insurance
Newton’s third law of health care
There are many players in the health care world, from doctors and nurses to hospital and drug execs. Then there are the LaRoques.
The Texas couple started a business, spawned by a law banning surprise billing, that helps providers navigate the arbitration process with insurance companies.
Tara Bannow describes their story as “emblematic of an American health care system that’s rife with profit-seekers who critics say repeatedly test the lines of legality.”
Each effort by lawmakers to rein in the excesses of the U.S. health care system is met with an opposite reaction of retooled tactics.
Tara reviewed thousands of pages of court filings and company documents and interviewed more than 50 people for this investigative account of the LaRoques’ health care empire.
Read more. The first three paragraphs alone are worth the click.
research grants
Bhattacharya: NIH to spend full budget this year
The NIH has been slow to award research grants this year, according to an analysis by Anil Oza. But Director Jay Bhattacharya promised House appropriators he will spend its full budget by the end of this fiscal year, Jonathan Wosen reports.
This year could be shaping up to be a repeat of 2025, when NIH started off slow, then sped grants out the door in the latter half of the year, spending nearly its full budget by Sept. 30.
Bhattacharya blamed fears of unspent funds on “hype.” But Rep. Rosa DeLauro (D-Conn.) blamed the White House Office of Management and Budget for the current pace of awards, noting that OMB needs to approve the agency’s apportionment before it can be spent.
Read more.
fraud, waste, and abuse
Disabled community wary of fraud crackdown
The Trump administration says it's getting tough on fraud, waste, and abuse, announcing a new fraud-fighting task force on Monday, then expanding its probe to Florida on Tuesday.
To the disability community, the crackdown feels less about rooting out crime and more about using fraud as an excuse to cut critical services, O. Rose Broderick reports.
Many of the products and services that are being targeted by investigations are heavily used by people with disabilities. Read more.
fda
FDA’s top infectious disease regulator to depart
Adam Sherwat, the FDA official in charge of reviewing infectious disease products, is leaving the agency, Lizzy Lawrence scoops.
Sherwat is the director of the Office of Infectious Diseases in the FDA’s Center for Drug Evaluation and Research.
His office has faced scrutiny from FDA political appointee Tracy Beth Høeg. Read more.
drug research
Save the mice
HHS announced yesterday several initiatives to try to reduce reliance on animal testing in drug development, Lizzy reports.
Mice and rats account for the vast majority of animals used to test drugs. But other animals are also used, including dogs, rabbits, hamsters, guinea pigs, ferrets, and non-human primates.
FDA Commissioner Marty Makary said animal testing in drug development has a poor track record of predicting whether drugs work and are safe in humans, and technological advances often make it possible to research drugs without harming animals.
Read more for what agencies are doing to help drugmakers avoid animal testing.
