In brief: Study links OSA & mental health, MACs drop LCDs, CMS invests in rural health 

YARMOUTH, Maine - Middle-aged and older adults at high risk of obstructive sleep apnea (OSA) had consistently worse mental health outcomes, according to a national longitudinal cohort study published in the Journal of the American Medical Association (JAMA). Key points from the study: 

• Question: Is high risk of OSA associated with increased odds of concurrent and future mental health conditions among middle-aged and older adults? 
• Findings: In this national cohort study of 30 ,097 individuals, those at high risk of OSA had approximately 40% higher odds of mental health conditions at both baseline and follow-up. Over time, high risk of OSA remained associated with a 44% increased odds of reporting new mental health conditions. 
• Meaning: These findings bridge knowledge gaps on the association between OSA and mental health during aging, highlighting the need for integrated screening and intervention strategies. 

“These findings highlight the importance of systematic mental health screening for older adults at risk for OSA,” researchers stated. “Incorporating mental health assessment tools into sleep evaluation may help identify individuals at greatest risk and support early intervention. Educating older adults about the potential associations of untreated OSA with mood, cognition, and long-term brain health could also improve engagement in diagnostic testing and treatment adherence. As OSA has been associated with increased risk of cognitive impairment and dementia, future studies should explore whether integrating screening and prevention strategies enhances both mental and cognitive health outcomes.” 

• Related: Researchers at the University of Missouri School of Medicine and the Marshall University Joan C. Edwards School of Medicine have found evidence that untreated obstructive sleep apnea (OSA) accelerates cardiovascular aging and significantly increases the risk of premature death.   

MACs withdraw new coverage policies for skin substitutes 

WASHINGTON – The seven Medicare Administrative Contractors (MACs) are withdrawing the local coverage determinations (LCDs) for skin substitute grafts/cellular and tissue-based products for the treatment of diabetic foot ulcers and venous leg ulcers that were scheduled to go into effect Jan. 1, 2026. 

The Centers for Medicare & Medicaid Services (CMS) made the announcement on Dec. 24, only days after announcing that the MACs would release updated LCDs that would go into effect Jan. 1, 2026. 

The only other information provided by CMS: 

• For more information on the LCD process, see https://www.cms.gov/cms-guide-medical-technology-companies-and-other-interested-parties/coverage/local-coverage-determination-process-and-timeline.  
• For additional information on CMS’s efforts to reduce Medicare spending waste for skin substitutes, see the following: 
• Press release, “CMS Modernizes Payment Accuracy and Significantly Cuts Spending Waste”: https://www.cms.gov/newsroom/press-releases/cms-modernizes-payment-accuracy-significantly-cuts-spending-waste. 
• Fact Sheet, Calendar Year 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F): https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-final-rule-cms-1832-f. 

In calendar year 2026, CMS plans to finalize payment for skin substitute products as incident-to supplies when they are used as part of a covered application procedure paid under the physician fee schedule in the non-facility setting or under the Medicare Hospital Outpatient Prospective Payment System in the hospital outpatient department setting, 

The agency also plans to finalize the alignment of skin substitute categorization consistent with their U.S. Food and Drug Administration (FDA) regulatory status, such as 361 Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/P) and the device types: pre-market approvals (PMAs) and 510(k)s. 

CMS announces $50B in rural health care spending for all 50 states 

WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has announced that all 50 states will receive awards under the Rural Health Transformation Program, a $50 billion initiative established under President Trump’s Working Families Tax Cuts legislation to strengthen and modernize health care in rural communities across the country. 

In 2026, states will receive first-year awards from CMS, averaging $200 million within a range of $147 million to $281 million. 

“More than 60 million Americans living in rural areas have the right to equal access to quality care,” said Health and Human Services Secretary Robert F. Kennedy, Jr. “This historic investment puts local hospitals, clinics, and health workers in control of their communities’ health care. Thanks to President Trump’s leadership, rural Americans will now have affordable healthcare close to home, free from bureaucratic obstacles.”   

With this funding, states will implement comprehensive strategies to improve care delivery, support providers, and advance new approaches to coordinating health care services across rural communities, CMS says. 

Many states are planning efforts that will: 

• Bring more care within reach 
• Strengthen and sustain the rural clinical workforce 
• Modernize rural health infrastructure and technology 
• Drive structural efficiency and empower community providers 
• Advance innovative care models and payment reform 

The Rural Health Transformation Program’s $50 billion in funds will be allocated to approved states over five years, with $10 billion available each year from 2026 through 2030. As directed by Public Law 119-21:  

• 50% of the funding is distributed equally among all approved states. 
• 50% is allocated based on a variety of factors. As described in the Notice of Funding Opportunity, those factors include individual state metrics around rurality and a state’s rural health system, current or proposed state policy actions that enhance access and quality of care in rural communities, and application initiatives or activities that reflect the greatest potential for, and scale of, impact on the health of rural communities. 

Go here for a state award list. 

CMS has also announced the establishment of the Office of Rural Health Transformation (ORHT) within the Center for Medicaid and CHIP Services (CMCS). 

