fruergaard Jorgensen.”

Monday report

From Washington, DC,

  • The Wall Street Journal reports,
    • “Medicare drug plan premiums are expected to rise significantly next year due to rising costs and regulatory changes.
    • “A subsidy program that shielded seniors from rising monthly bills will be cut by about 40% in 2026.
    • “The premium increase will affect millions of seniors and may push more enrollees into Medicare Advantage plans.”
  • KFF tells us,
    • “Two new KFF analyses examine the latest data about Medicare Advantage, including trends in enrollment, premiums, out-of-pocket limits, supplemental benefits and prior authorization.
    • “The first analysis, focusing on enrollment trends, finds that 54% of eligible Medicare beneficiaries are enrolled in Medicare Advantage in 2025, though increases in enrollment slowed this year. One in five Medicare Advantage enrollees is in a special needs plan (SNP), reflecting a steady increase in recent years. And Medicare Advantage enrollment remains highly concentrated among a handful of insurance companies. 
    • “The second analysis finds that more than three quarters (76%) of enrollees in individual Medicare Advantage plans with prescription drug coverage pay no premium other than the Medicare Part B premium. The share of enrollees in plans offering a rebate against the Part B premium rose sharply from 12% in 2024 to 32% in 2025, but among these enrollees, about half are in plans that offer rebates of less than $10 a month while fewer (36%) are in plans that offer rebates of $50 or more per month. Prior authorization is most often required for expensive services such as skilled nursing facility stays (99%), Part B drugs (98%), inpatient hospital stays (acute: 96%; psychiatric: 93%) and outpatient psychiatric services (80%).” 
  • STAT News reports,
    • “No decision has been made on the future of an advisory panel [the U.S. Preventive Services Task Force] that decides which preventive care offerings, like cancer screenings, must be covered by insurers, a federal health department spokesperson said, after a [Wall Street Journal] report that health secretary Robert F. Kennedy Jr. is planning to oust all members. 
    • “But the report has alarmed the American Medical Association, which is calling on Kennedy to keep the panel’s members in place.” 
  • Modern Healthcare informs us,
    • “The Centers for Medicare and Medicaid Services wants to take another crack at creating a national provider directory in an effort to replace insurance company lists that are often riddled with errors.
    • “Health and Human Services Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz touted the idea at a meeting with health information technology executives in June. In a later post on the social media platform X, CMS described its goal as a “dynamic, interoperable directory that connects the data CMS has with what the industry knows, so we all work from the same map.” * * *
    • “The insurance industry would support a national provider directory “grounded in a robust public-private partnership,” the trade group AHIP said in a statement. At the AHIP 2025 conference last month, executives from Centene, Cigna and Aetna parent company CVS Health said their companies have met with CMS to discuss the concept.”
  • and
    • “Top Trump administration health officials are expected to bring tech companies to the White House this week to roll out a plan to encourage more seamless sharing of healthcare data, according to people familiar with the matter.
    • “Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services Administrator Mehmet Oz are expected to host executives at an event on Wednesday, said the people, who did not provide names of the attendees and asked not to be named because the details haven’t been made public.
    • “The plan was developed in coordination with the White House, building on a May effort by CMS to get public input on addressing barriers to sharing patient data.”
  • The American Hospital Association lets us know,
    • “The Substance Abuse and Mental Health Services Administration July 28 released its latest national survey on drug use and mental health. Among the findings, the percentage of adolescents aged 12 to 17 who had serious thoughts of suicide declined from 12.9% in 2021 to 10.1% in 2024. It also found a decline in adolescents who experienced a major depressive episode, dropping from 20.8% in 2021 to 15.4% in 2024. The survey also found that among the 61.5 million adults aged 18 or older in 2024 with any mental illness, 52.1% (32 million) received any mental health treatment in the past year. Among 14.6 million adults with serious mental illness in the past year, 70.8% (10.3 million) received mental health treatment. Due to changes to the survey questions and approach, not all estimates in the 2024 survey are comparable with 2023 and 2022 estimates, SAMHSA notes.” 
  • An HHS news release adds,
    • “The U.S. Department of Health and Human Services (HHS) has announced a $100M pilot funding opportunity to prevent, test for, treat, and cure Hepatitis C (HCV) in individuals with substance use disorder (SUD) and/or serious mental illness (SMI). This program is designed to support communities severely affected by homelessness and to gain insights on effective ways to identify patients, complete treatment, cure infections, and reduce reinfection by Hepatitis C (a liver disease caused by the Hepatitis C virus).
    • “HHS is delivering on our promise to the American people for a healthier, brighter future,” said HHS Secretary Robert F. Kennedy, Jr. “Through this pilot program, we are launching a comprehensive, integrated care model that not only cures HCV but also tackles critical risk factors like substance use, mental health challenges, and homelessness head-on.”
  • Beckers Hospital Review highlights five things to know about the foreign trade deals that the Trump administration has recently struck.

From the Food and Drug Administration front,

  • BioPharma Dive reports,
    • “The Food and Drug Administration has given Sarepta Therapeutics a green light to resume shipping its gene therapy Elevidys to some patients with Duchenne muscular dystrophy, a little over one week after demanding the company halt sales over safety concerns. 
    • “In a statement Monday evening, Sarepta said it would begin shipments to treatment sites “imminently.” The resumption applies only to Duchenne patients who can still walk, which typically describes individuals who are younger and whose disease hasn’t advanced as far.”
  • and
    • “The Food and Drug Administration has delayed its review of a Bayer therapy for hot flashes related to menopause, telling the drugmaker it needs additional to review the company’s application.
    • “In a Friday statement, Bayer said the FDA did not raise any concerns around “general approvability” of the drug, called elinzanetant. Still, the agency extended its decision deadline by three months.”
  • Per MedTech Dive,
    • “Johnson & Johnson’s Ethicon unit has corrected disposable surgical stapler cartridges over a fault related to one death and one injury, the Food and Drug Administration said Friday.
    • “The company wrote to customers in April after learning that devices may activate but not cut or staple tissue. Additional steps are needed to open and remove locked devices from tissue. 
    • “Ethicon designed the stapler to prevent lockout events from harming patients. Still, the FDA said the lockout problem could cause life-threatening hemorrhage, surgical delay and death.”

