First Edition: Dec. 22, 2023

KFF Health News and CBS News: ‘AGGA’ Inventor Testifies His Dental Device Was Not Meant For TMJ Or Sleep Apnea 
A Tennessee dentist who has been sued by multiple TMJ and sleep apnea patients over an unproven dental device he invented has said under oath that he never taught dentists to use the device for those ailments — contradicting video footage of him telling dentists how to use it. Steve Galella, the inventor of the Anterior Growth Guidance Appliance, or “AGGA,” has said in court depositions that his device had been used on about 10,000 patients, and that he trained many dentists to use the AGGA in classes around the U.S. and overseas. (Kelman and Werner, 12/22)

KFF Health News: Cancer Patients Face Frightening Delays In Treatment Approvals 
Marine Corps veteran Ron Winters clearly recalls his doctor’s sobering assessment of his bladder cancer diagnosis in August 2022. “This is bad,” the 66-year-old Durant, Oklahoma, resident remembered his urologist saying. Winters braced for the fight of his life. Little did he anticipate, however, that he wouldn’t be waging war only against cancer. He also was up against the Department of Veterans Affairs, which Winters blames for dragging its feet and setting up obstacles that have delayed his treatments. (Sausser, 12/22)

KFF Health News: Bold Changes Are In Store For Medi-Cal In 2024, But Will Patients Benefit? 
California’s safety-net health program, Medi-Cal, is on the cusp of major changes that could rectify long-standing problems and improve health care for the state’s low-income population. Starting Jan. 1, Medi-Cal, California’s Medicaid program, will implement new standardized contracts with its 22 managed care health plans, which collectively cover 99% of enrollees. The new contracts tighten enforcement of quality measures, especially for women and children; require the health plans to report publicly on the performance of medical providers ― and in some cases other insurers ― to whom they delegate care; and mandate that plans reveal the number of enrollees who don’t have access to primary care and invest more to plug the gap. They also commit plans to better integration of physical and mental health care and greater responsiveness to the cultural and linguistic needs, sexual orientation, and gender identity of members. (Wolfson, 12/22)

KFF Health News' 'What The Health?' Podcast: 2023 Is A Wrap 
Even without covid dominating the headlines, 2023 was a busy year for health policy. The ever-rising cost of health care remained an issue plaguing patients and policymakers alike, while millions of Americans lost insurance coverage as states redetermined eligibility for their Medicaid programs in the wake of the public health emergency. (12/21)

Stat: 2023 Sets A New Record For Health Data Breaches 
Odds are, you’ve gotten at least one of the unnerving letters in your mailbox this year: “We’re writing to inform you of a cybersecurity incident,” it might start. It’s the standard notice many health care organizations are required to provide when your protected health information gets exposed — and in 2023, data leaks, hacks, and mishandling led more of them to be delivered than ever before. (Palmer, 12/21)

Modern Healthcare: Doctors, Hospitals Face Cuts As Congress Takes Christmas Off
When Congress went on its winter break before Christmas, it left much of its healthcare business—along with most of it other responsibilities for 2023—unfinished, and now faces an intense scramble to get it all done in just weeks. At the top of the healthcare list is funding programs that depend on annual appropriations for the Health and Human Services Department, which like the rest of the government is running on the latest stopgap funding bill enacted since fiscal 2023 ended Sept. 30. In addition, numerous health-related programs and initiatives expired and are also operating on a short-term lifeline. (McAuliff, 12/21)

Stateline: Grassroots Groups Help Medicaid Recipients Regain Lost Coverage
Eight months after states started dropping millions of low-income families from Medicaid rolls, grassroots groups say they are leading the push to re-enroll people denied coverage for bureaucratic reasons. Nationwide, more than 12.5 million people have lost coverage since April. That’s when the federal pandemic provision that had required states not to drop anyone from the rolls expired and states restarted income eligibility checks. (Hassanein, 12/21)

News Service of Florida: Florida Is Suing The Federal Government Over Medicaid Records 
As it tries to fend off a potential class-action lawsuit over dropping people from the Medicaid program, Gov. Ron DeSantis’ administration this week alleged that federal health officials have violated an open-government law by not providing records that could be relevant to the case. (Saunders, 12/21)

