Friday report
From Washington, DC
- MedCity News offers four takeaways from yesterday’s House of Representatives hearings with health insurance CEOs.
- Everyone agrees healthcare affordability is a problem.
- Everyone has different ideas for addressing the affordability problem.
- Vertical integration [bad per a bipartisan group of members of Congress]
- Prior authorization and denials [bad per a bipartisan group of members of Congress]
- Roll Call adds,
- “The House left Thursday night after barely shooting down another war powers resolution and passing a last slate of funding bills, leaving it up to the Senate to avert a partial government shutdown by next week’s deadline.
- “But with a major winter storm predicted to blanket Washington and other swaths of the country in double digits of snow this weekend, senators are already facing delays that make for tight timing. A spokesman for Senate Majority Leader John Thune, R-S.D., announced Friday that Senate votes originally slated for Monday would be postponed until 5:30 p.m. on Tuesday [due to the impending winter storm].”
- The Wall Street Journal offers the Medicare-eligible community helpful information about Medicare Part B and D’s income adjustment premiums, which are known as IRRMA.
- OPM Director Scott Kupor added to his Secrets of OPM blog with a post about improving claims administration for the complex federal employee retirement systems.
- “Here’s the reality: OPM does not receive a fully completed application and cannot begin its work – on average – for about 120 days from when the applicant starts the application process.
- “So, where are those 107,000 total [online retirement] applications [(ORA)} sitting today?
- Roughly half are at OPM (more on that later), but 30% are sitting with the payroll providers; 12% are sitting with agency HR teams, and 8% are sitting with the applicant.
- That matters, because when cases do reach OPM, we move quickly. We are issuing interim pay immediately in about 75% of cases, and on average within seven days in 100% of cases. That means, on average, within seven days of receiving the application, annuitants will be getting 80% of their expected final post-adjudication payout. Making sure retirees have money in their bank accounts as fast as possible is our first priority, and our performance there is strong.
- And we are also seeing huge dividends from ORA in the time it takes for us to complete the final review of an annuitant’s case and deliver them 100% of their earned pension. As of today, we are completing ORA applications in less than 40 days from when we receive them in OPM. To give you a reference point, it takes at least twice as long for us to adjudicate paper-based cases. So, we are moving in the right direction.
- But we are not complacent with the status quo and will continue to do even better.
- FedWeek reports,
- “The Postal Service has launched a new bid solicitation platform allowing businesses to submit proposals to access its last-mile delivery network, something Postmaster General David Steiner has touted as a key to turning around the service’s finances.
- “Competitive bidding is now open for its 18,000 delivery destination units (DDUs) for same day or next day service, something that had become increasingly likely as contract renewal talks with Amazon stalled late last year – and with Amazon reportedly threatening to directly compete with it own, expanded, fleet.
- “USPS officials said the move responds to growing demand for speed and convenience in the shipping market and to better leverage agency’s last-mile capabilities. Accepted bids are expected to be formalized through negotiated service agreements, with winning bidders notified in the second quarter of 2026 and service beginning in the third quarter.
- ‘The news is bitter sweet for some postal carriers that have been wrestling Amazon packages to their final destinations for years, as any relief could be short lived and potentially result in the same volume but dealing with multiple carriers instead of one.”
- The American Hospital Association News tells us,
- “The Substance Abuse and Mental Health Services Administration has released a guide to improve coordination between 988 lifeline and 911 emergency services. It outlines strategies to reduce legal risk, clarify roles and strengthen partnerships to ensure appropriate care in crisis situations. The guide also includes resources to help achieve interoperability between the services.”
From the Food and Drug Administration front,
- BioPharma Dive reports,
- “Sanofi said Friday it will ask regulators around the world to review its new eczema drug amlitelimab following mixed study results that could lead to a clearance in the U.S. but spell trouble in Europe.
- “A combination of amlitelimab and topical steroids helped between one-quarter and one-third of people with eczema completely or almost completely clear their skin lesions, depending on the dose frequency received and trial they’d participated in. Amlitelimab met all its objectives in one late-stage study. too. But in a second trial, amlitelimab missed a statistical threshold sought by European regulators. A safety study also uncovered one case of a type of skin cancer in a drug recipient.
- ‘The results show amlitelimab is “a U.S. file-able drug that can differentiate on convenience,” Jefferies analyst Michael Leuchten wrote in a note to clients. Sanofi said it intends to move forward with global submissions based on the “totality of the data.”