From the public health and medical research front,

  • The New York Times reports,
    • “A combination of healthy activities including exercise, nutritious diet, computer brain games and socializing can improve cognitive performance in people at risk for dementia, according to a large new study.
    • “The study, conducted in five locations across the United States over two years, is the biggest randomized trial to examine whether healthy behaviors protect brain health.
    • “It confirms that paying attention to things like physical activity and vascular risk factors and diet are all really important ways to maintain brain health,” said Dr. Kristine Yaffe, an expert in cognitive aging at the University of California, San Francisco, who was not involved in the study.
    • “The results were presented on Monday at the Alzheimer’s Association International Conference in Toronto and published in the journal JAMA.”
  • The Washington Post adds,
    • “Any amount of walking is good for your health but picking up the pace has significant benefits — and it’s never too late for someone to train to walk faster.
    • “In an analysis published in PLOS One earlier this month, researchers found that frail older adults who deliberately walked faster saw a meaningful improvement in the distance they could travel when instructed to walk for six minutes straight. (Frailty is an age-related syndrome that affects 5 to 17 percent of older adults and is characterized by fatigue, a loss of strength and unexplained weight loss.)
    • “The results show that regardless of your age, the intensity of your workout can lead to greater improvements in physical function, said Daniel Rubin, the lead author of the analysis and an associate professor of anesthesia and critical care at the University of Chicago.”
  • Per the National Academy of Medicine,
    • “With more than half a million people globally living beyond the age of 100, it is time to rethink how health professionals and educators view older adults and the aging process. “Redefining aging” begins with transforming the mindset of current and future health professionals through targeted education. This involves encouraging them to reconsider how they address the unique needs of older adults and identifying those who can drive this change. Educators, health professionals, administrators, and policymakers must collaborate to reshape systems and attitudes. Together, they can build a well‑trained workforce that is not only prepared but motivated to address the complexities of aging that may include chronic disease and functional decline but also opportunities for growth and innovation. The barriers to achieving a change in mindset and solutions for overcoming challenges prompt a call to action. This paper is an entreaty by a group of interprofessional educators passionate about ensuring all health professionals are trained to meet the complex needs of older adults.”
  • MedPage Today tells us,
    • “Chronic obstructive pulmonary disease (COPD) affects at least 4.5% of those 18-49 years old, according to an analysis of U.S. cohorts * * * as reported in NEJM Evidence.”
    • “The early COPD group was more likely to be hospitalized or die from chronic respiratory disease, to develop heart failure, and to die before 75 years of age from any cause.
    • “Having a definition for early COPD might allow for studies to find ways to treat the disease and reduce its impact.”
  • The AHA News informs us,
    • “Five pediatric flu deaths were reported to the Centers for Disease Control and Prevention last week, pushing the total to 266 for the 2024-2025 flu season, according to the latest data. The total is the highest reported in any non-pandemic flu season since the agency began reporting it in 2004. The CDC said 90% of reported pediatric deaths this flu season have happened to children who were not fully vaccinated against the flu.”
  • The American Medical Association lets us know what doctors wish their patients knew about the impact of caffeine.

From the U.S. healthcare business front,

  • The Wall Street Journal reports,
    • Bristol Myers Squibb BMY and Bain Capital are forming a new biopharmaceutical company focused on therapies for autoimmune diseases.
    • The new company will be created with $300 million in financing led by Bain Capital, including funds from the Canada Pension Plan Investment Board.
    • The company will begin with five potential treatments for autoimmune diseases in-licensed from Bristol Myers Squibb, which will retain 20% equity in the new company. Bristol Myers Squibb will also be entitled to royalties and milestones from the potential treatments.
    • Biotech executive Daniel Lynch, currently chairman of the board at Xilio Therapeutics XLO, will lead the new company as chief executive.
  • Per BioPharma Dive,
    • “GSK is turning to a China-based biotechnology company in search of its next blockbuster medicine, announcing Monday a broad drug making alliance with Hengrui Pharma that could be worth billions of dollars.
    • “GSK will pay Hengrui $500 million upfront to start the alliance. In return, it will receive rights outside of the greater China region and Taiwan to an experimental drug for chronic obstructive pulmonary disease as well as the potential to develop up to 11 other therapies for respiratory illnesses, immune disorders or cancer. If a variety of milestones are met, the deal could be worth up to $12 billion, plus royalties, GSK said.”
  • Beckers Payer Issues offers us six prior authorization updates that Beckers has reported since June 23.
  • Per an NIH news release,
    • “Researchers at the National Institutes of Health (NIH) have developed an artificial intelligence (AI) agent powered by a large language model (LLM) that creates more accurate and informative descriptions of biological processes and their functions in gene set analysis than current systems.
    • “The system, called GeneAgent, cross-checks its own initial predictions—also known as claims— for accuracy against information from established, expert-curated databases and returns a verification report detailing its successes and failures. The AI agent can help researchers interpret high-throughput molecular data and identify relevant biological pathways or functional modules, which can lead to a better understanding of how different diseases and conditions affect groups of genes individually and together.”

Weekend Update

From Washington, DC

  • Roll Call discusses likely Senate activities this week.
  • Congress in the July 4, 2025, budget reconciliation act (§ 90101, at 291) did enact a law requiring OPM to place more internal controls over family member eligibility.
    • – No later than 12/31/25, OPM must develop a process by which any [ineligible] individual enrolled in, or covered under, a [FEHB or PSHB] shall be disenrolled or removed from enrollment in, or coverage under, that plan.
  • This requirement should include implementation of the HIPAA 820 standard enrollment roster transaction. 
    • – No later than July 3, 2026, OPM must issue regulations and implement a process to verify – (1) the veracity of any qualifying life event through which an enrollee seeks to add a member of family to his/her coverage; and (2) that, when an enrollee in the Program seeks to add a member of family to his/her coverage, including during any open season, the individual so added is a qualifying member of family with respect to the enrollee.
  • It would be sensible for OPM to implement a program similar to TRICARE’s DEERS program which places the reporting burden on the TRICARE enrollee. 
  • HIPAA Suite explains,
    • “The HIPAA 820 transaction set [which has been around since 2008] handles the [electronic] communication between a sponsor that is an entity that pays for someone’s health care, and another entity that manages health care benefits, such as an insurance company.
    • “For example, a large employer that has a contract with an insurance company or a government agency that handles social and health benefits will use the 820 transaction to manage premium payments. This information can either be very detailed and contain demographic information on each individual that is covered or just contain a summary of the payment for all members.
  • The HIPAA standard transaction law requires health plans to be able to process the HIPAA 820. What’s more nearly half of FEHB and PSHB enrollees have self only coverage.

From the public health and medical reseach front,

  • MedPage Today reports,
    • “For years, we’ve told our patients that human papillomavirus (HPV) vaccination works best when administered before sexual debut — and rightfully so. But what happens when a woman has already developed high-grade cervical dysplasia and undergoes surgical treatment?
    • Our recent study, published in The Lancet Regional Health – Europe, explored that very question. And the results were striking: women who received the HPV vaccine after surgical excision (conization) experienced a 74% reduction in recurrent high-grade cervical lesions (CIN2+), with the most dramatic benefit seen within the first 6 months after surgery.
  • and
    • “Cases of “Ozempic mouth” and “Ozempic teeth” have recently been described in the news, with most of the problems — inflammation affecting the gums, tooth decay, and even bad breath — linked to a dry mouth.
    • “All of the GLP-1 agonists that we use now cause changes in how everything is secreted in your GI tract,” Ann Marie Defnet, MD, who specializes in obesity medicine and bariatric surgery at Northwell Health’s North Shore University Hospital and Long Island Jewish Medical Center in New York City, told MedPage Today. And this “definitely has an impact on saliva.”
    • “People taking GLP-1 drugs also tend to be a bit dehydrated because they are often not hungry or thirsty, she noted.
    • “I haven’t seen too many horrible cases of periodontal disease, gingivitis, or anything like that, nor have I had any patients really complaining about dry mouth,” she noted. “But definitely I have patients all the time that [say], ‘Oh yeah, I can tell I’m dehydrated.'”
    • “Defnet said she believes some of the serious oral health issues that have been reported are likely representative of “more of a later stage issue with patients who maybe just aren’t staying hydrated in general.”
    • “One of the big things I always counsel my patients on is they just have to remember to continue to drink water, even if they’re not thirsty, even if they’re not hungry,” Defnet said. “That seems to help with all of these symptoms.”
  • The New York Times discusses “Coronary artery calcium testing [which] can reveal plaque in arteries, offering a more precise estimate of a patient’s risk [of having a heart attack]. Yet the test remains underused.”
    • “A brief and painless CT scan, it would show whether the fatty deposits called plaque were developing in the arteries leading to her heart.
    • “When plaque ruptures, it can cause clots that block blood flow and trigger heart attacks. The scan would help determine whether Ms. Hollander would benefit from taking a statin, which could reduce plaque and prevent more from forming.
    • “The test is used by more people every year,” said Dr. Michael Blaha, co-director of the preventive cardiology program at Johns Hopkins University. Calcium scans quadrupled between 2006 and 2017, his research team reported, and Google searches for related terms have risen even more sharply.
    • “Yet “it’s still being underused compared to its value,” he said.
    • “One reason is that although the test is comparatively inexpensive — sometimes up to $300, but often $100 or less — patients must pay for it out of pocket. Medicare rarely covers it, though some doctors argue that it should.”

