FEHBlog note: Since the FEHBlog launched in 2006, the FEHBlog has featured a photograph at the top of the post. The FEHBlog learned today that email subscribers to the FEHBlog see a blank spot at the top of the page as the email system blocks photographs. For that reason, the FEHBlog has stopped using photographs in the blog except when necessary.

From Washington, DC,

• Roll Call informs us,
  • “Senate Republicans say they are looking for ways to safeguard rural hospitals from proposed cuts to a key Medicaid funding method, amid concerns from the powerful hospital lobby and others that the budget reconciliation bill could force many facilities to close.
  • “The draft text that the Senate Finance Committee released this week reduces the ability of states who expanded Medicaid under the 2010 health care law to levy taxes on providers to fund their programs. 
  • “Senate Majority Leader John Thune, R-S.D., told reporters Wednesday he is working on the issue, though he did not offer details. Leadership is attempting to balance directives to cut government spending with demands from senators like Josh Hawley, R-Mo., who said that the bill should protect rural hospitals from the effects of shrinking provider taxes.
  • “The right thing to do is not defund rural hospitals to pay for your pet projects,” Hawley said. “So, if you want your pet project in the bill, go find your own money. Don’t defund rural hospitals.” 
  • “Medicaid is often one of the top payers for rural facilities.”

• STAT News adds,
  • “Hospitals are now lobbying senators to return to the House’s version of the bill, which also is expected to substantially cut hospitals’ revenues and the number of patients covered — but less so than the Senate’s version of the bill. 
  • “But that lobbying effort is butting up against senators who want to further reduce government spending. The Congressional Budget Office has not yet projected the budget impact of the Senate bill.”

• The American Hospital Association News tells us,
  • The Centers for Medicare & Medicaid Services June 20 announced it is finalizing its 2025 Marketplace Integrity and Affordability final rule. The rule shortens the open enrollment period for the federal marketplace to Nov. 1-Dec. 15 starting in 2027, and limits open enrollment periods for state-based marketplaces to Nov. 1-Dec. 31. The rule also includes a change to the premium adjustment percentage that would increase the maximum annual cost sharing limitation. Additionally, the rule makes updates to the income verification process and pre-enrollment verification process for SEPs, changes to the essential health benefits, modifications to the redetermination and re-enrollment processes, and ends a special enrollment period for low-income individuals, among other policies. Many of the provisions reinstate policies finalized during the prior Trump administration.
    
• Here is a link to CMS’s fact sheet on this final rule.

• Govexec lets us know,
  • “The White House and its Department of Government Efficiency are spearheading efforts to shake up the Postal Service, according to details of the meetings obtained by Government Executive, with topics including pricing for mail and general reform proposals. 
  • “The meetings were not clearly within the scope of a memorandum of understanding former Postmaster General Louis DeJoy signed with DOGE, which focused on specific cost-cutting measures and real estate planning. Some of the meetings also involved top officials from the Treasury Department, White House attorneys and policy advisors and additional USPS executives. A source familiar with the meetings confirmed DOGE has been active at the Postal Service’s Washington headquarters in recent months.” 

• Per an OPM news release,
  • This week, the U.S. Office of Personnel Management (OPM) Inspector General (IG) released a report that uncovered widespread compliance failures and weak internal oversight in the agencyʼs telework and remote work programs during the Biden Administration.
  • The report revealed more than half of OPM employees reviewed failed to meet basic in-office requirements and nearly a third of sampled teleworkers had expired or missing agreements. Additionally, 15 percent of remote workers had no approved agreement on file, and many discrepancies flagged by HR remained unresolved for months.
  • Since President Trump took office, OPM has reinstated in-office requirements to restore a culture of accountability and public service.
  • “Under the previous administration, OPMʼs telework and remote work policies were mismanaged and oversight was virtually nonexistent,” Acting Director Chuck Ezell said. “That era of telework abuse is over. At President Trumpʼs direction, OPM has restored in-person operations to ensure federal employees are working for the taxpayers.”
  • OPM has already implemented new internal controls and compliance reviews, and effective March 3, 2025, all employees are required to report to their official duty station full-time.
  • Read the OIG report here.