New tech: MIT researchers develop non-invasive glucose monitor 

CAMBRIDGE, Mass. - A team of researchers at the Massachusetts Institute of Technology (MIT) has used Raman spectroscopy to develop a shoebox-sized device that can measure blood glucose levels without any needles, MIT News reports. In tests in a healthy volunteer, researchers found the device’s measurements were similar to those of a commercial continuous glucose monitor, which requires a wire to be implanted under the skin. “For a long time, the finger stick has been the standard method for measuring blood sugar, but nobody wants to prick their finger every day, multiple times a day,” says Jeon Woong Kang, an MIT research scientist. “Naturally, many diabetic patients are undertesting their blood glucose levels, which can cause serious complications. If we can make a noninvasive glucose monitor with high accuracy, then almost everyone with diabetes will benefit from this new technology.” Researchers recently published their work using Raman spectroscopy, a technique that reveals the chemical composition of tissues by shining near-infrared or visible light on them, in the journal Analytical Chemistry. While the device is too large to be used as a wearable sensor, researchers have since developed a smaller version about the size of a cell phone that they are now testing in a small clinical study of healthy and prediabetic volunteers. Next year, they plan to run a larger study working with a local hospital that will include people with diabetes. Researchers are also working on making the device even smaller – about the size of a watch. 

Do weight-loss drugs reduce need for CPAP? Modestly, according to new research 

YARMOUTH, Maine – Popular weight-loss drugs, especially tirzepatide, are linked to modestly lower CPAP initiation among adults with Type 2 diabetes and obstructive sleep apnea (OSA), according to a research letter in the Journal of the American Medical Association (JAMA). Researchers found a stronger link between the drugs and reduced hospitalization and mortality. “These findings align with recent randomized clinical trials showing that incretin receptor agonists (IRAs), especially tirzepatide, improved OSA severity, potentially through weight loss and metabolic or respiratory mechanisms,” researchers wrote. “The modest effect size for IRAs suggests limited clinical relevance for CPAP use alone, but reductions in mortality and hospitalization support broader cardiometabolic benefits. Notably, tirzepatide showed greater reductions in risk of CPAP use and mortality than GLP-1RAs, highlighting its potential therapeutic advantage.” Researchers said future research should clarify causal pathways linking pharmacologic weight loss with OSA outcomes. 

Medline closes IPO, trades at $42.78 

NORTHFIELD, Ill. - Medline announced Dec. 18 that it closed its upsized initial public offering (IPO) of 248,439,654 shares of its Class A common stock at a public offering price of $29.00 per share, including the full exercise by the underwriters of their option to purchase up to an additional 32,405,172 shares of Class A common stock. Medline intends to use the proceeds (net of underwriting discounts) from the issuance of 179,000,000 shares to repay outstanding indebtedness under its senior secured term loan facilities and the remainder for general corporate purposes and to bear the expenses of the offering. Medline intends to use the proceeds (net of underwriting discounts) from the issuance of 37,034,482 shares and from the issuance of shares pursuant to the exercise by the underwriters of their option to purchase an additional 32,405,172 shares of Class A common stock to purchase or redeem an equivalent aggregate number of outstanding equity interests from certain of its pre-IPO owners. Medline started trading on the NASDAQ on Dec. 17 under the symbol “MDLN.” At press time, the company’s shares were trading at $42.78. 

AdaptHealth agrees to resolve lawsuit for $35M 

CONSHOHOCKEN, Pa. - AdaptHealth has agreed to pay $35 million to resolve a class action lawsuit that alleged the company made false and misleading statements about its billing practices, compliance systems, acquisition integration and financial performance from Aug. 4, 2020, to Nov. 7, 2023. The settlement, which covers investors who purchased or acquired AdaptHealth common stock during that period, will be funded by the company’s available insurance, ensuring near-term recovery and avoiding litigation risks. In May 2025, the parties agreed to mediation and in October 2025, they participated in a full-day mediation session. Later in October, the parties reached an agreement in principle, and in December, they entered into the stipulation, setting forth the terms and conditions of the settlement. 

Henry Schein provides update on search for new CEO 

MELVILLE, N.Y. – Henry Schein expects to appoint its next CEO by mid-January 2026. The company says it has nearly completed the search process, but it will not be finalized before year-end. “We have evaluated a pool of highly qualified candidates, and the level of interest and caliber of talent have been exceptional,” said Philip A. Laskawy, lead director for Henry Schein. “We expect to make a final decision on a candidate and formal announcement regarding the appointment to the role by mid-January.” In the meantime, Henry Schein says Stanley Bergman will continue in his role of CEO and chairman at the request of the board of directors. In July, the company announced that Bergman would retire at the end of 2025 after 45 years at the company, including more than 35 years in the top role. “The board has engaged in a thoughtful and thorough search process,” Bergman said. “Until a successor CEO assumes the position, I look forward to working with the team to build on the continued momentum in the business and ensuring a smooth transition.”