• District of Columbia: According to a new report from Georgetown University, the total cost associated with the No Surprises Act's IDR process was $22.4 billion at the end of 2025. Of this amount, $15.6 billion was from payments to providers that were higher than in-network rates. An additional $4.2 billion was from administrative costs, and $2.7 billion was for fees and costs for IDR entities. Although the No Surprises Act was designed with the expectation that most claims would be resolved outside the IDR, this has not been the case. In 2025, there were 2.6 million IDR disputes, up 77% year-over-year. The figure has only continued to grow, with the first half of 2026 seeing around 1.75 million disputes, a 50% increase from the first half of 2025. As the number of IDR cases and payout amounts both increase, there have been calls to change the No Surprises Act to mitigate these trends and avoid growing healthcare costs. "The enormous IDR cost inevitably will add to the insurance premiums paid by consumers, and we've already seen some employers and insurers attributing a portion of their premium increases to IDR costs," said Jack Hoadley, a research professor at Georgetown's Center on Health Insurance Reforms and one of the study's authors. "The time may, in fact, be ripe to revisit the [No Surprises Act] to realize the law's original cost containment goals without jeopardizing the consumer protections that are really the main reason this law got passed in the first place." (Minemyer, Fierce Healthcare, 8/26)
• Minnesota: According to a recent Public Health Alerts report, over two-thirds of U.S. e-cigarette sales are illicit, with most of them targeting young people. Currently, 7% of adults (ages 25 and older), 24.8% of young adults (ages 18 to 24), 7.8% of high school students, and 3.5% of middle school students report using e-cigarettes. For the report, researchers analyzed retail scanner data from Circana and found that 30.6% of e-cigarette sales were matched to products authorized by FDA while 69.4% were matched to unauthorized products. Although most tobacco-flavored e-cigarettes sales (93.1%) came from FDA-authorized products, only 26.1% of menthol-flavored sales were from authorized products. Sales of other flavored products, like fruit or candy, were all unauthorized. "Disposable e-cigarettes in flavors that may appeal to young people comprised the majority of unauthorized sales," the researchers wrote. "Insufficient public data regarding which tobacco products are legally marketed presents compliance challenges for retailers and complicates research." (Wappes, CIDRAP News, 8/11)
• Texas: Oracle Health has released a clinical AI agent for nurses embedded in the company's EHR, which includes voice-enabled charting, search, and acute nursing summaries. Previously, Oracle released a clinical AI agent for physicians, which it says helped save physicians more than 400,000 hours across U.S. healthcare organizations. The new tool for nurses simplifies their workflows and allows them more time for direct care "by making it easy to find relevant patient information, understand a patient's current condition and complete documentation in near real time," Oracle said. Lynette Clinton, chief information officer of BayCare Health, has praised the new tool for nurses. "As we've expanded the use of generative AI across our organization, Oracle Health has continued to listen to our feedback to help ensure nursing capabilities fit naturally into the flow of care," Clinton said. "Helping our nurses complete documentation in real time has the potential to reduce after-shift charting, ease administrative burden and give them more time to focus on patients." (Twenter, Becker's Health IT, 9/14)

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