Category: Health

MIL-OSI United Kingdom: Hospices receive multi-million pound boost to improve facilities

Source: United Kingdom – Executive Government & Departments

Press release

Hospices receive multi-million pound boost to improve facilities

The government has confirmed the release of £25 million for upgrades and refurbishments today for hospices across England,

An additional £75 million will be available from April as part of the largest investment in hospices in a generation.
The funding will modernise facilities, improve IT systems and ensure patients receive the highest quality care.

Families across England will start to see improved end-of-life care as the government brings in major upgrades to hospice services nationwide.

New investments in hospices will make sure people receive compassionate care in comfortable, dignified surroundings during their most vulnerable moments by creating outdoor gardens where memories can be shared and upgrading patient rooms, so they feel more like home.

Every change is focused on supporting families when they need it most.

The improvements will help ensure that during life’s most challenging moments, patients and their loved ones receive the highest quality care in the most appropriate and comfortable settings.

Hospices will begin receiving £25 million for facility upgrades and refurbishments from today as part of the biggest investment into hospices in a generation.

The cash will be distributed immediately for the 2024/25 financial year, with a further £75 million to follow from April. More than 170 hospices across the country will receive funding, including those run by Marie Curie and Sue Ryder, as well as independent hospices like Zoe’s Place in Liverpool.

This cash forms a key part of the government’s Plan for Change, improving care in the community where people need it most.

Minister for Care Stephen Kinnock said:

This is the largest investment in a generation to help transform hospice facilities across England. From upgrading patient rooms to improving gardens and outdoor spaces, this funding will make a real difference to people at the end of their lives.

Hospices provide invaluable care and support when people need it most and this funding boost will ensure they are able to continue delivering exceptional care in better, modernised facilities.

The immediate cash injection, allocated through Hospice UK from the department, will enable hospices to purchase essential new medical equipment, undertake building refurbishments, improve technology, upgrade facilities for patients and families and implement energy efficiency measures. 

The larger £75 million investment will support more substantial capital projects, including major building works and facility modernisation, throughout the next financial year. 

Toby Porter, CEO of Hospice UK, said:

The announcement before Christmas of £100m of additional funding for hospices in England was a significant boost, and today’s news of the allocation of the first £25m of this funding will be a huge relief for our members.

Several years of rapidly rising costs have curtailed the extent to which hospices have been able to invest in their infrastructure for the longer term. This additional support will enable them to do so – and relieve the immediate pressures on hospice finances.

The hospice sector is ready to support the government’s ambition to shift more care into the community. This couldn’t be more important for people approaching the end of life, when it’s vital to have the right care, in the right place.

The greater stability provided by the government’s funding injection this year and next gives us a golden opportunity to now reform the palliative and end of life care system, so it’s fit for the future.

Nick Carroll, Chief Executive of children’s palliative care charity Together for Short Lives, said:

We’re really pleased that the Department of Health and Social Care has moved quickly to finalise the details of this much-needed funding and ensure it is ready for distribution.

We know that children’s hospices across England face an increasingly challenging funding landscape, with costs continuing to rise significantly. This investment will help children’s hospices continue to deliver essential care for seriously ill children and their families across England.

A key focus of the investment will be digital transformation, enabling hospices to modernise their IT systems and improve data sharing between healthcare providers. The funding will also support the development of outreach services, allowing hospices to extend their care beyond their physical buildings. This includes investing in mobile equipment and technology that will help support people who wish to receive end-of-life care in their own homes. 

Creating more welcoming spaces for families is another priority, with funding allocated for the renovation of family rooms and outdoor areas. These improvements will provide peaceful, comfortable spaces where families can spend precious time with their loved ones during difficult periods. 

The funding forms part of the government’s commitment to improving end-of-life care services across England, so hospices can continue providing exceptional care in the best possible environments. 

It also supports the government’s ambitions in the 10 Year Health Plan to shift healthcare out of hospitals into the community and from analogue to digital, to ensure patients and their families receive personalised care in the most appropriate setting.

NOTES TO EDITORS: 

Hospice UK is managing the distribution without charging administration fees.

BREAKDOWN OF FUNDING
Acorns Children’s Hospice Trust	302,003
Alexander Devine Children’s Hospice Service	47,956
Arthur Rank Hospice Charity	235,374
Ashgate Hospicecare	211,820
Barnsley Hospice	80,039
Bassetlaw Hospice	7,274
Beaumond House Community Hospice	32,852
Birmingham – adjusted for 12 months	345,224
Bluebell Wood Children’s Hospice	73,256
Blythe House Hospice	39,958
Bolton Hospice	107,466
Bury Hospice	61,674
Butterfly Hospice	12,215
Butterwick Hospice Limited	60,656
Campden Home Nursing	23,060
Children’s Hospice South West	275,928
Claire House Children’s Hospice	172,160
Community Hospice for Greenwich & Bexley	231,143
Compton Hospice	217,778
Cornwall Hospice Care	161,125
Demelza Hospice Care for Children – Demelza Kent	242,135
Derian House Children’s Hospice	115,875
Dorothy House Hospice Care	297,862
Douglas Macmillan Hospice	328,758
Dove Cottage Day Hospice	9,309
Dove House Hospice	111,822
Dr Kershaw’s Hospice	92,588
Earl Mountbatten Hospice	332,433
East Anglia’s Children’s Hospices	222,453
East Cheshire Hospice	130,738
East Lancashire Hospice	85,513
Eden Valley Hospice	92,849
Ellenor	137,518
Farleigh Hospice	268,268
Forget Me Not Children’s Hospice	75,232
Francis House Children’s Hospice	152,127
Garden House Hospice	124,170
Great Oaks, Dean Forest Hospice	25,137
Halton Haven Hospice	55,394
Harlington Hospice Association	116,191
Hartlepool & District Hospice	60,881
Haven House Children’s Hospice	88,446
Havens Hospices	261,310
Heart of Kent Hospice	97,348
Helen & Douglas House	136,890
Hope House Children’s Hospices (Hope House)	144,966
Hospice at Home West Cumbria	33,871
Hospice at Home, Carlisle and North Lakeland	31,287
Hospice Care for Burnley & Pendle	95,256
Hospice in the Weald	199,653
Hospice of St Francis (Berkhamsted)	121,619
Hospice of the Good Shepherd	81,185
HospiceCare North Northumberland	18,653
Hospiscare (Exeter)	180,911
Isabel Hospice	120,401
Jessie May	22,929
John Eastwood Hospice	12,573
Julia’s House Ltd.	131,315
Kate’s Home Nursing	8,843
Katharine House Hospice (Banbury)	35,454
Katharine House Hospice (Stafford)	97,658
Keech Hospice Care	189,753
Kemp Hospice Trust	21,942
Kirkwood Hospice	160,020
Lakelands Hospice	9,251
Lawrence Home Nursing	9,586
Lewis-Manning Hospice	49,050
Lindsey Lodge Hospice	78,577
Longfield	50,229
LOROS Leicestershire & Rutland Hospice	302,751
Marie Curie unadjusted	1,250,000
Martin House Children’s Hospice	148,596
Mary Ann Evans Hospice	37,177
Mary Stevens Hospice	83,256
Naomi House & Jacksplace Children’s Hospice	122,736
Noah’s Ark Children’s Hospice	114,605
North Devon Hospice	104,128
North London Hospice	283,640
Nottinghamshire Hospice	72,123
Oakhaven Hospice	157,402
Overgate Hospice	85,938
Phyllis Tuckwell Hospice	280,455
Pilgrims Hospices in East Kent, Canterbury	290,911
Primrose Hospice	29,035
Princess Alice Hospice	264,319
Priscilla Bacon	3,958
Prospect Hospice	127,153
Queenscourt Hospice	137,157
Rainbows Hospice for Children and Young People	145,128
Rennie Grove Peace Hospice Care	278,579
Richard House Children’s Hospice	85,846
Rosemary Foundation – Hospice at Home	17,247
Rossendale Hospice	25,229
Rotherham Hospice	121,115
Rowcroft – The Torbay & South Devon Hospice	158,301
Royal Trinity Hospice	318,609
Saint Catherine’s Hospice (Scaraborough)	104,720
Saint Francis Hospice	191,131
Saint Michael’s Hospice (Harrogate)	140,243
Severn Hospice	229,964
Shipston Home Nursing	10,206
Shooting Star CHASE	169,787
Sidmouth Hospice at Home	16,934
Sobell House Hospice	78,633
South Bucks Hospice	19,251
Springhill Hospice	111,983
St Andrew’s Hospice (Grimsby)	92,589
St Ann’s Hospice (Cheadle, Cheshire)	228,447
St Barnabas Hospices (Sussex)	368,232
St Barnabas Lincolnshire Hospice	236,601
St Catherine’s Hospice (Crawley)	203,142
St Catherine’s Hospice (Lancashire)	166,720
St Christopher’s Hospice	526,754
St Clare Hospice (West Essex)	144,945
St Cuthbert’s Hospice	68,486
St Elizabeth Hospice	239,262
St Gemma’s Hospice	225,450
St Giles Hospice	213,793
St Helena Hospice	237,083
St John’s Hospice, Lancaster	126,624
St Johns, London	147,500
St Joseph’s Hospice Association	66,973
St Joseph’s Hospice, HACKNEY	313,531
St Leonard’s Hospice	144,606
St Luke’s (Cheshire) Hospice	84,318
St Luke’s Hospice (Basildon)	256,843
St Luke’s Hospice (Harrow & Brent)	129,220
St Luke’s Hospice (Sheffield)	223,481
St Luke’s Hospice Plymouth	176,616
St Margaret’s Hospice – SOMERSET	204,046
St Mary’s Hospice	86,382
St Michael’s Hospice (Hereford)	166,755
St Michael’s Hospice (North Hampshire) Basingstoke	86,086
St Michael’s hospice, Hastings	146,943
St Nicholas Hospice Care	97,852
St Oswald’s Hospice	252,524
St Peter & St James Hospice & Continuing Care Centre	78,032
St Peter’s Hospice (BRISTOL)	251,252
St Raphael’s Hospice	131,769
St Richard’s Hospice (WORCESTER)	172,108
St Rocco’s Hospice	88,421
St Teresa’s Hospice	76,912
St Wilfrid’s Hospice (EASTBOURNE)	179,191
St Wilfrid’s Hospice (SOUTH COAST) – Chichester	141,670
Sue Ryder unadjusted	1,250,000
Teesside Hospice Care Foundation	74,899
Thames Hospice	224,843
The Martlets Hospice	253,129
The Myton Hospices	223,905
The Norfolk Hospice, Tapping House	81,531
The Prince of Wales Hospice	70,669
The Rowans Hospice	171,289
The Shakespeare Hospice	32,216
Treetops Hospice Care	65,496
Trinity Hospice & Palliative Care Services	205,071
Tynedale Hospice at Home	16,145
Wakefield Hospice	78,381
Weldmar Hospicecare Trust	177,100
Weston Hospicecare	71,633
Wigan & Leigh Hospice	123,224
Willen Hospice	143,687
Willow Burn Hospice	24,014
Willow Wood Hospice	60,478
Willowbrook Hospice	99,908
Wirral Hospice St John’s	131,516
Woking Hospice	160,768
Woodlands Hospice	20,172
Zoe’s Place – Baby Hospice	75,336

Published 26 February 2025

MIL OSI United Kingdom –

February 26, 2025

MIL-OSI United Kingdom: expert reaction to the Climate Change Committee’s Seventh Carbon Budget

Source: United Kingdom – Executive Government & Departments

February 26, 2025

Scientists comment on the Seventh Carbon Budget, published by the Climate Change Committee.

Prof John Barrett, Professor in Energy and Climate Policy and Director of the Climate Evidence Unit at the University of Leeds, said:

“This is a very welcome report with a robust analysis that lets the Government, industry and citizens know that the pathway to net zero is possible and very much needed. However, it does place enormous responsibility on some key technologies and their rapid roll out to achieve these goals. As the UK Government digests the findings, we would suggest greater consideration of the “social” transformation that examines how we travel and what we buy.”

“While the report acknowledges some upfront costs, it confirms that acting now will reduce expenses in the long run, with cost savings emerging by the late 2030s and beyond.”

“The key takeaway from today’s report is clear: the transition to net zero is not only possible but highly beneficial. Independent academic analyses consistently supports this conclusion, showing that it will strengthen the economy, deliver widespread co-benefits, and position the UK as a leader in global climate action.”

Dr Sean Beevers, Reader in Atmospheric Modelling, School of Public Health, Imperial College London, said:

“A National Institute for Health and Care Research project examined the effects of net zero policies on air quality, active travel, health, and associated economic benefits in the UK.

“Our cost benefit analysis showed that net zero transport and building policies deliver substantial co-benefits, including improved indoor and outdoor air quality, better health, increase active travel, lessening inequalities and with long-term economic gains. We estimated an overall monetised air quality and active travel benefit of £46.4 billion by 2060 and £153 billion by 2154.

“Net zero policy analyses should include benefits from the air pollution reductions and physical activity increases. These benefits apply to current and future generations and failure to act will lead to worse health outcomes and higher costs for attaining net zero.”

Dr Edward Gryspeerdt, Research Fellow at the Department of Physics, Imperial College London, said:

“The CCC’s advice highlights that aviation will become the highest emitting sector in the UK by 2040. Clean alternatives, such as low-carbon fuel and technology for low emission flights are currently limited and a range of measures will be needed to meet net-zero – there is no silver bullet.

“The government has described ‘sustainable aviation fuels’ as a ‘game changer.’ However, to have a significant impact on the climate impact of flying, they will need to be produced at a huge scale. It is not yet clear how this will be achieved. To reach net zero, the CCC also note that a switch from flying to other modes of transport will be required, especially for flights with an easy rail alternative.

“These measures alone won’t solve the problem. The CCC’s report highlights that a significant amount of carbon capture will be needed, highlighting the simple fact that the technological solutions to eliminate the climate impact of flying don’t yet exist. Any expansion of the UK’s aviation infrastructure will have to be coupled with improved sustainable transport options.”

Dr Caterina Brandmayr, Director of Policy and Translation at the Grantham Institute – Climate Change and the Environment, Imperial College London, said:

“Today’s advice marks an important milestone in charting the UK’s path to net zero. Public opinion surveys continue to show that climate change remains a key issue of concern for a large majority of people in the UK.

“To put us firmly on track to deliver the deep emission cuts needed from 2038 to 2042, the UK government needs to strengthen its action in the near term, giving confidence to businesses and households to invest in clean alternatives in sectors like housing, transport and energy.

“There is strong public support for the benefits that emission reduction interventions can bring, such as warmer homes, energy security and cleaner air.

“Effectively communicating these benefits, while ensuring fairness and choice in policy design, will be key to sustaining public support for the transition and driving change in harder to decarbonise sectors, such as aviation and land use.”

Dr Friederike Otto, Senior Lecturer at the Centre for Environmental Policy and co-lead of World Weather Attribution, Imperial College London, said

“People shouldn’t forget why we need these targets – we’re already feeling the pain at 1.3°C of warming and things will keep getting worse until emissions are reduced to net zero.

“Here in the UK, we’ll experience even wetter winters that could wipe out crops, threaten our food security and turn sports pitches into miserable bogs. In summer, more frequent heatwaves will contribute to thousands of premature deaths, could put additional strain on the NHS, and reduce economic productivity. Overseas, extreme weather could disrupt supply chains we depend on and could contribute to worsening political instability and conflict.

“Arguments that climate action is too costly are dangerous, short-sighted and disproportionately harm poorer people. If governments don’t cut emissions, both now and in the future, our children will live in an increasingly hostile climate and even more inequal society.

“The UK needs to push ahead and lead the way in emission reductions for a safer, healthier future.”

Prof Lorraine Whitmarsh, Director at the Centre for Climate Change and Social Transformations (CAST) at the University of Bath, said:

“The government’s climate advisors make clear that tackling climate change requires significant action from all sections of society in the coming years. A third of emission reductions will come from household behaviour change alone. Low-carbon choices include switching to electric vehicles and heat pumps, eating more plant-based foods, and shifting to cleaner forms of transport. Many of these changes offer wider benefits, like improved health and lower bills. The report also highlights the need for government to reduce the barriers for the public to make these changes and to engage the public more actively in the net zero transition. The citizens panel that fed into these recommendations highlight that measures need to be fair and reduce the cost of low-carbon options.”

Dr Christina Demski, Deputy Director at the Centre for Climate Change and Social Transformations (CAST) at the University of Bath, said:

“The latest CCC progress report makes it clear that decisive action is needed now to ensure we meet the net zero target, and that action to reduce emissions also has other benefits like economic security, better health and reducing fuel poverty. While the UK is on track to reduce emissions substantially from energy supply, the report clearly shows that action is also needed in sectors like transport, buildings and agriculture, and that this requires widespread uptake of essential low-carbon technologies like EVs and heat pumps.

“We have long called for a comprehensive engagement strategy, so it is great to see this included as one of the key recommendations, especially the recommendation to go beyond one-way communication strategies.”

Dr Sam Hampton, Research Fellow at the Centre for Climate Change and Social Transformations (CAST) at the University of Bath, said:

“The Climate Change Committee’s 7th Carbon Budget provides a comprehensive account of the changes required across UK society to address the increasingly alarming impacts of climate change. As we have largely exhausted the low-hanging fruit of decarbonising our electricity supply, the focus in the 2030s and 2040s must shift towards demand-side changes. This includes changes in how we eat and travel, as well as the technologies we adopt. The report highlights key solutions including the adoption of electric vehicles and heat pumps, as well as the need for innovation to rid fossil fuels from industry. Another important takeaway is that Sustainable Aviation Fuel (SAF) is not a viable solution to decarbonising air travel. This comes just weeks after government expressed its support for airport expansion, and highlights the need for more radical solutions to limit flying, especially amongst the rich.”

The Climate Change Committee’s Seventh Carbon Budget was published at 00:01 UK Time Wednesday 26 February 2025.

Declared interests

Prof John Barrett: Deputy Director for Policy, Priestly Centre for Climate Futures, University of Leeds, Theme Leader for the UKRI Energy Research Demand Centre

For all other experts, no reply to our request for DOIs was received.

MIL OSI United Kingdom –

February 26, 2025
MIL-OSI New Zealand: Fast-tracked mining, cut-rate safety? A miner’s warning – E tū

Source: Etu Union

By Mark Anderson, Process Operator at OceaniaGold Waihi, and Convenor of the E tū Engineering, Infrastructure, and Extractives Industry Council

It’s 3 a.m. on a Sunday morning. I’m at work, constantly hopping in and out of my front-end loader to pull five-foot-long, waterlogged timber beams out of the ore that the underground crew has brought up overnight. These beams come from the old timber framing used to build the Waihi mine over 100 years ago.

Pieces of timber like this are absolute showstoppers for us – if they end up on the conveyor belt heading into the mill, they could jam the system or get stuck in the feed chute, shutting us down for hours and leaving a massive mess to clean up. I don’t want to be that guy, so here I am, sweaty and covered in mud at 3 a.m., hauling them out by hand. But I don’t mind. I’ve got a huge smile on my face because I love the job I do.

I work as a process operator at the gold mine in Waihi. There have been big developments recently, not just at the site but across the town, the country, and in the news. I’ve been doing a lot of reflecting on that.