From the U.S. healthcare business front,

  • Radiology Business lets us know,
    • “Physicians are increasingly exiting Medicare, according to new research published in JAMA Health Forum
    • “Radiology and other specialties have expressed concern in recent years that inadequate payment rates could push practices to close or stop accepting the federal program for seniors. Since 2001, Medicare reimbursements to physicians have fallen 33%, when adjusting for inflation, according to the American Medical Association. 
    • “Researchers recently sought to test this theory, analyzing 100% of fee-for-service Medicare Part B claims logged between 2010 to 2024. They found the share of physicians exiting Medicare increased “significantly” from 1.8% to 3.6% by the end of the study period. 
    • “The findings may reflect multiple factors, including the greater burden of new communication methods (e.g., portal messages) and demands for clinical documentation,” Hannah T. Neprash, PhD, and Michael E. Chernew, PhD, healthcare policy experts with the University of Minnesota and Harvard Medical School, respectively, wrote July 18. “More rapid growth in exit[s] among small practices likely contributes to consolidated physician markets, given that new physicians increasingly work for large practices.”
    • “Researchers excluded docs who on average billed for fewer than 100 Medicare claims annually. They defined an exit as the absence of any claims in the payment program for 12 consecutive months. Altogether, the study sample included over 791,000 physicians at an average age of nearly 45. Physician Medicare exits displayed a gradual increase from 2010-2013 before stabilizing between 2014-2016. They saw another gradual increase from 2017-2019 and then spiked amid the COVID-19 pandemic in 2020-2021 before returning to regular levels by 2023.” 
  • The boilerplate in an FEHB or PSHB brochure (meaning its OPM policy) reads,
    • If you are enrolled in Medicare Part B, a physician may ask you to sign a private contract agreeing that you can be billed directly for services ordinarily covered by Original Medicare. Should you sign an agreement, Medicare will not pay any portion of the charges, and we will not increase our payment. We will still limit our payment to the amount we would have paid after Original Medicare’s payment. You may be responsible for paying the difference between the billed amount and the amount we paid.
  • MedCity News informs us that “Sentara Health has rolled out Regard’s AI-powered chart review and discharge summary tool across all 12 of its hospitals [located in Virginia and North Carolina]. The tool has delivered consistent benefits when it comes to patient safety and documentation accuracy, said Joseph Evans, Sentara’s chief health information officer.

Cybersecurity Saturday

Exploitation of Microsoft SharePoint Vulnerabilities

  • Last Sunday, July 20, the Cybersecurity and Infrastructure Security Agency (CISA) added a known exploited vulnerability to its catalog
    • CVE-2025-53770 Microsoft SharePoint Server Remote Code Execution Vulnerability
  • CISA also created an alert on the new KVE, which the agency updated on Tuesday and Thursday.
  • The Wall Street Journal reported on July 21,
    • Microsoft issued an alert about “active attacks” targeting its server software and urged customers to install new security updates that have been released.
    • Microsoft’s Security Response Center said in a blog post over the weekend that the attacks target on-premises SharePoint server customers and exploit vulnerabilities that were partially addressed by a July security update.
    • “Organizations typically use Microsoft SharePoint to create intranet websites, store and organize information, and facilitate file-sharing among workers. Cloud-based SharePoint Online in Microsoft 365 isn’t affected, the company said.
    • “By Monday, cybersecurity investigators said that the SharePoint attacks were widespread. At least one of the “multiple” hacking groups involved in the attacks was linked to China, according to Google’s Mandiant cybersecurity group.
    • “Microsoft declined to comment beyond its blog post.
    • “Hackers exploiting the SharePoint flaws then stole cryptographic keys that could be used to run commands on the affected server in the future, even if it had been patched, cybersecurity investigators said on Monday.”
  • and added on July 24,
    • Last year, Satya Nadella pledged to make security priority number one at Microsoft. A new hack involving China is showing just how difficult that can be.
    • The attack involves several versions of Microsoft’s SharePoint software that serve as a document storage platform for customers who don’t want to use the cloud. Microsoft released patches for a pair of SharePoint bugs earlier this month, but the fixes were quickly bypassed, allowing China-linked hackers to break into hundreds of organizations, according to security researchers.
    • Instead of protecting customers, the faulty patches may have served as a road map for hackers to hone their attacks, the researchers said.
    • It’s the latest in a string of lapses by the technology giant that have benefited China’s vast and global cyber-espionage operations, a top U.S. national security threat. * * *
    • “In the SharePoint attack * * * the issue began in May 2025, at a hacking contest in Berlin where the Vietnamese researcher [and pentester] Dinh Khoa (LinkedIn page) won $100,000 and a laptop.
    • “This is a very hard target so we spent a lot of time digging into it,” Khoa said in an interview posted online after the contest.
    • “To the applause of audience members, he showed how to break into a SharePoint system and was soon escorted into a private room where he explained the bugs to a representative from Microsoft and Dustin Childs, head of threat awareness with cybersecurity company Trend Micro’s Zero Day Initiative. Two months later, on July 8, Microsoft fixed the bugs. They were two of the 130 bugs that Microsoft fixed that month.” * * *
    • “On Saturday [July 19], Microsoft took the unusual step of issuing two emergency patches, which contain “more robust protections” to the bugs that Khoa had found, the company said. SharePoint customers should also change the cryptographic keys used by their servers, a move that—when combined with the new patches—effectively closes the back door created by the attack, Microsoft said.”
  • Cyberscoop noted on July 24,
    • The fallout from an attack spree targeting defects in on-premises Microsoft SharePoint servers continues to spread nearly a week after zero-day exploits were discovered, setting off alarms across the globe. More than 400 organizations have been actively compromised across four waves of attacks, according to Eye Security.
    • Multiple government agencies, including the Departments of Energy, Homeland Security and Health and Human Services, have been hit. The California Independent System Operator, which operates some of the state’s wholesale electric grid, was also impacted.
    • As more victims confirm varying levels of compromise from the attack spree, researchers are learning and sharing more details about post-exploit activities. One of the China-based attackers behind the initial wave of attacks, Storm-2603, deployed Warlock ransomware starting July 18, Microsoft Threat Intelligence said Wednesday in an updated blog post.
    • The Chinese government-affiliated threat groups Linen Typhoon and Violet Typhoon — which have been active for at least a decade — are also actively exploiting the zero-day vulnerabilities, Microsoft said. Linen Typhoon has focused on stealing intellectual property and Violet Typhoon is an espionage threat group. Storm is a moniker Microsoft uses for threat groups in development.
  • NextGov/FCW discusses the impact of the Sharepoint vulnerabilities on federal government agencie here (Homeland Security, among other agencies affected) and there (Defense Department not affected).

