First Edition: Monday, Jan. 6, 2024

KFF Health News: Health Insurers Limit Coverage Of Prosthetic Limbs, Questioning Their Medical Necessity 
When Michael Adams was researching health insurance options in 2023, he had one very specific requirement: coverage for prosthetic limbs. Adams, 51, lost his right leg to cancer 40 years ago, and he has worn out more legs than he can count. He picked a gold plan on the Colorado health insurance marketplace that covered prosthetics, including microprocessor-controlled knees like the one he has used for many years. That function adds stability and helps prevent falls. But when his leg needed replacing last January after about five years of everyday use, his new marketplace health plan wouldn’t authorize it. (Andrews, 1/6)

KFF Health News: Listen: NPR And KFF Health News Explore How Racism And Violence Hurt Health 
KFF Health News Midwest correspondent Cara Anthony and Emily Kwong, host of NPR’s podcast “Shortwave,” talk about Black families living in the aftermath of lynchings and police killings in their communities. Anthony shares her southeastern Missouri-based reporting from “Silence in Sikeston,” a documentary film, podcast, and print reporting project. She discusses the latest research on the health effects of racism and violence, including the emerging, controversial field of epigenetics. (Anthony, 1/6)

Reuters: Winter Storm Will Not Delay Trump Election Certification In Congress, House Leader Says 
A massive winter storm moving across the United States will not keep the U.S. Congress from meeting on Monday to formally certify Republican Donald Trump's election as president, Republican House Speaker Mike Johnson said on Sunday. "The Electoral Count Act requires this on January 6 at 1 p.m. - so, whether we’re in a blizzard or not we’re going to be in that chamber making sure this is done," Johnson told Fox News' "Sunday Morning Futures" in an interview. (Chiacu, 1/5)

Modern Healthcare: Meet The House, Senate Committee Chairs In Charge Of Healthcare 
As happens every two years, 2025 brings a fresh start. All the legislation drafted and debated in 2023 and 2024 has ceased to exist. Lawmakers will have to start negotiations again on issues affecting Medicare, Medicaid, providers, health insurers, pharmacy benefit managers and more. The shift from a divided Congress to a legislature entirely in the GOP's hands is the biggest and most obvious change. (McAuliff, 1/3)

The 19th: The 119th Congress: Some History Makers, But Fewer Women Overall
For the first time since 2011, the number of women serving in the Senate and House of Representatives will decline. Kelly Dittmar, director of research at Rutgers University’s Center for American Women and Politics, said that while the drop in the number of women in Congress is small, “any decline when we’re talking about women’s representation is effectively slowed or stalled progress because women are already so underrepresented in Congress.” ... Jessica Mackler, the president of EMILYs List, a group that works to elect Democratic women who support abortion rights, said the organization backed all 19 of the new Democratic women joining Congress. (Becker, 1/3)

The Hill: Mike Johnson Says He Expects To Pass Most Of Trump's Agenda With 'One Big, Beautiful Bill' By Memorial Day
Speaker Mike Johnson (R-La.) said Sunday he expects to pass President-elect Trump’s agenda through one big reconciliation package before Memorial Day. In an interview on Fox News’s “Sunday Morning Futures,” Johnson reiterated that Republicans will try to pack in as many policy items as possible into a large reconciliation bill, which would avoid the 60-vote threshold necessary to pass most legislation in the Senate. Reconciliation legislation requires a simple majority, or 50 votes, in the upper chamber. Johnson said there are some “low-hanging fruit” bills, including those that would address the border, that he will put on the floor right away for a vote. But immigration and deportation policies will also be included in the reconciliation package, Johnson said, as will tax cuts and energy permitting reform. Johnson said Trump also asked that the debt ceiling be dealt with before June. (Fortinsky, 1/5)

Stat: Trump FDA Transition Team Takes Shape: Zeta, Traficant 
The Trump administration’s Food and Drug Administration transition team is taking shape, with a former adviser to ex-Commissioner Stephen Hahn and a top executive of a communications firm that has worked with Trump’s FDA commissioner pick Marty Makary. The team is in conversations with a top Capitol Hill aide about a key role at the agency. (Zhang, 1/3)

AP: Higher Social Security Payments Coming For Millions 
President Joe Biden on Sunday signed into law a measure that boosts Social Security payments for current and former public employees, affecting nearly 3 million people who receive pensions from their time as teachers, firefighters, police officers and in other public service jobs. Advocates say the Social Security Fairness Act rights a decades-old disparity, though it will also put strain on Social Security Trust Funds, which face a looming insolvency crisis. (Hussein, 1/5)

Stat: Why Medicaid Cuts Could Be A 'Crisis' For People With Disabilities
Americans want Medicaid. The waiting list to receive home- and community-based services through the state-federal health program has hovered around 700,000 people in recent years. A line that long would stretch from Cleveland to Chicago. The queue may get longer. (Broderick, 1/6)

