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Good morning. Sour cream and onion chips are on my mind again.
When puff-puff-pass turns quid-pro-quo
A Democratic senator has initiated an investigation into the Trump administration’s recent decisions regarding flavored vapes and kratom. The inquiry stems from suspicions of a quid pro quo arrangement following substantial donations from industry players to the presidential campaigns of Donald Trump and Robert F. Kennedy Jr.
Earlier this year, the FDA introduced a lenient policy on flavored vape products, which critics argue gives manufacturers undue freedom. Additionally, as health secretary, Kennedy has reportedly advised Ohio’s governor against imposing strict regulations on kratom products. This raises questions about the potential influence of financial contributions on these policy decisions. STAT’s Sarah Todd reports on the inquiries Sen. Ron Wyden (D-Ore.) has directed towards the president, health secretary, and industry executives to uncover the truth.
Does your autistic kid get ABA therapy through Medicaid?
Changes might be on the horizon for their care.
The Centers for Medicare and Medicaid Services unveiled a new “toolkit” on Tuesday, designed to reshape states’ strategies regarding applied behavior analysis, the central therapy for children with autism.
The toolkit emphasizes enhanced oversight and the need for more measurable outcomes, particularly for children receiving Medicaid services. Telehealth, a focus of potential fraud concerns, is highlighted in the report, which urges states to “limit” its use for delivering ABA.
Autism care in the U.S. faces a critical moment. Spending on ABA through Medicaid and CHIP surged by 421% from 2021 to 2025, with several state Medicaid agencies grossly overpaying. Some providers are accused of extravagant spending, charging $400 an hour to supervise children’s activities, while others warn of rising denials of care and lengthening waitlists.
Though the updated guidance is not mandatory, experts anticipate gradual adoption by states, based on discussions with CMS officials. — O. Rose Broderick
Ebola vaccine efforts are underway
A medical journal report reveals that an Ebola outbreak at a hospital where the first American infected in the current outbreak worked was partly due to the disease. Of the 37 staff members who fell ill beginning in late April, 11 tested positive for Ebola Bundibugyo. The remaining 26 were either not tested, tested negative, or their results were lost. Notably, a higher percentage of those who tested negative had previously been vaccinated with Merck’s Ervebo vaccine, which guards against the Zaire strain of the virus. Efforts are underway to organize a clinical trial to explore potential cross-protection against the Bundibugyo virus.
The endeavor to create Bundibugyo-specific vaccines expanded on Tuesday with Moderna’s announcement of a Phase 1 clinical trial for its messenger RNA vaccine. If successful, an mRNA vaccine could offer production advantages over other vaccines in development. This trial is funded by the Coalition for Epidemic Preparedness Innovations. The outbreak is the second largest on record, with 3,802 confirmed cases, including over 1,700 fatalities. — Helen Branswell
The prostate cancer paradox
Prostate cancer is the most frequently diagnosed yet least deadly cancer in the U.S. Of the more than 333,000 new cases annually, up to 70% require no treatment. Some doctors argue these low-grade cases should not even be classified as cancer. Nonetheless, about 50% of men with these minor cases undergo treatment. As STAT’s Annalisa Merelli notes, this is a uniquely American issue.
“Why are we using a test that is worse than tossing a coin when there’s a much better test?” asks Mark Emberton, an oncologist dedicated to minimally invasive prostate cancer treatment. While MRIs are widely recommended for diagnosis, many American doctors still opt for biopsies. Emberton asserts, “The MRI is twice as good — and no needles.” Read more from Nalis on the system’s continued disregard for this recommendation.
MD vs. DO — Who cares?
Nearly 10% of medical residency programs in the U.S. never consider applicants with osteopathic medicine credentials. In highly competitive specialties, these doctors face even more barriers. In a new First Opinion essay, two doctors advocate for equal treatment of DO students and those in MD programs. Their proposed solution is straightforward.
“Merge the two medical education systems into one,” they propose. “This is not as radical as it sounds.” Read more on the potential implications of integrating the two medical education systems.
What we’re reading
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I tried the Trump Cabinet’s steak and sauerkraut diet. It was (mostly) fantastic, New York Times Magazine
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CDC expands largest known cyclospora outbreak to 15 states, Washington Post
- Opinion: Something is missing from movies about medical aid in dying, STAT
- Nurses chase cyclospora, aided by interviews, fast-food receipts — and the messy details, KFF Health News