From the cybersecurity breaches and vulnerabilities front,

  • Security Week informs us,
    • “The Alcohol & Drug Testing Service (TADTS) is notifying roughly 750,000 people that their personal information was compromised in a July 2024 data breach.
    • “TADTS is based in Texas and was until recently known as the Texas Alcohol and Drug Testing Service. It provides workplace and individual alcohol and drug testing services in Texas and other states.
    • “The incident, TADTS says, was identified on July 9, 2024, and involved unauthorized access to and the theft of data maintained in its systems.
    • “The investigation into the potentially compromised information, conducted with the assistance of a professional data mining team, was concluded only recently, and determined that personal information was included in the stolen data.” * * *
    • “While TADTS did not share details on the type of cyberattack it fell victim to, the infamous BianLian ransomware group took credit for the intrusion on July 14, 2024, claiming the theft of roughly 218 gigabytes of data.
    • “It is unclear whether the hackers released the stolen information publicly, as their Tor-based leak site is currently offline and the group has been quiet for months, with their last known victim announced on March 31.”
  • and
    • “Marketing software and services company Cierant Corporation and law firm Zumpano Patricios have independently disclosed data breaches, each impacting more than 200,000 individuals.
    • “What the Cierant and Zumpano Patricios incidents have in common is that the number of impacted people was brought to light in recent days by the healthcare data breach tracker maintained by the US Department of Health and Human Services (HHS).
    • “The Zumpano Patricios breach impacts nearly 280,000 individuals. The law firm, which has offices in several major US cities, is representing healthcare providers in disputes with health insurance companies over medical service payments to patients. 
    • “Zumpano Patricios is informing impacted individuals that it had detected an intrusion in its IT network on May 6, 2025, but could not determine the date and time of initial access. 
    • “An investigation revealed that the hackers accessed and possibly exfiltrated files containing information such as patient name, date of birth, Social Security number, provider name, health insurer information, dates of service, and amounts charged by the provider and payments they received.”
  • Cybersecurity Dive tells us,
    • “Hackers breached the Philadelphia Indemnity Insurance Company in June and stole customer data, the company said in a filing with the California Attorney General’s office
    • “An unauthorized party accessed customer data during an intrusion discovered between June 9 and June 10, according to the disclosure.
    • “The company previously called the incident a network outage, however it said there was no ransomware and no encryption. The company did report the incident to law enforcement and retained outside forensic experts to investigate.”
  • In addition to the June 20 addition discussed above, CISA added six known exploited vulnerabilities to its catalog this week.
    • July 22, 2025
      • CVE-2025-49704 Microsoft SharePoint Code Injection Vulnerability
      • CVE-2025-49706 Microsoft SharePoint Improper Authentication Vulnerability”
        • Cybersecurity Dive explains,
          • “The [Sharefile] intrusions are exploiting ToolShell, an attack sequence that combines remote code injection and network spoofing vulnerabilities tracked as CVE-2025-49704 and CVE-2025-49706.” 
    • Also July 22, 2025,
      • CVE-2025-54309 CrushFTP Unprotected Alternate Channel Vulnerability
        • Tenable discusses the CrushFTP vulnerability
      • CVE-2025-6558 Google Chromium ANGLE and GPU Improper Input Validation Vulnerability
      • CVE-2025-2776 SysAid On-Prem Improper Restriction of XML External Entity Reference Vulnerability
      • CVE-2025-2775 SysAid On-Prem Improper Restriction of XML External Entity Reference Vulnerability
  • Security Week notes,
    • “SonicWall on Wednesday announced patches for a critical vulnerability in Secure Mobile Access (SMA) 100 series secure access gateways, urging organizations to take immediate action in the wake of the recently disclosed Overstep malware attacks.
    • “The newly addressed flaw, tracked as CVE-2025-40599 (CVSS score of 9.1), is described as an arbitrary file upload issue in the SMA 100’s web management interface.
    • “The bug can be exploited by remote attackers to upload arbitrary files to the system, which could lead to remote code execution (RCE). The attackers need administrative privileges to exploit the security defect, SonicWall’s advisory reads.”
  • and
    • “The Lumma Stealer has returned after Microsoft and law enforcement caused significant disruption to its infrastructure, Trend Micro reported on Tuesday.” * * *
    • “The ability of Lumma Stealer’s operators to regroup and innovate poses a continued risk to organizations and individuals worldwide,” Trend Micro said. “This emphasizes the need for ongoing vigilance, proactive threat intelligence, and sustained collaboration between law enforcement and the cybersecurity community. Without this, even the most significant takedowns might only offer temporary relief from evolving cyber threats.”
  • Per Dark Reading,
    • “A suspected Chinese nation-state threat group is conducting an extensive cyberespionage campaign that takes advantage of vulnerable VMware ESXi and vCenter environments.
    • “Since early 2025, researchers at Sygnia have responded to multiple incidents tied to a cyberespionage campaign they track as “Fire Ant.” According to research published Thursday, Fire Ant actors are establishing initial access in organizations’ VMware systems, which have become popular targets for attackers in recent years.
    • “More importantly, Fire Ant actors used deep knowledge of the target environments and strong capabilities to consistently bypass segmentations and reach isolated portions of the network.”

From the ransomware front,

  • In line with this week’s theme, Bleeping Computer points out,
    • “A China-based hacking group is deploying Warlock ransomware on Microsoft SharePoint servers vulnerable to widespread attacks targeting the recently patched ToolShell zero-day exploit chain.
    • “Non-profit security organization Shadowserver is currently tracking over 420 SharePoint servers that are exposed online and remain vulnerable to these ongoing attacks.
    • “Although Microsoft has observed this threat actor deploying Warlock and Lockbit ransomware in the past, Microsoft is currently unable to confidently assess the threat actor’s objectives,” the company said in a Wednesday report.”
  • July 22, 2025, CISA issued an alert and advisory on Interlock ransomware.
  • Per Bleeping Computer,
    • “Law enforcement has seized the dark web extortion sites of the BlackSuit ransomware operation, which has targeted and breached the networks of hundreds of organizations worldwide over the past several years.
    • “The U.S. Department of Justice confirmed the takedown in an email earlier today, saying the authorities involved in the action executed a court-authorized seizure of the BlackSuit domains.
    • “Earlier today, the websites on the BlackSuit.onion domains were replaced with seizure banners announcing that the ransomware gang’s sites were taken down by the U.S. Homeland Security Investigations federal law enforcement agency as part of a joint international action codenamed Operation Checkmate.”