The New York Times: Telemedicine For Seniors Gets A Last-Minute Reprieve 
Telemedicine lives, at least until March 31. Kyle Zebley, senior vice president for public policy at the American Telemedicine Association, who estimates that 20 to 30 percent of medical encounters could occur virtually, expects further renewal. Telemedicine is “so popular and so bipartisan in nature I can’t imagine the Trump administration and Congress allowing it to lapse,” he said. (Span, 1/5)

Modern Healthcare: Why Digital Mental Health May Flourish In 2025
Health tech companies focused on behavioral health are confident that reimbursement trends favor them in 2025. Payment flexibilities for telehealth, hospital-at-home care and remote prescribing have been temporarily extended until March 31. The changes will prolong COVID-19-era payment for remote care across all specialties. For many in mental health tech, new reimbursement codes from the Centers for Medicare and Medicaid Services’ November physician payment rule are an even bigger deal. The codes reimburse providers for using digital mental health treatment applications or devices that have been cleared or granted De Novo authorization by the Food and Drug Administration. (Perna, 1/3)

The Hill: Changing Alcohol Labels Could Take 'Decades': Expert
United States Surgeon General Vivek Murthy proposed labelling alcohol as a leading cause of cancer. Dr. Marion Nestle, a professor of nutrition, food studies and public health at New York University who has served on the U.S. Dietary Guidelines Advisory Committee, discusses research surrounding the move. (Kutz, 1/4)

NPR: Dr. Rachel Levine Reflects On Her Service And Trans Politics As She Leaves HHS 
In 2021, the country had one state with a ban on gender-affirming care for youth on the books — Arkansas. In March of the same year, Dr. Rachel Levine won confirmation by the Senate to lead the U.S. Public Health Service Commissioned Corps as the assistant secretary for health. She holds the rank of admiral. Levine is the highest ranking, out transgender person ever to serve in the federal government. In the nearly four years that she's been at the Department of Health and Human Services, there has been an explosion in anti-trans legislation. (Simmons-Duffin, 1/6)

Fierce Healthcare: Aetna Sues Drugmakers For Alleged Widespread Price-Fixing And Collusion
Aetna is taking legal action against Pfizer, Novartis, Teva Pharmaceuticals and others, saying the list of drugmakers conspired to overcharge the insurer, consumers and the federal government for generic drugs. The complaint (PDF), filed Dec. 31, claims the drugmakers communicated secretly at trade conferences or through phone calls, beginning in 2012, to determine the market share, prices and bids of certain drugs. If communication was in writing, they destroyed the evidence, Aetna claimed. (Tong, 1/3)

Fortune Well: Pfizer Has Increased Prices On Over 60 Drugs In The U.S. As Of Jan. 1 
The start of the new year is typically a time when people make big changes around health—and drug companies are no exception. As of Jan. 1, more than 250 branded drugs from pharmaceutical giants including Bristol Myers Squibb, Sanofi-Pasteur, Merck, Pfizer, and more will see price hikes in the U.S., according to data analysis conducted by health care research firm 3 Axis Advisors. Pfizer alone is raising prices on over 60 drugs, the most on the list. (Pfizer has nearly 500 products in its portfolio.) In addition to a 3% increase on Paxlovid, its COVID treatment, Pfizer’s cancer drugs Adcetris and Ibrance, as well as arthritis treatment Xeljanz, will now cost between 3% and 5% more, according to Reuters. (Fields, 1/3)

Bloomberg: UPS Seeks $20 Billion Lifeline From Medical Supply Shipping
United Parcel Service Inc. has been quietly building a health-care empire to offset stagnating revenue in its core package-delivery business. Specialized logistics services, unlike standard brown-box delivery, have appealing profit margins. A customer who needs injectable medicines shipped overnight in a refrigerated box is willing to pay a hefty premium. (LaPara, 1/6)

The Washington Post: Virginia Nurse Arrested After Babies In NICU Suffer Unexplained Injuries
The Virginia hospital first noticed newborns were suffering mysterious injuries in the summer of 2023. Then, roughly a month ago, three babies in the neonatal intensive care unit experienced “unexplainable fractures,” according to a statement from the Henrico Doctors’ Hospital. The hospital grew so concerned that last week, it announced it would stop admitting babies into the NICU until they discovered what was breaking their bones. Now, a registered nurse has been arrested and charged with malicious wounding and felony child abuse. (Uber, 1/5)

News Service of Florida: Orlando OB-GYN Fined $10,000 By The State Medical Board In Abortion Case 
After the state Department of Health called for revoking the doctor’s license, the Florida Board of Medicine this week imposed a $10,000 fine and reprimand for a physician who did not comply in 2022 with a law requiring 24-hour waiting periods before abortions can be performed. The final order came after the board decided last month to approve penalties for Dr. Candace Sue Cooley that were less severe than what the Department of Health wanted. (Saunders, 1/6)

MedPage Today: What Happened With The USMLE Cheating Scandal? 
In February, we reported on a cheating scandal that resulted in U.S. Medical Licensing Examination (USMLE) scores being invalidated for hundreds of Nepali test takers, some of whom later filed a class action lawsuit. In this report, we follow up on what has happened since. (Robertson, 1/4)

