Fierce Healthcare: No Deal In Sight Following High-Stakes White House Negotiations
President Donald Trump and congressional leaders from both parties exited a high-stakes negotiation meeting Monday afternoon with little optimism a deal could be struck before the end of the month to avoid a government shutdown. "I think we’re heading to a shutdown because the Democrats won’t do the right thing," Vice President J.D. Vance told reporters after the meeting. "I hope they change their mind, but we’re going to see.” Healthcare issues have and continue to be a sticking point of the negotiations, with Democrats demanding an extension of Affordable Care Act (ACA) enhanced premiums set to run dry at the end of the year as well as protections against White House recissions of appropriated funding. (Muoio and Beavins, 9/29)

The New York Times: Explaining The G.O.P.’s Misleading Talking Point On The Looming Shutdown
With Congress at an impasse over federal spending, Republicans have emerged with a new and misleading talking point: Democrats are shutting down the government to fund free health care for unauthorized immigrants. It is a message repeated by Vice President JD Vance, the official X account of Senate Republicans and Speaker Mike Johnson. But the proposal does not provide free health care for unauthorized immigrants. Republicans may be referring to the law changing the eligibility requirements for certain immigrant groups. (Qiu, 9/29)

Politico: Trump Posts Vulgar Deepfake Slam Of Democratic Leaders After White House Meeting 
If a government shutdown wasn’t already exceedingly likely, President Donald Trump might have made it a near certainty Monday night. The president posted a vulgar AI-generated deepfake video to his Truth Social slamming the top Democratic leaders — Senate Minority Leader Chuck Schumer and House Minority Leader Hakeem Jeffries — just hours after he hosted the two for an Oval Office meeting. (Hill, 9/29)

Politico: Top Tax-Writing Democrat Open To Negotiating Income Caps For Obamacare Subsidies
The top Democrat on the tax-writing House Ways and Means Committee cracked open the door to negotiating income limits for recipients of health care subsidies set to expire at the end of the year. “I think the question of subsidies for people that are making half a million dollars — I mean, that should be subject to a discussion and negotiation as well, but that shouldn’t become the pretense for shutting down the government,” Rep. Richie Neal of Massachusetts said in a brief interview, though he stressed it’d be “premature” to get too far into the specifics. (Wu, 9/29)

Fierce Healthcare: Telehealth Waivers Expire Oct. 1 As Shutdown Inches Closer
Medicare beneficiaries stand to lose access to two key virtual care programs that the federal government has offered since the start of the pandemic if the government shuts down on Tuesday at midnight. The Medicare telehealth waivers and Acute Hospital at Home (AcHaH) programs are set to expire Oct. 1 unless Congress passes a short-term government funding bill to avert the crisis. (Beavins, 9/29)

Also —

Axios: Government Shutdown: HHS Would Furlough Nearly 32,500 Health Workers
Federal health agencies under Robert F. Kennedy Jr. would furlough more than 40% of their remaining workforce in a government shutdown, according to a contingency plan. Some 32,460 government health workers would be without work at least temporarily under the plan and could lose their jobs if Trump follows through on threats to fire those deemed nonessential in a funding lapse. (Goldman, 9/29)

The New York Times: Here’s How A Government Shutdown Works 
In some parts of the federal government, there is an immediate impact. But not every federally funded initiative is at the mercy of Congress’s budgeting standoffs, and even some that are may be able to rely on cash reserves to get through a brief shutdown. Department to department, the impacts vary. The Postal Service, which is self-funded, and Social Security and Medicare benefits, which are considered “mandatory” spending, should keep on going. While most federal workers are likely to be furloughed, those designated as “excepted,” such as active-duty troops, air traffic controllers and federal law enforcement officers, stay on the job, even though they cannot be paid for that work until after the shutdown is over. (Demirjian, 9/30)

Atlanta Journal-Constitution: Georgia Health Sector Faces $3.7B Loss As ACA Subsidies End, Forecast Finds
Georgia’s hospitals, doctors and other health businesses stand to lose $3.7 billion in revenue next year alone, if Congress and President Donald Trump allow Affordable Care Act health insurance subsidies to expire in December, a new forecast has found. Georgia’s expected loss of health sector revenue would be among the three largest in the nation, behind only Florida and Texas, according to the study by the Robert Wood Johnson Foundation and the left-leaning Urban Institute. (Hart, 9/29)