From the cybersecurity policy and law enforcement front,

  • Cyberscoop reports,
    • “The Trump administration’s new AI Action Plan calls for companies and governments to lean into the technology when protecting critical infrastructure from cyberattacks.
    • “But it also recognizes that these systems are themselves vulnerable to hacking and manipulation, and calls for industry adoption of “secure by design” technology design standards to limit their attack surfaces.
    • “The White House plan, released Wednesday, calls for critical infrastructure owners — particularly those with “limited financial resources” — to deploy AI tools to protect their information and operational technologies.
    • “Fortunately, AI systems themselves can be excellent defensive tools,” the plan said. “With continued adoption of AI-enabled cyberdefensive tools, providers of critical infrastructure can stay ahead of emerging threats.” * * *
    • “The Trump plan states that “all use of AI in safety-critical or homeland security applications should entail the use of secure-by-design, robust, and resilient AI systems that are instrumented to detect performance shifts, and alert to potential malicious activities like data poisoning or adversarial example attacks.”
    • “The plan also recommends the creation of a new AI-Information Sharing and Analysis Center (AI-ISAC) led by the Department of Homeland Security to share threat intelligence on AI-related threats.”
  • Cybersecurity Dive lets us know,
    • “Sean Plankey, President Donald Trump’s nominee to lead the Cybersecurity and Infrastructure Security Agency, faced sharp questions during a Senate confirmation hearing Thursday about the looming expiration of an information-sharing law and CISA’s work on election security.
    • Plankey — currently a senior adviser to Secretary of Homeland Security Kristi Noem — explained his vision for leading an agency that has experienced major workforce cuts and faces significant budget reductions in Trump’s Fiscal Year 2026 spending proposal.”
    • The Senate Homeland Security and Governmental Affairs Committee will vote on whether to send Mr. Plankey’s nomination to the Senate floor at a business meeting next Thursday.
  • Cyberscoop adds,
    • “President Donald Trump’s pick to lead the Cybersecurity and Information Security Agency told senators Thursday that he would prioritize evicting China from the U.S. supply chain, and wouldn’t hesitate to ask for more money for the shrunken agency if he thought it needed it.
    • “If confirmed it will be a priority of mine to remove all Chinese intrusions, exploitations or infestation into the American supply chain,” Sean Plankey told Rick Scott, R-Fla., at his confirmation hearing before the Homeland Security and Governmental Affairs Committee. Scott had asked Plankey about reports of Chinese infiltration of U.S. energy infrastructure.”
  • Per a National Institute of Standards and Technology news release,
    • “NIST has issued draft updates to Special Publication (SP) 800-53 to provide additional guidance on how to securely and reliably deploy patches and updates in response to the Executive Order 14306Sustaining Select Efforts to Strengthen the Nation’s Cybersecurity and Amending Executive Order 13694 and Executive Order 14144. A two-week expedited public comment period on the draft updates is open through August 5, 2025.” 
  • Per a July 23, 2025, HHS news release,
    • “Today, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) announced a settlement with Syracuse ASC, LLC doing business as Specialty Surgery Center of Central New York, for potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security and Breach Notification Rules. Syracuse ASC is a single-facility, ambulatory surgery center located in Liverpool, New York that provides ophthalmic and ENT surgical services and pain management procedures to patients.” * * *
    • “The settlement resolves an OCR investigation concerning a ransomware breach of ePHI that affected 24,891 individuals. OCR initiated the investigation in October 2021 after Syracuse ASC reported to HHS that an unauthorized individual had accessed its network in March 2021. Further investigation revealed that Syracuse ASC was affected by a ransomware attack involving the PYSA ransomware variant, which is a cross-platform cyber weapon known to target the healthcare industry. OCR’s investigation found that Syracuse ASC never conducted an accurate and thorough risk analysis to determine the risks and vulnerabilities to the ePHI it held. OCR also found that Syracuse ASC failed to timely notify affected individuals and the Secretary of the breach.
    • “Under the terms of the resolution agreement, Syracuse ASC agreed to implement a corrective action plan that OCR will monitor for 2 years and paid $250,000 to OCR.”
  • Cyberscoop reports,
    • “Ukrainian authorities Tuesday [July 22, 2025] arrested the alleged administrator of XSS.is, a Russian-language cybercrime forum, following a four-year investigation by the Paris public prosecutor’s office. 
    • “Law enforcement officials from France and Europol seized the domain of the influential forum following the arrest. Authorities have not named the suspected administrator of XSS.is.
    • “The forum, which was active since 2013, had more than 50,000 registered users and was a key marketplace for stolen data, malware, access to compromised systems and ransomware services, officials said. “It has long been a central platform for some of the most active and dangerous cybercriminal networks, used to coordinate, advertise and recruit,” Europol said in a news release.”
  • Dark Reading alerts us,
    • “A “laptop farmer” [Christina Marie Chapman] in Arizona responsible for enabling North Korean IT worker infiltration into US companies is going to jail for eight and a half years, after raising $17 million in illicit funds for Kim Jong-Un’s regime. That news, however, is merely a drop in the justice bucket, and DPRK’s efforts to siphon salaries off of American companies is unlikely to wane anytime soon. So, US organizations need to wrap their heads around the magnitude of the threat.
    • “North Korea’s multiyear HR-compromise effort has the twin goals of earning money for the hermit kingdom’s nuclear program and other efforts via salaries, as well as gaining a foothold inside corporate networks for the purpose of planting cryptominers or malware for stealing secrets.”
  • Cybersecurity Dive adds,
    • “The U.S. Department of the Treasury on Thursday [July 24, 2025] sanctioned three North Koreans and their company for participating in remote IT worker scams and other operations designed to generate revenue for Pyongyang.
    • The sanctions target the North Korean firm Korea Sobaeksu Trading Co., Sobaeksu employee Kim Se Un, Sobaeksu “IT team leader” Jo Kyong Hun and Kim’s associate Myong Chol Min. 
    • “The Treasury Department calls Sobaeksu a front for North Korea’s Munitions Industry Department, which oversees the country’s nuclear weapons program. North Korea “has previously utilized Sobaeksu to send teams of IT workers overseas, including to Vietnam, in order to generate revenue,” the department said.”

From the cybersecurity defenses front,

  • HelpNet Security explains “Why we must go beyond tooling and CVEs to illuminate security blind spots.”
  • SC Media discusses “exposure management [, which is] a new blueprint for modern cyber defense.
  • Here is a link to Dark Reading’s CISO Corner.

