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Monica Bertagnolli, President Biden’s nominee to lead the National Institutes of Health, spent her confirmation hearing Wednesday stuck in the middle of Republicans’ and Democrats’ bickering over her agency’s role in high drug costs, ultimately refusing to commit to either party’s approach. (Owermohle, 10/18)

Bertagnolli hinted at what her priorities will be for the biomedical agency if she is confirmed. At the top of the list is improving the diversity of clinical-trial participants, enhancing collaboration among the NIH’s 27 institutes and centers and restoring public trust in scientists and the agency. (10/19)

The committee plans to vote Oct. 25 on whether to send her nomination to the Senate floor. ... The top job at the NIH has been vacant since December 2021, when long-time director Francis Collins retired. Biden announced plans to nominate Bertagnolli in May, but HELP Committee Chairman Bernie Sanders delayed a hearing because of concerns that the Biden administration was not doing enough to lower the cost of prescription drugs. Sanders, I-Vt., reiterated those concerns during the hearing, noting the high cost of drugs in the U.S. compared to other western nations. (Cohen, 10/18)

Watch as Dr. Monica Bertagnolli, nominee to be director of the National Institutes of Health, testifies at a confirmation hearing before the Senate Health Committee. (10/19)

California Sen. Alex Padilla announced Tuesday that he and three other senators were forming the chamber’s first mental health caucus, a group dedicated to decreasing mental health stigma, improving quality of care and expanding the mental health workforce. (Stein, 10/18)

Senate Finance Committee members from both parties took aim Wednesday at insurance brokers that sell plans for large Medicare Advantage insurers. Older adults at times have more than 100 plan options, and brokers help them choose the right one. But brokers can be incentivized by large insurance companies to aggressively sell plans that are a poor fit for the Medicare beneficiaries they’re supposed to help. (Wilkerson, 10/18)

Medicare Advantage brokers may face tougher restrictions from the Centers for Medicare and Medicaid after a highly critical Senate Finance Committee hearing Wednesday. The hearing, the topic of which was "cracking down on deceptive practices," catalogued a litany of alleged abuses by brokers—from providing false information and harassment to switching people out of plans without consent, all in a bid to boost increasingly opaque compensation from insurers. That includes "add-on" fees for administration. (McAuliff, 10/18)

The fight over drug prices is far from over. Investors in biopharma companies, who lobbied vigorously — but unsuccessfully — against allowing Medicare to negotiate drug prices, are trying a new tactic to preserve their profits. (Weisman, 10/18)

A Medicare proposal to help alleviate major shortages of cancer drugs and other essential medicines could disadvantage facilities serving vulnerable populations and instigate new supply issues, experts and hospital groups say. (Goldman, 10/19)

Medicare beneficiaries have until Dec. 7 to change their Medicare health and prescription drug coverage for the coming year through annual open enrollment. This year, there’s even more reason to pay attention, as financial assistance for prescription drug coverage is set to expand starting Jan. 1, according to Meena Seshamani, director of the Center for Medicare at the Centers for Medicare and Medicaid Services. (Konish, 10/18)

�鶹Ů�� Health News: Health Care ‘Game-Changer’? Feds Boost Care For Homeless Americans 

The Biden administration is making it easier for doctors and nurses to treat homeless people wherever they find them, from creekside encampments to freeway underpasses, marking a fundamental shift in how — and where — health care is delivered. As of Oct. 1, the Centers for Medicare & Medicaid Services began allowing public and private insurers to pay “street medicine” providers for medical services they deliver anyplace homeless people might be staying. (Hart, 10/19)

�鶹Ů�� Health News and Cox Media Group: Under Fire, Social Security Chief Vows ‘Top-To-Bottom’ Review Of Payment Clawbacks 

The head of the Social Security Administration said Wednesday the agency has been sending about 1 million people a year notices that they were paid benefits to which they were not entitled, and she said she has ordered a “top-to-bottom, comprehensive review” of how the agency deals with such overpayments. Kilolo Kijakazi, the acting commissioner, testified at a congressional hearing at which House members faulted the agency for issuing billions of dollars of payments in error and then, often much later, demanding that beneficiaries pay the money back. (Hilzenrath and Fleischer, 10/18)