Mountain State Spotlight: 60,000 West Virginians Risk Losing Affordable Health Care As Congress Stalls On Subsidies
Ellen Allen, executive director of West Virginians for Affordable Health Care, said more than 60,000 people in the state — including herself — rely on getting their healthcare from the ACA Marketplace Exchange. Without the subsidies, Allen said families could see their health insurance premiums — the amount paid per month — skyrocket by hundreds of dollars. For instance, Allen said she pays $497 per month for her health insurance. Without the tax credit, it would cost her $2,800 a month. (Culvyhouse, 9/30)

WUSF: Here's How ACA Tax Credits Expiring And Medicaid Cuts Could Impact Floridians 
Medicaid coverage and enhanced credits in Affordable Care Act plans have been a safety net for many people. In Florida, over 4.3 million people received Medicaid benefits, and more than 4.7 million are enrolled in the ACA for health care coverage. In Florida, about 2 out of 5 people benefit from ACA or Medicaid plans. But that will soon change. (Bowman, 9/30)

North Carolina Health News: NC Aging Advocates Worry About Federal Government Shutdown Effects 
The gears of government are turning slower by the day with a gridlocked U.S. Congress, and they’re threatening to seize altogether as another shutdown looms. For North Carolina’s older adults — many enduring the slow grind of aging bodies and shrinking budgets — the prospect feels all too familiar. (Fredde, 9/30)

In related news on Medicaid cuts —

Los Angeles Times: How California Families Are Already Bracing For Looming Medicaid Cuts
Ever since Elijah Maldonado was born at just 29 weeks, he has needed specialty treatments that his family could afford only with publicly funded healthcare. Diagnosed with cerebral palsy as an infant, he spent his first three months at a public hospital in Orange County, where the family lives. Now 7, Elijah receives physical and speech therapy among a host of other services paid for through Medicaid. He relies on a wheelchair funded by the government. An assistant paid for with taxpayer dollars makes sure he’s safe on the bus ride to and from school. (Beason, 9/29)

The CT Mirror: Rising Costs Strain Medicaid In CT – Before Federal Cuts Are Counted
Deep cuts in federal Medicaid assistance aren’t the only threat to health care for needy families and children here. Gov. Ned Lamont’s administration has identified major cost overruns in the entitlement program, known as HUSKY in Connecticut, which has struggled to stay out of the red since 2022. (Phaneuf, 9/30)

KFF Health News: Health Care’s Employment Growth Clouded By Immigration Crackdown, Medicaid Cuts
The health care sector is a bright spot in the economy this year, driving nearly half of the nation’s employment gains, but economists and experts say immigration crackdowns and looming Medicaid cuts pose a threat to future job growth. Employers added 487,000 jobs from January to August, according to the latest nonfarm payroll data from the Bureau of Labor Statistics. The health care sector accounted for 48% of that lackluster growth, expanding by about 232,000 jobs, even though the sector employs only about 11% of workers. (Reese, 9/30)

Modern Healthcare: The Tools Advocate, Ascension Are Using To Ease Medicaid Cuts
Healthcare providers, payers and other companies are facing an uncertain regulatory and political environment in the coming years. Massive reductions in Medicaid funding under President Donald Trump’s tax law, known as H.R. 1, and the looming expiration of the Affordable Care Act premium tax subsidies are among the issues likely to undercut margins and operations. (Dubinsky, Early, Perna and McAuliff, 9/29)

Bloomberg: US Recommends Harvard Be Excluded From Federal Funding, HHS Says
The US Department of Health and Human Services said Monday that it is referring Harvard University for administrative suspension and debarment proceedings, a move that would exclude the school from entering into contracts with all government agencies or receiving any federal funding, including research grants and student aid. If successful, the debarment attempt would cut off a key funding source for Harvard, a fresh financial blow after the Trump administration’s freeze of more than $2.6 billion in existing federal dollars. (Knox, 9/29)

The Washington Post: Trump Administration Moves To Defund Inspector General Watchdog Group 
The Trump administration plans to end funding starting Wednesday for an oversight group that helps inspectors general root out waste, fraud and abuse, marking the latest example of Trump’s drive to limit federal watchdog activities. The group — called the Council of the Inspectors General on Integrity and Efficiency — is the umbrella organization for 72 inspectors general across government. It informed four House and Senate committees on Saturday that it would “cease our statutorily mandated functions and furlough 25 permanent employees” without funding, according to a letter obtained by The Washington Post. (Kornfield, 0/30)

