First Edition: Feb. 12, 2024

KFF Health News: States Target Health Insurers’ ‘Prior Authorization’ Red Tape
Christopher Marks noticed an immediate improvement when his doctor prescribed him the Type 2 diabetes medication Mounjaro last year. The 40-year-old truck driver from Kansas City, Missouri, said his average blood sugar reading decreased significantly and that keeping it within target range took less insulin than before. But when his doctor followed the typical prescribing pattern and increased his dose of Mounjaro — a drug with a wholesale list price of more than $1,000 a month — Marks’ health insurer declined to pay for it. (Sable-Smith, 2/12)

KFF Health News: GoFundMe Has Become A Health Care Utility 
GoFundMe started as a crowdfunding site for underwriting “ideas and dreams,” and, as GoFundMe’s co-founders, Andrew Ballester and Brad Damphousse, once put it, “for life’s important moments.” In the early years, it funded honeymoon trips, graduation gifts, and church missions to overseas hospitals in need. Now GoFundMe has become a go-to platform for patients trying to escape medical billing nightmares. One study found that, in 2020, the annual number of U.S. campaigns related to medical causes — about 200,000 — was 25 times the number of such campaigns on the site in 2011. More than 500 current campaigns are dedicated to asking for financial help for treating people, mostly kids, who have spinal muscular atrophy, a neurodegenerative genetic condition. The recently approved gene therapy for young children with the condition, by the drugmaker Novartis, has a price tag of about $2.1 million for the single-dose treatment. (Rosenthal, 2/12)

AP: Flu Hangs On In US, Fading In Some Areas And Intensifying In Others 
The flu virus is hanging on in the U.S., intensifying in some areas of the country after weeks of an apparent national decline. Centers for Disease Control and Prevention data released Friday showed a continued national drop in flu hospitalizations, but other indicators were up — including the number of states with high or very high levels for respiratory illnesses. “Nationally, we can say we’ve peaked, but on a regional level it varies,” said the CDC’s Alicia Budd. “A couple of regions haven’t peaked yet.” (Stobbe, 2/9)

St. Louis Public Radio: Wash U Researchers Find Evidence Of Long Flu
Scientists at Washington University have found that patients hospitalized with the flu can display long-term effects similar to those found in long COVID patients. The researchers found evidence of long flu by looking at Veterans Administration hospital records of flu and COVID-19 patients that had been stripped of identifying information. In the year and a half after patients became sick with the flu, some suffered elevated risk of continued breathing and lung problems. (Fentem, 2/9)

CIDRAP: Early Estimates Of RSV Drug Show 70% Protection Against Hospital Illness 
Real-world efficacy data from Spain indicate that the RSV drug nirsevimab (Beyfortus) is at least 70% effective at preventing RSV hospitalizations in infants under 9 months old, according to new research in Eurosurveillance. Spain was one of the first countries to introduce nirsevimab as universal RSV prophylaxis (prevention) into its national immunization program for all infants born on April 1, 2023, and after. (Soucheray, 2/9)

NBC News: Oregon's First Case Of Human Plague In 8 Years Likely Came From Cat
Health officials announced this week that a resident of Deschutes County — a rural part of Oregon — was diagnosed with plague, marking the state's first human case in more than eight years. The person was likely infected by their pet cat, who had developed symptoms, according to Deschutes County Health Services.Humans are most commonly exposed to plague from the bites of fleas carrying Yersinia pestis, the bacterium that causes the disease. (Bendix, 2/9)

NBC News: Fungal Infections Are Getting Harder To Treat. Will The FDA Approve New Drugs?
In recent years, the potential danger fungal infections pose to human health has become more and more apparent, as fungi either evolve to evade treatments or spread beyond their typical geographical regions. Doctors around the world are desperate for new medicines to combat the growing threat. “The problem with fungal diseases has gotten to the point where the World Health Organization has recognized it as a widespread threat,” said Dr. Arturo Casadevall, a microbiologist and chair of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health in Baltimore. (Sullivan, 2/11)