Pfizer told the pharmacies and clinics that will dispense Paxlovid, in a letter dated Wednesday that was viewed by The Wall Street Journal, that a five-day course of the antiviral will list for $1,390. The U.S. government had paid $529. Health plans will probably pay much less than the list price for the pills, and most patients will have a small or no out-of-pocket cost because Pfizer is expected to offer price discounts and help patients with their out-of-pocket charges. (Rockoff and Hopkins, 19/18)

The U.S. government has halted some efforts to collect an estimated $62 billion in past-due pandemic loans made to small businesses, concluding that aggressive attempts to recover the money — a portion of which may have been lost to fraud — could cost more than simply writing off the debt. The Small Business Administration, which manages the program, adopted the policy in April, prompting the agency’s watchdogs to compute the potential losses in a September report that found the practice “risks” violating federal law. The internal directive since then has sparked an outcry on Capitol Hill, where House Republicans on Wednesday opened an investigation and joined their Senate GOP counterparts in demanding documents from the SBA. (Romm, 10/18)

A new study from Israel ties COVID-19 infection to an increased risk of a diagnosis of Guillain-Barre syndrome (GBS) within 6 weeks, while mRNA vaccination was linked to a decreased risk of the rare but serious autoimmune disease. The study was published today in Neurology. (Van Beusekom, 10/18)

People with HIV are at increased risk of being reinfected with the virus that causes COVID-19, according to new federal data. Researchers from the Centers for Disease Control and Prevention and the Chicago Department of Public Health followed adult residents in Chicago from their first reported infection from March 2020 through the end of May 2022, according to the report published Wednesday by the CDC. ... About 5% experienced reinfection among more than 453,000 Chicago residents who tested positive for the virus. (Kekatos, 10/189

It’s fall in the Northern Hemisphere, and the weather is getting cooler. Many people have cold-like symptoms, and some may have tested positive for Covid-19, influenza or the respiratory syncytial virus (RSV). With winter on the way and viral infections increasing, a lot of people may wonder how long they will be contagious after infection and how long they should take precautions and avoid contact with others. (Hetter, 10/18)

Amazon will soon make prescription drugs fall from the sky when the e-commerce giant becomes the latest company to test drone deliveries for medications. The company said Wednesday that customers in College Station, Texas, can now get prescriptions delivered by a drone within an hour of placing their order. The drone, programed to fly from a delivery center with a secure pharmacy, will travel to the customer’s address, descend to a height of about four meters — or 13 feet — and drop a padded package. (Murphy and Hadero, 10/18)

The branches set to be shuttered were detailed in a filing on Tuesday in bankruptcy court in New Jersey. The store closings are meant to help Rite Aid save money on rent and improve its financial footing. Rite Aid stores in Pennsylvania, California and New York will take the brunt of the closures. About 40 locations in Pennsylvania will be shut. More closings are expected as the company works to rid itself of billions of dollars in debt. It has about 45,000 employees, including 6,100 pharmacists. (Young, 10/19)

Rite Aid lost more than $1 billion in the months before it filed for bankruptcy, the failed drugstore chain revealed in a Wednesday regulatory filing, as it warned investors it may not be able to keep its business running. The warning, which came three days after Rite Aid filed for bankruptcy protection, was contained in a late quarterly filing that showed the company racked up more losses in the 13 weeks ending Sept. 2 than it did during its entire previous fiscal year. (Fonrouge, 10/18)

The federal trial judge overseeing a four-year-old multidistrict litigation over Merck’s Zostavax shingles vaccine decided in March 2022 that it was time for plaintiffs to put up or shut up. The judge, U.S. District Judge Harvey Bartle of Philadelphia, had already granted summary judgment to Merck (MRK.N) in five bellwether cases by plaintiffs who claimed that the Zostavax vaccine caused them to develop shingles instead of protecting them from the virus. Bartle ruled that the bellwether plaintiffs’ expert failed to offer scientifically reliable evidence that their illness was specifically triggered by Merck’s vaccine and not instead linked to the far more common strain of virus that lingers in the nerve cells of people who have had chicken pox. (Frankel, 10/18)

