Battle over Medicare Advantage audits, longevity field recasts its work, & Eric Lander back at the Broad

Billions of dollars could get redirected to taxpayers and Medicare enrollees, but odds are the clash will clog up courts for years to come.

January 30, 2023 Check out STAT+

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By Elizabeth Cooney Reporter, Morning Rounds Writer

Good morning. I highly recommend Jason Mast's piece gleaned while embedding (at JPM) with the longevity crowd. One takeaway: Don't call them billionaires who want to live forever.

Health insurance A billion-dollar battle over Medicare Advantage audits hits a crucial point this week Alex Hogan/STAT Get ready. After more than a decade of fighting over how Medicare Advantage plans should be inspected and how the government can claw back billions in well-documented overpayments to those plans, the dispute is coming to a head this week. That's when Medicare will say just how aggressively it will go after an industry whose profitable plans haven't been audited since 2007.  Billions of dollars could get redirected back to taxpayers and Medicare enrollees, but odds are the clash will clog up courts for years to come. A refresher: Medicare Advantage is the growing alternative to traditional Medicare run by private health insurers. Members get lower premiums, gym memberships, and caps on out-of-pocket expenses. But the plans cost taxpayers more, especially when something called "risk adjustment data validation" is abused. "Everybody has blood on their hands," Richard Lieberman, CEO of Cortex Analytics, told STAT's Bob Herman. Read what that means. science Bullying allegations behind him, Eric Lander will return to the Broad Institute to run a lab Eric Lander's coming back to the genomic powerhouse he co-founded, but not in the same capacity as when he left it to become the White House's first Cabinet-level science adviser. The founding director of the Broad Institute of MIT and Harvard will return to his genetics lab in Cambridge with the title "founding director emeritus," nearly a year after he resigned from his Washington post after complaints he had bullied staffers and created a toxic work culture inside the Office of Science Technology and Policy. In an announcement to the institute's staff on Friday, current Broad Director Todd Golub wrote only that the allegations of workplace bullying had "stimulated important and often tough discussions about academic culture here and across the nation." Neither Lander nor Golub was available for an interview. STAT's Megan Molteni has more.  coronavirus With no antibody treatments against Covid, CDC urges vulnerable people to take precautions Following the FDA's decision last week to pull its authorization of Evusheld, the last antibody treatment to fight Covid-19, the CDC is urging people with weakened immune systems — and members of their households — to protect themselves with multiple prevention measures. That means staying up to date on their Covid vaccinations, masking and social distancing, improving ventilation inside, continuing to wash their hands, testing at the first sign of symptoms, and, if positive and eligible, getting treatment such as Paxlovid, remdesivir, or molnupiravir.  Evusheld, given to people at high risk of severe illness before exposure to the virus, is another casualty of the mutating coronavirus. The FDA warned in October that Omicron subvariants were undermining its power, and earlier this month, the agency said that it anticipated it would not neutralize now-dominant XBB.1.5. Post-infection antibody therapies are also history. Authorization for the last of those treatments, bebtelovimab, was withdrawn in November.

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Closer Look Why leaders in the longevity field say it's time to take them seriously MIKE REDDY FOR STAT As a scientific pursuit or a business, longevity does not enjoy a good reputation. The FDA doesn't even consider aging a disease. And the longevity community hates headlines about billionaires living forever. "Why is it in popular culture, if you want to live forever, you are evil and you want to kill babies on the side?" Martin Borch Jensen, co-founder of anti-aging gene therapy startup Gordian, asked at the J.P. Morgan Healthcare Conference.  Efforts to defeat aging have been controversial endeavors since the Fountain of Youth, but practical investors now appreciate the science when it targets dementia, heart disease, and other age-related ills in the name of extending health span, not lifespan. "The thing I hear is how you want to live forever," the top scientist at one startup said. "And it's not. I want your grandma to be hiking at 85." STAT's Jason Mast has more on how that's going. In the lab NIH advisers approve proposal to safeguard lab-made virus research Their vote was unanimous, but concerns remained when a federal advisory panel endorsed proposals to strengthen oversight of pathogen research that could make viruses more transmissible. Experts in biosecurity, ethics, and infectious diseases convened on Friday to consider "gain of function" research, which involves changing pathogens to learn about their origins and potential treatments. Some panelists worried that the language they approved could create roadblocks for even low-risk research. "We need to make sure that it is not inadvertently inhibiting important research," Rachel Levinson of Arizona State University said. The panel's draft report recommends safeguards including "federal department-level review" of gain-of-function studies and a broader definition of pathogens that could potentially cause pandemics. Once final, the proposals will go to NIH leadership, which now lacks a permanent director to succeed Francis Collins or a replacement for NIAID Director Anthony Fauci. STAT's Sarah Owermohle has more. health  Deaths during or just after pregnancy rose in 2020 The U.S. has long had the worst rates of maternal mortality among industrialized nations, and a new study in JAMA Network Open cements that status. The analysis of death certificates shows the number of deaths during or shortly after pregnancy rose from 2,019 in 2019 to 2,516 in 2020. Deaths from pregnancy complications rose, as did deaths from drugs, car crashes, and homicides. Suicides stayed the same; Covid was listed as the cause of 23 deaths but contributed to 171 other deaths.  There were disparities: Compared with white women, mortality rates were three to five times higher among American Indian or Alaska Native women for every cause, including suicide. Black women experienced significantly higher mortality rates across causes, with the highest rates for homicide. "Enhanced surveillance and intervention for these vulnerable groups may be warranted," the authors write.    by the numbers

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Thanks for reading! More tomorrow,

@cooney_liz

elizabeth.cooney@statnews.com

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