First Edition: Jan. 27, 2023

KHN:
Did Your Health Plan Rip Off Medicare? 

Today, KHN has released details of 90 previously secret government audits that reveal millions of dollars in overpayments to Medicare Advantage health plans for seniors. The audits, which cover billings from 2011 through 2013, are the most recent financial reviews available, even though enrollment in the health plans has exploded over the past decade to over 30 million and is expected to grow further. (Schulte, 1/27)

KHN:
FDA Experts Are Still Puzzled Over Who Should Get Which Covid Shots And When

At a meeting to simplify the nation’s covid vaccination policy, the FDA’s panel of experts could agree on only one thing: Information is woefully lacking about how often different groups of Americans need to be vaccinated. That data gap has contributed to widespread skepticism, undervaccination, and ultimately unnecessary deaths from covid-19. The committee voted unanimously Thursday to support the FDA’s proposal for all vaccine-makers to adopt the same strain of the virus when making changes in their vaccines, and suggested they might meet in May or June to select a strain for the vaccines that would be rolled out this fall. (Allen, 1/27)

KHN:
California’s Resolve Questioned After It Grants Medi-Cal Contract Concessions 

California’s decision last month to cancel the results of a long-planned bidding competition among commercial health plans in its Medicaid program has some industry insiders and consumer advocates wondering whether the state can stand up to insurers and force improvements in care for millions of low-income beneficiaries. In a backroom agreement announced in the final days of 2022, Gov. Gavin Newsom’s administration, facing lawsuits, granted concessions that allowed major insurers to claw back business they would have lost had health officials stuck with the state’s initial contract awards for managed-care plans. Oakland-based Blue Shield of California and St. Louis-based Centene Corp. — which owns Health Net, the largest commercial health plan in Medi-Cal, the state’s version of Medicaid — were among those that had aggressively challenged the initial results. (Wolfson and Young, 1/27)

KHN:
Montana Pharmacists May Get More Power To Prescribe 

Mark Buck, a physician and pharmacist in Helena, Montana, said he’s been seeing more patients turn to urgent care clinics when they run out of medication. Their doctors have retired, moved away, or left the field because they burned out during the covid-19 pandemic, leaving the patients with few options to renew their prescriptions, he said. “Access is where we’re really hurting in this state,” Buck said. (Larson, 1/27)

KHN:
Part I: The State Of The Abortion Debate 50 Years After ‘Roe’ 

The abortion debate has changed dramatically in the seven months since the Supreme Court overturned Roe v. Wade and its nationwide right to abortion. Nearly half the states have banned or restricted the procedure, even though the public, at the ballot box, continues to show support for abortion rights. In this special two-part podcast, taped the week of the 50th anniversary of the Roe decision, an expert panel delves into the fight, the sometimes-unintended side effects, and what each side plans for 2023. (1/26)

NPR:
FDA Committee Votes To Change And Simplify U.S. COVID Vaccination Strategy

A committee of advisers to the Food and Drug Administration voted unanimously on a proposal to simplify the nation’s strategy for vaccinating people against COVID-19. The recommendation is that future COVID-19 vaccines should be interchangeable: no matter whether you’re getting your first dose or a booster, the vaccines would all have the same formulation targeting the same viral strain or strains, regardless of the manufacturer. The vote was unanimous: 21-0. (Hensley, 1/26)

The Washington Post:
FDA Advisers Favor Retiring Original Covid Shot And Using Newer Version

The FDA also sought input from its advisers on several complicated topics, including whether the agency should switch to a once-a-year vaccine schedule that is akin to the annual shot for the influenza vaccine. Many committee members favored simplifying the shot regimen but called for more data to understand whether additional doses should be given to young children who have never been vaccinated along with people who are older and immunocompromised. (Johnson and McGinley, 1/26)

USA Today:
Future Of COVID Boosters: FDA Panel Moves Toward Simplifying Shots

Most of the committee’s discussion was aimed at informing the FDA, rather than providing formal direction. Any changes in vaccine policy will need to be ratified by the FDA commissioner. Implementation of the strategy requires a meeting of a second advisory panel and approval by the director of the Centers for Disease Control and Prevention. (Weintraub, 1/26)