Meta founder Mark Zuckerberg and his wife, pediatrician and philanthropist Priscilla Chan, announced on Wednesday plans to invest $250 million over 10 years to establish a new “biohub” in New York City focused on building a new class of cellular machines that can surveil the body and snuff out disease. (Mast, 10/18)

Treatments like Ozempic, Wegovy, and Mounjaro have been hailed for showing 15% to over 20% weight loss in trials, but those are just averages. In reality, there are big variations in how much weight people lose on the therapies, and it’s unclear what explains those differences. One way researchers are trying to figure this out is by focusing on genes. (Chen, 10/18)

There’s a specter haunting Wall Street. It started in biotech, where companies making drugs for the obesity-related liver disease NASH saw their valuations crash on the assumption that GLP-1 weight loss treatments would cut them out of the market. Then the Ozempic panic came for dialysis firms, whose stocks fell about 20% in a single day on the news that Novo Nordisk’s medicine had delayed the progression of kidney disease in a study enrolling people with type 2 diabetes. (Garde, 10/18)

You’ve seen the Jardiance commercial. The one where Deanna Colón sings about lowering your A1C — but she also has a lot to say about her trolls. ... “You really get how hated and despised overweight people are if you check out the comments under my Jardiance video” on YouTube, she says. (Andrews, 10/18)

Research by Penn Medicine and Independence Blue Cross has found that a new model for providing and paying for mental health services at primary care practices doesn’t increase overall costs for insurers. The two institutions have been studying a new billing code created to help health-care providers address mental health issues since 2018. Their work previously showed that linking primary care and mental health services increased the number of patients receiving needed behavioral health care and led to mental health improvements. Researchers have long found strong ties between physical and mental health. (Brubaker, 10/18)

Henry Ford Health and Ascension Michigan plan to form a combined $10.5 billion health system with 13 hospitals in the Detroit area, the nonprofit health systems said Wednesday. Detroit-based Henry Ford and the Michigan division of St. Louis-based Ascension described the agreement as a joint venture, although the eight Ascension Michigan acute-care hospitals and an addiction treatment center involved in the no-cash deal would be rebranded as Henry Ford facilities and run by Henry Ford president and CEO Robert Riney. (Kacik, 10/18)

Laurie Glimcher trained at Massachusetts General Hospital. Her father was the chair of orthopedic surgery there, and her son is currently a thoracic surgeon at the hospital. But Glimcher, the CEO of the neighboring Dana-Farber Cancer Institute, has no qualms about the contentious decision to sever a 30-year partnership with Massachusetts General’s parent organization. (DeAngelis, 10/18)

Walgreens-backed VillageMD is adding leadership roles to oversee its Village Medical, Summit Health and CityMD operations. The executive appointments come as Walgreens sees VillageMD as a main growth engine for the company. Dr. Rishi Sikka, formerly president of system enterprises at Sacramento, California-based Sutter Health, was named president of Village Medical, which offers primary care services at its clinics and via telehealth. (Hudson, 10/18)

Cleveland Clinic is once again in the spotlight for its limited investments in the community. The Clinic is one of 12 major nonprofit hospitals that dedicated less than 2% of their total revenue to charity care in 2021, the U.S. Senate Committee on Health, Education, Labor and Pensions recently found. (Allard, 10/18)

Brentwood, Tenn.-based Quorum Health acknowledged that it failed to provide compliance reports to the state of North Carolina for shuttered Martin General Hospital for five years, local news outlet WITN reported Oct. 18.The Williamston, N.C.-based hospital closed Aug. 3 due to financial challenges. Quorum Health owns Williamston Hospital Corp., which operated Martin General. The revelations came about after an investigation from North Carolina Attorney General Josh Stein.(Schwartz, 10/18)

Washington hospitals are looking to take their state’s Department of Health to court over a September notice requiring certain providers to offer charity care to poor patients regardless of where in the world they live. (Muoio, 10/18)