The Washington Post: Trump’s USAID Pause Stranded Lifesaving Drugs. Children Died Waiting.
USAID antimalarial and HIV supplies valued at nearly $140 million were delayed in the first half of the year or not delivered at all due to the Trump administration’s foreign aid pause, The Post found. (Kelly, Lee, Ombuor, Blaskey, Tran, Galocha, Lau and Houreld, 9/30)

On prescription drug prices —

The Wall Street Journal: Novartis To Launch Direct-To-Patient Platform For Cosentyx In U.S.
Novartis said it is launching a direct-to-patient platform in the U.S. to sell a discounted version of its Cosentyx drug, the latest big pharma company to move to cut prices ahead of the Trump administration’s deadline. The Swiss pharmaceutical company said Monday that it would offer select units of Cosentyx—a drug treating immune-mediated inflammatory conditions like psoriasis and psoriatic arthritis—at a 55% discount to cash-paying patients with a prescription. The platform will come into effect on Nov. 1. (Look, 9/29)

Politico: Trump’s Strategy To Get Drug Companies To Act Voluntarily Is About To Be Tested
President Donald Trump sent letters to 17 of the world’s largest pharmaceutical companies at the end of July. He demanded that they voluntarily lower U.S. prices for some of their drugs to match what they charge affluent foreign nations. “If you refuse to step up, we will deploy every tool in our arsenal to protect American families from continued abusive drug pricing practices,” he wrote, requesting a response by September 29. (Lim, 9/29)

On Tylenol lawsuits —

NPR: Trump Blaming Tylenol For Autism Boosts Lawsuits Against The Drugmaker
President Trump's announcement last week linking Tylenol with autism could play a role in ongoing legal cases against the company that makes it. One lawyer representing patients who say they were harmed by the drug says his firm has gotten an influx of more than a thousand calls this week from potential new clients asking for information. (Lupkin, 9/29)

On cannabis —

The Guardian: Cannabis Stocks Soar After Trump Shares Video Promoting Drug’s Use For Seniors
Cannabis stocks are on a high after Donald Trump shared a video on Sunday promoting cannabis use for seniors and Medicaid coverage of CBD products. The nearly three-minute-long video, posted on the president’s Truth Social platform, touts the usage of hemp-derived CBD as a “gamechanger” that is a pain and stress reliever for seniors. (Aratani, 9/29)

AP: Vertanical's Drug Made From Marijuana Reduced Back Pain, Study Finds
An experimental medication made from marijuana successfully reduced back pain in a new study, offering further support for the drug’s potential in treating one of the most common forms of chronic pain. The 800-patient study by a German drugmaker is the latest evidence of the therapeutic properties of cannabis, which remains illegal under U.S. federal law even as most states have made it available for medical or recreational use. (Perrone, 9/29)

Axios: Opioid Use Disorder Cases Jumped Post-Pandemic
Diagnoses of opioid use disorder among the commercially insured jumped nearly 40% nationwide between 2021 and 2024, according to data from FAIR Health's Opioid Tracker shared first with Axios. (Reed, 9/30)

More pharmaceutical news —

MedPage Today: Gabapentin Use Skyrockets Despite Risks, CDC Analysis Shows
Gabapentin prescribing rose sharply in recent years, with the generic drug becoming the fifth most dispensed product in retail pharmacies in 2024, a CDC analysis showed. From 2010 to 2024, prescriptions jumped from 79.5 to 177.6 per 1,000 people, according to Gery Guy Jr., PhD, of the CDC National Center for Injury Prevention and Control, and co-authors. (George, 8/29)

Fox News: GLP-1 Drugs Linked To Lower Cancer Risk, Particularly In Women, New Study Finds
The potential benefits of GLP-1 medications continue to expand. New research has found that the weight loss and diabetes drugs — officially known as glucagon-like peptide 1 receptor agonists — are associated with a reduced risk of some cancers, especially in women. (Stabile, 9/29)

CIDRAP: Inhaled Heparin Slashes Ventilation, Death In COVID Patients, Analysis Suggests
A meta-trial of randomized clinical studies conducted in 6 countries suggests that the use of inhaled heparin dramatically reduced the risk of intubation, death, and in-hospital death in hospitalized COVID-19 patients. (Van Beusekom, 9/29)