From the Food and Drug Administration front,

• The Wall Street Journal reports,
  • “Sanofi and Regeneron Pharmaceuticals said they got Food and Drug Administration approval for anti-inflammatory drug Dupixent as a treatment for a rare skin disease, adding an eighth indication in the U.S. for their blockbuster medicine.
  • “France’s Sanofi and Tarrytown, N.Y.-based Regeneron said Friday that the FDA gave the green light for Dupixent as a treatment of adult patients with bullous pemphigoid, a skin disease that mainly affects elderly people and is characterized by itch, blisters and lesions, as well as a reddening of the skin.”

From the judicial front,

• SCOTUSblog reports,
  • In a splintered decision, the Supreme Court did not allow a retired firefighter to sue her prior employer under the ADA. The majority opinion, written by Justice Gorsuch, determined the retiree was not a “qualified individual” under the law. In dissent, Justice Jackson called the majority opinion “counterintuitive.”
• and
  • “On Friday, the Supreme Court opined on a challenge by retailers of e-cigarettes to an FDA decision. The majority opinion, written by Justice Amy Coney Barrett, held that the challengers were “adversely affected” by the FDA’s decision and could thus seek judicial review in the 5th Circuit.”

• The AHA News relates,
  • “The U.S. District Court for the Northern District of Iowa June 18 vacated components of the Centers for Medicare & Medicaid Services’ minimum nurse staffing rule requiring nursing homes to have a registered nurse onsite 24/7 and prescribing a minimum total nurse staffing hours per resident day. The court kept in place the rule’s enhanced facility assessment and Medicaid reporting requirements.
  • “CMS’s general rulemaking power to promulgate ‘such other requirements as the Secretary deems necessary’ does not constitute clear authorization to mandate rigid staffing requirements for [long-term care] facilities,” wrote District Court Judge Leonard T. Strand in the ruling. “Therefore, I find that CMS did not have authority to promulgate the 24/7 RN requirement and the HPRD requirements pursuant to its health and safety rulemaking authority.”
  • “A district court in Texas also vacated the minimum staffing mandate in April.”

• Beckers Payer Issues points out,
  • “New York City can implement an Aetna Medicare Advantage plan for its retirees, the state’s highest court ruled June 18. 
  • “The city has pushed to switch its health benefits for retired city employees to a Medicare Advantage plan since 2021. A group of retired employees sued to block the plan, arguing that the city had promised to provide supplemental Medicare benefits, and that their healthcare benefits would be diminished under an MA plan. 
  • “The New York Court of Appeals ruled against the retirees, reversing lower courts’ decisions. The judges ruled the city was not obligated to offer Medigap plans to its retirees. The court also ruled the retirees did not prove their care would be harmed under an MA plan.” 

From the public health and medical research front,

• The Centers for Disease Control and Prevention announced today,
  • “Seasonal influenza activity is low. COVID-19 and RSV activity is very low.
  • “COVID-19
    • “COVID-19 wastewater activity is low and emergency department visits and laboratory percent positivity are at very low levels.
  • “Influenza
    • “Seasonal influenza activity is low.
    • “Additional information about current influenza activity can be found at: Weekly U.S. Influenza Surveillance Report | CDC
  • “RSV
    • “RSV activity is very low.