Employers across the country are using price transparency data to tweak health plan benefits and push legislation to pressure hospitals to lower prices. Historically, employers have been reluctant to limit employees’ choice by cutting inefficient healthcare providers from their health plan networks. But that sentiment has changed as employers continue to see costs rise. (Kacik, 10/18)

Ryan Sheedy, the parent of a child with a rare genetic mutation, became fed up and fatigued by filling out repetitive forms for each new specialist's office. So, he built an app. (Sparkman, 10/18)

Lack of child care can limit employment opportunities for many parents, which also affects the overall workforce. The situation is especially troubling for industries like healthcare already struggling to find qualified staff. Community Hospital in Grand Junction, Colorado, addressed the problem head-on by opening its own early childhood education center on the campus. Tawny Espinoza, chief development officer at the hospital, explains how leadership got it done. (10/18)

Artificial intelligence (AI) is slowly making its way into many professions, from personal training to marketing. It shows special promise in health care, but experts say buy-in from nurses and other clinical professionals is key. While AI has the potential to make work easier in many ways, many in health care — and other industries — worry about being replaced by the latest technology. But a recent article from Med Page Today argues that the risk to job security is far outweighed by the potential benefits of AI, and encouraged nurses to embrace the coming changes. (Williams, 10/18)

Saying that notices sent by the state “border on incomprehensible,” attorneys for Medicaid beneficiaries fired back this week in a potential class-action lawsuit alleging Florida has not provided adequate information before dropping people from the health care program. (Saunders, 10/18)

North Carolina’s six local behavioral health management companies — known as LME-MCOs — will see some significant restructuring soon. For years, patients, their families and mental health advocates have lodged repeated complaints about the lack of services some of the LME-MCOs provide and about the difficulty people have navigating the mental health system. State lawmakers have also had their share of frustrations with trying to hold the organizations accountable when problems arise. (Knopf, 10/18)

A Mississippi man's religious objections to being forcibly treated with psychiatric medication must be considered first before he can be involuntarily medicated and made to stand trial for threatening a judge, a federal appeals court has concluded. A three-judge panel of the New Orleans-based 5th U.S. Circuit Court of Appeals reached that conclusion in a Tuesday opinion that replaced their own earlier, less-expansive ruling in August in favor Bryant Lamont Harris. (Raymond, 10/18)

L.A. General's locked psychiatric unit has restrained patients at a higher rate than in any other in California, a Times analysis has found. (Poston and Reyes, 10/19)

The $2,000 per month that Anna Hegwer receives from Medicaid to take her 11-year-old daughter on outings and teach her to cook and clean is helping keep her family from its breaking point. Without it, the Parker mom would feel overwhelmed by the stress of trying to figure out how to pay the bills when she can’t take her eyes off her daughter, Chloe, who has an intellectual disability and severe attention deficit disorder. (Brown, 10/17)

“Emerging research is making it clear that artificial turf poses an environmental threat due to its lack of recyclability and presence of toxins such as lead and PFAS,” said state Sen. Ben Allen, the Redondo Beach Democrat who authored the bill. With the new law “local governments will again be able to regulate artificial turf in a way to both protect our environment in the face of drought and climate change but also by preventing further contribution to our recycling challenges and toxic runoff,” he said. (Agrawal, 10/18)

Reports of abuse involving reproductive coercion — actions that prevent someone from making crucial decisions about their body and reproductive health — nearly doubled in the yearlong period after Roe v. Wade was overturned, according to new data from the National Domestic Violence Hotline (NDVH). (Gerson, 10/18)

Illinois Gov. J.B. Pritzker is taking his abortion-rights advocacy nationwide, introducing on Wednesday a political organization to fund similar efforts outside Illinois, a state that legalized abortion by statute even before the Supreme Court invalidated the right to undergo the procedure. Think Big America has already funded support for constitutional amendments favoring abortion access in Ohio, Arizona and Nevada. The effort also enhances the profile of the Democratic governor and multibillionaire equity investor and philanthropist. Pritzker has said he’s focused on serving as a Midwest governor, but speculation is rampant that he harbors presidential ambitions. (O'Connor, 10/18)

