Connect with us

Science

Outbreak of neurotoxin killing unprecedented number of sea lions along California coast

Published

on

Outbreak of neurotoxin killing unprecedented number of sea lions along California coast

By the time the rescue squad got to her, a small crowd had formed around the agitated California sea lion. As the team crept toward her — carrying large wooden shields and a giant net — the animal’s head weaved, craned and rocked back and forth in frenzied rhythms.

Lucille — as she was later named by the Marine Mammal Center’s Morro Bay field office — had barely registered her captors’ approach as the team of five animal rescue volunteers pounced on her. A small struggle ensued as the creature’s body went rigid with seizures, but the team managed eventually to push her into an XXL portable dog crate.

“It’s really hard when they’re not acting like sea lions,” said Jake Roth, a 22-year-old volunteer who helped with the rescue.

It was the first of dozens of frantic rescue phone calls made by horrified beachgoers that day, as an acute domoic acid outbreak continued to wreak havoc along the San Luis Obispo and Santa Barbara coasts this summer.

Advertisement

“The levels we’re finding inside these animals is off the charts,” said Giancarlo Rulli, a spokesman for the Sausalito-based Marine Mammal Center. “It’s all hands on deck.”

Domoic acid is a neurotoxin released by Pseudo-nitzschia, a common phytoplankton species found in coastal waters. Sea lions — and other marine mammals — become poisoned when they eat large amounts of fish or invertebrates that have been chowing on the contaminated diatoms.

Symptoms include lethargy, vomiting, unusual behavior, seizures, loss of pregnancy and death.

Marine Mammal Center volunteer Cris Lewis guides a sick sea lion into a crate during a rescue at Cayucos State Beach.

(Justin Sullivan/Getty Images)

Advertisement

Domoic acid, which is an amino acid, is not always produced by the phytoplankton. It is only manufactured under certain conditions — ones which scientists are still trying to determine. But upwelling of seawater seems to be a common factor — and strong upwelling of cold, nutrient-rich water is currently hugging the Central California coastline.

The outbreak has been at crisis levels since late July.

“One of the things that has come out again and again in a lot of our studies… is that, yes, when you get upwelling — which is typified by colder water temperatures and lots of nutrients — you will stimulate a bloom of diatoms,” said Clarissa Anderson, director of Southern California Coastal Ocean Observing System and the Cooperative Institute for Marine, Earth, and Atmospheric Systems, which are operated out of UC San Diego’s Scripps Institution of Oceanography.

“But then the bigger question — the one we’ve not been able to totally wrap our heads around — is, when does it produce the toxin? What is the mixture of conditions that requires that? Because this organism is around all the time,” she said.

Advertisement

Domoic acid outbreaks are not new. They have been happening for decades, if not millennia. And although it wasn’t identified in California waters until 1991, it is believed to have been behind outbreaks before that — including the 1961 “invasion” of chaotic sea birds in Capitola that partly inspired Alfred Hitchcock’s 1963 film, “The Birds.”

What has changed, said Anderson, are the frequency, timing and location of the events.

“We know that upwelling season in California has always been a great time to expect a Pseudo-nitzschia bloom and potentially a domoic acid event, and that can start as early as March,” she said. As a result, scientists had associated springtime with domoic acid outbreaks.

“But now we’re starting to see something different: These past three summers there have been these intense, long, lasting blooms,” she said.

And while Monterey and Humboldt Bay had been considered the classical hot spots, it’s Southern California that has been clobbered since 2022.

Advertisement

She said climate change is likely playing a role in these changes — but not necessarily because of warm water temperatures.

A veterinarian examines an ill sea lion.

Marine Mammal Center veterinarian Greg Frankfurter inspects a newly admitted California sea lion that was rescued from a beach showing signs of domoic acid poisoning in Sausalito.

(Justin Sullivan/Getty Images)

“One of the things we have seen in our years and years and years of data is that it’s the mixture of nutrients that come with upwelling that is potentially responsible for turning the toxin on or off,” she said. “And that mixture of nutrients may be impacted by global climate change, because climate change is changing ocean circulation physics at the basin scale — like the Pacific Ocean scale — and that can have ramification on what kinds of water — the flavor of water — that is upwelling onto the coast in California.”

Raphe Kudela, a professor of ocean science at UC Santa Cruz, said there might also be a connection to heat and runoff from inland rivers.

