�鶹Ů��

Private insurers often require a cumbersome review process that frequently results in the denial or delay of essential treatments that are readily covered by traditional Medicare. ... The Centers for Medicare and Medicaid Services plans to begin a pilot program that would involve a similar review process for traditional Medicare, the federal insurance program for people 65 and older as well as for many younger people with disabilities. The pilot would start in six states next year, including Oklahoma, where Ms. Ayres lives. (Abelson and Rosenbluth, 8/28)

But the most controversial part of the program is how the government will make decisions on what is and isn't covered. The program contracts private AI firms to review cases, which, experts say, could lead to inappropriate denials. The AI firms have an incentive to say "no" to coverage because of the direct payments they make for each denial. Health experts worry it could lead to many patients being denied services they are legally entitled to. (Lu, 8/29)

Payers and providers are on the clock to comply with federal interoperability rules designed to streamline prior authorization. In June 2024, the Centers for Medicare and Medicaid Services finalized a regulation that set prior authorization transparency requirements and sped up mandatory reporting timelines for government-sponsored health plans. The rule kicks in on Jan. 1, with additional deadlines in January 2027, when the industry will need to stand up infrastructure that facilitates seamless data exchange between payers, providers and patients. (Early, 8/29)

Tens of thousands of retirees could learn that their current health care plan will no longer be available in Maryland this fall, as major insurance providers consider ending their Medicare Advantage plans for next year. About 25% of Maryland Medicare recipients use a supplemental Medicare care program that helps low-income retirees use a private insurer for health coverage that often provides additional services such as vision, dental and transportation assistance. (Brown, 9/1)

When city of Charlotte workers get sick, they don’t have to wait weeks for a primary care appointment or shell out a co-pay for an urgent care visit. Instead, they can often be seen on the same day, at no charge, at one of six local clinics run by Marathon Health. (Crouch, 9/2)

�鶹Ů�� Health News: When Hospitals And Insurers Fight, Patients Get Caught In The Middle

Amy Frank said it took 17 hours on the phone over nearly three weeks, bouncing between her insurer and her local hospital system, to make sure her plan would cover her husband’s post-surgery care. Many of her calls never got past the hold music. When they did, the hospital told her to call her insurer. The insurer told her to have the hospital fax a form to a special number. The hospital responded that they’d been instructed to send faxes to a different number. “It was just a big loophole we were caught in, going around and around,” Frank said. (Sable-Smith, 9/2)

Jacalyn Stuff was nearing the end of her first trimester when doctors at UK St. Claire Regional Medical Center delivered shattering news: her twins were in danger. Then came a second blow: Those doctors — the ones she had come to know and trust, the ones less than 10 minutes from her home — could no longer treat her. During the following 10 weeks, Jacalyn — then 19 — had to travel repeatedly to hospitals able to provide more advanced maternity care. Appointments at the one 70 miles away in Lexington required $30 for a tank of gas. Appointments at the one 100 miles away in Cincinnati required gas and a hotel stay. And they all required Jacalyn either to bring her infant son or to find a babysitter. (Abutaleb, 9/1)

The Holland Food Shelf announced Tuesday it would close its doors the last week of September, citing the loss of federal nutrition assistance funds and high rent costs as major factors in the decision. “We can’t do it without funding,” said Don Stevens, executive director of the pantry’s nonprofit operator, Abenaki Helping Abenaki, and chief of the Nulhegan band of the Coosuk Abenaki Nation. “It’s not just us, right?” he added, referencing Vermont Foodbank’s recent cuts in addition to other struggles in the state’s food assistance network. (Wells-Spackman, 8/29)

Connecticut’s health care leaders and state officials have been warning for months about the potentially devastating impacts of President Donald J. Trump’s One Big Beautiful Bill Act on access to care for millions of Americans. Nearly two months after the law’s passage, hospital executives here say there are critical details still unknown that make it difficult to determine exactly how it will impact providers and patients. (Golvala, 9/2)

�鶹Ů�� Health News: Social Security Praises Its New Chatbot. Ex-Officials Say It Was Tested But Shelved Under Biden