- MedTech Dive informs us,
- “Integra LifeSciences has recalled wound and burn treatments over issues linked to 14 serious injuries, the Food and Drug Administration said Thursday.
- “The FDA published an early alert after Integra wrote to customers about packaging failures that affected the sterile barrier and could lead to patient infection.
- “Integra wrote to customers last week, around five months after recalling other wound and burn devices because of inadequate sealing of sterile barrier packaging.”
From the judicial front,
- Beckers Payer Issues reports,
- “Jury selection in the federal murder trial of Luigi Mangione is scheduled to begin Sept. 8, U.S. District Judge Margaret Garnett said Jan. 23.
- “The 27-year-old is accused of fatally shooting UnitedHealthcare CEO Brian Thompson outside the New York Hilton Midtown in late 2024. Mangione has pleaded not guilty to four federal charges, including murder through use of a firearm, as well as state murder charges.
- “The next milestone in the federal case will depend on Judge Garnett’s decision on whether Mangione will face the death penalty, which Attorney General Pamela Bondi directed federal prosecutors to pursue in April. If Judge Garnett removes capital punishment as an option, the trial would begin Oct. 13; if she allows the case to proceed as a capital case, the trial would start in early 2027, according to reporting from The Guardian.“
- MedPage Today points out,
- “The American Psychiatric Association (APA) is suing a New York State health plan over its alleged use of “ghost networks” that list mental health providers that are not in their network or aren’t taking new patients.
- “The class action lawsuit, filed on Dec. 30 in federal court against EmblemHealth, alleges that the ghost network directory “constitutes unlawful deceptive acts and practices, false advertising, and violations of statutory and regulatory requirements,” according to an APA press releaseopens in a new tab or window. “It also alleges that their provider directory violates federal trademark law by falsely advertising and misusing the names, identities and reputations of mental health clinicians.”
From the U.S. healthcare and medical / Rx research front,
- The Centers for Disease Control and Prevention announced today,
- “Seasonal influenza activity remains elevated nationally but has decreased for three consecutive weeks. Among children 5–17 years, hospitalizations are stable and emergency department visits are increasing. RSV activity is elevated in many areas of the country. Emergency department visits for RSV are highest among infants under 1 year and children 1-4 years old. RSV hospitalizations are highest among infants less than 1 year old.
- “COVID-19
- COVID-19 activity is elevated in some areas of the country.
- “Influenza
- “Seasonal influenza activity remains elevated nationally but has decreased for three consecutive weeks. Among children 5–17 years, hospitalizations are stable and emergency department visits are increasing. Activity is increasing or stable in the Midwest, Central, and West Coast regions.
- “Additional information about current influenza activity can be found at: Weekly U.S. Influenza Surveillance Report | CDC.
- “RSV
- “RSV activity is elevated in many areas of the country, including emergency department visits among infants under 1 year and children 1-4 years old. Hospitalizations among infants less than 1 year old are elevated.”
- “Vaccination
- “National vaccination coverage for COVID-19, influenza, and RSV vaccines remains suboptimal for children and adults. COVID-19, influenza, and RSV vaccines can provide protection against severe disease this season. It is not too late to get vaccinated this season. Talk to your doctor or trusted healthcare provider about what vaccines are recommended for you and your family.”
- The University of Minnesota’s CIDRAP adds,
- “The South Carolina Department of Public Health (DPH) today confirmed 54 new measles cases in just three days, raising the size of its outbreak, which DPH first reported in October, to 700 cases.
- “The news comes as the Centers for Disease Control and Prevention (CDC) confirmed 416 total US cases so far this month—an increase of 245 infections in the past week—and as US health officials downplay the burgeoning outbreak and the key role that vaccines play in preventing illness.”
- and
- “Routine childhood vaccinations, nor the aluminum used as vaccine adjuvants, are not associated with an increased risk of epilepsy in young children, according to a new case-control study published this week in The Journal of Pediatrics.
- “The study, led by a team from the Marshfield Clinic Research Institute in Marshfield, Wisconsin, examined whether being up to date on recommended vaccines or having higher cumulative exposure to vaccine-related aluminum was linked to the development of epilepsy in children under age four.
- “Analyzing a decade of pediatric health data from the Vaccine Safety Datalink, which is a collaboration between the Centers for Disease Control and Prevention and several health care sites that monitor vaccine safety, the team identified 2,089 children diagnosed as having epilepsy from age 1 year to less than 4 years and matched them with 20,139 children without epilepsy based on age, sex, and health care site.