Advertisement

He said in the last few years, really wet winters have contributed to an increase in river runoff — and a resulting dump of nutrients into California’s coastal waters.

“So you get a pulse of upwelling, which brought some cool water with even more nutrients to the surface, and then everything warmed up. That’s just absolutely perfect conditions for a bloom like this,” he said.

It’s also a perfect recipe for creatures like sardines and anchovies, who feast on the diatoms, algae and phytoplankton in these cool, nutrient-rich waters. And those fish bring in predators, such as sea lions, dolphins, fur seals, birds and other fish that then proceed to feast on these “toxic bullets.”

Anderson said people will occasionally ask her if they, too, could get sick from eating anchovies.

“I’m like, are you planning on eating as many anchovy as a sea lion?” she said, noting that sea lions eat roughly 5% to 8% of their body weight per day. For a 150-pound person, that would be 7.5 to 12 pounds of anchovy.

Advertisement

And that’s part of the tragedy of this latest outbreak.

Barbie Halaska, a necropsy specialist with the Marine Mammal Center, showed visitors the milk-rich tissue enveloping the single six-inch incisions she had made in the chests of six of the dead sea lions that had died at the Morro Bay center.

All six were adult, lactating females, she said, with thick layers of fat.

“You can see how big she is. She’s gorgeous,” said Halaska, pointing at the dead but otherwise healthy-looking animal. “They’ve got a great food supply. It just happens to be tainted. When they’re lactating, and they find a good food stock, they just go and go and go. Unfortunately, that means the neurotoxin just bioaccumulates.”

She said female sea lions tend to give birth around June 15 — “we call it sea lion birthday” — which means these females most likely had a young, dependent pup with them before they were stranded. Sea lion pups are dependent on their mothers until they are about 9 months old.

Advertisement

Research shows that pups growing inside contaminated pregnant females suffer brain damage. Milk from contaminated females also carries the toxin, suggesting it could be transmitted to pups.

By early afternoon, Lucille and three other sea lions were being treated for domoic acid poisoning.

Lucille was passed out, snoring on the cement floor of the pen. Soon after she arrived, a center staff member had delivered a shot full of phenobarbital and midazolam into her back haunch, to control the seizures. Staff then hooked her up to an IV bag of fluid to help flush the toxin out of her body.

But one of the three newer arrivals, a large, adult female named Yippee, arrived with a broken and dislocated jaw. Staff concluded she’d die if she was returned to the wild. They made the hard decision to medically euthanize her.

She struggled to flee from the small team that came in to deliver the shot, but was finally backed into a corner and succumbed. Her breathing slowed and within a few minutes, she was still.

Advertisement

Rulli said such episodes are always painful, and the center works hard to support staff who respond to these events. Repeated encounters with suffering animals can take a toll.

Roughly 30% of the animals that have come to the center in this latest outbreak — which began at the end of July — have died, said Aliah Meza, operation manager of the Morro Bay field office.

Farther south, where staff from the Channel Islands Marine Wildlife Institute are responding to animals along the Santa Barbara and Ventura coasts, the number exceeds 50%, said Sam Dover, founder and chief veterinarian of Channel Islands Marine and Wildlife Institute.

To keep these facilities running and these teams operating, both institutions rely on donations and some level of state and federal funding.

State funding was nearly pulled last year when the governor’s office struck $2 million in funding from the state budget. For smaller operations, such as Dover’s, that would have been a 50% hit on its operating budget. The groups were able to convince lawmakers to replace the funding.

Advertisement

“I don’t envy the sharpened pencil and eraser work that they were doing,” said Jeffrey Boehm, the marine center’s chief external relations officer, who said he and others went to Sacramento to make the case that their work is in the public interest. “Having an entity that is prepared, skilled and professional to respond to wildlife that might be having a seizure on a public beach, that’s in the public interest. As is the science we advance through doing this work… Because at the end of the day, it’s all just one system.”

Lucille, who recovered from her seizures, was transported to the center’s Sausalito hospital via air-conditioned truck the following day. She died in transport.

Veggie, another sea lion who was rescued the same day, did make it to Sausalito however. She is now undergoing a seven-day protocol at the hospital, where roughly 50 other sea lions are being treated.

Rulli said that two sea lions were recently released back into the wild at Point Reyes National Seashore, where there is no sign of an outbreak and where humpback whales are currently feeding — an indication that there’s plenty of food available.