AP: DeSantis Spread False Information While Pushing Trans Health Care Ban And Restrictions, A Judge Says 
A federal judge hearing a challenge to a transgender health care ban for minors and restrictions for adults noted Thursday that Republican Florida Gov. Ron DeSantis repeatedly spread false information about doctors mutilating children’s genitals even though there’s been no such documented cases. The law was sold as defending children from mutilation when it is actually about preventing trans children from getting health care, Judge Robert Hinkle said to Mohammad Jazil, a lawyer for the state. (Farrington, 12/22)

Roll Call: Democrats Eye Appropriations To Protect Pediatrician Training 
House Republicans attempting to tie the reauthorization of a critical pediatrician training program to efforts to limit gender-affirming care for transgender children acknowledge those efforts will collapse. Now lawmakers are looking to fund the program as-is through the appropriations process. Federal authorization for the Children’s Hospitals Graduate Medical Education Program, which trains more than half of pediatric specialists and almost half of general pediatricians nationwide, lapsed on Sept. 30. (Cohen, 12/21)

St. Louis Public Radio: Advocates Launch Emergency Program For Missouri Trans Kids
Transgender Missourians under 18 and their families can now get help finding gender-affirming care in other states through a regional project operated by a North Carolina-based nonprofit. (Fentem, 12/21)

The Baltimore Sun: Traveling For The Holidays? Here’s How To Check Flu And COVID Levels At Your Destination 
When you get ready to travel for the holidays, you may want to know how sick people are in destination where you are going. As of Friday, 17 states are reporting “high” or “very high” levels of respiratory illness activity, federal health data shows. The states where illness activity is highest are scattered throughout the U.S. but most of the Southeastern states are seeing high levels, along with Western states like California, Nevada and Colorado. New Jersey and New York City also are seeing high levels, based on percentage of visits to outpatient healthcare providers or emergency departments for fever and cough or sore throat. (Goodman, 12/21)

The Boston Globe: Mass. Hospitals Resume Mask Requirements As Infections Rise
With COVID-19 cases and other respiratory illnesses rising across the region, some area hospitals have begun to bring back face mask requirements to halt the spread of infections. Boston Medical Center said Thursday it would resume masking requirements in all patient-care areas beginning Friday. On Monday, the Dana-Farber Cancer Institute reinstated its mask requirements in all clinical and public spaces, and the Beth Israel Lahey Health system (BILH) updated its policies to require masking for all health care personnel upon entry to a patient room or bed space. (Piore, 12/22)

CIDRAP: Reviews Uncover No Consistent Link Between Antiviral Drugs Like Paxlovid And COVID Rebound 
Two systematic reviews by US federal agencies on the possible link between antiviral treatment for COVID-19 and viral rebound—one specifically on Paxlovid—find no consistent association. The studies were published today in Morbidity and Mortality Weekly Report. The National Institutes of Health COVID-19 Treatment Guidelines recommend early treatment with a first-line (nirmatrelvir/ritonavir [Paxlovid] or remdesivir) or second-line (molnupiravir [Lagevrio]) antiviral drug to help prevent hospitalization and death in high-risk COVID-19 patients with mild or moderate illness. (Van Beusekom, 12/21)

NPR: Shortage In Primary Care Clinicians Eroding Patient Trust
First, her favorite doctor in Providence, R.I. retired. Then her other doctor, at a health center a few miles away, left the practice. Now, Piedad Fred has developed a new chronic condition: distrust in the American medical system. "I don't know,'' she said, eyes filling up. "To go to a doctor that doesn't know who you are? That doesn't know what allergies you have, the medicines that make you feel bad? It's difficult...I know that I feel cheated, sad, and like I have my hands tied.'' (Arditi, 12/22)

Stat: Keeping Primary Care Docs In Field Isn't Impossible, Says AAFP CEO
In ten years, the United States could be short as many as 48,000 primary care doctors. The specialty is underpaid, to a point that doctors are lobbying Medicare to pay it extra. Even medical residents who chose the specialty are leaving primary care; some 45% of residents who planned to be generalists changed their mind during their residencies. (Trang, 12/22)

Modern Healthcare: Hospital Observation Status Appeals Under Medicare Outlined
The Centers for Medicare and Medicaid Services has outlined an appeals process for Medicare beneficiaries who believe hospitals inappropriately classified their stays as observations instead of admissions. The proposed rule published Thursday aims to resolve a 12-year-old class-action lawsuit seeking redress for fee-for-service enrollees whose hospital or nursing home care wasn't covered under Medicare Part A because hospitals designated them as outpatients. (Bennett, 12/21)