Bloomberg: Lloyd Austin In Critical Care Unit, Hospitalized For Second Time In A Month
US Defense Secretary Lloyd Austin was admitted into care late Sunday with an apparent bladder issue, after being hospitalized for the second time in a month. His security detail brought him to Walter Reed National Military Medical Center outside Washington with “symptoms suggesting an emergent bladder issue,” Pentagon spokesman Pat Ryder said in a statement. Austin, who in January had been in for treatment for complications from prostate cancer, was moved “for supportive care and close monitoring,” according to a statement from Walter Reed physicians. (Diaz and Wadhams, 2/11)

CQ-Roll Call: Lawmakers’ Retirements Risk Leaving Doctor Pay Fix Unfinished
Physician groups and other advocates for overhauling the Medicare payment system will lose three of their biggest Capitol Hill supporters to retirement next year, raising questions about next steps for long-term changes to the Medicare payment program. Republican Reps. Larry Bucshon of Indiana, Michael C. Burgess of Texas and Brad Wenstrup of Ohio, all members of the GOP Doctors Caucus, have been vocal in pushing for changes to the way Medicare pays physicians. (Hellmann, 2/9)

The Washington Post: U.S. Investigates Alleged Medicare Fraud Scheme Estimated At $2 Billion 
The first angry calls to the Pretty in Pink Boutique began last August, confusing staff at the Franklin, Tenn., provider of wigs, mastectomy bras and other accessories for cancer patients. Medicare recipients from around the country claimed that a company called Pretty in Pink had charged their health insurance companies thousands of dollars for urinary catheters that they never ordered or received. Flooded by dozens of complaints, the boutique launched a webpage in September to explain that its leaders were dumbfounded, too. (Diamond, Weber and Keating, 2/9)

Modern Healthcare: CMS Proposed Rule To Increase Accrediting Organization Oversight 
The Centers for Medicare and Medicaid Services proposed Thursday to crack down on accrediting organizations following concerns of biased, inconsistent survey results and conflicts of interest. The proposed rule would strengthen CMS’ oversight of accrediting bodies and mandate the organizations reduce conflicts of interest with healthcare facilities, including by limiting fee-based consulting services. The proposal also would standardize accrediting organizations' survey processes. (Devereaux, 2/9)

Modern Healthcare: Prior Authorization Legislation Proliferates In States
A growing number of states is imposing new limitations on prior authorization requirements to address provider and patient complaints that health insurance companies are delaying and denying care. Some of these legislative efforts go further than what the Centers for Medicare and Medicaid Services proposed last month for insurers participating in federal programs such as Medicare, Medicaid and the health insurance exchanges. (McAuliff, 2/9)

Stat: States Are Ramping Up Scrutiny Of Health Transactions, As More Provider Groups Look For Buyers
Oregon is at the forefront of the push for more scrutiny; it already has some of the strongest health care market oversight laws in the nation. But state legislatures in Illinois, Minnesota, and New York approved similar oversight programs last year, meaning deals in those states will start getting more scrutiny soon. And five more states, Vermont, Washington, Pennsylvania, Indiana, and New Mexico, are already looking at legislation to start or expand their own programs. It doesn’t necessarily mean the deals won’t happen, experts cautioned. In Oregon, for example, where Optum is trying to buy the 100-provider Corvallis Clinic, the oversight has mostly served as a way for the public to raise concerns, and for the state to get more insight into the group’s activities. But it gives states and the public new and valuable insight into their health care landscape, experts told STAT. (Trang, 2/12)

Stat: FTC Sends Signal To Private Equity On Medical Firm Consolidations
Lina Khan’s Federal Trade Commission is eager to make Big Physician a lot smaller. Last September, the FTC sued private equity firm Welsh, Carson, Anderson & Stowe and U.S. Anesthesia Partners, alleging the two parties conspired to create monopolies for anesthesia services. Both Welsh Carson and USAP have tried to get the case thrown out, but the FTC recently doubled down. (Herman, 2/12)

Minnesota Public Radio: University Of Minnesota Moving To Reacquire Medical Center From Fairview Health Services 
The University of Minnesota is pursuing a plan to reacquire its Twin Cities campus health care facilities from Fairview Health Services. The University of Minnesota Regents on Friday voted to support a nonbinding letter of intent with Fairview to regain ownership of the U’s teaching hospital by the end of 2027. (2/9)