At the end of January, Hon. Shane Jones brought MBIE and the media pack that follows him to Waihi for his big “Critical Minerals” announcement. Naturally, the protestors followed too, eager to let him know exactly what they thought of his plans.

I was part of the delegation that hosted the Minister, not just because I work at the mill but because I’m also a union delegate and the Convenor of the Engineering, Infrastructure and Extractives Industry Council for E tū, representing nearly 8,000 members in these industries. One thing I’ve noticed in all the discussions about fast-tracking mining, the use of public land, and economic impacts is that the voices of workers have been completely missing.

For workers, the first part of this conversation is obvious: it’s great news for the industry. The Government wants to invest in and expand mining, which means more security for those of us in the sector. That kind of stability is rare.

When I started my job at Waihi in 2007, they told me the “life of the mine” was about 18 months. I didn’t tell my partner that right away – we had just bought a house and had our second child, and we had enough pressure as it was. Mines open and close depending on commodity prices and market shifts. That’s just the way it is. But for the first time, there’s a sense of long-term security for workers and contractors, and that’s a huge win. Most mines in New Zealand are in regional areas, so this also means a boost for those communities and the families who rely on these jobs.

That said, every silver lining has a dark cloud. In my role as delegate and Convenor, my job is to look at the bigger picture and consider how all this affects workers. Is the Government rushing into this? Have they really thought it through? Are we actually prepared to scale up the industry safely?

Safety is always the first thing on a worker’s mind in this industry. It’s the first thing we talk about at the start of every shift, and it’s the foundation of most of our training. While Shane Jones is out there making big mining expansion announcements, over in the health and safety sector, the Minister for Workplace Relations and Safety, Hon. Brooke van Velden, has quietly been working on a review of the Health and Safety at Work Act – what most people know as the Pike River legislation.

Last year, she held a roadshow to gather input on the review. Workers and unions did everything they could to attend those meetings, but getting a seat at the table was very difficult. Meanwhile, business and industry representatives seemed to have no trouble getting in.

Late last year, I was lucky enough to attend a CTU-organised event at Parliament where Brooke van Velden was present. She was asked directly why she hadn’t been engaging with workers about the review, and she responded saying she had. Never mind the experience of the workers and their unions in the audience before her, who have found it impossible to have real engagement with her on this issue and many others.

After the event, I approached her and invited her to visit Waihi, to come and see firsthand the work we do and the risks we manage to keep people safe. I invited her because I believe we do a very good job with safety, in comparison to other places around the country. A few days later, her office emailed me back with a polite but clear refusal. She had no immediate plans to visit Waihi or the surrounding area. The invite remains open.

So here we are, with one part of the Government rushing full steam ahead to expand mining while another is quietly working to weaken health and safety laws.

Expanding mining means an influx of new, inexperienced workers into a high-risk industry. It takes time to train people properly so they can work safely in these hazardous environments. In Waihi, new workers wear green hard hats so they’re easily identifiable – so we can look out for them. But if we get too many “Green Hats” at once, especially in newly established mines, we might have a serious safety issue. Without enough experienced workers to mentor them, the risks multiply.

The Minister for Workplace Relations and Safety hasn’t yet detailed her plans for the Act, but my biggest fear is that, in classic libertarian fashion, the goal will be to deregulate, deregulate, deregulate – then tell companies to sort it out by increasing their insurance premiums.

Maybe that sounds cynical. I hope I’m wrong. But this Government hasn’t exactly shown much concern for workers’ rights so far, so I wouldn’t be surprised.

Then there are the other questions. Where are these workers going to come from? Where will they live in the remote areas where these mines are located? No one seems to be asking those questions, and I fear they’ll just be left for “the market” to sort out.

Back in Waihi, when protestors delayed Shane Jones’ speech, I noticed him sitting alone and decided to take my chance to talk to him. I asked him about worker safety, about where we’d get the people we need, about whether the Government had a plan. For a man who’s usually never short of words, all I got was a raised eyebrow and a nod.

I don’t think this Government has the answers. This year we will acknowledge the 15^th anniversary of the Pike River tragedy. The only way we can honour the lives of those workers is to ensure we never let health and safety standards fall behind again. Without workers at the forefront of this project, and without a Government committed to the highest standards, I find myself fearing the worst.

MIL OSI New Zealand News –

February 26, 2025
MIL-OSI USA: Reed, Capito Lead Bipartisan Effort to Accelerate Pediatric Rare Disease Research & Treatment Advances

US Senate News:

Source: United States Senator for Rhode Island Jack Reed

WASHINGTON, DC – In an effort to accelerate research and treatment advances for rare diseases that affect children, U.S. Senators Jack Reed (D-RI) and Shelley Moore Capito (R-WV) teamed up to introduce the Innovation in Pediatric Drugs Act. This bipartisan bill would ensure drugs for rare diseases are studied in children and that drug companies are accountable for completing pediatric study requirements. It would close research gaps created by the growth in so-called “orphan drug” approvals by the U.S. Food and Drug Administration (FDA).

Children are not just small adults who can take smaller doses of adult medication: They metabolize drugs differently and in order for drugs to be safe and effective for kids, they must be studied specifically for children’s use. Yet too often, drug development still leaves children behind. The Innovation in Pediatric Drugs Act would help speed therapies to children who need them, making needed changes to the Best Pharmaceuticals for Children Act (BPCA) and the Pediatric Research Equity Act (PREA), two laws that encourage and require the study of drugs in children.

“This bill would help children battling rare diseases and their families by addressing crucial gaps in pediatric research and treatment and empower the FDA to go after companies that break the rules. Congress must work together to help address the unmet needs of those affected by rare diseases, particularly pediatric patients. The Innovation in Pediatric Drugs Act would include children in the drug development process to expand access to safe and effective treatments and therapies for children with rare ailments and appropriately meet their needs. Our bipartisan bill would provide new paths for pediatric rare disease research and development and ensure patients with rare diseases aren’t left behind,” said Senator Reed.

“It is essential medicines be studied specifically for children’s use, especially for rare diseases,” Senator Capito said. “The same medicines that may work well for some adults could have drastically different results for a child. Our legislation will help ensure pediatric studies are actually being done on both new and innovative drugs, as well as those older drugs now off-patent.”

According to the National Institutes of Health, a “rare disease” is any disease affecting fewer than 200,000 people in the United States (60 cases per 100,000 individuals).

There are more than 7,000 known rare diseases that affect about 30 million people in the U.S., according to the Orphan Drug Act. These rare diseases can vary widely, from genetic conditions to certain types of cancers to cases that are the result of an infection or allergy or unknown causes.

More than 90 percent of rare diseases lack a treatment approved by the FDA. And according to rarediseases.org: Approximately two-thirds of Americans with rare diseases are children.

The Innovation in Pediatric Drugs Act would help ensure children can benefit from advancements in new treatments and therapies by:

Ensuring Drugs for Rare Diseases are Studied in Children

There are close to 7,000 rare diseases without appropriate treatments, and the vast majority of these diseases affect children. Unfortunately, in most cases, drugs for rare diseases, also known as orphan drugs, are not required to be studied in children. Yet the majority of new drugs approved are orphan drugs, meaning that the majority of newly approved drugs are exempt from pediatric study requirements, leaving doctors, parents, and sick kids in the dark about possible treatments.

The Innovation in Pediatric Drugs Act would ensure that children with rare diseases can benefit from new and innovative treatments, lifting the orphan drug exemption in PREA.

Providing Equal Accountability for Pediatric Study Requirements

Due dates for studies required by PREA are typically deferred by FDA until after the approval of the drug for adults. Unfortunately, FDA has no effective enforcement tools to ensure that these studies are completed on time—or at all. Congress tried to solve this problem in 2012. It allowed FDA to send “non-compliance letters” to companies that failed to complete their pediatric studies. Disappointingly, this did not fix the problem. According to an analysis conducted by the American Academy of Pediatrics, as of early 2021, 123 PREA non-compliance letters had been issued, yet only one third had been resolved. On average, studies were 4.4 years late, with some more than 15 years late.

The Innovation in Pediatric Drugs Act would give FDA the authority it needs to ensure that legally required pediatric studies are completed in a timely manner.

Investing in Pediatric Studies of Older Off-Patent Drugs

The FDA incentives and requirements under BPCA and PREA work for many newer drugs, but unfortunately cannot help encourage studies of older drugs. For this reason, in 2002, Congress authorized a program which funds the National Institutes of Health to conduct studies of off-patent drugs used in children that would never be completed otherwise. Drug studies are expensive and costs have only increased since then, but the program has been flat-funded at $25 million since it was created more than 20 years ago.

The Innovation in Pediatric Drugs Act would increase funding for the BPCA NIH program to ensure we have better data about older drugs to treat diseases in children.

Reed and Capito previously teamed up to pass and fund the landmark Childhood Cancer STAR Act.

What They Are Saying About the Innovation in Pediatric Drugs Act:

“Children are not little adults; they have unique health needs. It is essential that children’s needs are considered and prioritized during the drug development process so they do not miss out on new therapies and treatments. The Innovation in Pediatric Drugs Act of 2025 would make needed changes to pediatric drug laws so that children can benefit from new advancements in medicine – including children with rare diseases. Pediatricians applaud Senators Jack Reed (D-RI) and Shelley Moore Capito (R-WV) for their leadership on this issue and call on Congress to swiftly pass this bipartisan legislation into law,” said American Academy of Pediatrics President Susan Kressly, MD, FAAP.

“The biology of cancer children is different from cancer in adults. Drugs to treat children must be developed that are tailored for children. The Innovation In Pediatric Drugs Act of 2025 builds upon the promise of the Research To Accelerate Cures and Equity (RACE) Act For Children to increase pediatric studies of novel therapeutics for pediatric cancers. The new bill is an important step to ensure that required studies are completed for children as they are currently done for adults,” said Steve Wosahla, Chief Executive Officer of Children’s Cancer Cause.

“Kids with cancer need us to put promising new therapies to the test to find the next generation of pediatric treatments. The Innovation in Pediatric Drugs Act would help by holding trial sponsors accountable and opening the door to exciting treatments that could make all the difference for kids,” said Matt Marks of the Leukemia & Lymphoma Society.

MIL OSI USA News –

February 26, 2025
MIL-OSI USA: ICYMI: Tuberville on X: Trump and DOGE are Making the Federal Government Efficient Again

US Senate News:

Source: United States Senator Tommy Tuberville (Alabama)

WASHINGTON – Today, U.S. Senator Tommy Tuberville (R-AL) penned an op-ed on X praising the progress President Trump and DOGE have made during Trump’s first month in office to cut waste, fraud, and abuse in the federal government and save taxpayers’ money.

Read excerpts from the piece below or here.

Trump and DOGE are Making the Federal Government Efficient Again

“Tax season is upon us, and Americans are once again reminded of how much of their hard-earned paychecks is taken by the federal government. Most Americans use this time to reevaluate their spending habits and consider ways to be more fiscally responsible. Unfortunately, the U.S. government doesn’t do the same. The United States is $36 trillion in debt and we are spending nearly $2 trillion more each year than we bring in. If the United States were a business, we’d be dead broke.

Thankfully, President Trump is back in the White House and is working around the clock to audit the federal government. On the campaign trail, President Trump promised to create the Department of Government Efficiency (DOGE), advised by Elon Musk, to take a businesslike approach to auditing waste, fraud, and abuse within the federal government. A majority of Americans support the President’s efforts to cut wasteful spending, and they support the work the DOGE is doing. President Trump is making the Federal Government Efficient Again.

Thanks to President Trump, the D.C. gravy train is being cut off. So far, Elon Musk and his team have saved American taxpayers a staggering $55 billion. Some of the taxpayer-funded programs that DOGE has uncovered are truly astounding. For example, DOGE found that $59 million was sent by FEMA to house illegal immigrants in fancy New York hotels. It was also discovered that taxpayers were on the hook for a $ 168,000 Anthony Fauci exhibit at the National Institutes of Health Museum, which has thankfully been canceled. DOGE also found $9 million in payments to fund woke programs at the Department of Agriculture, including contracts for “Central American gender assessment consultant services” and “Brazilian forest and gender consultants” – whatever that is.

In addition to cutting waste, DOGE is also restoring accountability and transparency. Under the Biden administration, the Pentagon failed its seventh consecutive audit. That’s ridiculous. If a business tried this in the real world, they’d go bankrupt. American taxpayers spend nearly a trillion dollars annually on the U.S. military. The least we can do is provide an accurate accounting of how their money is being spent. To clean this up, President Trump directed Secretary of Defense Pete Hegseth to start cutting the Pentagon budget by 8% in each of the next five years. By restoring fiscal sanity to our armed forces, we will ensure we have the long-term resources to continue defending our interests and national security. […]

Just this weekend, DOGE sent an email to all federal government employees asking for them to submit five things they have accomplished this week. Predictably, the media is throwing a fit about this. When I was a football coach, we had performance reviews where we would discuss an employee’s performance and if they weren’t performing at a certain standard, they would be fired. But apparently, that isn’t allowed in the government.

DOGE has also shone a light on the corrupt relationship between the bureaucrats and the Mainstream Media. White House Press Secretary Karoline Leavitt revealed that more than $8 million taxpayer dollars were used for Politico subscriptions. This doesn’t include other outlets taxpayers have been funding like the New York Times, Associated Press, and Reuters. It is completely inappropriate for taxpayers to be forced to fund the Corporate Media. If American taxpayers want to support these publications, they can subscribe themselves. But most do not, which is perhaps why many of these publications are failing.

Thanks to President Trump, Americans are finally witnessing a government that is by the people and for the people. The fake news media and the D.C. Swamp are in DEFCON level 1 over DOGE, and as far as I’m concerned, that’s a good thing. We should be thanking President Trump and the entire DOGE team for the incredible service they are doing for our country. In fact, as a proud member of the Senate DOGE Caucus, I’m 100% committed to making sure Congress does our part to follow the President’s lead to rightsize the government and cut waste, fraud, and abuse. President Trump promised to fight every day for the American worker – and the hardworking men and women in this country deserve to know that their tax dollars are not being used to fund gender transition surgeries in Africa. Together, we will restore accountability and transparency in Washington and unleash the Golden Age of America.”

Senator Tommy Tuberville represents Alabama in the United States Senate and is a member of the Senate Armed Services, Agriculture, Veterans’ Affairs, HELP, and Aging Committees.

MIL OSI USA News –

February 26, 2025
MIL-OSI USA: Booker, Scott Reintroduce Legislation Addressing Sickle Cell Disease

US Senate News:

Source: United States Senator for New Jersey Cory Booker
WASHINGTON, D.C. – Today, U.S. Senators Cory Booker (D-NJ) and Tim Scott (R-SC) reintroduced the bipartisan Sickle Cell Disease Comprehensive Care Act. The legislation would allow State Medicaid programs to provide comprehensive and coordinated care to patients with sickle cell disease (SCD) through a health home model.
Sickle cell disease is an inherited blood disorder that disproportionately impacts people of African descent. Among the most notable symptoms of SCD is debilitating pain, but those with SCD also experience complications like stroke, acute chest syndrome, and organ damage. Furthermore, individuals with SCD have a significantly lower life expectancy than the overall population.
While there have been some advancements in the treatment of SCD, many with the disease are not receiving the level of care needed to adequately manage SCD. The Sickle Cell Disease Comprehensive Care Act directs CMS to establish a SCD Health Home to improve access to comprehensive, high-quality, outpatient care, which will be available to Medicaid beneficiaries with SCD in states that submit a state plan amendment (SPA). Further, this program shows promise in saving money, as it aims to reduce patients’ reliance on costly emergency room care.
“Sickle cell disease is the most common inherited blood disorder in our country, and is a disease that primarily affects those of African ancestry,” said Senator Booker. “Despite the prevalence and the severe health consequences of the disease, Americans battling sickle cell continue to face barriers to accessing the care they need. I urge my colleagues in the Senate to support this bipartisan legislation to increase access to comprehensive, high-quality care and invest in quality treatments for patients fighting SCD.”
“Nearly 100,000 Americans have sickle cell disease—many of whom are left without access to consistent care,” said Senator Scott. “I am glad to work on this bipartisan legislation to help treat this disease that affects thousands of Americans from minority communities. Creating access to high-quality comprehensive care to avoid costly emergency room visits continues to be a top priority of mine for folks facing diseases like SCD.”
Throughout his time in the Senate, Booker has raised awareness for sickle cell disease and advocated for equitable funding, increased attention, and better access to treatments and care for people with SCD. The Sickle Cell Disease Comprehensive Care Act builds upon this work, including his bipartisan Sickle Cell Disease and Other Heritable Blood Disorders Research, Surveillance, Prevention, and Treatment Act that he introduced with Senator Scott and which passed and was signed into law in 2018.
The legislation is endorsed by: Sickle Cell Disease Partnership; American Society of Hematology; Sickle Cell Disease Association of America, Inc.
To read the full text of the bill, click here.

MIL OSI USA News –

February 26, 2025
MIL-OSI USA News: Fact Sheet: President Donald J. Trump Announces Actions to Make Healthcare Prices Transparent
Source: The White House
EMPOWERING PATIENTS THROUGH RADICAL PRICE TRANSPARENCY: Today, President Donald J. Trump signed an Executive Order to empower patients with clear, accurate, and actionable healthcare pricing information.
- The order directs the Departments of the Treasury, Labor, and Health and Human Services to rapidly implement and enforce the Trump healthcare price transparency regulations, which were slow walked by the prior administration.
  
  The departments will ensure hospitals and insurers disclose actual prices, not estimates, and take action to make prices comparable across hospitals and insurers, including prescription drug prices.
  
  The departments will update their enforcement policies to ensure hospitals and insurers are in compliance with requirements to make prices transparent.
LOWERING COSTS FOR AMERICAN FAMILIES: When healthcare prices are hidden, large corporate entities like hospitals and insurance companies benefit at the expense of American patients. Price transparency will lower healthcare prices and help patients and employers get the best deal on healthcare.
- Prices vary widely from hospital to hospital in the same region. One patient in Wisconsin saved $1,095 by shopping for two tests between two hospitals located within 30 minutes of one another.
- One economic analysis found that President Trump’s original price transparency rules, if fully implemented, could deliver savings of $80 billion for consumers, employers, and insurers by 2025.
- Employers can lower their healthcare costs by an average of 27% on 500 common services by better shopping for care.
- The Biden Administration was sued in 2023 for not enforcing the prescription drug transparency requirements. The Trump Administration will work to hold health plans accountable for making drug prices transparent.
DELIVERING ON PROMISES TO PUT AMERICAN PATIENTS FIRST: President Trump is delivering on his promise to once again put American patients first by holding the healthcare industrial complex accountable for delivering transparent prices.
- In his first Administration, President Trump took historic action by mandating that hospitals and insurers make prices public.
- While the prior Administration failed to prioritize further implementation and enforcement of these requirements, President Trump is delivering on his promises to make the healthcare system more affordable and easier to navigate for patients.
- American patients are fed up with the status quo – 95% deem healthcare price transparency an important priority, with six in ten saying it should be a top priority of the government.
- President Trump has long pushed for radical price transparency to ensure the healthcare system puts American patients first:
  
  President Trump: “Our goal was to give patients the knowledge they need about the real price of healthcare services. They’ll be able to check them, compare them, go to different locations, so they can shop for the highest-quality care at the lowest cost. And this is about high-quality care. You’re also looking at that. You’re looking at comparisons between talents, which is very important. And then, you’re also looking at cost. And, in some cases, you get the best doctor for the lowest cost. That’s a good thing.”
MIL OSI USA News –
February 26, 2025
MIL-OSI USA News: Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information

Source: The White House

class=”has-text-align-left”> By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered:

Section 1. Purpose. During my first term, my Administration took historic steps to correct a fundamental wrong within the American healthcare system. For far too long, prices were hidden from patients and employers, with inadequate recourse available to individuals looking to shop for care or obtain pricing information from a healthcare provider in advance of a visit or procedure. These opaque pricing arrangements allowed powerful entities, such as hospitals and insurance companies, to operate with insufficient accountability regarding their pricing practices, resulting in patients, employers, and taxpayers shouldering the burden of inflated healthcare costs.