The Atlantic:
The Flu-Ification Of COVID Policy Is Almost Complete

For all the legwork that public-health experts have done over the past few years to quash comparisons between COVID-19 and the flu, there sure seems to be a lot of effort nowadays to equate the two. In an advisory meeting convened earlier today, the FDA signaled its intention to start doling out COVID vaccines just like flu shots: once a year in autumn, for just about everyone, ad infinitum. (Wu, 1/26)

CNBC:
Covid: FDA Pulls Evusheld Because It’s Not Effective Against Subvariants

The Food and Drug Administration on Thursday pulled its authorization for AstraZeneca’s Evusheld, an antibody injection that people with weak immune systems relied on for additional protection against Covid-19. The FDA pulled Evusheld from the market because it is not effective against more than 90% of the Covid subvariants that are currently circulating in the U.S. (Kimball, 1/26)

Stat:
Why The FDA Withdrew Evusheld Authorization

The evolution of the coronavirus has knocked out another treatment. The Food and Drug Administration on Thursday withdrew the authorization of Evusheld, the latest antibody therapy to be rendered ineffective by the mutations the virus has picked up. Notably, Evusheld — unlike other antibody therapies — was not for infected patients, but rather was given as a pre-exposure treatment to people at high risk for severe Covid-19, such as those with compromised immune systems. (Joseph, 1/26)

Stat:
After Nearly 4 Years, FDA Punts On How To Regulate CBD

The FDA is giving up on trying to figure out a way to regulate CBD on its own. The agency announced Thursday that it is formally calling on Congress for help — and, according to one official, looking for guidance on other hemp products like Delta 8 THC, too. (Florko, 1/26)

Roll Call:
FDA Seeks End Of Regulatory Wild West For CBD Products

As part of the announcement, the agency said it was denying three citizen petitions that had asked for FDA rule-making to allow the marketing of CBD products as dietary supplements — an idea that had gained some traction on Capitol Hill. In 2021, Oregon Rep. Kurt Schrader and 45 other Democrats introduced a bill to regulate CBD as a dietary substance. (Cohen, 1/26)

The Washington Post:
FDA To Ease Blood Donation Ban On Gay Men, Allow Monogamous To Give

Gay and bisexual men in monogamous relationships will no longer be forced to abstain from sex to donate blood under federal guidelines to be proposed in coming days, ending a vestige of the earliest days of the AIDS crisis. The planned relaxation of restrictions by the Food and Drug Administration follows years of pressure by blood banks, the American Medical Association and LGBT rights organizations to abandon rules some experts say are outdated, homophobic and ineffective at keeping the nation’s blood supply safe. (McGinley, Amenabar and Nirappil, 1/26)

The Washington Post:
FBI Shuts Down Ransomware Gang That Targeted Schools And Hospitals

The FBI and law enforcement in Europe have shut down a major ransomware operation accused of extorting more than $100 million from organizations across the world by encrypting victims’ computer systems and demanding payments to provide a key to unlock them, U.S. officials said Thursday. Attorney General Merrick Garland said the ransomware group called Hive attacked hospitals, school districts, financial firms and others, stealing and sometimes publishing their data. Like some other prolific groups, Hive partnered with independent hackers who broke in through phishing or other means: The gang provided the encryption program and ransomware negotiations, and split the profits with the hackers. (Menn, Stein and Schaffer, 1/26)

Politico:
Justice Department Disrupts Group Behind Thousands Of Ransomware Attacks 

Justice Department personnel used a court order on Wednesday night to seize two back-end servers belonging to the Hive ransomware group in Los Angeles and took control of the group’s darknet website, Attorney General Merrick Garland said Thursday. Garland, at a press conference in Washington, said Hive was behind attacks in the past two years on a Midwest hospital, which was forced to stop accepting new patients and to pay a ransom to decrypt health data. While Garland did not name the hospital, the Memorial Health System in West Virginia and Ohio was attacked by Hive affiliates at the same time. Hive was also linked to an attack last year on Costa Rica’s public health service. (Miller, 1/26)

The Hill:
McCarthy: ‘We Won’t Touch Medicare Or Social Security’ 

Speaker Kevin McCarthy (R-Calif.) said on Thursday that House Republicans will not target Medicare or Social Security in their negotiations over the debt ceiling. “We won’t touch Medicare or Social Security,” he told Donald Trump Jr. in an interview in the Speaker’s office for Trump’s “Triggered” podcast. (Shapero, 1/26)

CBS News:
After Years Of Denials, VA Urges Millions Of Veterans Exposed To Burn Pits To File Claims

Andrew Myatt was willing to give his life for his country serving in the Army. After 9/11 he was deployed to Iraq, where he performed dangerous missions like searching for improvised explosive devices to disarm and destroy. But the 24-year Army veteran never thought the greatest risk to his health would show up years later. (O’Donnell and Hastey, 1/26)

CNN:
It’s Been Three Years Since The First Covid-19 Case In The United States. What Have We Learned And What More Do We Need To Understand?