- “Most participants were boys (54%) and between the ages of 1 year and 23 months (69%). White non-Hispanics composed the largest ethnicity group in the study (40%).”
- STAT News tells us,
- “The number of ongoing prescription drug shortages rose slightly in the last quarter of 2025, but remained significantly lower than the all-time high reached in the beginning of 2024. Moreover, the number of new shortages identified last year marked the lowest level in nearly 20 years, according to a new report from the American Society of Health-System Pharmacists.
- “As last year drew to a close, there were 216 prescription medicines in short supply in the U.S., which was slightly more than earlier in the year, but this was significantly less than the 323 prescription drug shortages recorded in the beginning of 2024, the report found.
- “The number of new shortages identified last year was just 89, the lowest figure since 2006, and considerably less than 130 medicines that were in shortly supply in 2024. And notably, long-standing shortages are beginning to resolve; 75% of all the active shortages started in 2022 or later.”
- Per MedPage Today,
- “People with the lowest serum vitamin D levels were 33% more likely than those with the highest levels to be hospitalized for respiratory tract infections.
- “Researchers found no evidence that the association between vitamin D status and respiratory tract infection risk differed by race or ethnicity.
- “Obesity, being male, older age, statin use, and lower income were all linked to a greater risk of hospitalization for respiratory infections.”
- and
- “Arthritis can be disabling enough to prevent people from working, but the factors influencing employability in this population have not been well studied.
- “This study used data from the long-running Health and Retirement Study to estimate “healthy working life expectancy” (HWLE) for people with arthritis, including major subgroups.
- “HWLE was found to be markedly diminished for people with arthritis, and especially so for arthritis patients not finishing high school, those with obesity, and Black individuals.”
From the U.S. healthcare business front,
- Fierce Pharma reports,
- “With just a few months to go before Eli Lilly expects to launch its own oral GLP-1 obesity drug, Novo Nordisk is making the most of its head start with the Wegovy pill.
- “In the second week of oral Wegovy’s launch, which ended Jan. 16, the pill logged roughly 18,400 total prescriptions, according to IMS data cited in a Friday note from analysts at Jefferies. Other tracking data put the second week of Wegovy pill prescriptions closer to 20,000, the analyst team pointed out.
- “The quick uptake of Novo’s new oral obesity offering is impressive and appears “numerically higher” than both injectable Wegovy (roughly 1,600 prescriptions) and its Lilly counterpart Zepbound (around 7,300 prescriptions) in the first two weeks of their respective launches, the Jefferies team said.”
- The FEHBlog ran across this Health Care Cost Institute website which “shows average price data for bundles of health services to help you better understand the cost of care in your area.” Check it out.
- Fierce Healthcare informs us,
- “CommonSpirit Health and Altru Health System are considering a deal to transfer three North Dakota hospitals to the latter, the organizations announced Thursday.
- “The pair’s signed letter of intent outlines plans to evaluate a potential deal for the facilities, a process they said would run “the next several months” before a potential definitive agreement might be struck.
- “In the balance are CHI St. Alexius Health Bismarck, a multispecialty acute care medical center in the state’s capital, and two smaller critical access hospitals, CHI St. Alexius Health Turtle Lake and CHI St. Alexius Health Garrison. All three are Catholic facilities within CommonSpirit’s regional healthcare system CHI St. Alexius Health.”
- Beckers Hospital Review notes,
- “Newly released data from KFF show there were an average of 422 emergency room visits per 1,000 population nationally in 2024, the most recent year for which data are available. KFF used data from the American Hospital Association’s annual survey of community hospitals — which accounts for 85% of all U.S. hospitals — and population estimates from the Census Bureau to compile ED visits per 100,000 population for every state.
- “ED utilization rose in many states compared to data from 2023. The latest figures offer a preview of where added strain from rising coverage losses and reduced access to preventive care may hit hardest.
- “[The article includes] a state-by-state breakdown of total emergency department visits per 1,000 population in 2024, including the District of Columbia, starting with states where rates are highest.”
- Beckers Health IT lets us know,
- “Walmart is set to open four clinical research sites in spring 2026, including at its former healthcare centers.
- “The Walmart Healthcare Research Institute is launching the facilities in collaboration with clinical research company Care Access at three ex-Walmart Health locations and a rural Walmart store. The sites will offer health screenings and explore study opportunities with patients.
- “Clinical research should feel practical and approachable, not distant or intimidating, especially for communities that have had difficulty participating in opportunities for innovative treatments,” Walmart Chief Medical Officer Emily Aaronson, MD, said in a Jan. 22 news release.”