Pursuant to Executive Order 13877 of June 24, 2019 (Improving Price and Quality Transparency in American Healthcare to Put Patients First), my Administration issued paradigm-shifting regulations to put patients first by requiring hospitals and health plans to deliver meaningful price information to the American people. These regulations require hospitals to maintain a consumer-friendly display of pricing information for up to 300 shoppable services and a machine-readable file with negotiated rates for every single service the hospital provides; health plans to post their negotiated rates with providers as well as their out-of-network payments to providers and the actual prices they or their pharmacy benefit manager pay for prescription drugs; and health plans to maintain a consumer-facing internet tool through which individuals can access price information.

One economic analysis from 2023 estimated the impact of these regulations, if fully implemented, could result in as much as $80 billion in healthcare savings for consumers, employers, and insurers by 2025. Another report from 2024 suggested healthcare price transparency could help employers reduce healthcare costs by 27 percent across 500 common healthcare services. Recent data has found the top 25 percent of most expensive healthcare service prices have dropped by 6.3 percent per year following the initial implementation of price transparency during my first term.

Unfortunately, progress on price transparency at the Federal level has stalled since the end of my first term. Hospitals and health plans were not adequately held to account when their price transparency data was incomplete or not even posted at all. The Biden Administration failed to take sufficient steps to fully enforce my Administration’s requirement that would end the opaque nature of drug prices by ensuring health plans publicly post the true prices they pay for prescription drugs.

The American people deserve better. Making America healthy again will require empowering individuals with the best information possible to inform their life and healthcare choices. By building on the historic efforts of my first term, my Administration will make more meaningful price information available to patients to support a more competitive, innovative, affordable, and higher quality healthcare system.

Sec. 2. Policy. It is the policy of the United States to put patients first and ensure they have the information they need to make well-informed healthcare decisions. The Federal Government will continue to promote universal access to clear and accurate healthcare prices and will take all necessary steps to improve existing price transparency requirements; increase enforcement of price transparency requirements; and identify opportunities to further empower patients with meaningful price information, potentially including through the expansion of existing price transparency requirements.

Sec. 3. Fulfilling the Promise of Radical Transparency. The Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health and Human Services shall take all necessary and appropriate action to rapidly implement and enforce the healthcare price transparency regulations issued pursuant to Executive Order 13877, including, within 90 days of the date of this order, action to:
(a) require the disclosure of the actual prices of items and services, not estimates;
(b) issue updated guidance or proposed regulatory action ensuring pricing information is standardized and easily comparable across hospitals and health plans; and
(c) issue guidance or proposed regulatory action updating enforcement policies designed to ensure compliance with the transparent reporting of complete, accurate, and meaningful data.

Sec. 4. General Provisions. (a) Nothing in this order shall be construed to impair or otherwise affect:
   (i) the authority granted by law to an executive department or agency, or the head thereof; or
   (ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.
(b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations.
(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

MIL OSI USA News –

February 26, 2025
MIL-OSI New Zealand: Clinical psychology interns boost mental health workforce

Source: New Zealand Government

Mental Health Minister Matt Doocey says a record number of health-funded clinical psychology interns show that the Government’s laser focus on improving the mental health workforce pipeline is working.
“In the first year of growing mental health and addiction capacity under New Zealand’s first dedicated Mental Health Workforce Plan, I am pleased to announce that we’ve increased the number of clinical psychology students receiving Health New Zealand-funded internships to 59, up from 41 in 2023 before the Government’s work commenced,” Mr Doocey says.
“While this represents 55 full-time equivalent (FTE) clinical psychology internships as some interns are part-time, we will continue to be ambitious in growing the mental health and addiction workforce. We have committed to growing the number of funded internships to 70 in 2026 and 80 in 2027.”
Mr Doocey says the Government is committed to doubling the number of funded clinical psychologist internships, from 40 in 2023 to 80 in 2027.
“Each year hundreds of university students graduate with Psychology degrees. But because there is such a constrained pathway to working clinically, we are missing out on an opportunity to better meet the needs of one of our biggest skills shortages in the mental health workforce.”
Mr Doocey met with some of the interns today who are also benefiting from the recently piloted clinical psychology hub in Waikato. The hubs coordinate with a number of different services to help the interns experience different environments in which clinical psychologists work.
“We are doing what’s needed to ensure that psychology students have placements to further their studies and careers, and to ensure that Kiwis can get the right help and support they need, when they need it.
“We are also developing an associate psychologist role, so that from the start of next year there are more pathways for psychology students to utilise their skills.
“New Zealanders deserve timely access to mental health and addiction support and I’m pleased that our initiatives are already helping people, so that they can thrive and be supported to have the quality of life that they deserve.”

MIL OSI New Zealand News –

February 26, 2025
MIL-OSI USA: Warren Questions Private Equity Executive Who Helped Bankrupt Steward Hospitals, Feinberg Squirms Without Answers

US Senate News:

Source: United States Senator for Massachusetts – Elizabeth Warren

February 25, 2025

Trump Nominee Seeks A Top Pentagon Leadership Role

Video of Exchange (YouTube)

Washington, D.C. – At a hearing of the Senate Armed Services Committee, U.S. Senator Elizabeth Warren (D-Mass.) questioned Mr. Stephen A. Feinberg, President of Cerberus Capital Management and nominee for Deputy Secretary of Defense, about his troubled private equity history and his qualifications for the job of second-in-command at the Pentagon.

Senator Warren called out Mr. Feinberg’s involvement in Steward Health Care, a now-bankrupt hospital system, which once owned 31 hospitals nationwide. In Massachusetts specifically, Mr. Feinberg enriched himself and his investors at the expense of the hospitals, sucking out over $700 million while leaving the hospitals understaffed, underresourced, and severely indebted. In part due to his corporate extraction, the system went bankrupt and, two Massachusetts hospitals shut down for good, leaving Massachusetts communities without access to the care they need.

Mr. Feinberg claimed Steward hospitals were doing “well” at the time Cerberus sold the company. However, “[m]any Steward hospitals were financially struggling as Cerberus began to make its exit in 2020,” according to the Private Equity Stakeholder Project. More importantly, before he left, Mr. Feinberg sold the hospitals’ real estate, cashing out the profits but leaving the hospitals with massive liabilities in the form of years of increasing lease payments for the land they used – a key factor in the hospitals’ 2024 bankruptcy.

Mr. Feinberg claimed he “turned [Steward] around, fixed them, grew them, [and] had a tremendous amount of success.” However, he slashed a full medical center, a primary and specialty care unit, a surgery department, an urgent care department, and a VA Clinic at a Quincy Medical Center, leaving nothing but an emergency room. Additionally, just two years after Cerberus took over Steward, nurses in Massachusetts filed more than 1,000 “unsafe staffing” complaints, a significant increase from previous years.

Transcript: Hearing to Consider the Nomination of Mr. Stephen A. Feinberg to be Deputy Secretary of Defense
U.S. Senate Armed Services Committee
February 25, 2025

Senator Elizabeth Warren: So, Mr. Feinberg, you’ve been nominated to be Deputy Secretary of Defense, in charge of DOD’s $850 billion budget. Your main qualification is that you have built one of the world’s largest private equity companies. You’ve spent your entire career honing the private equity tools used to hollow out businesses, from department stores to veterinary practices. And, presumably, those are the skills that you would bring to the Department of Defense. So, I just want to look at how that’s worked.

Let’s start with how you treat people. In Massachusetts, in 2010, your private equity firm bought six non-profit hospitals, turned them into for-profit hospitals called Steward. Ten years later you cashed out, having made a profit a little shy of a billion dollars, and leaving behind a hospital system that was staggered under a load of debt and, four years later, collapsed into bankruptcy.

Now, Mr. Feinberg, when we met in my office, you told me that your private equity outfit made an average 23% annual return each year that you owned our hospitals. If Steward nurses had gotten the same 23% salary increases that your investors effectively got every year, do you know how much they would be paid at the time you sold off your hospitals?

Mr. Stephen A. Feinberg, nominee for Deputy Secretary of Defense: Well, I do know that in 2010, the hospitals were going under, and we were asked –

Senator Warren: I’m sorry, Mr. Feinberg, we’re going to have very limited time here and I actually want to spend it on your qualifications to do this job. And it’s about how you treat people. The average nurse in the Steward hospitals at the time you bought them made $85,120.

At a 23% annual raise, how much money would they be making right now?

Mr. Feinberg: I’m not going to do the math, but what I could tell you –

Senator Warren: Okay, I’ll do the math for you. $829,828. Now, of course, the nurses didn’t do that well. During that same period of time, Carney Hospital, one of the hospitals you bought in Massachusetts, raised nurse salaries about 1.5% a year – and that was the best increase across the Steward hospitals that you were running.

Mr. Feinberg: That’s incorrect.

Senator Warren: In other words, you seem to think that when it is time to reorganize a business, that equity should get about fifteen times as much return on their investment as the people who actually do the work.

So, let’s take a look at the second issue, and that is maintaining critical functions –

Mr. Feinberg: Senator, would you like me to respond to Steward? Because a lot of inaccurate statements.

Senator Warren: We need to make cuts at the Department of Defense, but we also need to maintain our national security.

Chair Wicker: Mr. Feinberg, she’s entitled to make a speech.

Mr. Feinberg: I apologize.

Chair Wicker: She’s entitled to go on and on.

Senator Warren: So let’s go back to Steward Hospitals. Did you cut fat or cut vital functions?

Now, Mr. Feinberg, the town of Quincy used to have a full medical center, with primary and specialty care, a surgery department, an urgent care department, and a VA Clinic. That was its basic function. After your private equity company finished with it, what was left?

Mr. Feinberg: Well, when we exited the investment in 2020, the company was doing well –

Senator Warren: I’m asking what was left of the Quincy hospital. When you took it over –

Chair Wicker: Now, Senator, he’s trying to answer a question. You finally stopped for a breath.

Senator Warren: Well, that’s what I’m asking –

Chair Wicker: Do you intend to let him at least have maybe 20, 30 seconds to answer a question?

Senator Warren: Well, can I have my time back?

Chair Wicker: Yes, I said you’re entitled to make a speech, but you stopped for – you stopped with a question mark and he started to try to answer the question.

Senator Warren: All right, what’s the answer to the question? What was left of the Quincy hospital? That was my question.

Mr. Feinberg: Lots happened after we exited. And there has been mismanagement. We did save –

Senator Warren: My clarifying question: what was left when you exited?

Mr. Feinberg: I’m not certain about that –

Senator Warren: It was an emergency room, and nothing more.

Mr. Feinberg: But, but, we took those hospitals from collapse in 2010 – we were going to shut it down as the tenth largest employer in Massachusetts, turned them around, fixed them, grew them, had a tremendous amount of success, worked closely with the governor, and the problems with Steward happened after we exited the investment.

Senator Warren: I am asking about questions as you exited and during the period of time you ran it. Now, of course, a hospital is supposed to provide good quality care—and that takes qualified nurses and other staffers. Mr. Feinberg, for the hospitals that didn’t close down, during the time you ran it, do you know how many “unsafe staffing” complaints were filed?

Mr. Feinberg: I do know the vast majority of problems happened after we left. And by the way, our nurses were among the highest paid in the country.

Senator Warren: Is that a no, that you don’t know how much? How many “unsafe staffing” complaints were filed?

Mr. Feinberg: I don’t know.

Senator Warren: Well, let me tell you. There were over a thousand filed, that is five times the normal rate in Massachusetts.

Mr. Feinberg: What year was that?

Senator Warren: These are the years that you were in control. For the two hospitals –

Chair Wicker: Senator Warren, perhaps you would like to take another round?

Senator Warren: No, I’d like to just finish. I just have a quote.

Chair Wicker: Your time is expired, Senator. Your time is expired.

Senator Warren: I spent a great deal of that time listening to the Chairman telling me how I have to conduct my questions.

Chair Wicker: The senator’s time is expired.

Senator Warren: Could I just close?

Chair Wicker: Senator Sullivan.

Senator Warren: Could I just close, Mr. Chairman? I’d just like to say why I care about this issue.

Chair Wicker: The senator’s time has expired. She can have another round.

MIL OSI USA News –

February 26, 2025
MIL-OSI USA: Governor Polis in Washington Pushing Congress to Reject Harmful Medicaid Cuts

Source: US State of Colorado

WASHINGTON DC – While in Washington DC, Colorado Governor Jared Polis spoke with Members of Congress today, urging them to reject the proposed $880 billion dollar proposed cuts to Medicaid which would be devastating for hardworking Coloradans, rural hospitals, and safety net providers. Roughly 1.3 million Colorado children and adults are enrolled in Medicaid and the Child Health Plan Plus, which are funded jointly by the state and federal government. These cuts could lead to 15.9 million Americans losing Medicaid and CHIP coverage in 2026. The U.S. House of Representatives has a scheduled vote on Medicaid cuts this week.

“Today I urged members of Congress to reject these harmful cuts to Medicaid, which would devastate hardworking Coloradans. If Congress votes to cut Medicaid they will be pulling the rug out from under rural hospitals, communities, and safety net providers. Hundreds of thousands of people In Colorado could be kicked off their health care. The bottom line is that these cruel proposed cuts simply don’t make sense, and would harm Coloradans and children,” said Colorado Governor Jared Polis.

Recently, Governor Polis led the National Governors Association Winter Meeting as Chair, where Governors approved Federal Priorities, including protecting funding for important support like Medicaid and ensuring states have flexibility and waiver opportunities to deliver this critical support.

###

MIL OSI USA News –

February 26, 2025
MIL-OSI USA: Gillibrand And Hawley Introduce Bipartisan Legislation To Establish A Mental Health Hotline For First Responders

US Senate News:

Source: United States Senator for New York Kirsten Gillibrand
Today, U.S. Senators Kirsten Gillibrand and Josh Hawley introduced the bipartisan First Responders Wellness Act, legislation to establish a national mental health hotline for first responders. The bill would also expand mental health services for first responders during major disasters.
“Police officers, firefighters, and EMTs face unique stressors, and as a result, they are at high risk of developing PTSD and other mental health problems,” said Senator Gillibrand. “We owe it to our first responders to do more to help. I am introducing bipartisan legislation to establish a mental health hotline specifically tailored to the needs of first responders and staffed by peer specialists and counselors who have an understanding of the occupational stressors experienced by first responders and have completed trauma-informed training. The bill would also expand professional mental health services for first responders during times of major disasters. I am proud to be introducing this legislation with Senator Hawley and hope to get it passed soon.”
“Congress should prioritize the wellbeing of those first on the scene of life’s crises. That starts with investing in the health and safety of our police officers, firefighters, and EMTs. This bipartisan legislation would provide first responders with the mental health tools they need to cope with past trauma and the resources necessary to support them in their jobs,” said Senator Hawley.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), first responders face higher rates of behavioral health conditions, such as post-traumatic stress disorder (PTSD) and depression, compared to civilians. Furthermore, a study from the Ruderman Family Foundation found that law enforcement officers and firefighters are more likely to die by suicide than in the line of duty. EMS providers are 1.39 times more likely to die by suicide than the general public, and up to a quarter of all public safety telecommunicators have symptoms of PTSD or depression.
Although first responders are trained to respond to challenging situations, the post-response mental health needs of these professionals often go unaddressed. There is a clear and distinct need for mental health professionals and services that account for the occupational culture and hazards of first responders.
The First Responders Wellness Act would direct the Secretary of Health and Human Services to establish a national mental health hotline for first responders. Specifically, this bill would:
Establish a first responders mental health hotline to provide peer and emotional support, information, brief intervention, and mental or behavioral health and substance use disorder resources.
Require the Secretary of Health and Human Services to submit an annual report to Congress on the hotline and its implementation.
Ensure first responders can receive professional counseling and other mental health services offered through the FEMA Crisis Counseling Assistance and Training Program.
Direct HHS to issue a report on best practices and recommendations to establish a new mobile health care delivery site to provide short-term crisis services to first responders during a major disaster.
This legislation is endorsed by the NYPD Sergeants Benevolent Association, National Association of Police Organizations (NAPO), National Fraternal Order of Police (FOP), Federal Law Enforcement Officers Association, Major Cities Chiefs Association, Port Authority Lieutenants Benevolent Association, Uniformed EMTs, Paramedics, & Fire Inspectors FDNY – Local 2507, NYPD Detectives’ Endowment Association (DEA), and the Nassau County Police Benevolent Association.
“Federal, state, and local law enforcement officers are often exposed to more on-the-job trauma and traumatic events in a week than most people will experience in an entire lifetime,” said NYPD Sergeants Benevolent Association President Vincent Vallelong.  “By supporting efforts to expand access to mental health and wellness services, this legislation will provide the NYPD and other police departments with new resources to support the well-being of those who keep our communities safe. That is why we are grateful for Sen. Gillibrand and Hawley’s continued strong leadership on the ‘First Responders Wellness Act’ and working with us to ensure our nation’s police officers have access to the services they need when they need them most.”
“Law enforcement officers routinely encounter highly volatile, chaotic, and dangerous situations which put them in physical jeopardy. There is also overwhelming evidence that the cumulative and corrosive effects of the mental stresses suffered by officers in the line of duty inflict ‘invisible injuries’ which can be just as disabling—or as deadly—as any physical injury,” said Fraternal Order of Police National President, Patrick Yoes. “Too often, this unseen damage goes unaddressed. Our officers need greater access to mental health professionals and services that are culturally competent in the occupational culture and hazards of law enforcement. This legislation, the First Responders Wellness Act, would establish a grant program for law enforcement mental health and wellness professionals and establish a national mental health hotline specifically for law enforcement and other public safety officers. We look forward to working with Senators Gillibrand and Hawley in getting this bill through the Senate.”
“State and local law enforcement officers are our nation’s first responders. They respond to our country’s greatest tragedies, violent crimes, and horrible accidents that are occurring more frequently in our communities. They have seen and experienced horrors that they cannot forget, yet we still expect them each day to protect and serve our communities,” said National Association of Police Organizations Executive Director Bill Johnson. “The least we can do is ensure they have the culturally competent and accessible mental health and wellness services necessary for their wellbeing and that of their families, which is why we support the First Responders Wellness Act. NAPO thanks Senators Gillibrand and Hawley for their leadership and we look forward to working with them to pass this important bill.”
“The First Responders Wellness Act is a significant step toward addressing the mental health needs of federal law enforcement officers and other first responders,” said President Mathew Silverman of the Federal Law Enforcement Officers Association (FLEOA).  “Senators Gillibrand and Hawley have led this initiative, working alongside FLEOA, to ensure that first responders have access to a crisis hotline staffed by professionals who truly understand their unique challenges. This effort underscores a growing recognition of the psychological toll faced by first responders and their need for tailored support systems.”
“Supporting our nation’s law enforcement means supporting them in all aspects of their wellness and health care,” said Major Cities Chief Association Executive Director Laura Cooper. “MCCA is proud to support this important bipartisan legislation that will help accomplish that critical goal.”
“The Detectives’ Endowment Association of the NYPD applauds the efforts of the sponsors of this bill to care for the mental health and safety of those, like ourselves, who are daily on the stressful and dangerous front lines of our nation’s emergency situations,” said Detectives’ Endowment Association President Scott Munro.
“First Responders see things daily that are not normal.  Most of our work is dealing with crisis and negativity.  We need assistance processing and dealing with the mental health issues that our jobs create,” said Nassau County Police Benevolent Association President Tommy Shevlin. “I am honored to support this bill and thankful for Senator Gillibrand and Hawley’s dedication and support to our mental health and wellness.”
“The Port Authority Police Lieutenant’s Benevolent Association proudly supports the efforts of Senator Kristen Gillibrand for her sponsorship of the First Responders Wellness Act,” said Port Authority Police Department Lieutenants Benevolent Association President James Griglio. “Her collaborative efforts with Senator Josh Hawley demonstrate their selfless actions, putting the needs of first responders ahead of political agenda. Senator Gillibrand’s tireless efforts in support of this legislation will have significant impact on the health and well-being of our nation’s first responders for years to come. We sincerely thank Senators Gillibrand and Hawley for all their efforts.