It’s been three years since the first Covid-19 case was diagnosed in the United States, on January 20, 2020. In the time since, nearly 1.1 million Americans have died from the coronavirus; the US has reported 102 million Covid cases, more than any other country, according to Johns Hopkins University. Both figures, many health officials believe, are likely to have been undercounted. (Hetter, 1/26)

CIDRAP:
Global COVID Deaths Rise As WHO Emergency Committee Weighs COVID Status

The World Health Organization (WHO) emergency committee will meet [Friday] to assess whether the situation still warrants a public health emergency of international concern (PHEIC) against a backdrop of declining cases—but rising deaths. The WHO’s emergency committees meet every 3 months or more frequently as needed. The group has met 13 times since it recommended a PHEIC for COVID in January 2020, most recently in October. (Schnirring, 1/26)

CIDRAP:
Study: Home COVID Tests Lead To Vast Undercount Of Cases, Positivity Rates

With over 80% of US COVID-19 tests now being conducted at home, official case counts underreport the number of positive results and greatly underestimate the number of true infections, suggests a research letter published yesterday in JAMA Network Open. (Van Beusekom, 1/26)

CIDRAP:
New York To Expand Its Wastewater Surveillance Network

The New York State Department of Health (NYSDOH) announced earlier this week that it has received more than $21 million in funding to expand its wastewater surveillance and infectious disease monitoring capabilities. The $21.6 million in funding, which includes a $6.6 million grant from the Centers for Disease Control and Prevention, will help NYSDOH launch new pilot programs through its Wastewater Surveillance Network to test for influenza, respiratory syncytial virus, hepatitis A, norovirus, and antimicrobial-resistance genes. The number of participating watersheds in the network, which was established in August 2021 to help support the state’s COVID-19 response, will grow from 125 to 215 and cover 81% of the population served by public sewer systems in the state. (Dall, 1/26)

The Boston Globe:
New Coronavirus Waste Water Surveillance Program Reveals Neighborhood Disparities

Earlier this month, the City of Boston began sampling waste water from 11 manholes in as many neighborhoods across the city. The goal is to get a more localized look at how the coronavirus is spreading. What emerged was a picture of glaring, though unsurprising, disparities. (Mohammed, 1/26)

Reuters:
U.S. CDC Still Looking At Potential Stroke Risk From Pfizer Bivalent COVID Shot 

New data from one U.S. Centers for Disease Control and Prevention (CDC) database shows a possible stroke risk link for older adults who received an updated Pfizer/BioNTech COVID-19 booster shot, but the signal is weaker than what the agency had flagged earlier in January, health officials said on Thursday. (Erman, 1/26)

San Francisco Chronicle:
COVID In California: Study Says Long COVID Is Hitting College Campuses

Long COVID is becoming a reality of college life, according to a study published Thursday by researchers at George Washington University. In an analysis of nearly 1,400 cases of COVID-19 among fully vaccinated students, faculty and staff between July 2021 and March 2022, about 36% experienced symptoms that developed four weeks or more after their initial infection. (Vaziri, 1/26)

San Francisco Chronicle:
Judge Who Struck Down California’s COVID Misinformation Law Questions ‘Scientific Consensus’ On Vaccines

The coronavirus is “a disease that scientists have only been studying for a few years, and about which scientific conclusions have been hotly contested,” U.S. District Judge William Shubb of Sacramento said Wednesday in a ruling halting enforcement of the law, which had taken effect this month. “COVID-19 is a quickly evolving area of science that in many aspects eludes consensus.” (Egelko, 1/26)

AP:
Virginia Democrats Defeat Bills Limiting Abortion Access

In a series of key votes Thursday, Virginia Senate Democrats defeated several bills that would have restricted abortion access in the state, including a proposed 15-week ban with exceptions that was a priority for Republican Gov. Glenn Youngkin. They are the first decisive legislative votes in Virginia since the Supreme Court’s decision last year overturning Roe v. Wade. The votes mean that barring an extraordinary procedural move, such restrictions are unlikely to be enacted this year in Virginia, which currently has some of the South’s most permissive abortion laws. (Rankin, 1/27)