Midweek update

From Washington, DC,

  • Roll Call reports,
    • “Senate Republicans say they are working on a bipartisan health package to lower drug and health insurance costs, a development that’s news to some Democrats who remain skeptical that their GOP colleagues will work with them.
    • “Sen. Bill Cassidy, R-La., is leading the talks, with a particular focus on more transparency from pharmacy benefit managers, so-called upcoding practices in Medicare Advantage and other health items.
    • “A group of Republican senators, including Lisa Murkowski of Alaska, are pushing to extend expiring health insurance subsidies for people who buy their own insurance on the marketplaces.
    • “Republicans are tight-lipped about the package, which is in the very early stages, said Sen. Michael D. Crapo, R-Idaho, who chairs the Senate Finance Committee.
    • “We’re going to have PBM legislation that hopefully will remain bipartisan, and there have been a number of other initiatives. I’m not going to start singling things out,” Crapo said Tuesday. “We are discussing everything that people want to look at as issues,” including Medicare Advantage, a private alternative to traditional Medicare, adding that he was disappointed certain changes weren’t addressed in the reconciliation package.”
  • Healthcare Dive offers more details on Tuesday’s Senate hearing about the Medicare Advantage program.
  • Mercer tells us,
    • “The Affordable Care Act (ACA) benchmark for determining the affordability of employer-sponsored health coverage will increase significantly for the 2026 plan year according to IRS Rev. Proc. 2025-25 — to 9.96% of an employee’s household income up from the 2025 plan-year level of 9.02%. This affordability percentage can affect individuals’ eligibility for federally subsidized coverage from a public exchange, as well as employers’ potential liability for shared-responsibility (or “play or pay”) assessments.” * * *
    • “Employers should review the required employee contribution for 2026 coverage if they plan to meet the ACA’s affordability limit under the applicable safe harbor. For the many plans using the FPL affordability safe harbor, the considerations differ for calendar- and non-calendar-year plans.”
  • Modern Health lets us know,
    • “Medicare may soon test a plan to equalize reimbursements for outpatient services regardless of where the care is provided.
    • “This foray into so-called site-neutral payment would begin next year and focus on physician-administered medications such as chemotherapy drugs. Hospitals would get paid less than they are now for providing those services.
    • “The plan, contained in the Hospital Outpatient Prospective Payment System proposed rule for 2026 that the Centers for Medicare and Medicaid Services issued last Tuesday, reflects growing interest in setting uniform Medicare rates for services across settings.”
  • The American Hospital Association New informs us,
    • The White House July 23 released an action plan with a series of more than 90 policy recommendations to expand the use of artificial intelligence. The plan follows a directive from the administration’s Jan. 23 executive order, “Removing Barriers to American Leadership in Artificial Intelligence.” The policy recommendations are aligned across three pillars — accelerating innovation, building American AI infrastructure, and leading in international diplomacy and security. The action plan recommends the launch of sector-specific efforts, including health care, to convene stakeholders to accelerate the development and adoption of national standards for AI systems. It also calls for testing AI system pilots in real-world settings across health care and other sectors through regulatory sandboxes and AI centers of excellence.
    • Other policy recommendations include removing onerous federal regulations that hinder AI development and deployment; expediting permits for building data centers and semiconductor facilities; expanding AI literacy and skills for education and workforce training; and bolstering critical infrastructure cybersecurity pertaining to AI.
  • and
    • “The Department of Health and Human Services July 23 announced it is recommending the removal of thimerosal from all U.S. flu vaccines. The announcement follows a recommendation last month by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.”

From the Food and Drug Administration front,

  • STAT News reports,
    • “The FDA posted a webpage yesterday allowing drug companies to indicate their interest in participating in a pilot voucher program that aims to cut product review times down to just one to two months. The agency will be choosing five companies in the first round.
    • “The FDA announced last month that it would launch this program to reward companies whose actions align with certain policy priorities, including addressing unmet public health needs, beefing up domestic production of drugs, and delivering more innovative cures.
    • “The webpage states that another “program priority” is increasing affordability, such as lowering drug prices in line with President Trump’s most favored nation policy.
    • “Critics say the voucher program raises concerns that the FDA is injecting politics into drug review decisions that should be centered around science, and that one to two months is not a sufficient amount of time to review new drugs.”
  • Per BioPharma Dive,
    • “Roche is pausing sales of the Duchenne gene therapy Elevidys in some countries outside the U.S. after partner Sarepta Therapeutics agreed Monday to a Food and Drug Administration request to do the same in the U.S.
    • “Roche said Wednesday it is temporarily and voluntarily halting shipments of the treatment in countries that reference the FDA’s approval of Elevidys in their local decision. The Swiss pharmaceutical company markets the gene therapy outside the U.S. under a 2019 alliance with Sarepta and will continue to ship Elevidys in countries that don’t rely on FDA decisions.
    • “The FDA asked Sarepta to stop shipping Elevidys following the deaths from acute liver failure of two teenagers treated with it earlier this year. Both Sarepta and Roche maintain the benefit-risk balance to treatment remains positive in younger patients who can still walk.”
  • Fierce Pharma points out,
    • “Just when the future looked bleak for GSK’s Blenrep comeback in the U.S., the FDA has blessed the company’s multiple myeloma ambitions with a glimmer of hope.
    • “Following last week’s negative feedback from the FDA’s Oncologic Drugs Advisory Committee (ODAC), the agency was scheduled to make the final call on the drug’s use in patients with multiple myeloma who have received at least one prior line of therapy by July 23. 
    • “Now, the FDA has pushed back its decision date to Oct. 23, tacking on extra time to “review additional information provided in support of the application,” GSK announced Wednesday.”
  • The AHA News notes,
    • “The Food and Drug Administration July 22 released an early alert for Novum IQ large volume infusion pumps by Baxter. The company stated that the pump has potential for under infusion when transitioning to a higher flow rate. The FDA said Baxter has reported 79 serious injuries and two deaths associated with the issue as of June 27.”

From the judicial front,

  • Federal News Network reports,
    • “Details of the imminent reductions in force and staffing reorganizations planned across government will remain under wraps after an appeals court blocked a judge’s order for a list of those plans to be released.
    • “The Ninth Circuit Court of Appeals granted the Trump administration’s request for an emergency stay on U.S. District Court Judge Susan Illston’s order for the government’s lawyers turn over the dozens of RIF plans they said are ready for implementation.
    • “The appeals court’s decision means agencies can still move forward with any planned RIFs and staffing reorganizations without needing to divulge that information either to the court or to the public, at least for the time being.”
  • Per Bloomberg Law,
    • “Neurological Surgery Practice of Long Island, PLLC sued the Health and Human Services, Labor, and Treasury departments in April 2023, alleging the agencies failed to establish and enforce procedures to resolve surprise billing disputes as required by Congress under the No Surprises Act. The law requires insurers and doctors to resolve unexpected out-of-network bills through arbitration, rather than billing the patient.”
    • The district court ruled against the provider, and today the U.S. Court of Appeals for the Second Circuit affirmed (Dropbox link) the district court’s ruling (No. 24-1884).

From the public health and medical research front,

  • CBS News reports,
    • “Rich’s Ice Cream is recalling 110,292 cases of frozen dessert products across 23 states due to potential listeria contamination, which can lead to serious illness.
    • The recall, which was first initiated in June, was recently updated to a Class II threat, meaning the product “may cause temporary or medically reversible adverse health consequences,” the U.S. Food and Drug Administration says.
    • “According to federal health officials, the products were distributed to Alabama, Arizona, California, Florida, Georgia, Illinois, Iowa, Louisiana, Massachusetts, Montana, Nebraska, Nevada, New Jersey, New York, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia and Wisconsin. They were also sold in Nassau, Bahamas.” * * *
    • “Customers can visit the Rich’s Ice Cream website for more information on product labels.”
  • The University of Minnesota informs us,
    • “Amid ongoing record post-elimination measles activity in the United States, four states have reported more measles cases, including Colorado, Iowa, New Mexico, and Wyoming.
    • “Meanwhile, in its weekly update, the US Centers for Disease Control and Prevention (CDC) added 10 more cases to the national total, which has now reached 1,319 cases.
    • “In early July, the United States passed its previous post-elimination record of measles cases, and though cases in the West Texas outbreak have declined steadily, smaller outbreaks and travel-linked cases continue to push the nation’s total higher. The surge in US measles activity is part of a global rise in cases made worse by dropping childhood immunization rates.
    • “The CDC said the number of affected states remained at 40, with the number of outbreaks holding at 29. So far, 87% of the nation’s cases are connected to outbreaks and 92% of affected patients are unvaccinated or have unknown vaccination status. Children ages 5 to 19 years old are the most affected age group, followed closely by adults ages 20 and older.”
  • Per STAT News,
    • “The H5N1 bird flu virus has historically extracted a heavy toll when it infects humans, with nearly half of confirmed cases ending in death over the past three decades. But of the 70 cases reported in the United States over the past 18 months, only a single death occurred, leaving experts puzzled at how to explain the phenomenon.
    • “A new study published Wednesday adds weight to an argument that the immunity people have developed to the virus that caused the most recent flu pandemic, an H1N1 virus that emerged in 2009, has induced some cross-protection that may be making it harder for H5N1 to infect people, and mitigating the severity of the ensuing disease when such infections occur.
    • “The paper, published in the journal Science Translational Medicine, reports on a number of studies done in ferrets, the closest animal model for what happens when humans are infected with influenza. It showed that while H5N1 is lethal to ferrets with no immunity to influenza, animals that have previously been infected with influenza A — either H3N2 or H1N1 — appear to have some protection when they are later exposed to the bird flu virus. The protection is particularly strong with H1N1.
    • “Seema Lakdawala, one of the authors of the study, said the findings provide hope that, should H5N1 — long considered a major pandemic threat — acquire the ability to spread easily to and among humans, the resulting pandemic might not be as disastrous as people have feared.”
  • MedPage Today tells us,
    • “A meta-analysis pooled data on dose-response associations between daily steps and a broad range of health outcomes.
    • “Increasing daily step counts above 2,000 was associated with risk reductions in mortality and cardiovascular, cancer, and other outcomes.
    • “A goal of 5,000 to 7,000 steps per day [not 10,000 steps] was deemed appropriate for achieving good health.”
  • HCPLive points out,
    • “A study found no significant differences in IBS symptom severity between gluten, wheat, and sham challenges, questioning the role of these ingredients as triggers.
    • “Despite findings, many patients continued a gluten-free diet, indicating psychological factors may influence symptom perception and dietary choices.”
  • HHS, FDA and USDA discuss their approach to ultra-processed food here.