MIL OSI USA News –

February 26, 2025
MIL-OSI Global: USAID’s apparent demise and the US withdrawal from WHO put millions of lives worldwide at risk and imperil US national security

Source: The Conversation – USA – By Nicole Hassoun, Professor of Philosophy, Binghamton University, State University of New York

USAID was established by President John F. Kennedy in 1961 as a way to consolidate existing foreign aid programs. JAM STA ROSA/AFP via Getty Images

On his first day in office, Jan. 20, 2025, President Donald Trump began a drastic reshaping of the United States’ role in global health as part of the first 26 executive orders of his new term.

He initiated the process of withdrawing the U.S. from the World Health Organization, which works to promote and advance global health, following through on his first attempt in 2020. He also ordered staff members of the Centers for Disease Control and Prevention to cut off all communications with WHO representatives.

In his first week, Trump also issued a stop-work order pending a 90-day review on nearly all programs of the United States Agency for International Development, or USAID.

Many experts view this as a first step in dismantling the organization, which facilitates global efforts to improve health and education and to alleviate poverty. The sweeping move left aid workers and the people who depend on them in a panic and interrupted dozens of clinical trials across the world.

President Trump’s executive order sparked legal action from international health care organizations, resulting in a federal judge ordering a temporary halt to the Trump administration’s freeze on foreign aid. Ultimately, that legal action was unsuccessful.

On Feb. 23, the Trump administration put nearly all of USAID’s 4,700 workers on paid administrative leave globally and stated that it would be terminating 1,600 of those positions.

Most recently, on Feb. 25, a federal judge ordered the Trump administration to allow some USAID funding to resume and required that it pay all of its invoices for work completed before the foreign aid freeze went into effect.

I am the executive director of the Global Health Impact project, an organization that aims to advance access to essential medicines in part by evaluating their health consequences around the world, and a researcher focusing on global health and development ethics and policy.

In my view and that of many other public health scholars, closing down USAID will imperil our national security and put millions of lives at risk.

Because of the USAID stop-work order, 500,000 metric tons of food are at risk of spoiling.

20 million with HIV treated

USAID works with both nongovernmental organizations and private companies to help distribute medicines and vaccines around the world. The agency also helps improve government policies and invest in research and development to contain and address epidemics and pandemics.

Starting in the late 1960s, for instance, USAID helped lead the effort to eliminate smallpox and has also helped fight polio and other devastating diseases over the past six decades.

The smallpox pandemic was one of the worst of all time – it killed one-third of the people infected, causing an estimated 300 million to 500 million deaths worldwide in the 20th century. By contrast, COVID-19 killed less than 1% of those infected.

These efforts have brought immense financial as well as health benefits to the U.S. and the rest of the world. Some economists estimate that the Global Polio Eradication Initiative, created in 1988, alone saved the world more than US$27 billion as of 2017, and that it will save a total of $40 billion to $50 billion by 2035.

USAID also plays an important role in promoting global health equity. The agency works to increase access to primary health care, combat hunger and strengthen health systems – ultimately saving lives. In addition, USAID has provided a great deal of funding to fight infectious diseases such as malaria, tuberculosis and HIV.

For instance, the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, provides treatment for 20 million people living with HIV in Africa. Trump’s federal aid freeze has halted funding for PEPFAR projects.

While the limited waiver under which the agency must now operate means some PEPFAR activities may eventually resume, many are now left without federal funding indefinitely. Unless another organization fills the gap, millions will die without USAID assistance.

A 2022 photo of men in Afghanistan lining up to receive a monthly food ration, largely supplied by USAID.
Scott Peterson/Getty Images News via Getty Images

Mistakes made

This is not to deny that USAID has made some grave errors in its history.

For instance, USAID provided significant funding to the Democratic Republic of Congo (formerly Zaire) during the murderous regime of Mobutu Sese Seko, who was in power from 1965 to 1997.

But USAID also has done an immense amount of good. For instance, it has helped contain the Ebola epidemic in the Democratic Republic of Congo since 2018. USAID’s work in preventing epidemics from spreading helps people everywhere, including in the U.S.

If anything, there is a strong argument for increasing USAID funding. China has invested heavily in Asia and Africa through its Belt and Road Initiative, which is an attempt to recreate ancient trade routes by investing in roads, trains and ports. Some researchers argue that this has shifted diplomatic relations in favor of China. They believe that if the U.S. does not make similar investments and instead cuts foreign aid, it will affect the United States’ ability to achieve its foreign policy objectives.

Similarly, there is a strong argument for increasing U.S. support for the WHO rather than withdrawing from the organization.

Trump’s withdrawal order cites what he sees as the organization’s failures in addressing the COVID-19 pandemic as the rationale. But the WHO helped lead efforts to accelerate vaccine development and distribution, and retrospective reports claim that even more deaths could have been avoided with greater international cooperation.

While dismantling USAID will cause irreparable harm to global health, these actions taken together are likely to deal a devastating blow to efforts to protect Americans and everyone else in the world from sickness and death.

Alyssa Figueroa, an undergraduate student at Binghamton University, contributed to this article.

Nicole Hassoun has received funding for research from the World Health Organization and the United Nations. She is the executive director of Global Health Impact (global-health-impact.org) which participates in the Pandemic Action Network.

– ref. USAID’s apparent demise and the US withdrawal from WHO put millions of lives worldwide at risk and imperil US national security – https://theconversation.com/usaids-apparent-demise-and-the-us-withdrawal-from-who-put-millions-of-lives-worldwide-at-risk-and-imperil-us-national-security-249260

MIL OSI – Global Reports –

February 26, 2025
MIL-OSI United Nations: Success for polio campaign in Gaza while West Bank tensions continue

Source: United Nations MIL OSI b

25 February 2025 Humanitarian Aid

UN humanitarians reported on Tuesday that aid workers in Gaza supporting local health authorities have now managed to vaccinate nearly 550,000 children under 10 – nearly all those it aimed to reach.

The campaign has been extended until Wednesday to ensure full coverage, UN Spokesperson Stéphane Dujarric told journalists at the regular news briefing in New York, citing UN humanitarian coordinators.

As of Monday, the third day of the campaign, some 548,000 children had been inoculated, or 93 per cent of the target population.

Aid efforts continue

Humanitarian partners have been working to expand aid distribution since the fragile ceasefire began last month.

According to latest news reports, the Israeli Government is seeking to extend the first stage of the agreement, threatening to resume fighting without progress in talks this week on phase two.

The World Food Programme (WFP) has delivered over 30,000 metric tonnes of food, with more than 60 community kitchens across the Strip distributing nearly 10 million meals.

Similarly, the UN relief agency for Palestine refugees (UNRWA) has provided food parcels to two million people and flour to 1.3 million.

The UN Food and Agriculture Organization (FAO) also delivered animal feed in northern Gaza for the first time since the ceasefire, benefiting livestock-owning families in Gaza City and Deir al Balah.

Efforts are also underway by partner organizations to repair and reopen schools that had been used as shelters for displaced families in Rafah, Khan Younis, and Deir al Balah.

Biting cold claims lives

Despite the steady flow of aid, children in Gaza continue to suffer.

The head of Gaza’s Ministry of Health reported on Tuesday that six children died from the severe cold in recent days, bringing the total number of cold-related child deaths to 15, Mr. Dujarric said.

Ongoing military operations in the West Bank

In the West Bank the security situation remains volatile, with Israeli military operations in the north leading to further casualties, mass displacement and destruction of essential infrastructure.

A two-day military operation in Qabatiya, Jenin governorate, ended Monday, Mr. Dujarric said.

The operation involved bulldozers and exchanges of fire between Israeli forces and Palestinians, as well as detentions, disruption to electricity lines, water lines, and school closures.

“We once again warn that lethal, war-like tactics are being applied, raising concerns over use of force that exceeds law enforcement standards,” Mr. Dujarric emphasised.

MIL OSI United Nations News –

February 26, 2025
MIL-OSI Canada: Updating regulation, licensing of addiction treatment
[. The model is based on the fact that recovery is possible, and Albertans deserve the best care to support them on their path of recovery.

The Mental Health Services Protection Act provides a foundation to ensure safe, quality mental health and addiction care, and the authority to establish licensing programs for mental health and addiction services. Services for bed-based addiction treatment, narcotic transition, drug consumption and psychedelic drug treatment are currently licensed under the act.

Alberta’s government is proposing amendments to be more flexible and responsive to the evolving needs of Albertans. The proposed amendments position the act as a framework legislation to provide better oversight for mental health and addiction services and help ensure Albertans receive quality, standardized treatment and services.

If passed, the amendments would come into effect in fall 2025.

“We are committed to developing a recovery-oriented system of care that grows and evolves to meet the needs of every Albertan. These proposed amendments reflect our dedication to maintaining a system that is both effective and adaptable.”

Dan Williams, Minister of Mental Health and Addiction

Enhancing bed-based addiction treatment services

Currently, all bed-based addiction treatment services are subject to the same licensing requirements, regardless of the type or intensity of services provided. The proposed amendments would create three types of bed-based addiction treatment services subject to separate licensing requirements:
- Withdrawal management services: medically supervised services to manage or support an individual through the process of withdrawal from one or more substances;
- Intensive treatment services: intensive and structured residential care services for individuals with addiction; and
- Non-intensive recovery services: services in a recovery-oriented environment that provide less-intensive treatment compared to intensive treatment services.
In addition, proposed amendments would add a provision for title protection. This would mean only licensed bed-based addiction treatment services providers would be able to use these service descriptions.

The goal of these changes is to better support Albertans to find services, get the right support and know what to expect when accessing each type of service. Matching individuals with the appropriate level of care promotes better health outcomes and maximizes the effectiveness of resources. Service providers would also benefit from increased licensing clarity.

Introducing exemptions

Another proposed amendment includes authorizing the Minister of Mental Health and Addiction to exempt specific people or service providers on a unique case-by-case basis from the act’s framework.

Exemptions would only be allowed in very specific instances, such as for medical reasons, scientific research, or when there’s a clear public benefit. Clear guidelines would be developed to ensure exemptions would only be granted in appropriate circumstances.

The ability for the minister to grant exemptions would allow for flexibility and adaptability in rare circumstances or complex situations.

Refining regulatory requirements

The proposed legislation also includes administrative amendments to address regulatory inconsistencies, clarify requirements, and better align the act with the Alberta Recovery Model. As an example, references to residential addiction treatment services would be updated to bed-based treatment services.

Alberta’s government is making record investments and removing barriers to recovery-oriented supports for all Albertans, regardless of where they live or their financial situation. Actions include adding more than 10,000 new publicly funded addiction treatment spaces; eliminating daily user fees for bed-based treatment services; and expanding access to the Virtual Opioid Dependency Program, which provides same-day access to life-saving treatment medication.

Quick facts
- Albertans can call 211 Alberta to find supports and services in their area.
- Albertans struggling with opioid addiction can contact the Virtual Opioid Dependency Program (VODP) by calling 1-844-383-7688, seven days a week, from 6 a.m. to midnight. The VODP provides same-day access to addiction medicine specialists. There is no wait list.
Related information
- Modernizing addiction treatment licensing
- Mental Health Services Protection Act
- Residential addiction treatment service providers
- Residential addiction treatment service provider licensing
Multimedia
- Watch the news conference
- Listen to the news conference
MIL OSI Canada News –
February 26, 2025
MIL-OSI Security: United States Sues Skilled Nursing Company, Executives and Consultant for Fraudulent Billing

Source: Office of United States Attorneys

Complaint alleges systematic fraudulent billing of Medicare and Medicaid for unnecessary care at skilled nursing facilities in Massachusetts and Connecticut

BOSTON – The U.S. Attorney’s Office has filed a joint complaint with the Massachusetts Attorney General’s Office under the federal and Massachusetts False Claims Acts against 19 skilled nursing facilities (SNFs) in Massachusetts and Connecticut and their present and former management companies, RegalCare Management Group, LLC and RegalCare Management 2.0 (together “RegalCare”); RegalCare’s owner, Eliyahu Mirlis and an executive, Hector Caraballo; and RegalCare’s therapy consultant, Stern Therapy Consultants (Stern).

SNFs are inpatient facilities that provide transitional care to patients following a hospital stay. Federal healthcare programs, including Medicare and Medicaid, reimburse providers for medically reasonable and necessary services rendered to SNF patients. Both the federal and Massachusetts False Claims Acts prohibit individuals or entities from submitting, or causing the submission of, false claims for payment and false statements material to a claim for payment from the respective governments.

The complaint alleges that, between 2017 and 2023, RegalCare – at the direction of Mirlis and Caraballo and aided by Stern – fraudulently caused the submission of claims to Medicare and Medicaid (via MassHealth and its managed care organizations) for medically unreasonable and unnecessary services to patients of RegalCare’s SNFs. The defendants’ scheme allegedly resulted in millions of dollars in damages to the Medicare and Medicaid programs.

Specifically, the complaint alleges that RegalCare, at Mirlis’ direction, systematically caused Medicare to be billed for the highest level of skilled rehabilitation therapy services at RegalCare’s SNFs in Massachusetts and Connecticut, despite patients not clinically needing those services. Caraballo facilitated Mirlis’ plan by ensuring that RegalCare’s patient records supported billing for such services – including altering and amending records despite knowing he was not authorized to do so at his licensing level, without having assessed or spoken to the patients, and often without having spoken to clinicians about the changes he personally made. The United States also alleges that RegalCare, through Mirlis and Caraballo, improperly directed RegalCare’s third-party billing company to bill Medicare for the highest-level skilled rehabilitation therapy services before the underlying necessary clinical documentation was even complete.

The complaint further alleges that Stern, a New York long-term care consulting company, conspired with RegalCare to cause the submission of fraudulent claims to Medicare by scheduling therapists to provide unnecessary services, contrary to patients’ medical needs, to justify billing at the highest-level. When Stern therapists refused to provide services they deemed unnecessary or unreasonable, Stern managers threatened to take employment action against those therapists to pressure them to capitulate.

“As alleged, these defendants drained Medicare and Medicaid of millions of dollars and put vulnerable patients at risk – making them undergo unnecessary, and sometimes painful, services,” said United States Attorney Leah B. Foley. “When facilities prioritize profits over patient well-being, they endanger those in their care and undermine the integrity of our healthcare system. This office will continue to hold accountable those who exploit federal healthcare programs at the expense of patients and taxpayers alike.”

“I am proud of our team’s partnership with the USAO in this case, which advances elder justice and safeguards crucial nursing home funds,” said Massachusetts Attorney General Andrea Joy Campbell. “My office will continue to work aggressively to protect our elders and hold companies accountable that seek to harm them or violate our false claim laws.”

“Taxpayers who fund the Medicare and Medicaid programs expect skilled nursing facilities to bill those programs honestly and accurately,” said Roberto Coviello, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General. “The integrity of our federal health care system is undermined when that expectation is not met, and we will continue to thoroughly pursue allegations of False Claims Act violations.”

Massachusetts contends that RegalCare, directed by Mirlis and Caraballo, submitted inflated claims to MassHealth for long-term care services performed for patients of RegalCare’s SNFs in Massachusetts. Between 2017 and 2023, RegalCare operated SNFs in Amesbury, Danvers, Greenfield, Harwich, Holyoke, Lowell, Quincy, Saugus, Taunton and Worcester. The complaint alleges that RegalCare, Mirlis and Caraballo altered documentation to support billing for increased long term care services even though the patient did not clinically need the additional services.

The governments filed their complaint in a lawsuit filed by a whistleblower under the qui tam provisions of the False Claims Acts. Under those laws, a private citizen can sue on behalf of the United Staes or Massachusetts and share in any recovery. The United States and Massachusetts also are entitled to intervene in the lawsuit, as they have done in this case, which is captioned United States and Commonwealth of Massachusetts ex rel. McCormick v. RegalCare Management 2.0, LLC, et al.

U.S. Attorney Foley, AG Campbell and HHS-OIG SAC Coviello made the announcement today. This matter is being handled by Assistant U.S. Attorneys Steven Sharobem, Andrew Caffrey, Olivia Benjamin and Diane Seol of the U.S. Attorney’s Office’s Affirmative Civil Enforcement Unit and Assistant Attorney General Scott Grannemann of the Attorney General’s Office’s Medicaid Fraud Division.

The claims in which the United States and Massachusetts have intervened are allegations only. There has been no determination of liability.

MIL Security OSI –

February 26, 2025
MIL-OSI USA: Attorney General Bonta Files Amicus Brief to Continue Supporting the Affordable Care Act’s Preventive Care Mandate
Source: US State of California

OAKLAND — California Attorney General Rob Bonta today, as part of a coalition of 23 attorneys general, filed an amicus brief with the U.S. Supreme Court in support of the Affordable Care Act’s (ACA) preventive care mandate, which requires private insurers to cover at no cost certain preventive services — such as routine examinations, blood pressure checks, and cholesterol screenings — as determined by the Preventive Services Task Force (Task Force). In their brief, the attorneys general argue that the Fifth Circuit erred in finding the Task Force violates the Appointments Clause of the U.S. Constitution. The attorneys general also argue that the preventive services provision has significantly improved public health outcomes throughout the country by expanding access to important and often life-saving care. An opinion holding the Task Force’s recommendations unenforceable would put these advancements at risk, as health insurers and plans would be free to reinstate out-of-pocket fees for essential preventive care.

“Preventive care is the cornerstone of a healthy society and, in many instances, can be the difference between life and death,” said Attorney General Bonta. “That’s why I’m standing with my fellow attorneys general in urging the U.S. Supreme Court to reverse the Fifth Circuit’s decision and preserve the no-cost preventive health care services upon which millions of Americans rely.”