AP:
NC Democrats Pitch Abortion Safeguards Despite GOP Majority

North Carolina Democrats, who narrowly held off a Republican supermajority in the General Assembly, have introduced legislation to codify abortion protections into state law as Republicans are discussing early prospects for further restrictions. Their legislation, filed Wednesday in both chambers, would prohibit the state from imposing barriers that might restrict a patient’s ability to choose whether to terminate a pregnancy before fetal viability, which typically falls between 24 and 28 weeks. (Schoenbaum, 1/26)

AP:
SC Abortion Ban Gets Hearing For First Time This Session

A South Carolina Supreme Court decision five days before the General Assembly returned for 2023 raised the possibility that abortion bans could once more dominate legislative debate in the state. That likelihood increased on Thursday when a House subcommittee approved the first abortion ban to get a public hearing in the state this year. (Pollard, 1/26)

Reuters:
Anti-Abortion Protesters Break Into Walgreens AGM Meeting Room

Anti-abortion protesters broke into the room where Walgreens Boots Alliance Inc held its annual shareholders meeting in Newport Coast, California on Thursday for its decision to start selling abortion pills, the pharmacy chain said. (1/26)

AP:
Maternal Deaths And Disparities Increase In Mississippi 

Deaths from pregnancy complications have become more prevalent in Mississippi, and racial disparities in the health of those who give birth have widened in recent years, according to a report released Thursday by the state’s Department of Health. The Mississippi Maternal Mortality Report shows that the maternal mortality rate increased by 8.8% between 2013‐2016 and 2017‐2019, with the latter period being the most recent one analyzed by researchers. (Goldberg, 1/27)

Chicago Tribune:
University Of Chicago Medical School Withdraws From U.S. News Rankings 

University of Chicago’s Pritzker School of Medicine will no longer participate in U.S. News & World Report’s medical school rankings, joining a growing list of institutions rejecting the rankings. Leaders at the Chicago medical school have decided to no longer submit data to U.S. News to help the publication rank the institution. (Schencker, 1/26)

Crain’s Detroit Business:
MyMichigan Medical Center Nurses Vote To Strike

Nurses at MyMichigan Medical Center in Alma are preparing to strike. Of the approximately 150 nurses represented by the Michigan Nurses Association at the mid-Michigan hospital, 97 percent voted in favor of striking, the nurses said in a news release. (Walsh, 1/26)

Stateline:
Some States May Allow Nurses To Do More Without Doctors

When COVID-19 hit the United States in 2020, state policymakers across the country jumped to expand access to health care. They temporarily allowed more telehealth, for example, and made it easier for medical providers to practice across state lines. (Ollove, 1/26)

Modern Healthcare:
Feds Allege Fake Nursing Credentials Scheme In Florida

Federal authorities say they’ve uncovered a conspiracy to provide prospective nurses with bogus diplomas and credentials allowing them to sit for board exams—and care for patients if they managed to pass despite not earning nursing degrees. Three now-closed Florida nursing schools were involved in a scheme that distributed fraudulent credentials to more than 7,600 people, the Justice Department alleges in recently unsealed indictments announced Wednesday. (Berryman, 1/26)

Louisville Courier Journal:
Chiropractic Visit Caused Strokes? Jury Awards $1 Million To KY Woman

Amber Burgess, then 33, had never set foot in a chiropractor’s office when she went to Dr. Adam Fulkerson’s Heartland Family Chiropractic in Elizabethtown on May 18, 2020. In contrast, Becca Barlow, 31, had seen Dr. Leah Wright at Louisville Family Chiropractic 29 times for adjustments over three years when she went there on Jan. 7, 2019, seeking relief for “nursing mother’s neck.” (Wolfson, 1/27)

Stat:
Warren Urges The FTC To Scrutinize Two Pharma Mergers Over “Anti-Competitive” Practices 

In her latest bid to address prescription drug prices, U.S. Sen. Elizabeth Warren (D-Mass.) is urging the U.S. Federal Trade Commission to “closely scrutinize” two pending pharmaceutical company mergers over concerns that “rampant consolidation” will drive up costs for consumers. (Silverman, 1/26)

Reuters:
FDA Identifies Recall Of Emergent’s Decontamination Kits As Most Serious 