NBC News: Vital Signs Vs. Dollar Signs: At HCA Hospitals, The Person Monitoring Your Heart May Be Doing It For 79 Other Patients. Is That Safe?
In Wesley Medical Center, and in most hospitals today, the people monitoring patients’ heart rhythms, blood pressure or respiratory functions are not nurses who interact with them. They are “telemetry” technicians who are supposed to alert those nurses to meaningful changes in the vital signs transmitted by electronic devices hooked up to the patients. The technicians in telemetry units typically watch screens showing heart rhythms and numbers for many patients at a time — sometimes dozens — and often sit in a room far from the patients they are watching. (Morgenson, 12/21)

Modern Healthcare: 50 Healthcare Mergers Challenged By FTC In 2022: Report
The Federal Trade Commission and Justice Department challenged 50 merger and acquisition proposals across all sectors of the economy in 2022, including six proposed healthcare deals, according to a new report. The FTC’s 24 merger enforcement challenges in 2022—including five in healthcare—marked the second-highest number over the prior 10 years, according to the annual report for the fiscal year ended Sept. 30 on the Hart-Scott-Rodino Act premerger notification program issued Thursday. (Kacik, 12/21)

Modern Healthcare: Olive AI, Cano Health And Other Digital Health Flops Of 2023
While record funding in 2021 and 2022 launched companies to new heights, 2023 will be remembered as the year some of them came crashing down to earth. “There are many, many organizations that just tried and failed at providing a solution,” said Peter Micca, national health tech leader at professional services firm Deloitte. But Micca said this doesn't dampen his enthusiasm for the sector at all. "I'm incredibly bullish on the future of health and innovation." (Turner, 12/21)

Stat: How Pharma Companies Keep Drug Prices High And Competition Low
To ring the register, a pharmaceutical company may create a patent thicket, which involves filing dozens of patents that, in some cases, add little value to their medicines but extend precious monopolies. And one crucial, but little-known tool for making this happen is something called a terminal disclaimer. (Silverman, 12/21)

Bloomberg: Expensive Drugs From Big US Pharma Get More Money From FDA Program
Vertex Pharmaceuticals Inc. has made over $20 billion in worldwide sales from a cystic fibrosis drug approved four years ago that can cost up to $300,000 a year. With blockbuster sales like that, Vertex wouldn’t appear to need government assistance. But thanks to an obscure program designed to incentivize companies to make drugs for uncommon or neglected diseases, the Food and Drug Administration also awarded Vertex a bonus certificate that it can either use to expedite a future drug approval or sell for around $100 million. (Langreth, Rutherford, and Meghjani, 12/21)

Stat: FDA Approves AstraZeneca, Ionis Treatment For Rare Nerve Disease 
The Food and Drug Administration approved a novel medicine for a rare and devastating nerve disease Thursday, clearing a treatment that promises to be more convenient than available therapies. (Garde, 12/21)

NBC News: FDA Warns Against Unauthorized Fat-Melting Injection Treatments
The Food and Drug Administration issued a warning about the dangers of using unauthorized versions of fat-dissolving injections, saying it has received reports of severe side effects, such as persistent scarring, severe infections and skin deformities. ... The FDA on Wednesday noted the presence of unapproved fat-dissolving injections popping up at clinics and med spas across the U.S., including those sold online under brand names like Aqualyx, Lipodissolve, Lipo Lab and Kabelline. (Lovelace Jr., 12/21)

Reuters: US FDA Warns About Counterfeit Versions Of Novo's Diabetes Drug Ozempic
The U.S. Food and Drug Administration on Thursday warned consumers not to use counterfeit versions of Novo Nordisk's diabetes drug Ozempic that have been found in the country's drug supply chain. The health regulator said it will continue to investigate counterfeit Ozempic 1 milligram injections and has seized thousands of units, but flagged that some may still be available for purchase. (12/21)

CBS News: Ozempic And Wegovy Gain Popularity For Weight Loss, Also Causing Spike In Emergency Calls For Adverse Side Effects
While the drugs have proven useful for many in their weight loss journey, doctors note that stopping the medication will in most cases result in consumers gaining all of the weight back. More concerningly, Saltz said many who started taking the medications have had to go to the emergency room with other symptoms. "It can cause gallbladder disease and diarrhea. Those kinds of things will lead to dehydration which will lead to an ER visit," Saltz said. (Thomas, 12/21)