Numerous studies confirm that, after the ACA’s preventive care mandate was enacted, the use of preventive care increased across the board. These services improve public health outcomes by enabling medical professionals to identify and treat illnesses earlier, and in some cases, prevent them.

In the amicus brief, the coalition writes that:
- The structure of the Task Force, which is an independent, volunteer panel of national experts in disease prevention that makes evidence-based recommendations about clinical preventive services, does not violate the Appointments Clause. Task Force members serve as inferior officers subordinate to the Secretary of Health and Human Services.
- If the Supreme Court were to conclude that the Task Force members are principal officers, nothing requires the Court to cast aside the no-cost insurance coverage requirements that millions of Americans rely on.
- Prohibiting the enforcement of recommendations by the Task Force will inevitably lead to a significant decline in public health outcomes, undermining preventive care efforts and access to lifesaving care.
Attorney General Bonta has been committed to defending the ACA’s preventive care mandate. In January 2022, Attorney General Bonta joined a coalition of attorneys general in filing an amicus brief with a Texas federal district court in support of the mandate. In March 2023, the federal district court in Texas struck down part of the mandate in a ruling Attorney General Bonta described as “dangerous and short-sighted” for Americans. In June 2023, Attorney General Bonta again joined a coalition of attorneys general in filing an amicus brief with the Fifth Circuit in support of the mandate. In March 2024, he issued a statement on the Fifth Circuit hearing oral argument. In October 2024, Attorney General Bonta joined a group of attorneys general urging the Supreme Court to grant the government’s petition for writ of certiorari.

In filing this most recent amicus brief, Attorney General Bonta joins the attorneys general of Arizona, Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Rhode Island, Vermont, Washington and Wisconsin.

A copy of the brief can be found here.

MIL OSI USA News –
February 26, 2025
MIL-OSI: SiriusPoint Announces Secondary Offering of 4,106,631 Common Shares by Entities Associated with Daniel S. Loeb and Potential Repurchase of up to 2,000,000 Common Shares by SiriusPoint

Source: GlobeNewswire (MIL-OSI)

HAMILTON, Bermuda, Feb. 25, 2025 (GLOBE NEWSWIRE) — SiriusPoint Ltd. (“SiriusPoint” or the “Company”) (NYSE: SPNT) today announced that entities associated with Daniel S. Loeb (collectively, the “Loeb Entities”) are offering an aggregate of 4,106,631 common shares through a registered secondary offering.

SiriusPoint has indicated its intent to repurchase an aggregate of up to 2,000,000 of the common shares being offered in the offering at the public offering price. SiriusPoint would cancel any common shares it repurchases in the offering.

Immediately following the completion of the offering and our previously announced repurchase of all of common shares and warrants currently held by CM Bermuda, it is expected that the Loeb Entities will own approximately 9.67% of SiriusPoint’s issued and outstanding common shares, up from approximately 9.4% prior to the offering and the CM Bermuda repurchase.

Under the terms of the transaction, the remaining shares owned by the Loeb Entities will be subject to a 90 day lock-up agreement with the sole bookrunning manager.

Jefferies is acting as the sole bookrunning manager for the proposed offering.

The offering will be made only by means of an effective registration statement and a prospectus. The Company has previously filed with the U.S. Securities and Exchange Commission (the “SEC”) a registration statement (including a prospectus) on Form S-3 (File No. 333-283827), dated December 16, 2024, and a preliminary prospectus supplement for the offering to which this communication relates. Before you invest, you should read the prospectus in that registration statement, the accompanying prospectus supplement, and other documents the Company has filed with the SEC for more complete information about the Company and this offering. When available, copies of the preliminary prospectus supplement and the accompanying prospectus relating to the offering may be obtained from: Jefferies LLC, Attention: Equity Syndicate Prospectus Department, 520 Madison Avenue, New York, NY 10022, by telephone at (877) 821-7388, or by email at prospectus_department@jefferies.com. Electronic copies of the preliminary prospectus supplement and accompanying prospectus will also be available on the website of the SEC at http://www.sec.gov. This press release shall not constitute an offer to sell or the solicitation of an offer to buy, nor shall there be any sale of these securities in any state or jurisdiction in which such offer, solicitation or sale would be unlawful prior to registration or qualification under the securities laws of any such state or jurisdiction.

Contacts
Investor Relations
Liam Blackledge, SiriusPoint
Liam.Blackledge@siriuspt.com
+ 44 203 772 3082
Media
Sarah Hills, Rein4ce
Sarah.Hills@rein4ce.co.uk
+ 44 7718 882011

About SiriusPoint

SiriusPoint is a global underwriter of insurance and reinsurance providing solutions to clients and brokers around the world. Bermuda-headquartered with offices in New York, London, Stockholm and other locations, we are listed on the New York Stock Exchange (SPNT). We have licenses to write Property & Casualty and Accident & Health insurance and reinsurance globally. Our offering and distribution capabilities are strengthened by a portfolio of strategic partnerships with Managing General Agents and Program Administrators within our Insurance & Services segment. With over $2.6 billion total capital, SiriusPoint’s operating companies have a financial strength rating of A- (Excellent) from AM Best, S&P and Fitch, and A3 from Moody’s.

FORWARD-LOOKING STATEMENTS

We make statements in this press release that are forward-looking statements within the meaning of the U.S. federal securities laws. We intend these forward-looking statements to be covered by the safe harbor provisions for forward-looking statements in the U.S. federal securities laws. These statements involve risks and uncertainties that could cause actual results to differ materially from those contained in the forward-looking statements. These risks and uncertainties include, but are not limited to, the impact of general economic conditions and conditions affecting the insurance and reinsurance industry; the adequacy of our reserves; fluctuation in the results of operations; pandemic or other catastrophic event; uncertainty of success in investing in early-stage companies, such as the risk of loss of an initial investment, highly variable returns on investments, delay in receiving return on investment and difficulty in liquidating the investment; our ability to assess underwriting risk, trends in rates for property and casualty insurance and reinsurance, competition, investment market and investment income fluctuations; trends in insured and paid losses; regulatory and legal uncertainties; and other risk factors described in SiriusPoint’s Annual Report on Form 10-K for the period ended December 31, 2024.

Except as required by applicable law or regulation, we disclaim any obligation to publicly update or revise any forward-looking statement to reflect changes in underlying assumptions or factors, or new information, data or methods, future events, or other circumstances after the date of this press release.

The MIL Network –

February 26, 2025
MIL-OSI USA: Beating the Odds: Patient Survives Life-Threatening Pulmonary Embolism with Help from UConn Health

Source: US State of Connecticut

On November 6, 2023, Susan D’Addario of Farmington suffered a sudden and life-threatening pulmonary embolism at home. Her husband Peter immediately sprang into action, performing CPR until first responders arrived. Thanks to his quick thinking and the expert care at UConn John Dempsey Hospital, Susan survived against all odds.

Once at the hospital, Emergency Department physician, Dr. Matthew Ledford administered a dose of tPA, a medication, commonly used to treat pulmonary embolism as a “clot-busting” drug that breaks down blood clots in the lungs, restoring blood flow.

Susan was transferred to the Intensive Care Unit (ICU), where her condition remained under close observation. Her care was assumed by ICU physicians Dr. Debapriya Datta, Dr. Raymond Foley, and the ICU team. When her progress remained limited, the team consulted Dr. Juyong Lee, an interventional cardiologist.

Lee successfully removed the clots blocking her arteries, giving Susan a second chance at life. With only 5% of pulmonary embolism cases surviving such a crisis, Susan knows just how fortunate she is. She is grateful to Drs. Lee, Datta, Foley, Ledford and the ICU team that included residents, Drs. Erind Muco, Kiroloss Eskander, Bianca Thakker, Daphne Gonzalez Aponte, Dr. Angela Quental, Fellow, Kellie McPherson, RN, Stacy Philips, APP and Randy Lebron, Nurse’s Aide.

Susan’s story is a testament to the importance of heart health, rapid emergency response, and the dedicated medical professionals who make survival possible. It also highlights the vital role that UConn Health’s cardiovascular experts play in saving lives every day.

Recently, Susan met Dr. Lee for the first time, and together they spoke with WFSB’s Great Day CT about her experience, pulmonary embolisms, and the critical importance of knowing CPR.

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MIL OSI USA News –

February 26, 2025

MIL-OSI: EXL Reports 2024 Fourth Quarter and Year-End Results; Issues 2025 Guidance

Source: GlobeNewswire (MIL-OSI)

2024 Fourth Quarter Revenue of $481.4 Million, up 16.3% year-over-year
Q4 Diluted EPS (GAAP) of $0.31, up 28.4% from $0.24 in Q4 of 2023
Q4 Adjusted Diluted EPS (Non-GAAP) ⁽¹⁾of $0.44, up 26.1% from $0.35 in Q4 of 2023

2024 Revenue of $1.84 Billion, up 12.7% year-over-year
2024 Diluted EPS (GAAP) of $1.21, up 10.0% from $1.10 in 2023
2024 Adjusted Diluted EPS (Non-GAAP) ⁽¹⁾of $1.65, up 15.4% from $1.43 in 2023

NEW YORK, Feb. 25, 2025 (GLOBE NEWSWIRE) — ExlService Holdings, Inc. (NASDAQ: EXLS), a global data and AI company, today announced its financial results for the quarter and full year ended December 31, 2024.

Rohit Kapoor, chairman and chief executive officer, said, “As we executed our data and AI strategy in 2024, we achieved several key milestones, including launching an enterprise AI platform in partnership with NVIDIA, introducing our insurance-specific large language model (LLM) and expanding our data management capabilities with the acquisition of ITI Data. Our focus on innovating with speed led to industry-leading full-year revenue growth of 12.7% and adjusted EPS growth of 15.4%. As AI adoption continues to increase, EXL is well positioned to capture this opportunity and continue its strong growth momentum.”

Maurizio Nicolelli, chief financial officer, said, “We finished 2024 with robust growth across our business segments, a formidable balance sheet and strong free cash flow. For the full year 2025, we expect revenue to be in the range of $2.025 billion to $2.060 billion, representing a 10% to 12% increase year-over-year on a reported basis and 11% to 13% on constant currency basis. We expect adjusted diluted EPS to be in the range of $1.83 to $1.89, representing a 11% to 14% increase over 2024.”

__________________________________________________

Reconciliations of adjusted (non-GAAP) financial measures to the most directly comparable GAAP measures, where applicable, are included at the end of this release under “Reconciliation of Adjusted Financial Measures to GAAP Measures.” These non-GAAP measures, including adjusted diluted EPS and constant currency measures, are not measures of financial performance prepared in accordance with GAAP.

Financial Highlights: Fourth Quarter 2024

Revenue for the quarter ended December 31, 2024 increased to $481.4 million compared to $414.1 million for the fourth quarter of 2023, an increase of 16.3% on a reported basis and constant currency basis. Revenue increased by 2.0% sequentially on a reported basis and 2.4% on a constant currency basis, from the third quarter of 2024.

	Revenue						Gross Margin
	Three months ended						Three months ended
Reportable Segments	December 31, 2024		December 31, 2023		September 30, 2024		December 31, 2024		December 31, 2023		September 30, 2024
	(dollars in millions)
Insurance	$	162.0	$	139.1	$	157.6	36.9	%	36.2	%	36.3	%
Healthcare		31.6		26.0		30.5	31.7	%	36.9	%	33.6	%
Emerging Business		80.1		67.0		80.0	40.7	%	41.0	%	40.2	%
Analytics		207.7		182.0		204.0	39.0	%	35.4	%	38.5	%
Revenues, net	$	481.4	$	414.1	$	472.1	38.1	%	36.7	%	37.8	%

Operating income margin for the quarter ended December 31, 2024 was 14.8%, compared to 13.1% for the fourth quarter of 2023 and 14.7% for the third quarter of 2024. Adjusted operating income margin for the quarter ended December 31, 2024 was 18.8%, compared to 17.8% for the fourth quarter of 2023 and 19.9% for the third quarter of 2024.
Diluted earnings per share for the quarter ended December 31, 2024 was $0.31, compared to $0.24 for the fourth quarter of 2023 and $0.33 for the third quarter of 2024. Adjusted diluted earnings per share for the quarter ended December 31, 2024 was $0.44, compared to $0.35 for the fourth quarter of 2023 and $0.44 for the third quarter of 2024.

Financial Highlights: Full Year 2024

Revenue for the year ended December 31, 2024 increased to $1.84 billion compared to $1.63 billion for the year ended December 31, 2023, an increase of 12.7% on a reported basis and constant currency basis.

	Revenue				Gross Margin
	Year ended				Year ended
Reportable Segments	December 31, 2024		December 31, 2023		December 31, 2024		December 31, 2023
	(dollars in millions)
Insurance	$	614.0	$	529.9	36.4	%	35.5	%
Healthcare		116.4		106.0	33.0	%	34.6	%
Emerging Business		311.7		265.7	41.8	%	43.2	%
Analytics		796.3		729.1	37.5	%	36.8	%
Revenues, net	$	1,838.4	$	1,630.7	37.6	%	37.3	%

Operating income margin for the year ended December 31, 2024 was 14.3%, compared to 14.6% for the year ended December 31, 2023. Adjusted operating income margin for the year ended December 31, 2024 was 19.4%, compared to 19.3% for the year ended December 31, 2023.
Diluted earnings per share for the year ended December 31, 2024 was $1.21, compared to $1.10 for the year ended December 31, 2023. Adjusted diluted earnings per share for the year ended December 31, 2024 was $1.65, compared to $1.43 for the year ended December 31, 2023.

Business Highlights: Fourth Quarter 2024

Won 17 new clients in the fourth quarter of 2024, with 8 clients in digital operations and solutions and 9 in analytics. For the year, we won 69 new clients, with 32 in digital operations and solutions and 37 in analytics.
Launched EXLerate.AI, an agentic AI platform designed to help enterprises reimagine and build AI-native workflows that drive greater efficiency, lower costs, and increased accuracy and scalability across business operations.
Named a Leader in the ISG Provider Lens™ Generative AI Services 2024 report. Analysts cited EXL’s data integration capabilities, domain-specific expertise, and robust transformational framework as key differentiators driving its leadership in this space.
Recognized as a Market Leader in the HFS Research 2024 AADA Quadfecta Services for the Generative Enterprise™ 2024 study. The study evaluated 27 leading analytics, AI, data platforms, and automation service providers on their ability to unlock deep insights from data, automate complex processes, and enhance operational efficiencies. The Market Leader designation is the report’s highest distinction.

2025 Operating Model

To accelerate the execution of our data and AI strategy, capture a greater share of the growing AI market and drive EXL’s long-term growth, the company is changing its operating model. The new model is comprised of Industry Market Units focused on delivering higher value to clients leveraging our full suite of capabilities; and Strategic Growth Units focused on rapidly advancing our capabilities specific to various industries and client needs.

This enhances our ability to deepen client relationships, unlock new buying centers, expand our addressable markets across industries and geographies, accelerate investments in data and AI capabilities and industry-specific solutions, and create more professional development opportunities for our employees. This model enables us to deliver AI-powered integrated solutions more effectively and evolve engagements to maximize value for our clients.

EXL will adopt new financial reporting segments consistent with how management will be reviewing financial information and making operating decisions beginning in the first quarter of 2025. Our data, AI and analytics capabilities are driving all our solutions and business lines. Accordingly, we will now report data and AI revenue alongside our new reporting segments beginning with the first quarter of 2025. This shift will provide a higher quality and more relevant representation of our business performance as we continue executing our data and AI growth strategy. The new reportable segments, aligned to our Industry Market Units, are as follows:

Insurance
Healthcare and Life Sciences
Banking, Capital Markets and Diversified Industries
International Growth Markets

The change in segment presentation will not have any effect on our consolidated statements of income, balance sheets or cash flows. The revised presentation will be reflected in our periodic and annual reports beginning in the first quarter of 2025.

2025 Guidance

Based on current visibility, and a U.S. dollar to Indian rupee exchange rate of 87.0, U.K. pound sterling to U.S. dollar exchange rate of 1.25, U.S. dollar to the Philippine peso exchange rate of 58.0 and all other currencies at current exchange rates, we are providing the following guidance for the full year 2025:

Revenue of $2.025 billion to $2.060 billion, representing an increase of 10% to 12% on a reported basis, and 11% to 13% on a constant currency basis, from 2024; and
Adjusted diluted earnings per share of $1.83 to $1.89, representing an increase of 11% to 14% from 2024.

Conference Call

ExlService Holdings, Inc. will host a conference call on Wednesday, February 26, 2025, at 10:00 A.M. ET to discuss the Company’s fourth quarter and year-end operating and financial results. The conference call will be available live via the internet by accessing the investor relations section of EXL’s website at ir.exlservice.com, where an accompanying investor-friendly spreadsheet of historical operating and financial data can also be accessed. Please access the website at least fifteen minutes prior to the call to register, download and install any necessary audio software.

To join the live call, please register here. For those who cannot access the live broadcast, a replay will be available on the EXL website ir.exlservice.com for a period of twelve months.

About ExlService Holdings, Inc.

EXL (NASDAQ: EXLS) is a global data and artificial intelligence (“AI”) company that offers services and solutions to reinvent client business models, drive better outcomes and unlock growth with speed. EXL harnesses the power of data, AI, and deep industry knowledge to transform businesses, including the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 59,000 employees spanning six continents. For more information, visit www.exlservice.com.

Cautionary Statement Regarding Forward-Looking Statements This press release contains forward-looking statements within the meaning of the United States Private Securities Litigation Reform Act of 1995. You should not place undue reliance on those statements because they are subject to numerous uncertainties and factors relating to EXL’s operations and business environment, all of which are difficult to predict and many of which are beyond EXL’s control. Forward-looking statements include information concerning EXL’s possible or assumed future results of operations, including descriptions of its business strategy. These statements may include words such as “may,” “will,” “should,” “believe,” “expect,” “anticipate,” “intend,” “plan,” “estimate” or similar expressions. These statements are based on assumptions that we have made in light of management’s experience in the industry as well as its perceptions of historical trends, current conditions, expected future developments and other factors it believes are appropriate under the circumstances. You should understand that these statements are not guarantees of performance or results. They involve known and unknown risks, uncertainties and assumptions. Although EXL believes that these forward-looking statements are based on reasonable assumptions, you should be aware that many factors could affect EXL’s actual financial results or results of operations and could cause actual results to differ materially from those in the forward-looking statements. These factors, which include our ability to maintain and grow client demand, risks related to the use of AI technology, impact on client demand by the selling cycle of our contracts, fluctuations in our earnings, our ability to hire and retain sufficiently trained employees, and our ability to accurately estimate and/or manage costs, are discussed in more detail in EXL’s filings with the Securities and Exchange Commission, including EXL’s Annual Report on Form 10-K. You should keep in mind that any forward-looking statement made herein, or elsewhere, speaks only as of the date on which it is made. New risks and uncertainties come up from time to time, and it is impossible to predict these events or how they may affect EXL. EXL has no obligation to update any forward-looking statements after the date hereof, except as required by applicable law.