From the U.S. healthcare business front,

  • Fierce Healthcare reports,
    • “Molina Healthcare is seeing sustained pressure as the insurer released its second quarter financial results.
    • “For the full year, the company anticipates a floor of $16.90 per diluted share and adjusted earnings to be at least $19.00 per diluted share. Earlier this month, the insurer warned medical cost pressures would affect adjusted earnings, lowering its target to $21.50 to $22.50 per share.
    • “Molina’s stock has dipped about 4% in after-hours trading.
    • “The current earnings pressure we are experiencing results from what we believe to be a temporary dislocation between premium rates and medical cost trend which has recently accelerated.,” said CEO and President Joseph Zubretsky in a statement. “We are still performing near our long-term target ranges, and nothing has changed our outlook for the long-term performance of the business.”
    • “Adjusted net income for the quarter is $5.48 per diluted share, similar to its preview from early July, for a decrease of 6% year-over-year.”
  • MedCity New tells us,
    • “Aeroflow Health, a health tech company, has teamed up with Cigna to provide virtual nutrition services to its members nationally, the company announced (Opens in a new window)on Tuesday.
    • “Asheville, North Carolina-based Aeroflow Health was founded in 2001 and offers an array of medical devices covered by insurance. The company has four lines: Aeroflow Breastpumps, Aeroflow Diabetes, Aeroflow Sleep and Aeroflow Urology. In addition to medical devices, it provides education and consultations. The company has partnerships with more than 1,000 insurance plans.
    • “Through the partnership with Cigna, Aeroflow Health will serve Cigna members who would “most benefit from nutrition interventions,” such as new mothers, those with diabetes or those with a chronic disease, according to the announcement. These patients will have access to registered dietitians, who can create personalized meal plans and provide tips to support their goals, such as boosting breast milk production, losing weight, reducing cholesterol or lowering the risk of heart disease.”
  • Healthcare Dive relates,
    • “Tenet Healthcare raised its 2025 financial guidance on Tuesday after releasing second-quarter earnings that showed year-over-year growth in revenue and adjusted earnings before interest, taxes, depreciation and amortization.
    • “The hospital operator now expects between $20.95 billion and $21.25 billion in revenue for 2025 on net income of $1.3 billion to $1.4 billion. Previously, Tenet projected $20.6 billion to $21 billion in revenue and $1.1 billion to $1.2 billion in income.
    • “Still, Tenet declined to answer questions on a Tuesday morning call with investors about the future financial impacts from the recently enacted “One Big Beautiful Bill” and potentially expiring Affordable Care Act exchange premium tax credits. Tenet’s stock declined about 15% by market close on Tuesday.”
  • Per Fierce Healthcare,
    • “Community Health Systems (CHS) shared word that it beat Q2 consensus estimates for both revenue and earnings, as well as news that CEO Tim Hingtgen will retire later this year.
    • “The public for-profit logged net operating revenues of $3.13 billion for the quarter, above the $3.02 billion estimate. That’s a 0.2% dip from the second quarter of 2024 though same-store net operating revenues rose 6.5%, reflecting divestitures the company underwent during the past year.
    • “The revenues outline a 7.4% year-over-year decline in admissions and an 8.3% decline in year-over-year admissions. However, same-store admissions rose by 0.3% while same-store adjusted admission fell by 0.7%.
    • “Net income attributable to stockholders was $282 million ($2.09 per share), as opposed to the $13 million net loss (-$0.10 per share) a year prior. Those decrease to a $0.05 net loss per share for Q2 2025 and $-0.17 net loss per share for Q2 2024 when excluding adjusting items related to early extinguishment of debt and asset sales.”
  • Beckers Hospital Review lets us know how health systems are staying ahead of drug shortages, and
    • “Pfizer and Bristol Myers Squibb have launched a direct-to-patient program offering their blood thinner Eliquis at a 40% discount for cash-paying patients. 
    • “The list price for Eliquis (apixaban) is $606 for a 30-day supply, but through the new program, the discounted price is approximately $242. More than 15 million Americans have prescriptions for Eliquis, according to a July 17 news release from Bristol Myers Squibb.” 
  • Optum, writing in LinkedIn, discusses the connection between AI and Rx benefits.
  • Per a news release, the Institute for Clinical and Economic Review (ICER) has issued its Draft Evidence Report on Treatment for Non-Cystic Fibrosis Bronchiectasis. The public comment period is now open until August 19, 2025; Requests to make oral comment during public meeting also are being accepted.
  • Per BioPharma Dive,
    • “A new biotechnology company debuted Wednesday with a hefty bankroll and an immunotherapy approach it claims has the potential to treat an array of tough-to-reach solid tumors.
    • “Called Dispatch Bio, the startup was formed in 2022 through a collaboration between Arch Venture Partners and the Parker Institute for Cancer Immunotherapy and built around technologies from scientific labs in Pennsylvania and California. It has since raised $216 million and developed a lead program that’s expected to enter clinical testing next year.
    • “Dispatch aims to deliver to cancer cells a sequence for a unique type of protein flag, known as an antigen, that it says can draw in specially engineered immune cells it plans to administer afterwards. The company believes its approach could yield a “universal” solid tumor treatment.”
  • and
    • “Abivax’s shares soared more than 500% on Wednesday after the company released positive Phase 3 results for its experimental ulcerative colitis medicine.
    • “The Paris-based biotech conducted two studies of its drug, obefazimod, in patients with moderately to severely active ulcerative colitis who didn’t receive enough relief from prior therapies. The 50 milligram dose of the medicine achieved a pooled 16.4% placebo-adjusted clinical remission rate at week 8, better than what was reported in Phase 2 testing, Abivax said late Tuesday.
    • “Researchers are now conducting a 44-week maintenance trial that should yield topline results in the second quarter of next year. If those results are also positive, Abivax plans to submit applications to U.S. and European regulators in the second half of 2026.”