In health care industry news —

Modern Healthcare: UHS To Pay $500M In Prime Healthcare Lawsuit
Universal Health Services faces more than $500 million in damages after a Nevada jury ruled the system had interfered with Prime Healthcare physicians’ contracts. The lawsuit, which was filed in Washoe County, Nevada, in 2021, stems from Prime’s allegations that UHS illegally solicited physicians and other employees from Saint Mary’s Medical Group, stole trade secrets, diverted patients and triggered a mass resignation to gain an economic advantage, according to a Monday press release from Prime. (Hudson, 9/29)

The CT Mirror: Yale To Pay Prospect Medical $45M To End Hospital Sale Dispute
Yale New Haven Health will pay Prospect Medical Holdings $45 million to settle dueling lawsuits in state court, ending a contentious saga over the proposed sale of Prospect’s three Connecticut hospitals — with Yale acquiring none of them. (Altimari, 9/29)

KFF Health News: Doctors With Troubled Pasts Are Performing Cosmetic Surgeries Tied To Crippling Pain And Injury
Not long after California surgeon Andrew S. Hsu landed a job with a cosmetic surgery chain in Georgia, several of his patients suffered disfiguring injuries, and even his new employer had doubts about his competence, court records allege. Hsu, a board-certified general surgeon, was one of six out-of-state doctors who joined the Atlanta Goals Aesthetics & Plastic Surgery center during the pandemic. (Schulte, 9/30)

KFF Health News: How To Pick The Right Cosmetic Surgeon
The debate over which doctors are best qualified to perform cosmetic surgery — and who gets the best results for patients — has raged for decades. Here’s why: A state-issued medical license grants a physician what a Federation of State Medical Boards policy statement called the “privilege of practicing the full breadth of medicine.” (Schulte, 9/30)

CNN: Abortions Provided By Clinicians In The US Dropped In The First Half Of 2025, Report Shows 
The number of abortions provided by clinicians in the United States has declined this year as the effects of new restrictions bear out and it becomes more common to manage an abortion outside the formal health care system, a new report suggests. (McPhillips, 9/30)

In other reproductive health news —

AP: California Doctor Is 2nd To Face Louisiana Arrest Warrant Over Abortion Pills
Louisiana is pursuing a criminal case against another out-of-state doctor accused of mailing abortion pills to a patient in the state, court documents filed this month revealed. A warrant for the arrest of a California doctor is a rare charge of violating one of the state abortion bans that has taken effect since the U.S. Supreme Court overturned Roe v. Wade in 2022 and allowed enforcement. (Cline and Mulvihill, 9/30)

San Francisco Chronicle: California Catholic Hospitals Sued — Emergency Abortion Denial Alleged
A Northern California woman was twice denied an emergency abortion and sent home after Dignity Health doctors determined her pregnancy wasn’t viable but could not provide the procedure due to Dignity’s religious restrictions, according to a lawsuit filed Friday in San Francisco County Superior Court. In one instance, she developed life-threatening sepsis, the suit said. Rachel Harrison, 30, of Carmichael (Sacramento County), alleges she lost both pregnancies at 17 weeks’ gestation after her water broke and her amniotic fluid was lost. (Gafni, 9/29)

AP: Student Activists Go Underground At Catholic Colleges To Provide Contraception
College student Maya Roman has the handoff down to a science: a text message, a walk to a designated site, and a paper bag delivered with condoms and Plan B emergency contraception. At DePaul University, it’s the only way students can get a sliver of sexual health support, she said. DePaul, a Catholic school in Chicago, prohibits distribution of any kind of birth control on its campus. To get around that, a student group runs a covert contraceptive delivery network called “the womb service.” (Fernando, 9/30)

On sports physicals —

The Nevada Independent: Physicians: Rule That Doctors ID Athlete’s Sex At Birth ‘Inappropriate’ For School Physical
Pediatricians and advocates urged the Nevada Interscholastic Activities Association (NIAA) to remove a new requirement on sports physical evaluations that physicians identify a student’s birth sex and recommend whether they should play boys’ or girls’ sports, calling it “medically inappropriate.” The request came in the form of a letter signed by 18 doctors and medical professionals sent via email last week to Executive Director Timothy Jackson, who leads the association that governs high school sports in Nevada. (Mueller and Hernandez, 9/29)