EXLSERVICE HOLDINGS, INC. CONSOLIDATED STATEMENTS OF INCOME (In thousands, except per share amount and share count)

							(Unaudited)
	Year ended December 31,						Three months ended December 31,
	2024			2023			2024			2023
Revenues, net	$	1,838,372		$	1,630,668		$	481,426		$	414,058
Cost of revenues⁽¹⁾		1,147,359			1,022,902			298,023			262,211
Gross profit⁽¹⁾		691,013			607,766			183,403			151,847
Operating expenses:
General and administrative expenses		225,672			198,294			58,477			53,730
Selling and marketing expenses		146,502			120,227			37,520			31,553
Depreciation and amortization expense		55,219			50,490			16,164			12,298
Total operating expenses		427,393			369,011			112,161			97,581
Income from operations		263,620			238,755			71,242			54,266
Foreign exchange gain, net		891			1,532			218			694
Interest expense		(19,256	)		(13,180	)		(5,111	)		(3,150	)
Other income/(expense), net		16,092			10,834			4,216			4,240
Income before income tax expense and earnings from equity affiliates		261,347			237,941			70,565			56,050
Income tax expense		62,936			53,536			19,850			15,763
Income before earnings from equity affiliates		198,411			184,405			50,715			40,287
Gain/(loss) from equity-method investment		(114	)		153			(43	)		(4	)
Net income	$	198,297		$	184,558		$	50,672		$	40,283
Earnings per share:
Basic	$	1.22		$	1.11		$	0.31		$	0.24
Diluted	$	1.21		$	1.10		$	0.31		$	0.24
Weighted average number of shares used in computing earnings per share:
Basic		162,718,840			166,341,213			161,292,473			165,254,017
Diluted		164,321,656			168,161,371			163,436,793			166,880,836

⁽¹⁾Exclusive of depreciation and amortization expense.


EXLSERVICE HOLDINGS, INC. CONSOLIDATED BALANCE SHEETS (In thousands, except per share amount and share count)

	As of
	December 31, 2024			December 31, 2023
Assets
Current assets:
Cash and cash equivalents	$	153,355		$	136,953
Short-term investments		187,223			153,881
Restricted cash		9,972			4,062
Accounts receivable, net		304,322			308,108
Other current assets		140,317			76,669
Total current assets		795,189			679,673
Property and equipment, net		101,837			100,373
Operating lease right-of-use assets		68,784			64,856
Restricted cash		8,071			4,386
Deferred tax assets, net		104,747			82,927
Goodwill		420,387			405,639
Other intangible assets, net		49,331			50,164
Long-term investments		13,972			4,430
Other assets		56,085			49,524
Total assets	$	1,618,403		$	1,441,972
Liabilities and stockholders’ equity
Current liabilities:
Accounts payable	$	5,884		$	5,055
Current portion of long-term borrowings		4,886			65,000
Deferred revenue		19,264			12,318
Accrued employee costs		129,994			117,137
Accrued expenses and other current liabilities		113,597			114,113
Current portion of operating lease liabilities		16,491			12,780
Total current liabilities		290,116			326,403
Long-term borrowings, less current portion		283,598			135,000
Operating lease liabilities, less current portion		59,851			58,175
Deferred tax liabilities, net		1,403			1,495
Other non-current liabilities		53,573			31,462
Total liabilities		688,541			552,535
Commitments and contingencies
Stockholders’ equity:
Preferred stock, $0.001 par value; 15,000,000 shares authorized, none issued		—			—
Common stock, $0.001 par value; 400,000,000 shares authorized, 206,510,587 shares issued and 161,801,212 shares outstanding as of December 31, 2024 and 203,410,038 shares issued and 165,277,880 shares outstanding as of December 31, 2023		206			203
Additional paid-in capital		588,583			508,028
Retained earnings		1,281,960			1,083,663
Accumulated other comprehensive loss		(154,722	)		(127,040	)
Total including shares held in treasury		1,716,027			1,464,854
Less: 44,709,375 shares as of December 31, 2024 and 38,132,158 shares as of December 31, 2023, held in treasury, at cost		(786,165	)		(575,417	)
Total stockholders’ equity		929,862			889,437
Total liabilities and stockholders’ equity	$	1,618,403		$	1,441,972

EXLSERVICE HOLDINGS, INC.Reconciliation of Adjusted Financial Measures to GAAP Measures

In addition to its reported operating results in accordance with U.S. generally accepted accounting principles (GAAP), EXL has included in this release certain financial measures that are considered non-GAAP financial measures, including the following:

(i)		Adjusted operating income and adjusted operating income margin;
(ii)		Adjusted EBITDA and adjusted EBITDA margin;
(iii)		Adjusted net income and adjusted diluted earnings per share; and
(iv)		Revenue growth on constant currency basis.

These non-GAAP financial measures are not based on any comprehensive set of accounting rules or principles, should not be considered a substitute for, or superior to, financial measures calculated in accordance with GAAP, and may be different from non-GAAP financial measures used by other companies. Accordingly, the financial results calculated in accordance with GAAP and reconciliations from those financial statements should be carefully evaluated. EXL believes that providing these non-GAAP financial measures may help investors better understand EXL’s underlying financial performance. Management also believes that these non-GAAP financial measures, when read in conjunction with EXL’s reported results, can provide useful supplemental information for investors analyzing period-to-period comparisons of the Company’s results and comparisons of the Company’s results with the results of other companies. Additionally, management considers some of these non-GAAP financial measures to determine variable compensation of its employees. The Company believes that it is unreasonably difficult to provide its earnings per share financial guidance in accordance with GAAP, or a qualitative reconciliation thereof, for a number of reasons, including, without limitation, the Company’s inability to predict its future stock-based compensation expense under ASC Topic 718, the amortization of intangibles associated with future acquisitions and the currency fluctuations and associated tax effects. As such, the Company presents guidance with respect to adjusted diluted earnings per share. The Company also incurs significant non-cash charges for depreciation that may not be indicative of the Company’s ability to generate cash flow.

EXL non-GAAP financial measures exclude, where applicable, stock-based compensation expense, amortization of acquisition-related intangible assets, provision for restructuring and litigation settlement matters, effects of termination of leases, certain defined social security contributions, allowance for certain material expected credit losses, other acquisition-related expenses or benefits and effect of any non-recurring tax adjustments. Acquisition-related expenses or benefits include, changes in the fair value of contingent consideration, external deal costs, integration expenses, direct and incremental travel costs and non-recurring benefits or losses. Our adjusted net income and adjusted diluted EPS also excludes the effects of income tax on the above pre-tax items, as applicable. The effects of income tax of each item is calculated by applying the statutory rate of the local tax regulations in the jurisdiction in which the item was incurred.

A limitation of using non-GAAP financial measures versus financial measures calculated in accordance with GAAP is that non-GAAP financial measures do not reflect all of the amounts associated with our operating results as determined in accordance with GAAP and exclude costs that are recurring, namely stock-based compensation and amortization of acquisition-related intangible assets. EXL compensates for these limitations by providing specific information regarding the GAAP amounts excluded from non-GAAP financial measures to allow investors to evaluate such non-GAAP financial measures.

EXL’s primary exchange rate exposure is with the Indian rupee, the Philippine peso, the U.K. pound sterling and the South African rand. The average exchange rate of the U.S. dollar against the Indian rupee increased from 83.28 during the quarter ended December 31, 2023 to 84.72 during the quarter ended December 31, 2024, representing a depreciation of 1.7% against the U.S. dollar. The average exchange rate of the U.S. dollar against the Philippine peso increased from 55.86 during the quarter ended December 31, 2023 to 58.19 during the quarter ended December 31, 2024, representing a depreciation of 4.2% against the U.S. dollar. The average exchange rate of the U.K. pound sterling against the U.S. dollar increased from 1.25 during the quarter ended December 31, 2023 to 1.28 during the quarter ended December 31, 2024, representing an appreciation of 1.9% against the U.S. dollar. The average exchange rate of the U.S. dollar against the South African rand decreased from 18.63 during the quarter ended December 31, 2023 to 18.18 during the quarter ended December 31, 2024, representing an appreciation of 2.4% against the U.S. dollar.

The following table shows the reconciliation of these non-GAAP financial measures for the year ended December 31, 2024 and 2023, the three months ended December 31, 2024 and 2023 and the three months ended September 30, 2024:

Reconciliation of Adjusted Operating Income and Adjusted EBITDA (Amounts in thousands)

	Year ended						Three months ended
	December 31,						December 31,						September 30,
	2024			2023			2024			2023			2024
Net income (GAAP)	$	198,297		$	184,558		$	50,672		$	40,283		$	53,037
add: Income tax expense		62,936			53,536			19,850			15,763			15,460
add/(subtract): Foreign exchange gain, net, interest expense, gain/(loss) from equity-method investment and other income/(loss), net		2,387			661			720			(1,780	)		908
Income from operations (GAAP)	$	263,620		$	238,755		$	71,242		$	54,266		$	69,405
add: Stock-based compensation expense		72,658			58,437			15,479			15,452			21,232
add: Amortization of acquisition-related intangibles		13,630			14,678			4,024			3,168			3,449
add: Restructuring and litigation settlement costs (a)		6,174			613			—			613			—
add/(subtract): Allowance/(reversal) for expected credit losses (b)		—			1,436			—			(264	)		—
add: Other expenses (c)		—			771			—			282			—
Adjusted operating income (Non-GAAP)	$	356,082		$	314,690		$	90,745		$	73,517		$	94,086
Adjusted operating income margin as a % of Revenue (Non-GAAP)		19.4	%		19.3	%		18.8	%		17.8	%		19.9	%
add: Depreciation on long-lived assets		41,589			34,434			12,140			9,130			10,350
Adjusted EBITDA (Non-GAAP)	$	397,671		$	349,124		$	102,885		$	82,647		$	104,436
Adjusted EBITDA margin as a % of revenue (Non-GAAP)		21.6	%		21.4	%		21.4	%		20.0	%		22.1	%

(a) To exclude effects of employee severance costs and outplacement support costs of $4,762 and $nil and litigation settlement costs and associated legal fees of $1,412 and $613 for the year ended December 31, 2024 and 2023, respectively. To exclude effects of litigation settlement costs and associated legal fees of $nil and $613 for the three months ended December 31, 2024 and 2023, respectively.

(b) To exclude the effects of material allowance/(reversal) for expected credit losses on accounts receivables related to a customer bankruptcy event.

(c) To exclude effects of lease termination of $nil and $489 and other items, individually insignificant of $nil and $282 for the year ended December 31, 2024 and 2023, respectively. To exclude effects of other items, individually insignificant of $nil and $282 for the three months ended December 31, 2024 and 2023, respectively.


Reconciliation of Adjusted Net Income and Adjusted Diluted Earnings Per Share (Amounts in thousands, except per share data)

	Year ended						Three months ended
	December 31,						December 31,						September 30,
	2024			2023			2024			2023			2024
Net income (GAAP)	$	198,297		$	184,558		$	50,672		$	40,283		$	53,037
add: Stock-based compensation expense		72,658			58,437			15,479			15,452			21,232
add: Amortization of acquisition-related intangibles		13,630			14,678			4,024			3,168			3,449
add: Restructuring and litigation settlement costs (a)		6,174			613			—			613			—
add/(subtract): Changes in fair value of contingent consideration		(589	)		1,900			—			(600	)		—
add: Other tax expenses (b)		3,817			223			3,817			223			—
add/(subtract): Allowance/(reversal) for expected credit losses (c)		—			1,436			—			(264	)		—
add: Other expenses (d)		—			489			—			—			—
subtract: Tax impact on stock-based compensation expense (e)		(17,576	)		(17,333	)		(1,769	)		(374	)		(5,830	)
subtract: Tax impact on amortization of acquisition-related intangibles		(3,318	)		(3,622	)		(921	)		(792	)		(866	)
add/(subtract): Tax impact on restructuring and litigation settlement costs		(1,540	)		—			48			—			—
add/(subtract): Tax impact on changes in fair value of contingent consideration		146			152			(5	)		152			—
add/(subtract): Tax impact on allowance/(reversal) for expected credit losses		—			(364	)		—			65			—
subtract: Tax impact on other expenses		—			(280	)		—			(157	)		—
Adjusted net income (Non-GAAP)	$	271,699		$	240,887		$	71,345		$	57,769		$	71,022
Adjusted diluted earnings per share (Non-GAAP)	$	1.65		$	1.43		$	0.44		$	0.35		$	0.44

(b) To exclude other tax expenses/(benefits) related to certain deferred tax assets and liabilities.

(c) To exclude the effects of material allowance/(reversal) for expected credit losses on accounts receivables related to a customer bankruptcy event.

(d) To exclude effects of lease termination of $nil and $489 for the year ended December 31, 2024 and 2023, respectively.

(e) Tax impact includes $9,714 and $15,055 for the year ended December 31, 2024 and 2023 respectively, $500 and $1,883 for the three months ended December 31, 2024 and 2023 respectively, and $1,673 for the three months ended September 30, 2024 related to discrete benefit recognized in income tax expense in accordance with ASU No. 2016-09, Compensation – Stock Compensation.

Contacts:
Investor Relations
John Kristoff
Vice President, Investor Relations
+1 212 209 4613
ir@exlservice.com

Media – US
Keith Little
Assistant Vice President, Media Relations
+1 703 598 0980
media.relations@exlservice.com

The MIL Network –

February 26, 2025

MIL-OSI: SLR Investment Corp. Announces Quarter and Year Ended December 31, 2024 Financial Results

Source: GlobeNewswire (MIL-OSI)

Net Investment Income of $0.44 Per Share for Q4 2024;

Declared Quarterly Distribution of $0.41 Per Share;

Stable NAV/Strong Credit Quality

NEW YORK, Feb. 25, 2025 (GLOBE NEWSWIRE) — SLR Investment Corp. (NASDAQ: SLRC) (the “Company”, “SLRC”, “we”, “us”, or “our”) today reported net investment income (“NII”) of $23.8 million, or $0.44 per share, for the fourth quarter of 2024. On February 25, 2025, the Board declared a quarterly distribution of $0.41 per share payable on March 28, 2025, to holders of record as of March 14, 2025.

As of December 31, 2024, net asset value (“NAV”) was $18.20 per share, unchanged from the prior quarter ended September 30, 2024.

“This month, SLRC celebrated its 15^th anniversary since its initial public offering and more than 18 years of operating history as a private credit manager for SLR Capital Partners, our investment adviser,” said Michael Gross, Co-CEO of SLR Investment Corp. “Since inception in 2010, SLRC has made approximately $7.5 billion of investments including five platform specialty finance acquisitions and four related tuck-in acquisitions. Our asset mix across specialty and sponsor finance investment strategies and conservative underwriting approach has created a differentiated and attractive risk-adjusted return profile compared to sponsor finance only portfolios.”

“SLRC generated strong NII per share for both the fourth quarter and full year. In addition, NAV increased to $18.20 from $18.09 per share a year ago, reflecting solid credit performance from a diversified portfolio and disciplined underwriting in an environment of elevated rates and tighter cash flow coverage,” said Bruce Spohler, Co-CEO of SLR Investment Corp. “The ongoing retreat of regional banks from asset-based lending has resulted in a significant pipeline of specialty finance investment opportunities. Our flexibility to pivot to the most attractive investment strategies allows us to protect capital and perform across market cycles.”

FINANCIAL HIGHLIGHTS FOR THE QUARTER AND YEAR ENDED DECEMBER 31, 2024:

At December 31, 2024:

Investment portfolio fair value: $2.0 billion | Comprehensive Investment Portfolio fair value:⁽¹⁾ $3.1 billion
Net assets: $992.9 million or $18.20 per share
Leverage: 1.03x net debt-to-equity

Operating Results for the Quarter Ended December 31, 2024:

Net investment income: $23.8 million or $0.44 per share
Net realized and unrealized losses: $1.2 million or $0.02 per share
Net increase in net assets from operations: $22.6 million or $0.41 per share

Operating Results for the Year Ended December 31, 2024:

Net investment income: $96.3 million or $1.77 per share
Net realized and unrealized loss: $0.6 million or $0.01 per share
Net increase in net assets from operations: $95.8 million or $1.76 per share

Comprehensive Investment Portfolio Activity⁽²⁾ for the Quarter and Year Ended December 31, 2024:

Investments made during the quarter: $338.4 million
Investments prepaid and sold during the quarter: $442.7 million
Investments made during the year: $1,352.6 million
Investments prepaid and sold during the year: $1,377.8 million

_{⁽¹⁾ The Comprehensive Investment Portfolio for the quarter ended December 31, 2024 is comprised of SLRC’s investment portfolio and SLR Credit Solutions’ (“SLR-CS”) portfolio, SLR Equipment Finance’s (“SLR-EF”) portfolio, Kingsbridge Holdings, LLC’s (“KBH”) portfolio, SLR Business Credit’s (“SLR-BC”) portfolio, SLR Healthcare ABL’s (“SLR-HC ABL”) portfolio owned by the Company (collectively, the Company’s “Commercial Finance Portfolio Companies”), and the senior secured loans held by the SLR Senior Lending Program LLC (“SSLP”) attributable to the Company, and excludes the Company’s fair value of the equity interests in SSLP and the Commercial Finance Portfolio Companies and also excludes SLRC’s loans to KBH, SLR-EF, and SLR HC ABL.}
_{⁽²⁾ Comprehensive Investment Portfolio activity for the quarter ended December 31, 2024, includes investment activity of the Commercial Finance Portfolio Companies and SSLP attributable to the Company.}

Comprehensive Investment Portfolio

Portfolio Activity

During the three months ended December 31, 2024, SLRC had Comprehensive Investment Portfolio originations of $338.4 million and repayments of $442.7 million across the Company’s four investment strategies:

For the Quarter Ended December 31, 2024 ($mm)
Asset Class	Sponsor Finance⁽¹⁾	Asset-based Lending⁽²⁾	Equipment Finance⁽³⁾	Life Science Finance	Total Comprehensive Investment Portfolio Activity
Originations	$20.7	$128.6	$182.5	$6.6	$338.4
Repayments / Amortization	$102.3	$205.3	$101.7	$33.4	$442.7
Net Portfolio Activity	($81.6)	($76.7)	$80.8	($26.8)	($ 104.3)

During the year ended December 31, 2024, SLRC had Comprehensive Investment Portfolio originations of $1,352.6 million and repayments of $1,377.8 million across the Company’s four investment strategies:

For the Year Ended December 31, 2024 ($mm)
Asset Class	Sponsor Finance⁽¹⁾	Asset-based Lending⁽²⁾	Equipment Finance⁽³⁾	Life Science Finance	Total Comprehensive Investment Portfolio Activity
Originations	$113.0	$555.7	$649.4	$34.5	$1,352.6
Repayments / Amortization	$190.2	$515.8	$508.5	$163.3	$1,377.8
Net Portfolio Activity	($77.2)	$39.9	$140.9	($128.8)	($ 25.2)

_{⁽¹⁾ Sponsor Finance refers to cash flow loans to sponsor-owned companies including cash flow loans held in SSLP attributable to the Company.}
_{⁽²⁾ Includes SLR-CS, SLR-BC and SLR-HC ABL’s portfolios, as well as asset-based loans on the Company’s balance sheet.}
_{⁽³⁾ Includes SLR-EF’s portfolio and equipment financings on the Company’s balance sheet and Kingsbridge Holdings’ (KBH) portfolio.}

Comprehensive Investment Portfolio Composition

The Comprehensive Investment Portfolio is diversified across approximately 890 unique issuers, operating in over 110 industries, and resulting in an average exposure of $3.5 million or 0.1% per issuer. As of December 31, 2024, 98.2% of the Company’s Comprehensive Investment Portfolio was invested in senior secured loans of which 96.4% was held in first lien senior secured loans. Second lien ABL exposure was 1.5% and second lien cash flow exposure was 0.3% of the Comprehensive Investment Portfolio as of December 31, 2024.