• The University of Minnesota’s CIDRAP adds,
  • “New findings presented at the annual meeting of the American Society for Microbiology suggest increased levels of fungal spores in the air are strongly linked to surges in cases of influenza and COVID-19.
  • “The study was based on daily spore samples taken in 2022 and 2024 in San Juan and Caguas, Puerto Rico, where fungal spores and pollen are endemic and present year-round. The data on spores was matched to data on the daily incidence of people diagnosed with COVID-19 and flu.
  • “The researchers found increases in fungal spore counts matched surges in flu and COVID activity. There was no relationship between pollen levels and respiratory illness activity.
  • “The findings from our study suggest that monitoring airborne fungal spore levels could help predict short-term outbreaks (spikes) of flu and COVID-19, giving public health systems an early warning signal,” study author Felix Rivera-Mariani, PhD said in a press release from the American Society of Microbiology. “Our findings also highlight the potential role of environmental factors—not just person-to-person spread—in contributing to the incidence of respiratory viral infections. That could open new doors for targeted public health alerts, especially in areas with high outdoor airborne fungi.” 
• and
  • “The US Centers for Disease Control and Prevention (CDC) reported 17 more measles cases today in its weekly update, bringing its total for the year to 1,214 confirmed cases from 36 jurisdictions.
  • “Although measles cases have slowed since peaking in late March, the uptick in cases brings the country closer to surpassing the 1,274 cases reported in 2019, which to date is the highest number reported in a single year since the disease was eliminated from the United States in 2020. There were 285 confirmed measles cases in 2024. 
  • “The CDC reported two additional outbreaks (three or more related cases), bringing the 2025 total to 23 outbreaks. Of the 1,214 confirmed US cases, 89% are outbreak associated. Only 16 outbreaks were reported in 2024, with 69% of confirmed cases associated with those outbreaks. The biggest outbreak in 2025 has been in West Texas, which has seen 750 confirmed cases since late January.”
• and
  • “Since late April, an infectious diseases specialist at Stanford University and his colleagues have been volunteering their time on a project they hope will help educate the public, and combat misinformation, about the safety and efficacy vaccines.
  • “The project, led by Jake Scott, MD, is a spreadsheet of all the randomized controlled trials (RCTs) that have ever been conducted for licensed vaccines. The idea, hatched on the social media site X, was prompted by responses to an old video of current Department of Health and Human Services Secretary Robert F. Kennedy Jr., in which he claims that none of vaccines mandated for US children has ever been tested in preclinical studies against a placebo. In one of the responses, infectious disease physician Brad Spellberg, MD, suggested a crowd-sourced effort to identify and post all of the RCTs in which vaccines have been tested against a placebo.
  • “That night Scott, a self-proclaimed “spreadsheet geek” who has previously collaborated with Spellberg, began building a spreadsheet using Google Sheets, creating criteria for inclusion, and seeding it with seven vaccine RCTs. Each entry has columns for the name of the vaccine, the date the RCT was published, which populations were studied, how many people were involved in the study and, importantly, the types of placebo or active comparator that were used for the control group.
  • “By the next morning, there were 20 vaccine RCTs on the spreadsheet. By May 5, the list had grown to 100. The spreadsheet now stands at more than 270 RCTs and continues to grow. Scott and his colleagues, who aim to eventually publish a peer-reviewed paper on the project in a medical journal, thoroughly review each entry before inclusion and provide links to the RCTs on PubMed.
  • “I think we’re kind of looking at the tip of the iceberg,” Scott told CIDRAP News. “There’s going to be, I would say, easily 400-plus, maybe 500-plus trials with millions and millions of participants.”
    
• The AP reports,
  • “Older U.S. adults are increasingly dying from unintentional falls, according to a new federal report published Wednesday, with white people accounting for the vast majority of the deaths. 
  • “From 2003 to 2023, death rates from falls rose more than 70% for adults ages 65 to 74, the report from the U.S. Centers for Disease Control and Prevention said. The rate increased more than 75% for people 75 to 84, and more than doubled for seniors 85 and older.
  • “Falls continue to be a public health problem worth paying attention to,” said Geoffrey Hoffman, a University of Michigan researcher who was not involved in the new report. “It’s curious that these rates keep rising.”

• MedTech Dive notes five things to watch at the American Diabetes Association’s upcoming scientific session.
  • “At the American Diabetes Association’s Scientific Sessions, companies like Abbott, Dexcom and Beta Bionics will share the latest data on diabetes technology and new partnerships.
  • “The annual conference takes place June 20-23 in Chicago, with industry leaders gathering to discuss new developments in diabetes treatments. This year’s event follows new ADA standards of care that would expand access to continuous glucose monitors, recommending that the devices be used in adults with Type 2 diabetes who are taking glucose-lowering medications other than insulin.”