The U.S. Food and Drug Administration on Thursday classified the recall of Emergent BioSolutions Inc’s skin decontamination lotion kits as the most serious type. The contract manufacturer began the recall of 3,500 units of the kit in November, after receiving three customer complaints of leakage from the packets. No serious injuries or deaths related to the issue were reported. (1/26)

CIDRAP:
Rates Of Antipsychotic Drug Prescribing For Dementia Climbed During The Pandemic

Rates of antipsychotic drug prescribing among people with dementia increased substantially in six high-income countries during the initial months of the pandemic and remained elevated through 2021, researchers reported yesterday in JAMA Psychiatry. (Dall, 1/26)

The Washington Post:
New Study Finds 6 Ways To Slow Memory Decline And Lower Dementia Risk 

A new study of more than 29,000 older adults has identified six habits — from eating a variety of foods to regularly reading or playing cards — that are linked with a lower risk of dementia and a slower rate of memory decline. Eating a balanced diet, exercising the mind and body regularly, having regular contact with others, and not drinking or smoking — these six “healthy lifestyle factors” were associated with better cognitive outcomes in older adults, in a large Chinese study conducted over a decade and published in the BMJ on Wednesday. (Timsit, 1/26)

AP:
California Prison Inmates To Get Some Medicaid Care

The federal government will allow Medicaid dollars to treat some people in prisons, jails or juvenile detention centers for the first time ever, the Centers for Medicare and Medicaid Services announced Thursday. CMS will allow California inmates to access limited services, including substance use treatment and mental health diagnoses, 90 days before being released. Since Medicaid was established, federal law has prohibited Medicaid money from being used for people who are in custody, with inmates having access to their health care coverage suspended. (Seitz, 1/26)

Los Angeles Times:
Lawsuit Challenges Newsom’s CARE Court Program

A coalition of disability and civil rights advocates filed a lawsuit Thursday asking the California Supreme Court to block the rollout of Gov. Gavin Newsom’s far-reaching new plan to address severe mental illness by compelling treatment for thousands of people. (Wiley, 1/26)

The Washington Post:
Judge Curbs Florida Probe Into U.S. Medicine’s Trans Treatment Standards 

A legal battle over Florida’s ban on Medicaid spending for gender-affirming medical care spilled into Washington on Thursday as a federal judge partially granted an urgent request by 18 American medical and mental health groups to quash subpoenas sent to them by the state after they opposed the prohibition. The professional associations accused Florida of targeting members such as the American Academy of Pediatrics, the American Psychological Association and the Endocrine Society after they expressed the widely accepted medical view that care such as puberty blockers, hormones and gender transition surgery can be appropriate treatment for transgender youth and adults. (Hsu, 1/26)

AP:
1st Legal Medical Marijuana Sales Are Made In Mississippi 

Patients have started buying medical marijuana in Mississippi, nearly a year after the products were legalized in the state. The Mississippi Medical Marijuana Association said in a news release Thursday that the first purchases happened Wednesday at The Cannabis Company in Brookhaven and at two dispensaries in Oxford — Hybrid Relief and Star Buds. (1/26)

AP:
Georgia Agency Approves Rules For Medical Marijuana Sales 

Legal sales of medical marijuana oil could be only months away in Georgia after a state commission approved rules for testing, inspections and sales. The Atlanta Journal-Constitution reports the Georgia Access to Medical Cannabis Commission voted unanimously to approve the rules on Wednesday. (1/26)

Politico:
Social Media Is A Defective Product, Lawsuit Contends

A California court could soon decide whether social media firms need to pay — and change their ways — for the damage they’ve allegedly done to Americans’ mental health. Plaintiffs’ lawyers plan to file a consolidated complaint in the Northern District of California next month, accusing the tech giants of making products that can cause eating disorders, anxiety and depression. (Reader, 1/26)

The New York Times:
How Do Heavy Metals Like Lead Get In Baby Food? 

The Food and Drug Administration’s new plan to keep high levels of lead out of baby foods like mashed sweet potatoes, apple sauce and dry cereal is part of a larger effort to eliminate heavy metals from the foods the youngest children eat. The push follows years of studies by public health, consumer and government experts revealing concerning levels of arsenic in rice cereal and other items fed to infants, including big-name brands like Gerber and organic staples like Earth’s Best. (Jewett, 1/26)