SLRC’s Comprehensive Investment Portfolio composition by asset class as of December 31, 2024 was as follows:

Comprehensive Investment Portfolio Composition *(at fair value)*	Amount		Weighted Average
	($mm)	%	Asset Yield⁽⁵⁾
Senior Secured Investments
Cash Flow Loans (Sponsor Finance)⁽¹⁾	$633.8	20.6%	10.6%
Asset-Based Loans⁽²⁾	$1,037.3	33.6%	14.6%
Equipment Financings⁽³⁾	$1,147.9	37.2%	10.7%
Life Science Loans	$208.8	6.8%	12.1%
Total Senior Secured Investments	$3,027.8	98.2%	12.1%
Equity and Equity-like Securities	$54.8	1.8%
Total Comprehensive Investment Portfolio	$3,082.6	100.0%
Floating Rate Investments⁽⁴⁾	$1,866.7	61.0%
First Lien Senior Secured Loans	$2,972.1	96.4%
Second Lien Senior Secured Asset-Based Loans	$47.8	1.5%
Second Lien Senior Secured Cash Flow Loans	$7.8	0.3%

_{⁽¹⁾ Includes cash flow loans held in the SSLP attributable to the Company and excludes the Company’s equity investment in SSLP.}
_{⁽²⁾ Includes SLR-CS, SLR-BC, and SLR-HC ABL’s portfolios, as well as asset-based loans on the Company’s balance sheet, and excludes the Company’s equity investments in each of SLR-CS, SLR-BC, and SLR-HC ABL.}
_{⁽³⁾ Includes SLR-EF’s portfolio and equipment financings on the Company’s balance sheet and Kingsbridge Holdings’ (KBH) portfolio. Excludes the Company’s equity and debt investments in each of SLR-EF and KBH.}
_{⁽⁴⁾ Floating rate investments are calculated as a percent of the Company’s income-producing Comprehensive Investment Portfolio. The majority of fixed rate loans are associated with SLR-EF and leases held by KBH. Additionally, SLR-EF and KBH seek to match-fund their fixed rate assets with fixed rate liabilities.}
_{⁽⁵⁾ The weighted average asset yield for income producing cash flow, asset-based and life science loans on balance sheet is based on a yield to maturity calculation. The weighted average asset yield calculation for Life Science loans includes the amortization of expected exit/success fees. The weighted average yield for on-balance sheet equipment financings is calculated based on the expected average life of the investments. The weighted average asset yield for SLR-CS asset-based loans is an Internal Rate of Return (IRR) calculated using actual cash flows received and the expected terminal value. The weighted average asset yield for SLR-BC and SLR-HC ABL represents total interest and fee income for the three-month period ended on December 31, 2024 against the average portfolio over the same fiscal period, annualized. The weighted average asset yield for SLR-EF represents total interest and fee income for the three-month period ended on December 31, 2024 compared to the portfolio as of December 31, 2024, annualized. The weighted average yield for the KBH equipment leasing portfolio represents the blended yield from the company’s 1^st lien loan on par value and the annualized dividend yield on the cost basis of the company’s equity investment as of December 31, 2024.}

SLR Investment Corp. Portfolio

Asset Quality

As of December 31, 2024, 99.6% of SLRC’s portfolio was performing on a fair value basis and 99.4% on a cost basis, with only one investment on non-accrual.

The Company puts its largest emphasis on risk control and credit performance. On a quarterly basis, or more frequently if deemed necessary, the Company formally rates each portfolio investment on a scale of one to four, with one representing the least amount of risk.

As of December 31, 2024, the composition of our investment portfolio, on a risk ratings basis, was as follows:

Internal Investment Rating	Investments at Fair Value ($mm)	% of Total Portfolio
1	$701.0	34.9%
2	$1,286.9	64.2%
3	$9.9	0.5%
4	$7.8	0.4%

Investment Income Contribution by Asset Class

*Investment Income Contribution by Asset Class⁽¹⁾* *($mm)*
For the Quarter Ended:	Sponsor Finance	Asset-based Lending	Equipment Finance	Life Science Finance	Total
12/31/2024	$18.7	$18.1	$8.8	$10.0	$55.6
% Contribution	33.7%	32.5%	15.8%	18.0%	100.0%

*Investment Income Contribution by Asset Class⁽¹⁾* *($mm)*
For the Year Ended:	Sponsor Finance	Asset-based Lending	Equipment Finance	Life Science Finance	Total
12/31/2024	$82.6	$62.5	$36.6	$50.7	$232.4
% Contribution	35.5%	26.9%	15.8%	21.8%	100.0%

_{⁽¹⁾ Investment Income Contribution by Asset Class includes: interest income/fees from Sponsor Finance (cash flow) loans on balance sheet and distributions from SSLP; income/fees from asset-based loans on balance sheet and distributions from SLR-CS, SLR-BC, SLR-HC ABL; income/fees from equipment financings and distributions from SLR-EF and distributions from KBH; and income/fees from life science loans on balance sheet.}

SLR Senior Lending Program LLC (SSLP)

As of December 31, 2024, the Company and its 50% partner, Sunstone Senior Credit L.P., had contributed combined equity capital of $95.8 million of a total equity commitment for $100 million to the SSLP. At year end, SSLP had total commitments of $189.8 million at par and total funded portfolio investments of $178.7 million at fair value, consisting of floating rate senior secured loans to 32 different borrowers and an average investment of $5.6 million per borrower. This compares to funded portfolio investments of $204.1 million at fair value across 37 different borrowers at September 30, 2024. During the quarter ended December 31, 2024, SSLP invested $2.0 million in 4 portfolio companies and had $27.7 million of investments repaid.

In Q4 2024, the Company earned income of $1.9 million from its investment in the SSLP, representing an annualized yield of 15.6% on the cost basis of the Company’s investment, similar to Q3 2024.

SLR Investment Corp.’s Results of Operations Year Over Year

Investment Income

For the fiscal years ended December 31, 2024, and 2023, gross investment income totaled $232.4 million and $229.3 million, respectively. The increase in gross investment income for the year over year period was primarily due to an increase in dividend income from SSLP and our specialty finance company equity investments.

Expenses

SLRC’s net expenses totaled $136.1 million and $137.2 million, respectively, for the fiscal years ended December 31, 2024, and 2023. The decrease in expenses from 2024 to 2023 was primarily due to lower interest expense on a decrease in average borrowings as well as a reduction in general and administrative expenses, partially offset by higher fees stemming from higher net investment income.

SLRC’s investment adviser agreed to waive incentive fees resulting from income earned due to the accretion of the purchase price discount allocated to investments acquired in the Company’s merger with SLR Senior Investment Corp., which closed on April 1, 2022. For the fiscal years ended December 31, 2024 and 2023, $153 thousand and $500 thousand, respectively, of such performance-based incentive fees were waived.

Net Investment Income

SLRC’s net investment income totaled $96.3 million and $92.1 million, or $1.77 and $1.69, per average share, respectively, for the fiscal years ended December 31, 2024, and 2023.

Net Realized and Unrealized Loss

Net realized and unrealized loss for the fiscal years ended December 31, 2024 and 2023 totaled $0.6 million and $15.7 million, respectively.

Net Increase in Net Assets Resulting from Operations

For the fiscal years ended December 31, 2024, and 2023, the Company had a net increase in net assets resulting from operations of $95.8 million and $76.4 million, respectively. For the same periods, earnings per average share were $1.76 and $1.40, respectively.

Capital and Liquidity

Credit Facilities

As of December 31, 2024, the Company had $507 million drawn on $970 million of total commitments available on its revolving credit facilities and $140 million of term loans outstanding. In Q3 2024, the Company extended its SLRC revolver credit facility to a maturity of August 2029, increased the size, and lowered pricing. In Q4 2024, three new lenders were added to the SLRC revolving credit facility.

Unsecured Debt

On December 16, 2024, the Company closed a private offering of $49.0 million of the 2027 Series G Unsecured Notes with a fixed interest rate of 6.24% and a maturity date of December 16, 2027. As of December 31, 2024, the Company had $394 million of unsecured notes outstanding.

On February 18, 2025, the Company closed an additional private offering of $50.0 million of unsecured notes due 2028 with a fixed rate of interest of 6.14% and a maturity date of February 18, 2028.

Leverage

As of December 31, 2024, the Company’s net debt-to-equity ratio was 1.03x and compared to 1.19x as of December 31, 2023 and the Company’s target range of 0.9x to 1.25x.

Available Capital

As of December 31, 2024, including anticipated available borrowing capacity at the SSLP and our specialty finance portfolio companies, subject to borrowing base limits, SLRC, SSLP and our specialty finance portfolio companies had over $900 million of available capital in the aggregate.

Unfunded Commitments

As of December 31, 2024, excluding commitments to SLR-CS, SLR-BC, SLR-HC ABL, SLR Equipment Finance, and SSLP, over which the Company has discretion to fund, the Company had unfunded commitments of approximately $167.2 million.

Subsequent Events

On February 25, 2025, the Board declared a quarterly distribution of $0.41 per share payable on March 28, 2025, to holders of record as of March 14, 2025.

Conference Call and Webcast Information

The Company will host an earnings conference call and audio webcast at 10:00 a.m. (Eastern Time) on Wednesday, February 26, 2025. All interested parties may participate in the conference call by dialing (800) 579-2543 approximately 5-10 minutes prior to the call, international callers should dial (785) 424-1789. Participants should reference SLR Investment Corp. and Conference ID: SLRC4Q24. A telephone replay will be available until March 12, 2025 and can be accessed by dialing (800) 839-4568. International callers should dial (402) 220-2681.

This conference call will also be broadcast live over the Internet and can be accessed by all interested parties from the Event Calendar within the “Investors” tab of SLR Investment Corp.’s website, https://slrinvestmentcorp.com/Investors/Event-Calendar. Please register online prior to the start of the call. For those who are not able to listen to the broadcast live, a replay of the webcast will be available soon after the call.

Supplemental Information of SLR Investment Corp.’s Results of Operations Quarter Over Quarter

Operating results:	Quarter Ended December 31, 2024 (unaudited)		Quarter Ended September 30, 2024 (unaudited)
Interest income		$36,290		$45,373
Dividend income		16,502		12,578
Other income		2,791		1,820
Total investment income		55,583		59,771
Management fee		7,739		7,893
Net Performance-based Incentive fee		5,920		6,036
Interest and other credit facility expenses		16,184		18,913
Administrative services expense		1,376		1,392
Other general and administrative expenses		572		1,189
Net expenses		31,791		35,423
Net investment income		$23,792		$24,348
Net realized and unrealized gains (losses)		(1,183)		(2,299)
Net increase in net assets resulting from operations		22,609		22,049
Net investment income per common share		$0.44		$0.45
Net realized and unrealized gains (losses) per common share		($0.02)		($0.04)
Earnings per common share – basic and diluted		$0.41		$0.40

SLR INVESTMENT CORP. CONSOLIDATED STATEMENTS OF ASSETS AND LIABILITIES (in thousands, except share and per share amounts)

	December 31, 2024			December 31, 2023
Assets
Investments at fair value:
Companies less than 5% owned (cost: $1,019,357 and $1,260,205, respectively)	$	1,027,457		$	1,271,442
Companies 5% to 25% owned (cost: $103,655 and $60,064, respectively)		89,945			44,250
Companies more than 25% owned (cost: $916,554 and $870,128, respectively)		888,232			839,074
Cash		16,761			11,864
Cash equivalents (cost: $397,510 and $332,290, respectively)		397,510			332,290
Dividends receivable		15,375			11,768
Interest receivable		11,993			11,034
Receivable for investments sold		1,573			1,538
Prepaid expenses and other assets		571			608
Total assets	$	2,449,417		$	2,523,868
Liabilities
Debt ($1,041,093 and $1,183,250 face amounts, respectively, reported net of unamortized debt issuance costs of $9,399 and $5,473, respectively.)	$	1,031,694		$	1,177,777
Payable for investments and cash equivalents purchased		397,510			332,290
Management fee payable		7,739			8,027
Performance-based incentive fee payable		5,920			5,864
Interest payable		7,836			7,535
Administrative services payable		3,332			1,969
Other liabilities and accrued expenses		2,460			3,767
Total liabilities	$	1,456,491		$	1,537,229
Commitments and contingencies
Net Assets
Common stock, par value $0.01 per share, 200,000,000 and 200,000,000 common shares authorized, respectively, and 54,554,634 and 54,554,634 shares issued and outstanding, respectively	$	546		$	546
Paid-in capital in excess of par		1,117,606			1,117,930
Accumulated distributable net loss		(125,226	)		(131,837	)
Total net assets	$	992,926		$	986,639
Net Asset Value Per Share	$	18.20		$	18.09

SLR INVESTMENT CORP. CONSOLIDATED STATEMENTS OF OPERATIONS (in thousands, except per share amounts)

	2024			2023
INVESTMENT INCOME:
Interest:
Companies less than 5% owned	$	154,077		$	163,589
Companies 5% to 25% owned		3,881			2,058
Companies more than 25% owned		13,055			11,627
Dividends:
Companies 5% to less than 25% owned		845			—
Companies more than 25% owned		52,944			45,986
Other income:
Companies less than 5% owned		7,117			5,802
Companies 5% to 25% owned		—			26
Companies more than 25% owned		512			224
Total investment income		232,431			229,312
EXPENSES:
Management fees		31,389			31,661
Performance-based incentive fees		24,039			22,898
Interest and other credit facility expenses		71,464			72,507
Administrative services expense		5,520			5,899
Other general and administrative expenses		3,862			4,756
Total expenses		136,274			137,721
Performance-based incentive fees waived		(153	)		(500	)
Net expenses		136,121			137,221
Net investment income	$	96,310		$	92,091
REALIZED AND UNREALIZED GAIN (LOSS) ON INVESTMENTS AND CASH EQUIVALENTS:
Net realized loss on investments and cash equivalents:
Companies less than 5% owned	$	(2,252	)	$	(27,602	)
Companies more than 25% owned		—			(381	)
Net realized loss on investments and cash equivalents		(2,252	)		(27,983	)
Net change in unrealized gain (loss) on investments:
Companies less than 5% owned		(3,137	)		20,425
Companies 5% to 25% owned		2,105			(1,384	)
Companies more than 25% owned		2,731			(6,761	)
Net change in unrealized gain on investments		1,699			12,280
Net realized and unrealized loss on investments and cash equivalents		(553	)		(15,703	)
NET INCREASE IN NET ASSETS RESULTING FROM OPERATIONS	$	95,757		$	76,388
EARNINGS PER SHARE	$	1.76		$	1.40

About SLR Investment Corp.

SLR Investment Corp. is a closed-end investment company that has elected to be regulated as a business development company under the Investment Company Act of 1940. A specialty finance company with expertise in several niche markets, the Company primarily invests in leveraged, U.S. upper middle market companies in the form of cash flow, asset-based, and life sciences senior secured loans.

Forward-Looking Statements

Some of the statements in this press release constitute forward-looking statements because they relate to future events, future performance or financial condition. The forward-looking statements may include statements as to: the Company’s access to deal flow and attractive investment opportunities; the market environment and its impact on the business prospects of SLRC and the prospects of SLRC’s portfolio companies; prospects for additional portfolio growth of SLRC; and the quality of, and the impact on the performance of SLRC from the investments that SLRC has made and expects to make. In addition, words such as “anticipate,” “believe,” “expect,” “seek,” “plan,” “should,” “estimate,” “project” and “intend” indicate forward-looking statements, although not all forward-looking statements include these words. The forward-looking statements contained in this press release involve risks and uncertainties. Certain factors could cause actual results and conditions to differ materially from those projected, including the uncertainties associated with: (i) changes in the economy, financial markets and political environment, including the impacts of inflation and changing interest rates; (ii) risks associated with possible disruption in the operations of SLRC or the economy generally due to terrorism, war or other geopolitical conflicts, natural disasters, or pandemics; (iii) future changes in laws or regulations (including the interpretation of these laws and regulations by regulatory authorities); (iv) conditions in SLRC’s operating areas, particularly with respect to business development companies or regulated investment companies; and (v) other considerations that may be disclosed from time to time in SLRC’s publicly disseminated documents and filings. SLRC has based the forward-looking statements included in this press release on information available to it on the date of this press release, and SLRC assumes no obligation to update any such forward-looking statements. Although SLRC undertakes no obligation to revise or update any forward-looking statements, whether as a result of new information, future events or otherwise, you are advised to consult any additional disclosures that it may make directly to you or through reports that SLRC in the future may file with the Securities and Exchange Commission, including annual reports on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K.

Contact
SLR Investment Corp.
Investor Relations
slrinvestorrelations@slrcp.com | (646) 308-8770

The MIL Network –

February 26, 2025

MIL-OSI: Skyward Specialty Insurance Group Reports Fourth Quarter 2024 Results

Source: GlobeNewswire (MIL-OSI)

HOUSTON, Feb. 25, 2025 (GLOBE NEWSWIRE) — Skyward Specialty Insurance Group, Inc. (Nasdaq: SKWD) (“Skyward Specialty” or the “Company”) today reported fourth quarter 2024 net income of $14.4 million, or $0.35 per diluted share, compared to $29.3 million, or $0.74 per diluted share, for the same 2023 period. Net income for the year ended 2024 was $118.8 million, or $2.87 per diluted share, compared to $86.0 million, or $2.24 per diluted share, for the same 2023 period.

Adjusted operating income⁽¹⁾ for the fourth quarter of 2024 was $33.2 million, or $0.80 per diluted share, compared to $24.3 million, or $0.61 per diluted share, for the same 2023 period. Adjusted operating income⁽¹⁾ for the year ended 2024 was $126.7 million, or $3.06 per diluted share, compared to $80.8 million, or $2.11 per diluted share, for the same 2023 period.

Highlights for the fourth quarter included:

Gross written premiums of $388.4 million, an increase of $66.8 million, or 20.8%, when compared to 2023;
Adjusted combined ratio⁽¹⁾ of 91.6%, including catastrophe losses of 2.2 points;
Return on equity of 16.3% for the year ended 2024 compared to 15.9% for the same 2023 period;
Adjusted return on equity⁽¹⁾ of 17.4% for the year ended 2024 compared to 14.9% for the same 2023 period; and,
Book value per share of $19.79, an increase of 18% compared to December 31, 2023.