“Let’s just hope they stay up here,” he said.

Advertisement
Continue Reading
Advertisement
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Science

Senators Press Marty Makary on Abortion Pills and Vaccines

Published

on

Senators Press Marty Makary on Abortion Pills and Vaccines

At a confirmation hearing for Dr. Marty Makary on Thursday, senators focused heavily on the safety of the abortion pill, with Republican lawmakers urging him to restrict access and Democratic lawmakers demanding that he maintain its current availability.

Dr. Makary, President Trump’s nominee to lead the Food and Drug Administration, signaled that he shared Republicans’ concerns about the current policy, issued during the Biden administration, which expanded access by allowing people to obtain the pills without an in-person medical appointment.

Several Democrats pointed to volumes of studies showing that the drugs are safe. Dr. Makary told members of the Senate health committee, which held the hearing, that he would review the pill’s safety and the policy at issue.

He said he would “take a solid, hard look at the data and to meet with the professional career scientists who have reviewed the data at the F.D.A. and to build an expert coalition to review the ongoing data, which is required to be collected.”

The hearing also touched on vaccines, with several lawmakers, including the committee chairman, Senator Bill Cassidy, Republican of Louisiana, questioning why an advisory committee meeting on next year’s flu vaccine had been canceled in recent weeks and asking whether it would be held later. He and others stressed that the flu panel met annually, and some reminded Dr. Makary that Robert F. Kennedy Jr., who oversees the F.D.A. as health secretary, had pledged transparency in agency decision-making.

Advertisement

Senator Patty Murray, Democrat of Washington, called the cancellation “unprecedented and dangerous” after decades of annual meetings.

Dr. Makary repeatedly reminded senators that he was not responsible for scrapping the meeting. He also suggested there was a need for a broader review of the role of vaccine committees that convene experts to advise the F.D.A. He shot back at criticism, saying there is a “huge difference” between “requiring every 12-year-old girl to get an eighth Covid booster” and “rubber stamping” the vaccine chosen by a global health panel that had targeted dominant influenza strains.

He offered no details about any school or entity that requires children to have annual Covid boosters.

He also was questioned about the measles vaccine in light of the current outbreak in Texas, where one child has died and 22 people were hospitalized.

“Vaccines save lives,” Dr. Makary said. “I do believe that any child who dies of a vaccine-preventable illness is a tragedy in the modern era.”

Advertisement

But he did not take the bait lobbed by Senator John Hickenlooper, Democrat of Colorado, who criticized Mr. Kennedy’s endorsement of vitamin A and cod liver oil as remedies for measles. Dr. Makary responded by saying that supplements can improve conditions like malnutrition, which is associated with poor outcomes in measles outbreaks.

Lawmakers also warned about staff cuts and hiring freezes the Trump administration has ordered and how they could affect workers who inspect the safety of the food supply, and urged Dr. Makary to review the layoffs among those staff members whose salaries are backed by industry fees.

They also touched on work related to chemicals like dyes in the food supply, an area Dr. Makary agreed to study, invoking European products with fewer additives as an area for review.

Among other issues raised during the hearing, the vexing problem of illegal vape products from China with unknown ingredients was stressed by Senator Ashley Moody, Republican of Florida.

The vapes tend to have high levels of nicotine, advertise thousands of puffs and come in flavors like strawberry lemonade that are appealing to adolescents.

Advertisement

Ms. Moody said it was concerning that the products were banned within China.

“Whoever comes in as the head of F.D.A., this is one of your problems you have to address immediately,” said Ms. Moody, who was previously Florida’s attorney general.

Blocking the flow of the unauthorized vapes has been a priority for major tobacco companies that have followed F.D.A. rules and marketed vapes in tobacco or menthol flavors in the United States. It’s a priority public health groups also share. Dr. Makary said he would address the problem with the F.D.A.’s law enforcement division and the Justice Department.

Throughout the hearing, several senators returned to the abortion pill and the F.D.A.’s oversight of policy changes during the lengthy history of medication abortion over more than two decades.

Mifepristone — part of the standard two-drug medication regimen now used in nearly two-thirds of abortions — has become a focal point of anti-abortion efforts since the Supreme Court overturned the national right to abortion in 2022.

Advertisement

In a lawsuit filed against the F.D.A. and other efforts, abortion opponents have demanded that the agency either withdraw approval for mifepristone or roll back regulations to prevent abortion pills from being prescribed by telemedicine and mailed to patients.