John McGing couldn’t reach a human. That might be business-as-usual in this economy, but it wasn’t business; he had called the Social Security Administration, where the questions often aren’t generic and the callers tend to be older, disabled, or otherwise vulnerable Americans. McGing, calling on behalf of his son, had an in-the-weeds question: how to prevent overpayments that the federal government might later claw back. His call was intercepted by an artificial intelligence-powered chatbot. (Tahir, 9/2)

Duane Johnson starts his route about 8 a.m., driving through mountain roads, some gravel and single-lane, bringing frozen meals to aging farmers, coal miners, veterans and teachers who are homebound. Most live alone. One woman in her 80s told him he was the first human she had seen in two weeks. “I become friends with most of them,” he says. Johnson works for Mountain Empire Older Citizens, a nonprofit organization that began 51 years ago with three people who organized a meal-delivery program in the Appalachian Mountains of southwest Virginia. Its mission then, as now, was to help older adults live independently. (Ansberry, 9/1)

President Trump on Monday urged pharmaceutical companies to publicly prove that their Covid-19 products work, saying in a Truth Social post that the Centers for Disease Control and Prevention is “being ripped apart over this question.” “I want the answer, and I want it NOW,” he wrote in what appeared to be his first public acknowledgement of recent tumult at the CDC. (Payne and Herper, 9/1)

On Thursday, the Trump administration selected Jim O’Neill, a former biotechnology executive and the deputy to Health Secretary Robert F. Kennedy Jr., to serve as the acting director of the Centers for Disease Control and Prevention. The pick leaves the nation’s premier public health agency under the leadership of an official without medical or scientific training, and seems likely to tighten political control of the agency, critics in Congress said. (Anthes, 8/29)

�鶹Ů�� Health News: Senior CDC Officials Resign After Monarez's Ouster, Citing Concerns Over Scientific Independence

Four senior officials with the Centers for Disease Control and Prevention announced their resignations in recent days, citing what they described as growing political interference in the agency’s scientific work, particularly regarding vaccines. Two of them — Debra Houry, the CDC’s chief science and medical officer, and Demetre Daskalakis, who led the National Center for Immunization and Respiratory Diseases — stepped down on Aug. 27, hours after the White House announced the firing of CDC Director Susan Monarez. (Gounder, 8/29)

“I only see harm coming,” said Demetre Daskalakis in an interview that aired Sunday about his departure from the Centers for Disease Control and Prevention. Speaking to host Martha Raddatz on ABC’s “This Week,” Daskalakis discussed his resignation as director of the National Center for Immunization and Respiratory Diseases, which came after the ouster last week of CDC Director Susan Monarez, a Trump appointee who came in to conflict with Health and Human Services Secretary Robert F. Kennedy Jr. on vaccinations. Three other top health officials also resigned. (Cohen, 8/31)

Health and Human Services Secretary Robert F. Kennedy Jr.’s leadership is “unlike anything our country has ever experienced,” nine former directors and acting directors of the Centers for Disease Control and Prevention wrote in a scathing guest essay Monday for The New York Times. The piece — which appeared online under the headline “We Ran the C.D.C.: Kennedy Is Endangering Every American’s Health” — came days after President Donald Trump fired CDC director Susan Monarez. (Gomez, 9/1)

The Centers for Disease Control and Prevention told staff it expects them to return to offices by Sept. 15, roughly five weeks after a gunman’s deadly attack on the agency’s headquarters in Atlanta, CNBC has learned. “Your safety remains our top priority. We are taking necessary steps to restore our workplace and will return to regular on-site operations no later than Monday, September 15,” Lynda Chapman, the agency’s new chief operating officer, said in an email sent Thursday that was viewed by CNBC. (Constantino, 8/30)