The New York Times: Bellevue Hospital Bariatric Surgery Program Is Under NY State Scrutiny 
The New York State Department of Health is scrutinizing Bellevue Hospital’s use of unlicensed technicians to assist doctors in weight-loss surgeries. Bellevue, a large public hospital in Manhattan, churns thousands of low-income patients through bariatric surgery every year, The New York Times reported this month. Doctors are paid in part based on the volume of surgeries. (Silver-Greenberg and Kliff, 12/21)

CBS News: Woman's Waist Size May Be Contributing Factor To Infertility, Study Says
One in four couples struggle with infertility and a new study finds that a woman's waist size may be a contributing factor. A team in China studied more than 3,000 women of reproductive age and found that the chances of getting pregnant declined as waist size increased, independent of a woman's body mass index or BMI. In fact, for every 1 cm increase in waist circumference, the risk of infertility increased by 3 percent. (Marshall, 12/21)

The New York Times: Hormonal Implants, A Once Unpopular Birth Control, Surge Among Teens 
The hormonal implant, a long-acting reversible contraceptive, is an increasingly popular choice among teenagers, according to data published last week from the Centers for Disease Control and Prevention. Just over 13 percent of sexually active teenage girls used the implant between 2015 and 2019, compared with 0.6 percent between 2006 and 2010. This represents the biggest jump in usage compared to all other contraceptive methods. The uptick “probably contributed to a decline in teen pregnancies and births that we’ve seen,” said Joyce Abma, a social scientist with the National Center for Health Statistics and co-author of the latest C.D.C. report. The report notes that both teenage pregnancies and births have reached “historic lows.” (Gupta, 12/21)

CIDRAP: Doxy-PEP Didn't Cut Sexually Transmitted Infections In Women, But Adherence Could Be Factor, Trial Finds 
The results of a randomized clinical trial conducted in Kenya show that taking a dose of the antibiotic doxycycline after unprotected sex did not significantly reduce the incidence of sexually transmitted infections (STIs) in cisgender women, but many who were supposed to take the drug might not have, researchers reported today in the New England Journal of Medicine. The findings are in stark contrast to previous trials conducted in men who have sex with men (MSM) and transgender women that have found that doxycycline postexposure prophylaxis, or doxy-PEP, significantly reduced STI incidence. But the investigators say that the results likely reflect low adherence to the intervention among trial participants. (Dall, 12/21)

CBS News: New UCSF Study Finds Some Diagnosed With Kidney Disease May Not Need Dialysis
Dr. Chi Hsu is the Chief of the division of Nephrology at UCSF, he along with Dr. Ian McCoy were conducting a study on how patients with acute kidney disease requiring dialysis are currently being managed at outpatient dialysis clinics. ... "Most of the research on acute kidney injury has been on when patients should start dialysis or how much dialysis they need in the hospital. and there has been relatively little research on how to take people off of dialysis when they start recover and how to recognize recovery." (Cook, 12/21)

The Washington Post: Colon Cancer Is Rising In Young Americans. It’s Not Clear Why. 
The five people gathered around the restaurant table do not fit the profile of colon cancer patients. They’re female, and they’re young. Two were diagnosed in their 20s, one in her 30s, two in their early 40s. Their colon cancer support group gathers about once a month to share stories, such as the one about the doctor who said you just need a laxative, the one about the oncologist who said there’s nothing we can do for you but give you chemotherapy the rest of your life, the one about friends saying, “You don’t look sick,” without realizing that isn’t helpful. “It’s making themselves feel better,” said Carly Brown, 29, a schoolteacher diagnosed with Stage 4 colon cancer five years ago. (Achenbach and McGinley, 12/21)

The Washington Post: VR Can Help Seniors In Nursing Homes With Mood, Memory And Loneliness 
On Wednesday mornings, residents at Citrus Place, a retirement community in this middle-class town, gather for a weekly institution: 30 minutes in virtual reality. The activity is voluntary, and attendance is good. On this day, about a dozen participants from the facility’s assisted-living wing sat on love seats in a circle, wearing VR headsets that looked like big goggles. Their virtual schedule was packed: a hot-air balloon ride, then a safari, then to the grocery store. (Hunter, 12/21)

The Baltimore Sun: New Online Tool Helps Caregivers Pass On Plans For Loved Ones With Disabilities 
There is now an online tool that enables parents and guardians of people with disabilities to build personalized plans that are simple, secure and easy to share with other caregivers. “It is completely different from a will, which usually focuses on who gets what. The plan allows you to specify details (of your loved ones’) daily routine, pick-up times, medications and more,” Joel Pearlman said. “It is a really powerful day-to-day look at what makes their day and your life work best.” ... The Dani Plan has a free 21-day trial period as well as paid premium options. (Thwing, 12/21)