From the U.S. healthcare business front,

• The Wall Street Journal reports,
  • “Health insurers will pledge to smooth the preapproval process following backlash after the killing of an executive last year.
  • “Insurers will create a standard for electronic requests by 2027, with 80% answered in real time if documentation is included.
  • “The industry plan includes reducing procedures subject to authorization, improving explanations, and helping patients changing insurers.”
• and
  • “Planes have been jetting from Ireland to the U.S. this year carrying something more valuable than gold: $36 billion worth of hormones for popular obesity and diabetes drugs.
  • “The frantic airlift of those ingredients—more than double what was imported from Ireland for all of last year—reflects the collision of two powerful forces: tariff-driven stockpiling and weight-loss drug demand.
  • “The peptide- and protein-based hormones feed into a category of drugs that include wildly popular GLP-1 treatments and newer types of insulin known as analogues. Taken together the shipments weighed just 23,400 pounds, according to U.S. trade data, equivalent to the weight of less than four Tesla Cybertrucks.
  • “Fit into temperature-controlled air-cargo containers, the pharmaceutical ingredients have had a huge impact on the U.S. trade imbalance. The shipments have propelled Ireland, a country of only 5.4 million people, to the second-largest goods-trade imbalance with the U.S., trailing only China. They accounted for roughly half of the $71 billion in goods the U.S. imported from the country in the first four months of the year.
  • “Nearly 100% of the imports had a final destination of Indiana, according to U.S. customs records. Eli Lilly, the drug giant behind weight loss and diabetes drugs Zepbound and Mounjaro, is headquartered in Indianapolis.”

• Mercer Consulting notes,
  • “It’s been over three years since group health plan sponsors and issuers, in order to comply with the Transparency in Coverage final rule, began posting Machine-Readable Files that contain in-network negotiated charges for every medical item and service with providers in their networks, as well as out-of-network allowed amounts and billed charges. This data had previously been considered by insurers as proprietary and confidential, but the government recognized the need to make healthcare costs more transparent. The rule also requires group health plan sponsors and issuers to post files for negotiated rates and historical net prices for covered prescription drugs, but regulators have delayed that particular requirement .
  • “But even though the data has been available to the public since July 2022, almost 70% of very large employers (5,000+ employees) responding to our 2025 Health Policy Survey report that they have yet to meaningfully use the data.
  • “Impeding use is the sheer amount of data that was dropped on the internet all at once, but not all in one place. According to a recent report from the Congressional Review Service, users have faced significant challenge * * *.

• Per Fierce Healthcare,
  • “Hinge Health, which just went public last month, launched a referral network of in-person providers to complement its virtual physical therapy platform.
  • “The curated provider network for musculoskeletal (MSK) care, called HingeSelect, includes imaging centers and brick-and-mortar physical therapy providers to help bridge the gap between in-person and digital care. The aim is to offer a more comprehensive end-to-end MSK care model, executives said.
  • “Hinge Health’s technology and in-house orthopedic physicians triage and direct downstream care. When in-person care, such as imaging or injections, is required, members are connected to pre-vetted providers at up to 50% below PPO rates.” 

• Per Beckers Payer Issues,
  • “Philadelphia-based Independence Blue Cross has launched a new GenAI customer service tool to support customer service representatives in improving accuracy and speed of customer interactions, according to a news release shared with Becker’s. 
  • “The pilot, initiated in February 2025, tasked more than 40 customer service representatives with using the tool to assist with member-specific questions, summarize complex medical policies and search benefits. 
  • “The AI tool was found to have reduced the number of steps customer representatives must take to access critical information and improved efficiency by increasing the percentage of customers who receive solutions on their first inquiry. It also documents responses and validates the information with Independence Blue Cross’ existing customer relationship system.”