In interviews, about two dozen C.D.C. employees said that the mood inside the agency was bleak. Some blamed Mr. Kennedy for what they felt was a campaign waged against science. Others said they were terrified for the future of the C.D.C. and the nation’s health. Some said they were in shock. All spoke on condition of anonymity for fear of retaliation. “We’re scared for ourselves and for the country,” one said. At one small group meeting Thursday morning, two people broke down in tears, according to an employee who was present. At another meeting, a senior leader who has always stayed calm under pressure was visibly shaking, another scientist said. (Mandavilli, 8/28)

The most powerful lobbying group for America’s doctors has a big decision to make: Go to war with Health Secretary Robert F. Kennedy Jr. or try to work with him. For many members of the American Medical Association, publicly opposing Kennedy feels right. It means defending public health against policies — from changes to vaccine guidance to cuts to Medicaid — they see as dire threats. But it could come at a big cost if Republicans decide to overhaul how doctors are paid, as Kennedy has said he wants to do. (Levien, 8/30)

�鶹Ů�� Health News: Watch: How Concerns Of CDC Scientists Over Political Interference Have Grown This Year

CNN’s Erica Hill spoke with �鶹Ů�� Health News correspondent Amy Maxmen about leadership changes at the Centers for Disease Control and Prevention. Maxmen noted that turmoil at the CDC has been occurring since early in the Trump administration. She recently explored these issues in her article “As Measles Exploded, Officials in Texas Looked to CDC Scientists. Under Trump, No One Answered.” (Maxmen, 8/29)

The Centers for Disease Control and Prevention (CDC) has posted the agenda for the upcoming meeting of its Advisory Committee on Immunization Practices (ACIP). The ACIP meeting, to be held on September 18 and 19 at CDC headquarters in Atlanta, will include discussions and possible votes on recommendations for COVID-19 vaccines; hepatitis B vaccine; measles, mumps, rubella, and varicella (MMRV) vaccine; and respiratory syncytial virus. The ACIP will also provide updates on its work groups. (Dall, 8/28)

CVS and Walgreens are now requiring a prescription or are not offering COVID-19 vaccines in some states as the companies attempt to follow state guidelines that require approvals from the Centers for Disease Control and Prevention. The Food and Drug Administration has approved vaccines from Pfizer, Moderna and Novavax for all seniors, but only for younger adults and children with health conditions. In a statement, CVS said the pharmacy chain cannot vaccinate those even with a prescription in Massachusetts, Nevada and New Mexico due to state laws and regulations. (Frazier, 8/29)

This year’s updated Covid-19 vaccines have been approved by the US Food and Drug Administration for adults 65 and older and younger people with certain medical conditions that put them at a higher risk of a severe Covid-19 infection. (Howard, 8/31)

Patients are inundating some New York City medical practices with messages that they are experiencing Covid symptoms amid a late-summer surge of coronavirus infections and the appearance of a new variant. At the same time, patients are peppering medical providers with questions about whether they qualify to receive a coronavirus vaccine after the Food and Drug Administration released new vaccine restrictions. (Latson, 8/29)

�鶹Ů�� Health News: Listen: As Kids Head Back To School, Parents Sort Out Confusion Over Vaccine Access

Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist, replaced the members of a federal vaccine advisory committee in June. The committee plays an important role in recommending vaccines, and its guidance influences the coverage decisions insurance companies make. (Fortiér, 9/2)

Data on US COVID-19 activity continue to reflect low but increasing levels of illness, with activity increasing in most parts of the country, the US Centers for Disease Control and Prevention (CDC) said today in its latest update. The agency said the epidemic trend for the disease is growing in 16 states and likely growing in 14 others, plus in Washington, DC. (Wappes, 8/29)

Years lived with disability (YLDs) may be an early indicator of long-COVID risk, especially in low-resource communities where persistent symptoms are underreported, per data collected from the height of the pandemic. (Van Beusekom, 8/27)

When Congress returns to Washington on Tuesday, lawmakers will have around four weeks to fund the government and avoid a shutdown. It’s still unclear how — or whether — they’ll pull it off. Most congressional leaders acknowledge they’ll probably need to pass a short-term funding extension, known as a continuing resolution, given the time crunch. Government funding expires at the end of the day on Sept. 30, and much of the government would close without action. Congress may struggle to pass even a stopgap fix, though. (Beggin, Meyer and Bogage, 9/2)