The Biden administration waived the in-person dispensing requirement in 2021. Senator Maggie Hassan, Democrat of New Hampshire, said that she was concerned that Dr. Makary would “unilaterally overrule the data that currently exists for political purposes and for political reasons.”

Dr. Makary repeated that he had no preconceived notions and would examine the data. “I wish you were hedging a little bit less today,” Ms. Hassan shot back.

Mifepristone, which blocks progesterone, a hormone necessary for pregnancy to develop, has long been regulated by the F.D.A. under an especially strict program that applies to only a small number of drugs.

For years after its approval in 2000, mifepristone could be prescribed only by a doctor and patients were required to attend three in-person doctor visits to obtain and take the medication. In 2016 and 2021, based on updated scientific evidence, the agency made several changes, including that nurse practitioners and some other health care providers could prescribe mifepristone and that patients did not have to pick up the medication in person.

Advertisement

Senator Josh Hawley, Republican of Missouri, argued that the policy change to drop the requirement for in-person appointments was made in anticipation of the Supreme Court decision that overturned Roe v. Wade.

Reproductive health experts and organizations, however, had long argued that the requirement was unnecessary for safety and noted that the F.D.A. had already allowed women to take the medication at home without being supervised by a doctor. The Covid pandemic increased the importance of allowing people to obtain the pill by mail because many patients were not able to visit clinics or abortion providers.

Pressed further by Mr. Hawley, Dr. Makary signaled that he shared the concerns of some abortion opponents and said that he knew doctors who preferred to give the drug in their office: “I think their concern there is that if this drug is in the wrong hands, it could be used for coercion,” he said.

Mr. Cassidy closed the hearing with a direct request: to change the policy back to what it was in the first Trump administration and require an in-person visit.

The F.D.A. has a staff of about 18,000 and a budget of about $7.2 billion. The agency has vast regulatory authority over products that include prescription and over-the-counter drugs, medical devices, tobacco and about 80 percent of the food supply. It also regulates artificial intelligence software used to scan medical images, an area where the agency has been dismissed as too permissive in its approvals.

Advertisement

If confirmed, Dr. Makary would first encounter tensions among staff members, who have been whipsawed by the Trump administration’s aggressive measures to reshape the federal bureaucracy in recent weeks.

The staff endured an initial round of about 700 layoffs, decimating some product-review teams that ensure the safety of medical devices such as surgical robots and systems that deliver insulin to people with diabetes. Those firings were followed by some job reinstatements, though many of those in the tobacco division who review the safety of new products and lost their positions, were not called back.

Asked about the layoffs, Dr. Makary said he supported efforts to increase efficiency and that he would review recent personnel decisions.

Pam Belluck contributed reporting.

Advertisement
Continue Reading

Science

Contributor: How federally funded research saved my son's sight — and his life — from a rare cancer

Published

on

Contributor: How federally funded research saved my son's sight — and his life — from a rare cancer

If you want to make this country great, imagine the strength of a nation whose children have been fought for and know they have been fought for.

Last month, my son reached two years in remission from a rare, malignant cancer that almost took his eye and his life. He is alive, well and enjoying 20/20 vision because of a groundbreaking treatment that was pioneered by National Institutes of Health researchers, among others, and funded by the government grants the Trump administration is blocking and threatening to cut. If the president continues on this course, children diagnosed during and after this administration will needlessly fare worse than those who came before.

My son Jack was diagnosed in 2022 with retinoblastoma, a malignant childhood cancer of the central nervous system that originates and grows in the eye. If left untreated, it typically migrates through the optic nerve to the brain, eventually metastasizing and taking the life of the child.

Because the cancer usually attacks children under the age of 3, its victims are often unable to report the symptoms of a mass blocking their vision until it’s too late to treat with procedures that can salvage the eye. That’s when enucleation — removal of the eye — is required.

This is why pediatricians developed standard screening for retinoblastoma starting at birth. This now-routine preventative care has enabled medical professionals to find and treat most cases without a loss of vision or life. Because of these developments and others, retinoblastoma has a very high survival rate in 21st century America.