Weekend update

From Washington, DC

  • Roll Call discusses expected floor activities this week on Capitol Hill.
  • The House Financial Services and General Government Subcommittee of the House Appropriations Committee will meet on Monday July 21 to mark up its appropriations bill which includes OPM appropriations.
    • The bill includes the following FEHB Program measures
      • Ban on applying full federal cost accounting standards on FEHB and PSHB carriers (Sec. 611).
      • Banning abortion coverage except “where the life of the mother would be endangered if the fetus were carried to term, or the pregnancy is the result of an act of rape or incest. (Sec. 614, also known as the Hyde Amendment).
      • A contraception mandate with certain exceptions (Sec. 726) which has been modified by the Affordable Care Act’s contraception mandate.
      • A new ban for 2026 (Sec. 761) which reads as follows:
        • “None of the funds made available by this Act, or in any previous appropriation, may be provided for in insurance plans in the Federal Employees Health Benefits program to cover the cost of surgical procedures or puberty blockers or hormone therapy for the purpose of gender affirming care.”
  • OPM Director Scott Kupor has begun writing a weekly blog about OPM. Here is a link to his first post which is worth reading. 
  • USA Today reports,
    • “Social Security recipients could get a 2.7% raise next year, up from last month’s estimate of 2.5%, based on the latest inflation report, according to a new estimate.
    • “The Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W), the index used to calculate the annual adjustment to Social Security benefits, gained 2.6% in June. Overall inflation rose 2.7%from May’s 2.4% increase. The Federal Reserve’s inflation goal is 2%.” * * *
    • [However,] Medicare Part B costs are rising several times faster than its average rate of increase in recent years.
    • “According to the 2025 Medicare Trustees annual report released in June [2025], the Medicare Part B premium for 2026, is expected to increase to $206.50 from $185.00 in 2025 for a jump of $21.50 per month, or 11.6%. That’s the largest Part B increase since 2022 when it rose 14.5%.” 
  • MedTech Dive informs us,
    • “A warning letter sent by the Food and Drug Administration to wearable company Whoop has sparked a debate on when wellness claims should be regulated as medical devices.
    • Whoop, a company selling a wearable wristband to track metrics such as sleep, heart rate and strain, received the warning letter on Monday for marketing a blood pressure insights feature without FDA authorization. 
    • “The feature provides daily systolic and diastolic blood pressure estimates by measuring heart rate variability during sleep. Whoop’s website states that the feature is intended to help users track blood pressure trends and have a deeper understanding of how blood pressure affects their wellness. The website also marketed the feature as an example of how Whoop is “delivering medical-grade health & performance insights,” according to the warning letter. 
    • “In a response posted Tuesday, one day after the letter was sent to the company, Whoop said it disagrees with the FDA’s assertion that the blood pressure feature should be reviewed as a medical device before being available in the U.S., claiming it is a wellness feature, not a medical device.
    • “This interpretation is also inconsistent with the 21st Century Cures Act, which clarifies that functions intended to promote a healthy lifestyle — and unrelated to the diagnosis, cure, mitigation, prevention, or treatment of a disease or condition — are excluded from the definition of a medical device,” a Whoop spokesperson wrote in an emailed statement.” 

From the public health and medical research front,

  • The New York Times reports,
    • “Across the United States, an intricate system of hospitals, doctors and nonprofit donation coordinators carries out tens of thousands of lifesaving transplants each year. At every step, it relies on carefully calibrated protocols to protect both donors and recipients.
    • “But in recent years, as the system has pushed to increase transplants, a growing number of patients have endured premature or bungled attempts to retrieve their organs. 
    • “Across the United States, an intricate system of hospitals, doctors and nonprofit donation coordinators carries out tens of thousands of lifesaving transplants each year. At every step, it relies on carefully calibrated protocols to protect both donors and recipients.
    • “But in recent years, as the system has pushed to increase transplants, a growing number of patients have endured premature or bungled attempts to retrieve their organs. 
    • “Circulatory death donation is different. These patients are on life support, often in a coma. Their prognoses are more of a medical judgment call.
  • The FEHBlog certainly will be taking another look at his living will.
  • NPR Shots tells us
    • “After about age 40, our brains begin to lose a step or two.
    • “Each year, our reaction time slows by a few thousandths of a second. We’re also less able to recall items on a shopping list.
    • “Those changes can be signs of a disease, like Alzheimer’s. But usually, they’re not.
    • “Both of those things, memory and processing speed, change with age in a normal group of people,” says Matt Huentelman, a professor at TGen, the Translational Genomics Research Institute, in Phoenix.
    • “Huentelman should know. He helps run MindCrowd, a free online cognitive test that has been taken by more than 700,000 adults.”
    • “About a thousand of those people had test scores indicating that their brain was “exceptional,” meaning they performed like a person 30 years younger on tests of memory and processing speed.
    • “Genetics played a role, of course. But Huentelman and a team of researchers have been focusing on other differences.” * * *
    • “Early results suggest that sleep and maintaining cardiovascular health are a good start. Other measures include avoiding smoking, limiting alcohol and getting plenty of exercise.”
  • New York Times Well lets us know “Want More Self-Control? The Secret Isn’t Willpower. People who can delay gratification and master their impulses thrive in life. And experts say that you can learn skills to rein in bad habits.”
  • The Wall Street Journal reports,
    • “Long contentious, chronic Lyme, as it is called by patient advocates, has gained more acknowledgment and investment by researchers after Covid-19 showcased how an infection can leave people with lingering symptoms that last months or longer. The virus’s aftermath looked strikingly similar to what some Lyme disease patients had been describing for years.
    • * * * “In May, the National Academies of Sciences, Engineering and Medicine published a report saying that research funders should put more emphasis on developing treatments for patients with lingering symptoms after Lyme disease, even as the root cause behind why patients experience the symptoms remains a mystery.” * * *
    • “Some laboratory researchers are investigating what might be behind the symptoms, including whether a molecule that the bacteria left behind could be driving inflammation. Newer trials are now looking at whether certain antibiotics or electrical nerve stimulation might help treat the condition, since persistent infection and immune-system or neural-network dysfunction are also theories doctors have proposed. Prior trials haven’t found a benefit to more antibiotics after initial treatment.
    • “We’re not just focusing on one mechanism but many different possible mechanisms as to why people might have persistent symptoms,” said Dr. Brian Fallon, director of the Lyme and Tick-Borne Disease Research Center at Columbia University and head of the Lyme-focused clinical trial network that launched in 2021. 
    • “Preventing tick bites remains a person’s best defense against Lyme and other tickborne diseases. People should avoid wooded and brushy areas with high grass, walk in the center of trails and cover up extremities, health officials say. Wearing insect repellent, checking your body for ticks and showering soon after being outdoors also help reduce the risk.”
  • Modern Healthcare relates,
    • “People are beginning to trust AI for getting their health information, according to survey data from the Annenberg Public Policy Center of the University of Pennsylvania. Nearly eight out of 10 U.S. adults say they’re likely to look online for the answer to a question about a health symptom or condition. Of who are using AI, 75% say that AI-generated responses provide them with the answer they need. Most Americans (63%) think AI-generated health information is reliable.”