President Donald Trump asked Congress to claw back nearly $5 billion in already-approved foreign aid spending, a proposal timed to take advantage of the looming end of the fiscal year and allowing him to cut the funding himself if lawmakers fail to act by the close of September. The maneuver challenges Congress’ spending powers and intensifies an already contentious battle over government funding, which is due to lapse Sept. 30. (Korte, 8/29)

A federal appeals court ruled that a fast-moving fight over the Trump administration’s effort to block billions of dollars in foreign assistance approved by Congress can move forward as a large chunk of funds are set to expire. The US Court of Appeals for the DC Circuit took action on Thursday evening to send the case back to a Washington judge to consider whether to halt the funding freeze on new legal grounds before the end of the fiscal year on Sept. 30. (Tillman, 8/29)

Advocates worry that the founder of a private equity firm tied to one of the nation's largest hospital bankruptcies could affect the U.S. military health system in his new Pentagon role. As deputy secretary of defense, Steve Feinberg brings no military experience but deep private-equity ties to a position overseeing care for millions of service members and their families. (McCreary, 9/1)

A group of former employees is suing the Nevada Department of Veterans Services (NDVS), alleging that the agency and multiple officials engaged in retaliatory behavior and endangered the safety of residents at a state-run veterans nursing home in Southern Nevada. The lawsuit filed earlier this year in Clark County, alleges that leaders at NDVS and at the nursing home engaged in “sham” investigations against workers that eventually led to their unlawful termination. (Neugeboren, 8/29)

A class of drugs called beta-blockers — used for decades as a first-line treatment after a heart attack— doesn’t benefit the vast majority of patients and may contribute to a higher risk of hospitalization and death in some women but not in men, according to groundbreaking new research. (LaMotte, 8/30)

A silent heart disease risk factor may explain why some women end up having heart attacks and strokes despite seeming like they are healthy, a new study suggests. The analysis of 30 years of data from more than 12,000 women revealed that inflammation was comparable to high LDL cholesterol as a heart disease risk factor, researchers reported Friday at the European Society of Cardiology Congress meeting in Madrid. The results were simultaneously published in the European Heart Journal. (Carroll, 8/30)

A new global systematic literature review and meta-analysis shows that shingles vaccination is associated with a statistically significant lower risk of heart attack and stroke, according to a study presented today at the 2025 European Society of Cardiology Congress. The study is based on 19 studies, and the final analysis included eight observational studies and one randomized controlled trial. Across all nine studies, 53.3% of participants were male. (Soucheray, 8/28)

Beetroot juice, which is rich in nitrates, has been linked to changing the community of bacteria living in the mouth. Now, a new study has found that drinking this juice could reduce older adults’ blood pressure. Researchers at the University of Exeter compared the response of both younger and older participants to the juice and published the study in Free Radical Biology and Medicine. (DiMella, 9/1)

It’s one of the most insidious diseases you’ve never heard of, but Chagas is here in California and 29 other states across the U.S. It kills more people in Latin America than malaria each year, and researchers think roughly 300,000 people in the U.S. currently have it but are unaware. That’s because the illness tends to lie dormant for years, making itself known only when its victim keels over via heart attack, stroke or death. (Rust, 9/1)

Novo Nordisk said its blockbuster Wegovy weight-loss drug cuts the risk of heart attack, stroke or death by 57% compared with Eli Lilly’s Mounjaro and Zepbound. The Danish pharmaceutical giant said Sunday that the study suggests the heart-protective benefits of semaglutide—the active ingredient in Wegovy—may not be the same for all GLP-1 drugs such as tirzepatide, which is the active ingredient in Lilly’s Mounjaro and Zepbound. (Chopping, 9/1)

Eli Lilly & Co is partnering with Chinese online healthcare platform JD Health International Inc. to sell its blockbuster drugs for obesity and diabetes online, following in competitors’ footsteps to drive sales through direct-to-consumer channels. The tie-up will ease access to Lilly’s drugs treating obesity, diabetes and alopecia through a one-stop service via JD Health’s platform that combines consultations, prescriptions all the way to the drug delivery and subsequent follow-ups, according to an official statement from Lilly’s official WeChat account on Friday. (Tong, 8/29)