Modern Healthcare: Amazon's One Medical To Close Offices, Move CFO To New Role
Corporate office space is the latest expense on the chopping block at Amazon's One Medical, which announced layoffs earlier this week. One Medical will close offices in New York City, Minneapolis and St. Petersburg, Florida, by the end of the month, according to a Thursday report from Business Insider which cited a leaked internal email from One Medical’s CEO Trent Green. The primary care provider is also downsizing its San Francisco office to one floor, the report said. (Hudson, 2/9)

Houston Chronicle: MD Anderson Cancer Researcher Alleges Scientist Took Credit For Work
A junior faculty member at MD Anderson Cancer Center has accused a high-profile scientist of improperly taking credit for research and making false, defamatory statements that damaged her career, according to a lawsuit filed in Harris County. The suit, filed in August and first reported Thursday by STAT News, represents an unusual public clash at one of the world’s leading cancer research hubs. (Gill and MacDonald, 2/9)

Stat: Aurobindo Cuts Production At A Key Facility Amid Shortage Concerns
Aurobindo, which is one of the largest generic drug makers, has halted some production at a key facility in India after U.S. inspectors found manufacturing problems, the latest such episode to underscore concerns over both shortages and the quality of medicines produced by some suppliers. (Silverman, 2/9)

NBC News: Novo Nordisk Settles Two Lawsuits Over Copycat Versions Of Ozempic And Wegovy
Novo Nordisk said Friday it settled two lawsuits against two businesses claiming to offer compounded versions of its blockbuster drugs Ozempic and Wegovy. The drugmaker has filed a total of 12 lawsuits against clinics, med spas and compounding pharmacies in the U.S. that claim to offer semaglutide, the active ingredient in Ozempic and Wegovy. Novo Nordisk holds the patent on semaglutide, and the drugmaker does not supply the ingredient to outside groups, leaving some experts wondering what exactly is being sold to consumers. (Lovelace Jr., 2/9)

News Service of Florida and WFSU: House And Senate Committees OK Bills To Create 'Rural Emergency Hospitals' 
With supporters pointing to a need to ensure health care access in rural areas, House and Senate committees Thursday moved forward with bills that would create a new category of “rural emergency hospitals” in the state. The House Health & Human Services Committee approved the House version of the bill (HB 309), sponsored by Rep. Jason Shoaf, R-Port St. Joe, with the measure now positioned to go to the full House. (Andrews, 2/9)

AP: Virginia's Youngkin Aims To Bolster Mental Health Care, Part Of National Focus After The Pandemic 
John Clair, the police chief of a small Appalachian town in southwest Virginia, spends his days consumed by a growing problem: the frequency with which his officers are tapped to detain, transport and wait in hospitals with people in the throes of a mental health crisis. Officers from Clair’s 21-member Marion Police Department crisscross the state to deliver patients for court-ordered treatment, sometimes only to discover the hospital where they were sent has no available beds. Patients end up boarding in waiting rooms or emergency rooms, sometimes for days on end, while under the supervision of Clair’s officers. (Rankin, 2/12)

The Colorado Sun: The Cost Of Mental Health Care Is Increasingly Out Of Reach For Some Coloradans
When Drew Dummit’s mental illness worsened in 2017, he was admitted to Mind Springs Health in Grand Junction, the largest behavioral health services provider on the Western Slope. Three days later, staff deemed him stable enough to go home. Soon after, Dummit’s hallucinations worsened, he attempted suicide twice and began assaulting his mother, Sandra Sharp, more severely and frequently. “If I could have afforded inpatient care at the time, he would have gone,” said Sharp, who lives in Denver. (Flowers, 2/9)

AP: Schools Are Trying To Get More Students Therapy. Not All Parents Are On Board 
Derry Oliver was in fifth grade when she first talked to her mom about seeing a therapist. She was living in Georgia with her uncle and grandparents while her mom was in New York scoping out jobs and apartments ahead of moving the family. It was a rough year apart. Oliver, now 17, was feeling depressed. A school staffer raised the idea of a therapist. Oliver’s mom, also named Derry Oliver, questioned the school’s assessment and didn’t give consent for therapy. “You’re so young,” the mom recalled thinking. “There’s nothing wrong with you. These are growing pains.” (Elsen-Rooney, 2/10)