WUSF: How To Cope With Grief During The Holidays 
Mental health experts say it's OK to not be merry this holiday season if you're struggling with loss. They encourage people to look for small moments of joy. (Colombini, 12/21)

The Hill: California Law That Would Ban Firearms In Most Public Places Blocked 
A California law that would ban firearms in most public places was blocked by a federal judge Wednesday. The law, struck down because U.S. District Judge Cormac Carney ruled that it violates the Second Amendment, would have gone into effect at the beginning of next month. It was signed by California Gov. Gavin Newsom (D) back in September and would have barred the concealed carrying of guns in locations like public parks and playgrounds, churches, banks and zoos.  (Suter, 12/21)

CBS News: Person With Contagious Tuberculosis Identified At UC Davis; Contact Tracing Underway
Health officials have started contact tracing after a person at the UC Davis campus was identified as having contagious tuberculosis. UC Davis officials announced on Wednesday that they were working on identifying and notifying people who had been in close contact with the infected person. Only people who had at least 8 hours of exposure to the person are classified as close contacts. (Padilla, 12/21)

CIDRAP: Contaminated Water, Soil Tied To Rare Tropical Disease Melioidosis In 3 Men In Same Mississippi County 
Over a 3-year period, three men in Mississippi were infected with a newly identified strain of the bacterium that causes melioidosis after contact with contaminated water and soil, the first known cases of environmental transmission in the continental United States, the New England Journal of Medicine reports today. Caused by Burkholderia pseudomallei, melioidosis is a potentially life-threatening disease typically spread through inhalation, ingestion, or skin contact with the water or soil of tropical and subtropical regions, where it is endemic. (Van Beusekom, 12/21)

The Baltimore Sun: Last Open-Air Water Reservoirs In Baltimore Covered
The last open-air water reservoirs in Baltimore have been covered. Drinking water at Lake Ashburton and Druid Lake previously exposed to both the elements and microscopic danger are now in protected tanks, the city department of public works said Thursday. The illness-inducing parasite cryptosporidium was detected in the water at Druid Lake Reservoir in September, prompting state officials to issue a boiled water advisory. (Mullan, 12/21)

The Wall Street Journal: Flesh-Rotting ‘Tranq’ Undermines Fight Against Fentanyl 
Carisa Collins-Caddle peered at a scar in the crook of Regina Locklear’s arm. Weeks earlier, a wound that appeared after Locklear injected illicit drugs had swelled to the size of an orange. She had texted a photo to Collins-Caddle, who provides help including clean syringes to drug users. Collins-Caddle had been spreading the word about an infiltrator in North Carolina’s drug supply: xylazine, an animal tranquilizer that can rot flesh, requiring amputations.  “I never thought there would be a day when I would say there was something that scared me more than fentanyl. But here I am,” said Collins-Caddle, 47 years old. (Wernau, 12/21)

Los Angeles Times: Some Mexican Pharmacies Are Selling Full Bottles Of Adderall. But It's Actually Meth
As a shortage of Adderall stretches into its second year, millions of patients are still struggling to fill their prescriptions in U.S. pharmacies. But in Mexico, some pharmacies are selling the pricey orange pills over the counter, in sealed bottles bearing the names and logos of well-known pharmaceutical companies. One problem: They’re not real. Some are counterfeits made of methamphetamine, while others contain appetite suppressants, acetaminophen or caffeine. (Blakinger, Sheets, and Mejia, 12/21)

Bloomberg: World’s Oldest Lab Rats Contribute To Anti-Aging Research
In medical research, lab mice and rats die for us in great numbers. Sacrificed during or after experiments, they leave us with information that, over the years, has helped us understand diseases, develop medicines and map the functions of particular genes. But some aging-focused research projects require something else from these animals: that they stay alive, and healthy, for as long as possible. So in labs from North Dakota to Mumbai, select rodents grow old under heavy scrutiny. (Giaimo, 12/21)

Stat: Three Issues To Watch In Global Health In 2024
As we enter the fifth year of this challenging decade, life finally appears to be inching toward normal — a new normal — on the infectious diseases front. Humans and the SARS-CoV-2 virus seem to be making progress toward a detente with each other. Covid is still a major disruptor, a significant cause of illness and death. But the massive disease waves of the early 2020s have calmed down. Masks, in the main, have disappeared. Holiday parties are back. Covid is falling out of the headlines. (Branswell, 12/22)