The American Cancer Society said women who have one alcoholic drink a day have a seven to 10% increase in risk. If you're up to three drinks a day, the risk jumps to 20% higher. And while cancer prevention guidelines say it's best not to drink alcohol, it's recommended women limit their intake to no more than one drink a day. (Stahl, 10/18)

A breakthrough new test for ovarian cancer may for the first time offer a way to detect the disease before it progresses to potentially deadly later stages. The new blood test was 91% accurate at detecting high-grade serous ovarian carcinoma (HGSOC), which is the most common type of ovarian cancer, according to results published this month in the journal Clinical Cancer Research. HGSOC has a 5-year survival rate of 40% or less when diagnosed at later stages, the authors said, noting that the disease is advanced beyond stage I in about 85% of women at the time of diagnosis. (O'Mary, 10/18)

On TikTok, influencers promise you can beat burnout by planning your life around your menstrual cycle. (Gellman, 10/18)

�鶹Ů�� Health News: Feds Try To Head Off Growing Problem Of Overdoses Among Expectant Mothers 

When Andria Peterson began working as a clinical pharmacist in the pediatric and neonatal intensive care units at St. Rose Dominican Hospital in Henderson, Nevada, in 2009, she witnessed the devastating effects the opioid crisis had on the hospital’s youngest patients. She recalled vividly one baby who stayed in the NICU for 90 days with neonatal abstinence syndrome, a form of withdrawal, because his mother had used substances while pregnant. The mother came in every day, Peterson said. She took three buses to get to the hospital to see her baby. Peterson watched her sing to him some days and read to him on others. (Rodriguez and Houghton, 10/19)

American families on average saw large gains in income and wealth from 2019 to 2022 and households became less fragile during a period marked by the severe disruptions of the COVID-19 pandemic and massive subsequent government spending, a Federal Reserve survey published Wednesday showed. But the income gains were largest among the highest-earning families, and fastest among white families, with income at the median actually registering small declines for both Hispanic and Black families, the Fed found in its latest Survey of Consumer Finances, conducted every three years. (Saphir, 10/18)

A new report published Wednesday in the Journal of Sleep Research found no evidence that using the snooze feature on your alarm negatively impacts sleep and cognitive processes. And while morning drowsiness and shorter sleep were more common in those who snoozed, it could even have benefits if used shortly. The research even found that a brief snooze period could alleviate sleep inertia, the disorientation and performance or mood decline that occurs when waking up, without drastically disturbing sleep. (Robledo, 10/18)

Could a craving for salty chips actually be a sign of addiction? A new study from the University of Michigan suggests that could be the case. Researchers reviewed 281 studies from 36 different countries, finding that 14% of adults and 12% of children showed signs of addiction to ultra-processed foods, according to the Yale Food Addiction Scale (YFAS). That’s close to the addiction levels seen for alcohol and tobacco, noted the study article, which was published in the journal BMJ. (Rudy, 10/19)

Our electronic world is creating a lifetime of patients for orthopedic doctors and optometrists. They even have a name for it called text neck. ... "What you're talking about is hyperflexion of the neck. And if you roll your shoulders in and do that, which a lot of people do with media with the phones, then what can happen is the muscles fatigue, and you start to get that neck and upper back pain." Dr. Muzzonigro says that repetition could cause problems for the discs in the neck and upper back. (Shumway, 10/17)

An outbreak of salmonellosis that sickened people in 12 states during winter 2020-21 has been linked to wild songbirds, researchers reported today in Emerging Infectious Diseases. The outbreak of illness caused by Salmonella enterica serovar Typhimurium was first identified by public health officials in eight people in Oregon and Washington state in February 2021. ... Of the 22 patients interviewed, 14 reported having a bird feeder on their property, 7 had contact with living or dead songbirds in the week before illness onset, 18 had pet dogs, and 7 had pet cats. (Dall, 10/18)

�鶹Ů�� Health News: Suzanne Somers’ Legacy Tainted By Celebrity Medical Misinformation 

Before there was Gwyneth Paltrow or Jenny McCarthy or Dr. Oz, there was Suzanne Somers. Somers, who died from complications of breast cancer Oct. 15 at age 76, pioneered the role of celebrity wellness guru, using her sitcom television fame as a springboard to a second career as a self-professed health and beauty expert. (Szabo, 10/18)