More health care updates from across the U.S. —

Politico: Gavin Newsom Signs First-In-Nation AI Safety Law 
California Gov. Gavin Newsom signed a first-in-the-nation law on Monday that will force major AI companies to reveal their safety protocols — marking the end of a lobbying battle with big tech companies like ChatGPT maker OpenAI and Meta and setting the groundwork for a potential national standard. (DeFeliciantonio, 9/29)

MedPage Today: 'We Are Exhausted, Frustrated, And Sad': Docs Vent During Meeting With Senator
Sen. Tim Kaine (D-Va.), a member of the Senate health committee, heard from a variety of providers Monday about their frustrations with the healthcare system. "We are exhausted, frustrated, and sad, and trying to claw our way back up there," said Ashley Zelenak, MD, a pediatric emergency physician at Bon Secours St. Mary's Hospital in Richmond, Virginia. "We took such a hit during COVID and now to be hit [again] as a pediatrician, it's hard." (Frieden, 9/29)

Modesto Bee: Funding Crisis May Close Modesto's Homeless Shelter ACES
It can’t be good news for anyone encouraged by tiny home projects or other recent developments to assist the homeless. Stanislaus County has sent a six-month notice to end an agreement with The Salvation Army for operation of the low-barrier homeless shelter on D Street in Modesto. Closing the facility would remove 182 shelter beds for people who don’t have a home. (Carlson, 9/28)

AP: Seattle Bakers Donate Homemade Bread To Help Fight Hunger
On a recent Saturday near Seattle, Cheryl Ewaldsen pulled three golden loaves of wheat bread out of her kitchen oven. The fragrant, oat-topped bread was destined not for her table, but for a local food bank, to be distributed to families increasingly struggling with hunger and the high cost of groceries. ... Ewaldsen is a volunteer with Community Loaves, a Seattle-area nonprofit that started pairing home bakers with food pantries during the COVID-19 pandemic — and hasn’t stopped. (Aleccia, 9/29)

9news.com: West Nile Cases, Deaths Continue To Climb In Colorado 
West Nile virus cases are climbing higher in Colorado. According to the Colorado Department of Public Health and Environment, Colorado has had 235 cases of West Nile this year. Twelve people have died. Data from the Centers for Disease Control and Prevention shows Colorado has more than double the cases of any other state. (Krause, 9/28)

Boston.com: Mass. Health Officials Announce Additional Human Cases Of West Nile Virus
State health officials on Friday announced two new human cases of West Nile virus in Massachusetts this year. According to the Massachusetts Department of Public Health (DPH), one case involves a woman in her 60s who was exposed to the mosquito-borne illness in Middlesex County. The second case involves a man in his 50s who was exposed in Suffolk County. These bring the total number of confirmed human cases of West Nile Virus this season to eight. (Rousseau, 9/27)

Rhode Island Current: R.I. Reports First Probable Human Case Of West Nile Of 2025
A Providence County resident in their 60s is the first probable human case of West Nile virus in Rhode Island this year, the state Department of Health announced Thursday. The case will be confirmed through further testing by the U.S. Centers for Disease Control and Prevention (CDC). Health officials did not disclose where the person was exposed, but said they began showing symptoms in early September and have remained hospitalized since.  (Shea, 9/25)

CIDRAP: US Poll Shows West Nile Anxiety Low, As Is Insect Repellent Knowledge
A new Annenberg poll finds that, despite an increase in US infections, worry about West Nile virus remains low among Americans, and most people don't know how to correctly apply insect repellent in certain situations. West Nile is the leading mosquito-borne illness in the continental United States, and the Centers for Disease Control and Prevention (CDC) has tracked 1,137 cases so far in 2025 in 42 states. (Soucheray, 9/29)

More health and wellness news —

Newsweek: Why Millennials Need To Rethink Eye Care To Avoid Blindness
If you're in your 20s or 30s, eye disease or vision care might not be high on your list of priorities. But experts warn that this is exactly the time to start protecting your sight to avoid serious problems later in life. Newsweek spoke to two leading eye specialists who explained how everyday lifestyle choices can set the stage for poor eye health—and what you can do now to prevent blindness in the future. (Notarantonio, 9/29)

Stat: Why Risk Factors Matter: 99% Of Heart Attack, Stroke Victims, Had One 
Heart attacks, heart failure, and strokes don’t come out of nowhere, a new study concludes. The first time they strike, patients, clinicians, and researchers might think there were no red flags.  But a prospective cohort study reports that more than 99% of people who experienced these illnesses had at least one of four risks for cardiovascular disease. (Cooney, 9/29)