Advertisement

Jack’s was one of very few documented diagnoses with retinoblastoma after the age of 8. His oncologist suggested his tumor had been hiding in a dark corner of his retina for years, out of his vision and that of physicians; other doctors thought it had “self-arrested” or presented late and grew rapidly. We discovered it only because it burst from the impact of a belly flop at the neighborhood pool, spewing cancer cells in a constellation of poison floating inside his still-intact eyeball, visible to Jack as spots that didn’t go away.

It took weeks for doctors to nail down the diagnosis. When we walked out of that appointment on a day that was so windy I had to hold onto my dress, I put Jack in the car, turned the radio on for him, closed the passenger door and walked about 30 feet away to scream in the parking lot. “My baby!” I wailed through the phone to my mother.

It was an advanced-stage tumor, complicated by the release of cancer cells inside his eye. They could now attach and grow anywhere within — including the optic nerve, with its direct connection to his brain — if we didn’t act quickly. We might have just days before it was too late.

“We could remove his eye,” our oncologist offered at first, “and even that might not be enough.”

Medical researchers from universities and the National Institutes of Health rally near the Health and Human Services Department’s headquarters in Washington.

Advertisement

(John McDonnell / Associated Press)

Then he explained that we could try to save his eye with a highly advanced procedure called intra-arterial chemotherapy, or IAC. It involves threading a catheter through the thigh’s femoral artery, behind the heart through the carotid artery and into the skull. An interventional radiologist, guided by MRI, releases the chemotherapy agent directly into the artery feeding the retina. This allows doctors to deliver more aggressive and targeted medicine to the diseased cells and limit damage to the healthy ones.

Our oncologist explained that IAC is still a very new technology but one with extraordinary promise whose benefits far outweighed the risks for Jack.

My son underwent six rounds of intra-arterial chemotherapy and seven rounds of intravitreal chemotherapy, in which the medicine is injected directly into the eye. He went under anesthesia 13 times in six months, required monthly breathing treatments that made him spit gray foam, and lost most of the brow and all the lashes around the affected eye. His list of drugs included ketamine, propofol, hydromorphone, melphalan, fentanyl, topotecan, pentamidine, albuterol, prednisolone and aldosterone. At one point, he needed epinephrine because he nearly went into cardiac arrest. Toward the end of his treatment, he received cryotherapy to kill the base of the tumor and woke up from surgery in so much pain that he gritted his teeth to the point of cracking one.

Advertisement

At every turn, my family was reminded of our privilege — to live in a country that was scientifically advanced enough to have developed such miracle treatments, to live in a city (Denver) with such good hospitals, to have good health insurance through my husband’s employer. If we had lived without such access to care, in a country lacking our resources or just 15 years earlier, our story would have ended differently. Instead, nine months after his diagnosis, thanks to the advanced research our country has supported socially, academically and financially, my son’s cancer was in remission.

My family recently attended a gathering with other retinoblastoma survivors, from toddlers to adults who had conquered the disease decades earlier. As each survivor entered the conference, it became evident that this was once primarily a disease of blindness: The price of survival was generally a loss of sight and eyes. Some of the older survivors had facial abnormalities from radiation or enucleation. Some had canes or family members to guide them. When we told the group that Jack’s body, vision and dream of becoming a pilot were all still intact, many gasped in awe that the science had advanced so far.

But now the Trump administration’s lack of empathy threatens other children and families facing such horrific diagnoses. Continuing research on intra-arterial chemotherapy and other treatments at the University of Colorado’s Anschutz Medical Campus, where Jack was treated, is paid for by programs in the administration’s crosshairs. “These cuts to NIH funding jeopardize the foundation of our life-saving research,” a university spokeswoman told Chalkbeat Colorado. “Reduced research capacity means fewer scientific discoveries, job losses and delayed advancements on therapies and cures that could improve — and save — lives.”

I wonder whether our hospital will be able to continue offering groundbreaking treatments should Jack face a recurrence. And will the newly diagnosed have the same access to care that we did? What greatness can be celebrated when a mother fears she will lose her child’s access to lifesaving treatment?

My son’s recovery was a direct result of the greatness of our country and its past leaders, who had the foresight to pursue progress and excellence in science and refuse to accept losing children without a fight. Because of it, I believe my son will someday fly planes. And I can only hope the next child who faces a dire disease will get the same chance he did.

Advertisement

Dayna Copeland is a writer and teacher in Colorado.