Stat: What Health AI Developers Must Disclose Under New Federal Rule
Clinicians clacking away at workstations in hospitals know what the ones and zeroes humming away in the background are up to, right? In fact, doctors and health systems often don’t know important details about the algorithms they rely on for purposes like predicting the onset of dangerous medical conditions. But in what advocates call a step forward, federal regulators now require electronic health record (EHR) companies to disclose to customers a broad swath of information about artificial intelligence tools in their software. (Aguilar, 1/6)

North Carolina Health News and The Charlotte Ledger: AI May Listen In On Your Next MD's Appointment
When pediatrician Jocelyn Wilson sees patients at Atrium Health Levine Children’s Charlotte Pediatrics, she begins each visit with a simple request: for permission to record the conversation. The reason isn’t surveillance — it’s efficiency. (Crouch, 1/6)

Los Angeles Times: Newsom Aims To Limit Unhealthy Food In California, Getting Ahead Of Trump Administration And RFK Jr.
Gov. Gavin Newsom issued an executive order on Friday attempting to limit access to ultra-processed foods, a directive he cast as a continuation of California’s “nation leading” nutrition and health standards. “The food we eat shouldn’t make us sick with disease or lead to lifelong consequences,” Newsom said in a statement. “California has been a leader for years in creating healthy and delicious school meals, and removing harmful ingredients and chemicals from food. We’re going to work with the industry, consumers and experts to crack down on ultra-processed foods and create a healthier future for every Californian.” (Wick and Luna, 1/3)

Bay Area News Group: Bay Area Homeless Population Rose To A Record 38,891 People In 2024
The Bay Area’s homeless population grew 6% to an estimated 38,891 people in 2024, according to new federal data, extending a decade-long surge fueled by the housing affordability crisis, and drug and mental health challenges among those living on the region’s streets. In California, homelessness rose 3% to more than 187,000, while the U.S. homeless population spiked 18% to more than 770,000 from 2023 to 2024. All three totals are record highs. (Varian, 1/5)

Minnesota Public Radio: New Law Covering Wig Costs Gives Minnesota Cancer Patients Hope For Healing
Emily Wyman’s first wig after her stage three ovarian cancer diagnosis was so expensive she had to rely on family for help. “I tried to get my insurance company to cover part of it, and was denied,” she said. Health insurance companies in Minnesota are now required by law to cover the cost of wigs for those who have lost their hair due to a medical condition. Originally, only alopecia was covered, but not alopecia caused by cancer. (Wurzer and Levin, 1/3)

Minnesota Public Radio: More Minnesota Kids Get Exempted From Required Vaccinations. Here’s What’s Happening
Vaccination rates for school-aged children have declined in Minnesota and across the nation as more families seek to exempt their kids from required vaccinations. Medical professionals say those exemption counts are near the point where Minnesotans should be extremely concerned, especially when it comes to schools. (Miles, 1/6)

Fierce Healthcare: Aetna's Network Contract With Providence Expires
Providence is no longer in-network for Oregonians enrolled in Aetna plans amid lengthy contract negotiations between the two. The contract between Aetna and Providence expired Jan. 1, meaning most of the system's medical groups, hospitals and clinics are now out-of-network. Aetna's contract with Providence Medical Groups, located in the southern part of the state, expires Feb. 17. (Minemyer, 1/3)

ProPublica: Formaldehyde Poses An “Unreasonable” Public Health Risk, EPA Finds
A long-awaited report from the Environmental Protection Agency has found that formaldehyde presents an unreasonable risk to human health. But the report, released Thursday, downplayed the threat the chemical poses to people living near industrial plants that release large quantities of the carcinogen into the air. The health risk assessment was published weeks after a ProPublica investigation found that formaldehyde, one of the most widely used chemicals in commerce, causes more cases of cancer than any other chemical in the air and triggers asthma, miscarriages and fertility problems. (Lerner, 1/3)

AP: Sick Season Is In Full Force. What The Latest CDC Figures Show 
The holidays came with a side of flu for many Americans, with 40 states reporting high or very high levels of illness last week, according to the latest government health data. “A lot of flu out there,” said the Centers for Disease Control and Prevention’s Carrie Reed. The most recent CDC hospitalization data and other indicators show that the flu virus is trending higher than the other germs, Reed said. Several seasonal flu strains are driving cases, with no dominant one, she added. (Stobbe, 1/3)

Stat: What Covid Tried To Teach Us — And Why It Will Matter In The Next Pandemic
Five years ago this week, STAT was interviewing nervous infectious disease scientists about a mysterious disease spreading in the central Chinese city of Wuhan, located roughly 500 miles west of Shanghai. On Jan. 4, 2020, we published the first of what would become a torrent of articles on the disease now known as Covid-19. (Branswell, 1/6)

The Washington Post: Early Physical Therapy Is Better For Concussions, Study Indicates 
People who receive physical therapy shortly after suffering concussions have better outcomes than those who wait longer to start rehabilitation programs, a recent analysis suggests. Published in the Physical Therapy & Rehabilitation Journal, the study reports on a randomized trial of 203 adults diagnosed with a mild traumatic brain injury, or concussion, who were within two to 12 weeks from their injury. (Blakemore, 1/5)