Newsweek: Chemical Body Odors May Help Detect Cancers Early
Volatile chemicals released by the body—through urine, feces and odor—could one day help to noninvasively detect cancer early. In mouse models, researchers at Hefei Institutes of Physical Science of the Chinese Academy of Sciences found volatile organic compounds (VOCs) could offer helpful clues in screening for multiple types of cancer at once. (Millington, 9/29)

The New York Times: ‘Kpop Demon Hunters’ Noodle Cup Trend May Increase Burn Risks For Kids 
TikTok users have rushed to get their hands on the instant noodles that appear in the film. One prominent Boston hospital has sounded the alarm. Dr. Colleen Ryan, a doctor at the hospital, said in the statement that she had been treating children two to three times a week for burn injuries from instant noodles. Even before the movie, burn injuries from instant noodles made up almost a third of overall pediatric scald burn injuries, according to a study. (Young, 9/29)

AP: Arkansas Egg Producer Recalls Eggs Over Salmonella Contamination Risk
An Arkansas egg producer is recalling 12-count and 18-count cartons of free-range large brown eggs after federal health inspectors detected salmonella contamination at a processing site. ... The move came after U.S. Food and Drug Administration inspectors collected samples from the processing site and found 40 that were positive for salmonella bacteria. Seven different strains of salmonella were identified, including some known to cause human illness. (Aleccia, 9/29)

KFF Health News: KFF Health News’ ‘Letters To The Editor’: Readers Speak Up For Patients Who Can't, And For Kids With Disabilities
Too Close a Call With Organ Donation. When I was a third-year med student doing a rotation on the trauma surgery team, we had a patient in the surgical intensive care unit who had arrived 12 hours earlier with bullet holes in his abdomen. We worked to stabilize him all night; the next day, he was still alive. (9/30) 

Stat: How To Respond To Dangerous Changes To U.S. Public Health 
A dangerous idea is on the table: ending universal hepatitis B birth-dose vaccination in the United States. For many years, the Centers for Disease Control and Prevention has recommended that every baby born in this country receive the vaccine, preventing infections and deaths from a disease that causes liver cancer and deadly cirrhosis. (Most other higher-income countries have the same recommendation.) Abandoning this protection would condemn thousands of children every year to lifelong infection. One in four babies infected at birth eventually die from this preventable infection. (Tom Frieden, 9/30)

The New York Times: What Really Drives Vaccine Hesitancy
In the 20 years I’ve spent researching vaccine decisions, I have spoken to plenty of parents who reject shots for their children. Some say vaccines are never safe or necessary or that polio went away on its own and the vaccine wrongly got credit. I’ve heard comparisons of vaccines to snake venom. In reality, however, the number of people who reject all vaccines is quite small — so small that they are unlikely to compromise public health. (Jennifer Reich, 9/30)

Stat: What Are The Ethical Implications Of Saving A Single Child's Life?
He was two months old and already living on borrowed time. The baby, born in El Salvador, had never drawn a breath on his own. His rare congenital condition narrowed the airway deep within his chest. A ventilator kept him alive. A breathing tube threaded down his throat had become his surrogate airway. But that tube, and that machine, were reaching their limits. The baby’s oxygen levels were harder to maintain. Infections loomed. Without surgery to reconstruct his airway, he would not survive another month. (Christopher Hartnick, 9/30)

Kansas City Star: Missouri's Abortion Amendment Language Hides True Intent 
Everything you need to know about the latest effort to ban abortion in Missouri comes down to this: Republicans don’t actually want voters to know they’re going to ban abortion. Again. They’re trying to sneak it past you. (Joel Mathis, 9/29)

Stat: Insurance Companies Are On A New Slippery Slope: Downcoding 
Insurance companies continue to innovate. On Oct. 1, Cigna will roll out a policy that tracks how physicians bill. It will flag those who submit a higher proportion of level four or level five visits — which get reimbursed at a higher rate — than their peers. For doctors placed under this extra scrutiny, certain claims at those higher levels may be adjusted down by one level if the billing details do not appear to justify the service. The affected codes include 99204–99205 (new patient, office/outpatient), 99214–99215 (established patient, office/outpatient), and 99244–99245 (consultations). (Ryan Nadelson, 9/29)