Continue Reading

Science

Florida Seeks Drug Prescription Data With Names of Patients and Doctors

Published

on

Florida Seeks Drug Prescription Data With Names of Patients and Doctors

Florida’s insurance regulator has demanded an unusually intrusive trove of data on millions of prescription drugs filled in the state last year, including the names of patients taking the medications, their dates of birth and doctors they’ve seen.

The Florida Office of Insurance Regulation in January sought this information from pharmacy benefit managers like UnitedHealth’s Optum Rx and CVS Health’s Caremark, companies that oversee prescription drugs for employers and government programs.

It remained unclear why the state was ordering the submission of so much data. In a letter to one benefit manager reviewed by The New York Times, the regulator said the state required the data to review whether the benefit managers, known as P.B.M.s, were compliant with a 2023 state law aimed at lowering drug prices and reining in the managers.

But the demand is sparking concerns about government overreach and patient privacy.

“You don’t need such granular patient information for purposes of oversight,” said Sharona Hoffman, a health law and privacy expert at Case Western Reserve University. She added: “You have to worry: Is the government actually trying to get information about reproductive care or transgender care or mental health care?”

Advertisement

Florida’s six-week abortion ban, enacted by Gov. Ron DeSantis, a Republican, and the state’s Republican-dominated legislature, requires that doctors who prescribe abortion pills dispense them in person, not through the mail. Another Florida law banned transgender transition care for minors and made it harder for adults to seek such care. Last year, a judge struck down key parts of that law, though it is still being enforced while the legal fight makes its way through the courts.

The data requested by the state could, in theory, be used to determine whether physicians are complying with those laws.

It was also unclear whether any of the benefit managers had complied and turned over the information to the state.

Some benefit managers and the employers that hire them to handle prescription drug benefits for their workers have also criticized the state’s demand.

A group of large employers, the American Benefits Council, is asking the Florida regulator to withdraw its order to turn over the information. In a letter to the state, the council’s lawyers wrote that the “demand impermissibly violates the health privacy and security of millions of Floridians,” and that the state had not clearly outlined its authority or reasons for the action.

Advertisement

“We have a duty to employees and their data,” Katy Johnson, the president of the council, said in an interview.

Shiloh Elliott, a spokeswoman for Florida’s insurance regulator, said that objections to the state’s data request “are clearly from those who do not want to be regulated or have any oversight in their industry.” She said the office “will continue to request data in the best interest to protect consumers.”

Rosa Novo, the administrative benefits director for Miami-Dade County Public Schools, which provides health coverage to about 45,000 people, said in an interview that while she appreciated the state’s efforts to address drug prices, it was unclear why it would need this level of detailed information about patients and their medications.

“My doctor is the only one who should know that,” Ms. Novo said.

Federal privacy law allows benefit managers to hand over limited data about individual patients in certain circumstances, such as when regulators are conducting an audit. But, according to experts, Florida’s data request could violate the law because it is so broad and may go beyond what the regulator needs to conduct its review.

Advertisement

Experts said that another concern with Florida’s request is that when sensitive patient data is in multiple hands, it raises the risk of a breach in which the information may be stolen.

Ms. Elliott, the spokeswoman for the regulator, said those concerns “should be addressed to the actual health care insurance companies that have had countless data breaches exposing millions of Americans’ sensitive information.”

Florida’s data order was first reported by Bloomberg.

Like other states, Florida already has access to some of the data it is seeking, such as detailed information about prescriptions that are paid through Medicaid. But that data is generally strictly walled off, accessible only to staff members whose jobs require it.

Benefit managers often field requests from government regulators asking for slices of data to conduct audits or investigations. Such requests typically ask benefit managers to strip out patient names, and other identifying details, or ask for a small sample of patient claims.

Advertisement

By comparison, Florida’s data request was “pretty expansive and unprecedented,” said Joseph Shields, the president of a group of smaller benefit managers, Transparency-Rx.

Florida sought data not only on Florida residents, but also on patients who may have filled a prescription while visiting the state. Its request included patients covered through the federal Medicare program and commercial plans through employers that are regulated under federal law rather than state law, according to the regulator’s letter to one benefit manager reviewed by The Times.

The Prescription Drug Reform Act, the Florida law the regulator used to justify the data request, imposed new reporting requirements on the benefit managers but said nothing about a mandate requiring them to turn over such detailed patient information. Benefit managers have fiercely fought efforts to scrutinize their business practices.

Patricia Mazzei contributed reporting from Florida.

Advertisement
Continue Reading
Advertisement

Trending