From 2018 to 2022, more Americans aged 51 to 60 years filed private health insurance claims for Lyme disease than any other age-group, according to a new infographic from the nonprofit FAIR Health. The 51-to-60 age-group made up 23.5% of Lyme disease claims, followed by those aged 41 to 50 (18.8%), 31 to 40 (14.1%), 19 to 30 (14.0%), 61 to 70 (13.9%), 0 to 18 (11.3%), and older than 70 (4.3%). (Van Beusekom, 10/17)

Research in the Journal of Internal Medicine indicates that SARS-CoV-2 infections may worsen lower urinary tract symptoms (LUTS) in men, based on 18,000 men treated for LUTS in Hong Kong in 2021 and 2022. (Soucheray, 10/18)

The addition of vancomycin to cefazolin prophylaxis is not superior to placebo for prevention of surgical site infections in patients undergoing arthroplasty, according to a study published in the Oct. 19 issue of the New England Journal of Medicine. ... "In this pragmatic, randomized trial involving adult patients undergoing arthroplasty who had a low prevalence of MRSA colonization, the addition of vancomycin was not superior to surgical antimicrobial prophylaxis with cefazolin," the authors write. (Gotkine, 10/18)

A new study in Emerging Infectious Diseases describes two attempts by researchers to assess how many missed mpox cases were in San Francisco and the United States in general during the 2022 outbreak, while another study in The Journal of Infectious Diseases finds low household transmission of the virus among children. Because mpox is not endemic in the United States and the rash for the virus commonly appears on genitals, the researchers for the first paper hypothesized that clinicians may have misdiagnosed mpox as another sexually transmitted infection, such as herpes simplex virus infection or syphilis, or other conditions, including hand-foot-and-mouth disease, varicella zoster virus infection, and even spider bites. (Soucheray, 10/16)

The Journal of Infectious Diseases has posted a prospective study showing that 40% of a group of college-aged women in Quebec had human papillomavirus (HPV) infections within 2 years of starting a heterosexual relationship. A McGill University-led research team tested vaginal samples from 502 women aged 18 to 24 years self-collected at six university clinic visits over 2 years for 36 types of HPV from 2005 to 2011. The women, who had begun a sexual relationship with a man within the past 6 months, also completed questionnaires on sociodemographic factors and sexual behavior. (Van Beusekom, 10/13)

As doctors, we get a front-row seat to witnessing how high health-care costs, which have been rising across the board for decades, harm our patients. Many Americans know too well how they’ve been impacted by skyrocketing prescription drug costs or rising insurance premiums and deductibles. But another less obvious aspect of health care is also costing patients millions of dollars, both here in the Philadelphia area and across the country. And Congress must act on it. (Max Cooper and Meaghan Reid, 10/19)

The antibiotics crisis is a silent pandemic that threatens to knock modern society back into the medieval age of therapeutic leaches and serum therapy. A world where an accidental scratch in the rose garden can kill. Why is the supply of new antibiotics so thin, and growing thinner? A high-profile Wall Street Journal article recently highlighted what everyone knows: There is huge need but no market demand. (Brian Finrow, 10/18)

In 1994, the 15-year-old Liz Ianelli was sent by her parents to the Family Foundation School in Hancock, N.Y., which claimed to treat her disruptive behavior. But she said her “therapy” for most of the next three years consisted of daily emotional attacks by staff and fellow students, forced labor, food deprivation and other assaults. (Maia Szalavitz, 10/19)

Unless they’re in the top 1 percent, Americans are dying at higher rates than their British counterparts, and if you’re part of the bottom half of income earners, simply being American can cut as much as five years off your life expectancy. (David Wallace-Wells, 10/18)

This year marks the third anniversary of the Commander John Scott Hannon Veterans Mental Health Care Improvement (Hannon) Act, passed in 2020 to broaden mental health care and suicide prevention programs for veterans by building upon the Veterans Affairs Department’s existing mental health services. (Cole Lyle, 10/18)