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Good morning. Thinking about sour cream and onion chips again.
When puff-puff-pass turns quid-pro-quo
A Democratic senator has launched an inquiry into the Trump administration’s recent actions on flavored vapes and kratom, alleging a pattern of quid pro quo’s after industry players made large donations to presidential campaigns for Donald Trump and Robert F. Kennedy Jr.
This spring, the FDA released a new, permissive policy on flavored vape products that many critics called a get-out-of-jail-free card for manufacturers. And as health secretary, Kennedy has reportedly tried to discourage Ohio’s governor from cracking down on kratom products. How much could money have influenced these moves? Read more from STAT’s Sarah Todd on the questions Sen. Ron Wyden (D-Ore.) has posed to the president, the health secretary, and industry leaders to get to the bottom of it.
Does your autistic kid get ABA therapy through Medicaid?
Their care could change in the coming months.
The Centers for Medicare and Medicaid Services on Tuesday released a “toolkit” aimed at changing states’ approach to applied behavior analysis, the main therapy used for children with autism.
The document prioritizes stronger oversight and pushes for more measurable outcomes, especially for kids who receive care through Medicaid. Telehealth, in particular, is under scrutiny for potential fraud, and the report asks states to “limit” virtual care as a primary vehicle for offering ABA.
Autism care is at a crossroads in the United States. ABA spending in Medicaid and CHIP increased 421% between 2021 and 2025, with multiple state Medicaid agencies massively overpaying. Some care providers are living lavishly and charging $400 an hour to watch kids paint, but others are sounding the alarm as payers routinely deny care and their waitlists balloon.
While the updated guidance isn’t binding, experts expect states to slowly adopt these recommendations, according to a person who had talked about the changing framework with CMS officials. — O. Rose Broderick
Ebola vaccine efforts are underway
An outbreak at a hospital where the first American known to have been infected with Ebola in the current outbreak worked was caused at least in part by the disease, a new medical journal report reveals. Of 37 staff who became ill starting in late April, 11 tested positive for Ebola Bundibugyo. The 26 others were either untested, tested negative, or their tests were lost. Interestingly, a greater percentage of the patients who tested negative had been vaccinated during an earlier Ebola outbreak in the region with Merck’s Ervebo vaccine, which protects against the Zaire species of the virus. Efforts are underway to organize a clinical trial to see if it might offer cross protection against the Bundibugyo virus.
The race to develop Bundibugyo-specific vaccines broadened Tuesday with the announcement that Moderna has started enrolling participants in a Phase 1 clinical trial of its messenger RNA vaccine. An mRNA vaccine — should it prove to be effective — could have advantages over the other vaccines in development, given the speed with which wide-scale production can occur. The trial is being funded by the Coalition for Epidemic Preparedness Innovations. The outbreak is the second largest on record, with 3,802 confirmed cases to date, more than 1,700 of them fatal. — Helen Branswell
The prostate cancer paradox
In the U.S., prostate cancer is the most frequently diagnosed and least deadly cancer. Out of more than 333,000 new cases each year, up to 70% require no treatment at all. Some doctors say these low-grade cases shouldn’t even be called cancer. But still, as many as 50% of men with these clinically insignificant cases get treated anyway. It is, as STAT’s Annalisa Merelli writes, a uniquely American problem.
“Why are we using a test that is worse than tossing a coin, when there’s a much better test?” said Mark Emberton, an oncologist who has devoted his career to treating prostate cancer in the least invasive way possible. While many authorities recommend MRIs for diagnosis, most American doctors are still going straight to biopsies. But as Emberton sees it, “The MRI is twice as good — and no needles.” Read more from Nalis on why our system is regularly ignoring this widespread recommendation.
MD vs. DO — Who cares?
Nearly 1 in 10 medical residency programs around the U.S. never consider an applicant who studied osteopathic medicine. And in more competitive specialties, it’s even harder for these doctors to get a foot in the door. In a new First Opinion essay, two doctors argue that DO students deserve equal treatment to those in MD programs. Their solution is simple.
“Merge the two medical education systems into one,” they write. “This is not as radical as it sounds.” Read more on what combining the two medical school systems might look like.
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