Healthcare news for October 30, 2026
New federal rule makes drug 'middlemen' show employers how they get paid The U.S. Labor Department finalized a rule that requires pharmacy benefit managers, the companies that run prescription coverage for most job-based health plans, to tell employers exactly how much money they make. For the first time, PBMs will have to disclose the payments they collect from drugmakers, pharmacies and others in the supply chain, the rebates they negotiate, and any 'spread' they keep when a plan pays more for a drug than the pharmacy receives. Employers get those reports when they sign or renew a contract and every six months after that, and they can audit them once a year. Regulators estimate the change could save employers and workers about $22 billion over 10 years. The PBM industry argues the rule duplicates existing law and may challenge it. The rule covers large self-insured employer plans, not Medicare, and takes effect in July 2027. If you have job-based coverage, nothing changes at the pharmacy counter today, but your employer will have far better information for bargaining over drug costs.
In 30 seconds
- Have health insurance through work? A new federal rule will force the companies that manage your drug benefits to show your employer how they make money, starting July 2027. It's worth asking HR how your plan's drug costs compare.
- Caring for a parent or spouse? AARP finds family caregivers now spend about $11,500 a year of their own money. Ask your local Area Agency on Aging about respite care, tax breaks and other help you may qualify for.
- Flu is arriving early, with hospital stays at their highest mid-October level in 15 years. If you haven't had this season's shot, get it now, and call your doctor quickly if you get sick, since antivirals work best in the first two days.
- Visited a pumpkin patch or petting zoo? Wash hands well after touching animals. If a child gets bloody diarrhea or bad cramps within about 10 days, see a doctor and mention the farm visit.
Medicare & Seniors
Family caregivers now spend about $11,500 a year out of pocket, AARP finds
AARP's new study says caregivers' own spending has climbed almost 60% since 2021 and eats up about 31% of their income on average, and far more for lower-income households. Caring for someone with dementia costs more, about $15,800 a year. Most of the money goes to housing, household bills and medical costs. AARP is pushing Congress for caregiver tax credits and other relief.
AARPMedicare proposes protection when a plan's doctor list is wrong
CMS reviews found errors in about 44% of Medicare Advantage directory listings. A new proposal would make plans check their directories every 90 days and remove departed doctors within five business days starting in 2028. If a plan listed a doctor as in-network when you booked but they weren't when you were seen, you'd pay only the in-network share. Comments are due Dec. 15.
American Academy of OphthalmologyCentene sues Medicare over star ratings it says cost $448 million
Centene, which runs Wellcare plans, says CMS used 17 measures that a court already rejected in another insurer's case when scoring its 2027 Medicare Advantage ratings. It wants the ratings redone and low-rating warnings removed from two contracts on Medicare Plan Finder. No court has ruled yet.
Insurance Business
Insurance & ACA
What to know before ACA shopping opens Sunday
Premiums are set to rise about 15% on average for 2027, and subsidies stop for households earning above four times the poverty level, about $63,840 for a single person. The most you can owe out of pocket in a year climbs to $12,000 for an individual. On HealthCare.gov, some people, including first-time applicants, will need to verify their identity themselves. Don't let your plan simply renew; compare options.
KFF Health NewsFewer employers are covering GLP-1 weight-loss drugs
A WTW survey of 471 employers found coverage of drugs like Wegovy and Zepbound for weight loss fell to 53% from 57%, and nearly a third of those still covering them are thinking about stopping. Employers expect health costs to jump 9.7% next year. If your plan is dropping these drugs, ask about appeals or the drugmakers' lower self-pay prices.
Medical Daily
Medicines & FDA
Lilly's experimental 'triple' drug beats Ozempic in a big diabetes trial
In a 1,298-person study, people taking retatrutide lost about 20% of their body weight over 80 weeks, roughly twice as much as with semaglutide, and saw bigger drops in blood sugar. More people quit retatrutide because of side effects. The drug is not approved yet, and Lilly hasn't given an approval timeline.
AJMCMiyoko's plant-based butter recalled over mold, yeast and E. coli concerns
More than 1,300 cases of 8-ounce European Style Salted Plant Milk Butter were recalled in 10 states, including Florida, Georgia, Illinois and New Jersey. Look for lot 07871 with a Nov. 5, 2026 best-by date and throw it out or return it. The FDA rated the risk as moderate (Class II), and it's unclear whether anyone got sick.
ABC News
Staying Well
Flu hospital stays hit their highest mid-October level since 2010
CDC data show about 5.7% of flu tests coming back positive and hospital admissions rising, led by the Southeast. Overall activity is still rated low, and no child flu deaths have been reported this season. Doctors say now is the time to get vaccinated.
Medical DailyE. coli cases linked to pumpkin patches in California and Illinois
Five children who visited Bengtson's Pumpkin Farm in Homer Glen, Ill., have E. coli infections, and four were hospitalized; its petting zoo is closed. In California, five cases may be tied to Brookshire Farms in San Luis Obispo County, which has closed. Kids under 10 face the highest risk of serious kidney complications.
Food Safety NewsU.S. measles cases reach 4,588 ahead of a key November review
That's about double last year's total, with 479 hospitalizations and three deaths reported nationally, nearly all in people who were unvaccinated or whose status is unknown. A regional health panel meets Nov. 10-13 to decide whether the U.S. keeps the measles-free status it has held since 2000. Check that your family's MMR shots are up to date.
Medical Daily
Policy & Law
Florida gets $193.7 million for rural health from new federal fund
The money, from a five-year, $50 billion rural health program created in last year's budget law, will pay for telemedicine, remote monitoring, pharmacy services and community paramedics. Critics note the same law cuts far more from Florida's Medicaid funding over the next decade.
WUSFWyoming hospital asks voters for tax help as its rural grant is in doubt
St. John's Health in Jackson received $1.25 million in federal rural health money this month but may have to return it because it isn't a critical access hospital. It's asking Teton County voters to approve a property tax increase on Tuesday, while a statewide tax relief measure could shrink its revenue.
Wyoming Public Media
Hospitals & Business
Minnesota hospital to stop delivering babies in April
Sanford Health's Luverne center averages fewer than five births a month and will end labor and delivery in April 2027. Patients will travel about 30 miles to Worthington or Sioux Falls, S.D. Prenatal, postpartum and emergency delivery care will stay in Luverne.
MPR NewsWalmart adds a site to compare prices for doctor visits and health services
Walmart's Better Care Services now lets shoppers compare urgent care, pediatric, mental health and nutrition services from more than 10 outside providers. It shows estimated costs based on your insurance, plus cash prices when available. Always confirm the final price with the provider before booking.
Supermarket NewsMass General Brigham makes another round of layoffs and halves its hospital-at-home program
Massachusetts' largest health system hasn't said how many jobs are being cut. Its Home Hospital program, which treats patients at home instead of in a hospital bed, will shrink to no more than 30 patients at a time. The system blames rising labor and drug costs.
CBS Boston