Roughly 40 percent of adult Americans are considered obese, and weight-loss drugs have come to play a central role in medical treatment over the past few years. As of the spring of 2024, one in eight U.S. adults had taken drugs including Wegovy, Zepbound, or Ozempic, among others, for weight loss. These products belong to a class of drugs known as glucagon-like peptide-1 agonists, or GLP-1s, which can be remarkably effective, but when patients go off GLP-1s, weight rebound occurs. And as it turns out, a relatively large portion of patients discontinue these medications within one year. (Cohen, 9/1)

President Donald Trump’s administration this week told 40 states to eliminate parts of lessons that focus on LGBTQ+ issues from federally funded sexual education materials or that they will lose funding. The move is the latest in a line of efforts since Trump returned to the White House in January to recognize people as only male or female and to eliminate what he calls “gender ideology.” “Federal funds will not be used to poison the minds of the next generation or advance dangerous ideological agendas,” Acting Assistant Health and Human Service Secretary Andrew Gradison said in a statement. (Mulvihill, 8/29)

In recent years, authorities in numerous states have reported people falsely claiming to be licensed nurses or working in positions that require a nursing license without valid credentials. Some regulatory bodies use the term “impostor nurse” to refer to these individuals and maintain “impostor lists” to try to prevent them from working in other states. The extent of the problem is not clear because there is no centralized database tracking reports of fake nurses. But state lists hint at the scale. (Timsit, 8/28)

Dartmouth Hitchcock Medical Center has begun another multimillion-dollar expansion of its five-story patient pavilion. The expansion is set to double the 64 beds currently in use in that section of the hospital, Tom Manion, Dartmouth Hitchcock Medical Center’s chief operating officer, said in a Thursday video interview. (Dunford, 8/29)

Gov. Matt Meyer vetoed a bill Thursday that would have loosened regulations around where marijuana businesses can locate in Delaware, likely further delaying the growth of the weeks-old industry. But the governor also offered a competing proposal on such zoning reforms, based upon revenue-sharing from marijuana sales with counties and municipalities – opening a new salvo in a contentious relationship with statehouse Democrats. (Owens, 8/29)

Florida has moved to allow limited veterinary use of a sedative frequently added to fentanyl. Attorney General James Uthmeier on Wednesday announced a filing to reclassify xylazine under state law to ensure the veterinary and agriculture industries can continue to access the drug for animal care. (9/1)

An effort is being launched in Florida to enhance the relationship between law enforcement and people with autism. Sandra Worth, founder and executive director of My Autism Connection, is collaborating with the Florida Sheriffs Association to implement an autism identification program. For Worth, the initiative hits close to home. (Andarge, 8/29)

A woman unexpectedly went into labor at the desert festival. Within minutes, a neonatal nurse, an OB-GYN, a pediatric doctor and other attendees filled her camper. (Petri, 8/29)

Two people have died from eating raw oysters that were contaminated with a flesh-eating bacteria, Louisiana health officials said. Vibrio vulnificus is a bacteria that occurs in warm coastal waters. It is more common between May and October. The bacteria can cause illness when an open wound is exposed to contaminated waters, or when a person eats raw or undercooked seafood. Oysters are particularly risky, state health officials said in a July news release. (Breen, 8/29)

The US Centers for Disease Control and Prevention (CDC) yesterday announced a Salmonella Enteritidis outbreak linked to eggs that are subject to a recall. The outbreak bacterium has sickened at least 95 people in 18 states. Illness onsets range from January 7 to July 26. So far, 18 people have been hospitalized, with no deaths reported. State investigations found four subclusters tied to restaurants. Epidemiologic and trace-back data found that large brown cage-free eggs distributed by County Eggs may be the source of the outbreak. (Schnirring, 8/29)

