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Get your daily dose of health and medicine every weekday with STAT’s free newsletter Morning Rounds. Sign up here. Happy Halloween! I’m still figuring out costume ideas for tonight — any last-minute pitches? Advertisement Staff exits, tumbling morale threaten Vinay Prasad’s FDA empire Vinay Prasad’s tumultuous tenure at the Food and Drug Administration has entered a new, even rockier era: a slow-boiling feud with his staff that could lead to the exodus of dozens of scientists who regulate the nation’s vaccines, biological products, and blood supply. Insiders say Prasad, as director and chief medical and scientific officer for the Center for Biologics Evaluation and Research, has cultivated a work environment rife with mistrust and paranoia since returning from his brief departure. They say Prasad has fired key leaders without explanation and struggled to communicate with staff. They also say his vision for the center, other than applying additional scrutiny to vaccines, is unclear. Another fantastic story from STAT’s Lizzy Lawrence, who interviewed more than 15 current and former FDA staff, contractors, and regulatory experts about Prasad’s rocky tenure. Read on for why his second stint at the CBER has been even more chaotic than his first. Advertisement Health care takes center stage for midterm elections The results of next week’s governors’ races could have major implications on the parties’ midterm approaches to federal health policy. In Virginia and New Jersey’s gubernatorial races, new lines of attack are opening up, with both Democrats and Republicans refining their central message to highlight their perceived strengths. Democrats want to link health issues with economic ones, seizing on voter frustrations around rising costs and cuts to health programs. Republicans, meanwhile, are touting Trump’s deals to lower drug prices. If you’re a regular Morning Rounds reader, you don’t need me to tell you that American health care is undergoing a transformational shift, especially after the passage of Republicans’ One Big Beautiful Bill, which is set to slash Medicaid funding by nearly $1 trillion over the next decade. Elections are a great way to track how Americans are feeling about it all. Read more from STAT’s Daniel Payne. Trump’s pick for surgeon general goes into labor, delaying Senate hearing Casey Means, Trump’s surgeon general pick, was set to appear before a Senate committee for her confirmation hearing, but the meeting was postponed after she went into labor early Thursday morning. We’ve written about Means extensively, but in case you want some light reading while you wait for the hearing to be rescheduled: the Stanford-educated physician rose to popularity as a wellness influencer after becoming disillusioned with traditional medicine. If the Senate confirms Means, she will bring no government experience to the role and her license to practice as a physician is inactive. The 38-year-old and her brother Calley have been vital to the Make America Healthy Again movement, working hand-in-hand with health secretary Robert F. Kennedy Jr. on his push to end chronic disease. Means has made hundreds of thousands of dollars promoting supplements and other health and wellness products, inviting scrutiny into potential conflicts of interest. We’ll keep you posted on the hearing’s new date. Insurers and providers keep pace using the same financial strategy: more AI Insurers say AI tools driving overzealous coding and billing from providers are hurting their bottom line. What’s their plan? More AI tools. Advertisement Large insurers and their subsidiaries have long used AI to scrutinize medical claims — some have even been sued over allegedly wrongful denial of care using AI — but this recent strategy has emerged in recent months as health systems have also aggressively taken up AI. Top insurance executives such as UnitedHealthcare’s CEO have noted that increasing their use of AI tools has boosted profits, especially when applied to coding and billing practices. The mistrust runs deep and on both sides. Some payers are skeptical about whether the hospitals’ new AI tools accurately capture medical reality, while providers point to insurers’ upcoding patients within Medicare Advantage plans. To hear what doctors think about this infighting and what this will mean for patients, read more from STAT’s Katie Palmer. Proposed Medicare changes could end key procedure for chronic pain disorders Recent changes to Medicare coverage could imperil access to interventions that are critical for millions of Americans with chronic pain, writes Tricia Pendergrast, an anesthesiology resident physician at the University of Michigan. Medicare administrative contractors across the country have recently proposed eliminating coverage for peripheral nerve block procedures, which are minimally invasive, non-opioid treatment options for chronic pain disorders. If approved, Pendergrast writes, these changes could drive patients back to opioids, exacerbating the overdose epidemic in the United States, or force patients to pursue invasive and expensive surgical interventions. A leading cause of disability in the United States, chronic pain is associated with depression, substance use disorders, and roughly $722.8 billion in medical costs annually. It is also more prevalent in veterans, women, adults living in poverty, and rural residents. Read more from Pendergrast. Cryptids? Dragons? Scottish actors? No, this isn’t a Game of Thrones rip-off, it’s our weekly mini crossword puzzle! It includes a clue about one of my favorite actors — shoutout Beginners, such an underrated movie — and an answer that Republicans’ routinely use to describe federal health agencies. You should do it. Advertisement What we’re reading