The Baltimore Sun: Johns Hopkins Researchers Make Progress In Developing Blood Test For Psychiatric Disorders 
Johns Hopkins researchers say they’re getting closer to developing a blood test that would identify changes in the brain associated with psychiatric and neurological disorders — an advancement that could enable doctors to detect the early signs of mental health emergencies. (Roberts, 2/9)

Fox News: Ketamine Therapy Shown Effective In Treating Severe Depression In Veterans, Study Finds
The University of Michigan released a study on the effects of ketamine in cases of severe or treatment-resistant depression among veterans. Half of the study participants experienced significant relief after undergoing six weeks of ketamine therapy, according to a Michigan Medicine press release. The study, published in the Journal of Clinical Psychiatry, looked into the data of 215 veterans receiving intravenous ketamine therapy at Veterans Affairs (VA) hospitals. (Stabile, 2/10)

The 19th: For Some Pregnant Patients, Crisis Pregnancy Centers Are The Only Option
Savannah McNally was 24 years old, and in the middle of a divorce, trying to sell her house, wrapping up her service in the Navy and figuring out a way to finish college. She was also pregnant. (Luthra, 2/9)

The Wall Street Journal: Uterine Cancer Was Easy To Treat. Now It’s Killing More Women Than Ever
Stacy Hernandez always had irregular periods. But when the bleeding wouldn’t stop, she got scared. She said she visited her general practitioner and urgent care at least six times. Doctors changed her birth-control medications, blamed her excess weight and suggested the bleeding would eventually subside. It didn’t. After more than a year, a doctor ordered an ultrasound followed by a test that finally identified the problem: uterine cancer. (Abbott, 2/12)

The Washington Post: Many Children Don’t Get Cheap, Effective Treatment For Diarrhea 
Despite the wide availability of a cheap, effective remedy for potentially fatal diarrheal disease, too few children receive the treatment, according to an analysis that suggests provider misconceptions may be driving the crisis. ... Oral rehydration salts (ORS), a solution of glucose and electrolytes that prevents dehydration, is the front-line treatment for diarrhea in kids and is on the WHO List of Essential Medicines. But the study, published in the journal Science, suggests that misconceptions among providers lead physicians to underprescribe the inexpensive cure. (Blakemore, 2/11)

The Hill: Climate Change Is Making It More Dangerous For Kids To Play Outside, Report Finds 
Blistering heat waves and more frequent wildfires are reversing a generation of U.S. clean air gains, a new study has found. The peer-reviewed research by the climate analytics firm First Street Foundation projected that by midcentury, the increased levels of microscopic soot particles and ozone molecules entering Americans’ lungs will be back to the levels they were at in 2004 — before a decades-long federal campaign to clean up the air. ... Falling air quality has driven up the number of days when children in the U.S. West can’t safely play outside nearly fivefold since 2000. (Elbein, 2/12)

NPR: Debate Simmers Over When Doctors Should Declare Brain Death
There's a controversy simmering today about one of the ways doctors declare people to be dead. The debate is focused on the Uniform Determination of Death Act, a law that was adopted by most states in the 1980s. The law says that death can be declared if someone has experienced "irreversible cessation of all functions of the entire brain." But some parts of the brain can continue to function in people who have been declared brain dead, prompting calls to revise the statute. (Stein, 2/11)

NPR: A Tiny Robot Set To Simulate Remote-Controlled Surgery In Space
MIRA, which stands for miniaturized in vivo robotic assistant, recently became the first surgical robot at the International Space Station. The tiny robot, which weighs about 2 pounds, arrived at the space station on Feb. 1. Over the next few weeks, the robotic assistant will practice operating in zero gravity. Developers plan to use MIRA to conduct a surgical simulation via remote-controlled technology, with a surgeon directing its movements 250 miles away from Nebraska. (Kim, 2/10)

The Atlantic: Bedbugs Are Getting Scarier
For reasons that almost certainly have to do with global travel and poor pest management, bedbugs have resurfaced with a vengeance in 50 countries since the late 1990s. But recently, the resurgence has brought an added twist: When exterminators swarm out to hunt these pests, they might encounter not just one but two different kinds of bugs. (Eberle, 2/10)