Denied by AI, The fight for chocolate milk, The future of disease outbreak in the US, and much more!

Another Thursday has arrived and so has your weekly dose of STAT! Areesha Lodhi , Ryan Fitzgerald , and Alexander Bois-Spinelli here with highlights of the biggest STAT stories this week.

Before we jump in, we wanted to share that we announced our 2023 STATUS List this week! It’s the ultimate list of leaders shaping the future of life sciences. Explore the list.?

Now, let’s hop to it…?

Denied by AI

Our colleagues Bob Herman and Casey Ross released a major investigation this week on artificial intelligence and Medicare.?

Health insurance companies have rejected medical claims for as long as they’ve been around — but now #AI is driving denials to new heights in Medicare Advantage. Insurers are using unregulated predictive algorithms to pinpoint the precise moment when they can plausibly cut off payment for an elderly patient’s treatment.?

Elderly people who spent their lives paying into #Medicare, and who are now facing amputation, fast-spreading cancers, and other devastating diagnoses, are left to either pay for their care themselves or go without it.?

The fight for chocolate milk?

A new proposal from the US Department of Agriculture is facing pushback from an unlikely opponent: fourth graders. The agency plans to stop providing free chocolate milk at schools because of the drink’s high sugar content, but parents and children are not happy about it. One fourth-grader even pointed to potential health concerns, noting,“Kids are getting dehydrated.” More on the dairy debate in this article by Nick Florko.?

The future of disease outbreak in the US

While the world was trying to cope with the COVID-19 pandemic, the US was also going through another outbreak — a deadly spread of West Nile virus, transmitted by mosquitoes, in 2021. Unfortunately, climate change is accelerating the range of disease-carrying species like mosquitoes, fleas, and ticks, and unless something changes, underprepared health systems will leave people even more vulnerable going forward. Sara Van Note delves into what to expect.?

STATUSList academic aims to tackle ALS

Alberto Ascherio’s breakthrough findings on the likely cause of multiple sclerosis in 2022 have driven renewed research and investment into treating the condition. Now a principal investigator on nearly a half-dozen studies about various diseases, Ascherio hopes to tackle #ALS next. Isabella Cueto spoke with the Harvard professor of medicine about his plans for the future — and STAT reporters will continue the conversation with Ascherio at the Breakthrough Summit in May.?

Covid boosters and forever chemicals?

If you’re living in Canada or the United Kingdom, you have clear guidance on when you can expect to get your spring Covid-19 booster. But in the U.S., the #FDA has been radio silent on the issue so far, creating frustration among a small but determined group of people who are keen not to have to wait until the autumn to get another dose of Covid vaccine. Helen Branswell explores.?

Remember those “forever chemicals” that Brittany Trang reported on back in December??

Well, the Environmental Protection Agency for the first time on Tuesday proposed enforceable regulations for the chemicals, also called PFAS, in Americans’ drinking water. The six PFAS are the first new contaminants to be regulated under the Safe Drinking Water Act’s 1996 amendments.

Big changes for drug pricing and Medicare?

The Biden administration is fining drugmakers who hiked prices faster than the rate of inflation on 27 medications. Rachel Cohrs reports on the penalties the drugmakers will face as part of a larger political push to change the drug pricing process in the US.?

Debate rages on in the Capitol about the future of the Medicare program. Hospitals are worried that lawmakers could finally be considering a change they hate — so-called site neutral payment policy. Rachel Cohrs reports the policy saves the federal government tens of billions of dollars, reduces patient costs, and has gained bipartisan support over the years. But six hospital industry lobbyists say they’re nervous that lawmakers’ promises to cut the Medicare program may not apply to behind-the-scenes hospital payment policies.

Medicare laid out in the greatest detail yet how it will choose which drug prices it will negotiate in its brand-new program, and how it will figure out what the government’s opening offer will be. Democrats outlined some parts of the process in the Inflation Reduction Act that passed Congress last August, but the details of how drugs will be selected and what factors will be considered have been vague until now. Rachel Cohrs has yet another report from DC.?

That’s all we have for today! Join us next Thursday for another edition of “Weekly Update.”?

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— Ryan, Areesha, and Alexander