As of July 1, the CDC's Foodborne Diseases Active Surveillance Network (FoodNet), which works with the Food and Drug Administration, the US Department of Agriculture, and 10 state health departments to track infections commonly transmitted through food, has reduced required surveillance to two pathogens: Salmonella and Shiga toxin–producing Escherichia coli (STEC). Reporting of illnesses caused by Campylobacter, Cyclospora, Listeria, Shigella, Vibrio, and Yersinia is now optional, according to the Department of Health and Human Services (HHS). (Dall, 8/28)

Six deaths from rabies have been reported over the last 12 months in the U.S., the highest number in years, according to the Centers for Disease Control and Prevention. From rabid skunks in Kentucky to gray foxes in Arizona and raccoons on Long Island, wild animals in more than a dozen places across the U.S. have experienced a rise in the deadly disease, at least partly driven by shrinking natural habitats and better surveillance. “We are currently tracking 15 different likely outbreaks,” said Dr. Ryan Wallace, who leads the rabies team at the Centers for Disease Control and Prevention. The number of human deaths over the last year is concerning, experts say. In comparison, from 2015 to 2024, 17 cases of human rabies were reported, two of which were contracted outside the U.S., according to the CDC. (Kopf, Carroll and Thompson, 8/31)

In light of the recent report of a traveler-associated human case of New World screwworm (NWS) infection in Maryland, the first human US case in 50 years, the Centers for Disease Control and Prevention (CDC) and the US Department of Health and Human Services (HHS) reaffirmed their commitment to robust surveillance and trapping strategies targeting the parasitic fly. (Soucheray, 8/27)

New York City closed its investigation into a Legionnaires’ outbreak on Friday and announced more stringent testing requirements, after the disease sickened 114 people and caused seven deaths. The Health Department said the last day someone reported symptoms from the disease was Aug. 9, leaving three weeks of no new person with symptoms. The outbreak stemmed from the legionnella bacteria growing in multiple water cooling towers in the Central Harlem neighborhood of Manhattan. (Nix, 8/29)

We have each had the honor and privilege of serving as director of the Centers for Disease Control and Prevention, either in a permanent or an acting capacity, dating back to 1977. Collectively, we spent more than 100 years working at the C.D.C., the world’s pre-eminent public health agency. (William Foege, William Roper, David Satcher, Jeffrey Koplan, Richard Besser, Tom Frieden, Anne Schuchat, Rochelle P. Walensky, and Mandy K. Cohen, 9/1)

Childhood vaccines could be next on the chopping block. The advisory committee is already considering pulling hepatitis B immunizations and the measles, mumps, rubella and varicella vaccine from the standard schedule of shots that nearly all kids receive. At a recent Cabinet meeting, Kennedy hinted at a major announcement next month. (Leana S. Wen, 8/29)

When an authoritarian sets out to dismantle a democracy, they rarely begin with tanks in the streets. They start with the institutions that shape how a nation understands itself — its universities, its research labs, its spaces for free inquiry. In Hungary, Viktor Orbán perfected this slow-motion coup against knowledge. Now, the same playbook is being followed here by the Trump administration and Project 2025. (Carole LaBonne, 9/2)

Mayor Eric Adams’s recent proposal to force addicted New Yorkers into treatment if they pose a risk to themselves or others is “horrific,” one activist said. Another said the plan “sends a chill up my spine.” But mandated treatment, if properly implemented, can help addicted people and the communities where they live. (Keith Humphreys, 9/2)

There’s a saying in medicine: Statins should be in the water. While this may be hyperbolic, as a cardiologist, I don’t think it’s too far from the truth. Despite being around for a generation, statins — a specific class of drugs used to lower cholesterol levels — remain among our strongest tools for reducing a person’s risk for experiencing a life-altering heart attack and stroke. Many Americans with risk factors for heart disease should be taking them. (Vishal Khetpal, 9/2)

Every day, healthcare workers and employers strive to provide high-quality care in a deeply flawed healthcare system. Long-standing gaps in access, affordability, equity and staffing are becoming increasingly hard to ignore. (Leslie Frane, 8/29)