^{(1) See “Reconciliation of Non-GAAP Financial Measures”}

Skyward Specialty Chairman and CEO Andrew Robinson commented, “We wrapped up another remarkable year for Skyward Specialty, delivering both outstanding underwriting results while growing gross written premiums at over 20% for the quarter and 19% for the full year, with six out of eight divisions growing double-digits over the prior year. Our 16.3% return on equity for the year was again an excellent outcome. Throughout 2024 we continued to thoughtfully diversify our product portfolio, strategically launching new units including Media Liability, Life Sciences, Mortgage and Credit, and Renewable Energy. Our focus and disciplined execution of our “Rule Our Niche” strategy, and the extraordinary efforts of my 600 plus colleagues made 2024 another impressive year for our Company, and we are confident that we have built the foundation that will propel us in 2025 and beyond.”

Results of Operations

Underwriting Results

Premiums
($ in thousands)	Three months ended December 31,								Twelve months ended December 31,
unaudited	2024			2023			% Change		2024			2023			% Change
Gross written premiums	$	388,355		$	321,605		20.8	%	$	1,743,232		$	1,459,829		19.4	%
Ceded written premiums	$	(117,328	)	$	(107,488	)	9.2	%	$	(619,654	)	$	(549,138	)	12.8	%
Net retention		69.8	%		66.6	%	NM⁽¹⁾			64.5	%		62.4	%	NM⁽¹⁾
Net written premiums	$	271,027		$	214,117		26.6	%	$	1,123,578		$	910,691		23.4	%
Net earned premiums	$	293,240		$	224,932		30.4	%	$	1,056,722		$	829,143		27.4	%
⁽¹⁾Not meaningful

The increase in gross written premiums for the fourth quarter and year ended 2024, when compared to the same 2023 periods, was driven by double-digit premium growth primarily from our surety, programs, captives, global property & agriculture and transactional E&S underwriting divisions.

Combined Ratio	Three months ended December 31,				Twelve months ended December 31,
(unaudited)	2024		2023		2024		2023
Non-cat loss and LAE	60.5	%	60.9	%	60.6	%	60.9	%
Cat loss and LAE⁽¹⁾	2.2	%	0.4	%	1.7	%	1.4	%
Prior accident year development – LPT⁽²⁾	4.2	%	(0.2	)%	1.1	%	(0.2	)%
Loss Ratio	66.9	%	61.1	%	63.4	%	62.1	%
Net policy acquisition costs	15.3	%	13.4	%	14.2	%	13.0	%
Other operating and general expenses	13.9	%	16.3	%	15.3	%	16.3	%
Commission and fee income	(0.3	)%	(0.1	)%	(0.6	)%	(0.7	)%
Expense ratio	28.9	%	29.6	%	28.9	%	28.6	%
Combined ratio	95.8	%	90.7	%	92.3	%	90.7	%
Ex-Cat Combined Ratio⁽³⁾	93.6	%	90.3	%	90.6	%	89.3	%

Adjusted Underwriting Ratios
Adjusted loss ratio⁽²⁾	62.7	%	61.3	%	62.3	%	62.3	%
Expense ratio	28.9	%	29.6	%	28.9	%	28.6	%
Adjusted combined ratio⁽²⁾	91.6	%	90.9	%	91.2	%	90.9	%
⁽¹⁾Current accident year
⁽²⁾See “Reconciliation of Non-GAAP Financial Measures”
⁽³⁾Defined as the combined ratio excluding cat loss and LAE⁽¹⁾

The loss ratios for the fourth quarter and year ended 2024 increased 5.8 points and 1.3 points, respectively, when compared to the same 2023 periods, primarily due to the net impact of prior accident year development related to the LPT. The fourth quarter and year ended 2024 were also impacted by higher catastrophe losses, primarily from Hurricane Milton in the fourth quarter of 2024 and Hurricanes Helene and Beryl in the third quarter of 2024. The improvement in the non-cat loss and LAE ratios for the fourth quarter and year ended 2024, when compared to the same 2023 periods, was driven by the business mix shift.

The expense ratio for the fourth quarter improved when compared to the same 2023 period primarily due to earnings leverage partially offset by the business mix shift. The expense ratio for the year ended 2024 increased slightly when compared to the same 2023 period, driven by the business mix shift.

The expense ratios for all periods presented exclude the impact of IPO related stock compensation and secondary offering expenses, which are reported in other expenses in our condensed consolidated statements of operations and comprehensive income.

Investment Results

Net Investment Income
$ in thousands	Three months ended December 31,						Twelve months ended December 31,
(unaudited)	2024			2023			2024			2023
Short-term investments & cash and cash equivalents	$	3,998		$	3,670		$	17,643		$	11,677
Fixed income		15,909			11,680			57,631			36,547
Equities		771			880			2,745			2,212
Alternative & strategic investments		52			(2,226	)		2,667			(10,114	)
Net investment income	$	20,730		$	14,004		$	80,686		$	40,322
Net unrealized (losses) gains on securities still held	$	(7,688	)	$	8,736		$	7,921		$	11,130
Net realized losses		(2,721	)		(992	)		(1,665	)		(58	)
Net investment (losses) gains	$	(10,409	)	$	7,744		$	6,256		$	11,072

Beginning January 1, 2024 we simplified the investment portfolio classifications to align with our strategy and the underlying risk characteristics of the portfolio. The prior period has been reclassified to conform to the current period presentation.

Net investment income for the fourth quarter and year ended 2024 increased $6.7 million and $40.4 million, respectively when compared to the same 2023 periods, primarily driven by (i) increased income from our fixed income portfolio and short-term investments due to higher yields and larger asset bases, and (ii) income from alternative and strategic investments compared to losses for the same 2023 periods, which were impacted by the decline in the fair value of limited partnership investments.

Stockholders’ Equity

Stockholders’ equity was $794.0 million at December 31, 2024 which represented a decrease of 0.4% when compared to stockholders’ equity of $797.5 million at September 30, 2024. The decrease in stockholders’ equity was primarily due to a decline in the market value of our investment portfolio partially offset by net income.

Conference Call

At 9:30 a.m. eastern time tomorrow, February 26, 2025, Skyward Specialty management will hold a conference call to discuss quarterly results with insurance industry analysts. Interested parties may listen to the discussion at investors.skywardinsurance.com under Events & Presentations. Additionally, investors can access the earnings call via conference call by registering via the conference link. Users will receive dial-in information and a unique PIN to join the call upon registering.

Non-GAAP Financial Measures

This release contains certain financial measures and ratios that are not required by, or presented in accordance with, generally accepted accounting principles in the United States (“GAAP”). We refer to these measures as “non-GAAP financial measures.” We use these non-GAAP financial measures when planning, monitoring, and evaluating our performance.

We have chosen to exclude the net impact of the Loss Portfolio Transfer (“LPT”), all development on reserves fully or partially covered by the LPT and amortization of deferred gains associated with recoveries of prior LPT reserve strengthening in certain non-GAAP metrics, where noted, as the business subject to the LPT is not representative of our continuing business strategy. The business subject to the LPT is primarily related to policy years 2017 and prior, was generated and managed under prior leadership, and has either been exited or substantially repositioned during the reevaluation of our portfolio. The LPT was commuted effective January 31, 2025. We consider these non-GAAP financial measures to be useful metrics for our management and investors to facilitate operating performance comparisons from period to period. While we believe that these non-GAAP financial measures are useful in evaluating our business, this information should be considered supplemental in nature and is not meant to be a substitute for revenue or net income, in each case as recognized in accordance with GAAP. In addition, other companies, including companies in our industry, may calculate such measures differently, which reduces their usefulness as comparative measures. For more information regarding these non-GAAP financial measures and a reconciliation of such measures to comparable GAAP financial measures, see the section entitled “Reconciliation of Non-GAAP Financial Measures.”

About Skyward Specialty Insurance Group, Inc.

Skyward Specialty is a rapidly growing and innovative specialty insurance company, delivering commercial property and casualty products and solutions on a non-admitted and admitted basis. The Company operates through eight underwriting divisions – Accident & Health, Captives, Global Property & Agriculture, Industry Solutions, Professional Lines, Programs, Surety and Transactional E&S. SKWD stock is traded on the Nasdaq Global Select Market, which represents the top fourth of all Nasdaq listed companies.

Skyward Specialty’s subsidiary insurance companies consist of Houston Specialty Insurance Company, Imperium Insurance Company, Great Midwest Insurance Company, and Oklahoma Specialty Insurance Company. These insurance companies are rated A (Excellent) with stable outlook by A.M. Best Company. Additional information about Skyward Specialty can be found on our website at www.skywardinsurance.com.

Forward-Looking Statements

Except for historical information, all other information in this news release consists of forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. The forward-looking statements are typically, but not always, identified through use of the words “believe,” “expect,” “enable,” “may,” “will,” “could,” “intends,” “estimate,” “anticipate,” “plan,” “predict,” “probable,” “potential,” “possible,” “should,” “continue,” and other words of similar meaning. These forward-looking statements are subject to risks and uncertainties that could cause actual results to differ materially from those projected, anticipated or implied. The most significant of these uncertainties are described in Skyward Specialty’s Form 10-K, and include (but are not limited to) legislative changes at both the state and federal level, state and federal regulatory rule making promulgations and adjudications, class action litigation involving the insurance industry and judicial decisions affecting claims, policy coverages and the general costs of doing business, the potential loss of key members of our management team or key employees and our ability to attract and retain personnel, the impact of competition on products and pricing, inflation in the costs of the products and services insurance pays for, product development, geographic spread of risk, weather and weather-related events, other types of catastrophic events, our ability to obtain reinsurance coverage at prices and on terms that allow us to transfer risk and adequately protect our company against financial loss, and losses resulting from reinsurance counterparties failing to pay us on reinsurance claims. These forward-looking statements speak only as of the date of this release and the Company does not undertake any obligation to update or revise any forward-looking information to reflect changes in assumptions, the occurrence of unanticipated events, or otherwise.

Skyward Specialty Insurance Group, Inc.

Investor contact:
Natalie Schoolcraft,
nschoolcraft@skywardinsurance.com
614-494-4988

Media contact:
Haley Doughty
hdoughty@skywardinsurance.com
713-935-4944

Consolidated Balance Sheets
($ in thousands, except share and per share amounts)
(unaudited)	December 31, 2024			December 31, 2023
Assets
Investments:
Fixed maturity securities, available-for-sale, at fair value (amortized cost of $1,320,266 and $1,047,713, respectively)	$	1,292,218		$	1,017,651
Fixed maturity securities, held-to-maturity, at amortized cost (net of allowance for credit losses of $243 and $329, respectively)		39,153			42,986
Equity securities, at fair value		106,254			118,249
Mortgage loans, at fair value		26,490			50,070
Equity method investments		98,594			110,653
Other long-term investments		33,182			3,852
Short-term investments, at fair value		274,929			270,226
Total investments		1,870,820			1,613,687
Cash and cash equivalents		121,603			65,891
Restricted cash		35,922			34,445
Premiums receivable, net		321,641			179,235
Reinsurance recoverables, net		857,876			596,334
Ceded unearned premium		203,901			186,121
Deferred policy acquisition costs		113,183			91,955
Deferred income taxes		30,486			21,991
Goodwill and intangible assets, net		87,348			88,435
Other assets		86,698			75,341
Total assets	$	3,729,478		$	2,953,435
Liabilities and stockholders’ equity
Liabilities:
Reserves for losses and loss adjustment expenses	$	1,782,383		$	1,314,501
Unearned premiums		637,185			552,532
Deferred ceding commission		40,434			37,057
Reinsurance and premium payables		177,070			150,156
Funds held for others		102,665			58,588
Accounts payable and accrued liabilities		76,206			50,880
Notes payable		100,000			50,000
Subordinated debt, net of debt issuance costs		19,536			78,690
Total liabilities		2,935,479			2,292,404
Stockholders’ equity
Common stock, $0.01 par value, 500,000,000 shares authorized, 40,127,908 and 39,863,756 shares issued and outstanding, respectively		401			399
Additional paid-in capital		718,598			710,855
Stock notes receivable		—			(5,562	)
Accumulated other comprehensive loss		(22,120	)		(22,953	)
Retained earnings (accumulated deficit)		97,120			(21,708	)
Total stockholders’ equity		793,999			661,031
Total liabilities and stockholders’ equity	$	3,729,478		$	2,953,435

Condensed Consolidated Statements of Operations and Comprehensive Income
($ in thousands)	Three months ended December 31,						Twelve months ended December 31,
(unaudited)	2024			2023			2024			2023

Revenues:
Net earned premiums	$	293,240		$	224,932		$	1,056,722		$	829,143
Commission and fee income		806			247			6,703			6,064
Net investment income		20,730			14,004			80,686			40,322
Net investment (losses) gains		(10,409	)		7,744			6,256			11,072
Other income (loss)		35			(632	)		(167	)		(632	)
Total revenues		304,402			246,295			1,150,200			885,969
Expenses:
Losses and loss adjustment expenses		196,320			137,396			669,809			515,237
Underwriting, acquisition and insurance expenses		85,487			66,791			311,757			243,444
Interest expense		2,091			2,774			9,496			10,024
Amortization expense		908			462			2,007			1,798
Other expenses		1,042			1,303			4,392			5,364
Total expenses		285,848			208,726			997,461			775,867
Income before income taxes		18,554			37,569			152,739			110,102
Income tax expense		4,148			8,304			33,911			24,118
Net income		14,406			29,265			118,828			85,984
Net income attributable to participating securities		—			—			—			1,677
Net income attributable to common stockholders	$	14,406		$	29,265		$	118,828		$	84,307
Comprehensive income:
Net income	$	14,406		$	29,265		$	118,828		$	85,984
Other comprehensive income:
Unrealized gains and losses on investments:
Net change in unrealized (losses) gains on investments, net of tax		(14,735	)		30,825			9,792			25,516
Reclassification adjustment for losses on securities no longer held, net of tax		(5,682	)		(105	)		(8,959	)		(4,984	)
Total other comprehensive (loss) income		(20,417	)		30,720			833			20,532
Comprehensive (loss) income	$	(6,011	)	$	59,985		$	119,661		$	106,516

Share and Per Share Data
($ in thousands, except share and per share amounts)	Three months ended December 31,						Twelve months ended December 31,
(unaudited)	2024			2023			2024			2023

Weighted average basic shares		40,107,617			37,570,274			40,056,475			36,031,907
Weighted average diluted shares		41,622,397			39,582,352			41,377,460			38,317,534

Basic earnings per share	$	0.36		$	0.78		$	2.97		$	2.34
Diluted earnings per share	$	0.35		$	0.74		$	2.87		$	2.24
Basic adjusted operating earnings per share	$	0.83		$	0.65		$	3.16		$	2.20
Diluted adjusted operating earnings per share	$	0.80		$	0.61		$	3.06		$	2.11

Annualized ROE ⁽¹⁾		7.2	%		19.6	%		16.3	%		15.9	%
Annualized adjusted ROE ⁽²⁾		16.7	%		16.3	%		17.4	%		14.9	%
Annualized ROTE ⁽³⁾		8.1	%		23.0	%		18.6	%		19.0	%
Annualized adjusted ROTE ⁽⁴⁾		18.8	%		19.1	%		19.8	%		17.9	%

							December 31			December 31
							2024			2023

Shares outstanding								40,127,908			39,863,756
Fully diluted shares outstanding								42,059,182			41,771,854

Book value per share							$	19.79		$	16.72
Fully diluted book value per share							$	18.88		$	15.96
Fully diluted tangible book value per share							$	16.80		$	13.84

⁽¹⁾Annualized ROE is net income expressed on an annualized basis as a percentage of average beginning and ending stockholders’ equity during the period
⁽²⁾Annualized adjusted ROE is adjusted operating income expressed on an annualized basis as a percentage of average beginning and ending stockholders’ equity during the period
⁽³⁾Annualized ROTE is net income expressed on an annualized basis as a percentage of average beginning and ending tangible stockholders’ equity during the period
⁽⁴⁾Annualized adjusted ROTE is adjusted operating income expressed on an annualized basis as a percentage of average beginning and ending tangible stockholders’ equity during the period

Adjusted operating income – We define adjusted operating income as net income excluding the impact of certain items that may not be indicative of underlying business trends, operating results, or future outlook, net of tax impact. We use adjusted operating income as an internal performance measure in the management of our operations because we believe it gives our management and other users of our financial information useful insight into our results of operations and our underlying business performance. Adjusted operating income should not be viewed as a substitute for net income calculated in accordance with GAAP, and other companies may define adjusted operating income differently.

($ in thousands)	Three months ended December 31,												Twelve months ended December 31,
(unaudited)	2024						2023						2024						2023
	Pre-tax			After-tax			Pre-tax			After-tax			Pre-tax			After-tax			Pre-tax			After-tax
Income as reported	$	18,554		$	14,406		$	37,569		$	29,265		$	152,739		$	118,828		$	110,102		$	85,984
Less (add):
Net investment (losses) gains		(10,409	)		(8,223	)		7,744			6,118			6,256			4,942			11,072			8,747
Net impact of loss portfolio transfer		(12,398	)		(9,794	)		457			361			(11,598	)		(9,162	)		1,427			1,127
Other loss		35			28			(632	)		(499	)		(167	)		(132	)		(632	)		(499	)
Other expenses		(1,042	)		(823	)		(1,303	)		(1,029	)		(4,392	)		(3,470	)		(5,364	)		(4,238	)
Adjusted operating income	$	42,368		$	33,218		$	31,303		$	24,314		$	162,640		$	126,650		$	103,599		$	80,847

Underwriting income – We define underwriting income as net income before income taxes excluding net investment income, net realized and unrealized gains and losses on investments, impairment charges, interest expense, amortization expense and other income and expenses. Underwriting income represents the pre-tax profitability of our underwriting operations and allows us to evaluate our underwriting performance without regard to investment income. We use this metric as we believe it gives our management and other users of our financial information useful insight into our underlying business performance. Underwriting income should not be viewed as a substitute for pre-tax income calculated in accordance with GAAP, and other companies may define underwriting income differently.

($ in thousands)	Three months ended December 31,						Twelve months ended December 31,
(unaudited)	2024			2023			2024			2023
Income before income taxes	$	18,554		$	37,569		$	152,739		$	110,102
Add:
Interest expense		2,091			2,774			9,496			10,024
Amortization expense		908			462			2,007			1,798
Other expenses		1,042			1,303			4,392			5,364
Less (add):
Net investment income		20,730			14,004			80,686			40,322
Net investment (losses) gains		(10,409	)		7,744			6,256			11,072
Other income (loss)		35			(632	)		(167	)		(632	)
Underwriting income	$	12,239		$	20,992		$	81,859		$	76,526

Adjusted Loss Ratio / Adjusted Combined Ratio – We define adjusted loss ratio and adjusted combined ratio as the corresponding ratio (calculated in accordance with GAAP), excluding losses and LAE related to the LPT and all development on reserves fully or partially covered by the LPT and amortization of deferred gains associated with recoveries of prior LPT reserve strengthening. We use these adjusted ratios as internal performance measures in the management of our operations because we believe they give our management and other users of our financial information useful insight into our results of operations and our underlying business performance. Our adjusted loss ratio and adjusted combined ratio should not be viewed as substitutes for our loss ratio and combined ratio, respectively.

($ in thousands)	Three months ended December 31,						Twelve months ended December 31,
(unaudited)	2024			2023			2024			2023
Net earned premiums	$	293,240		$	224,932		$	1,056,722		$	829,143

Losses and LAE		196,320			137,396			669,809			515,237
Less: Pre-tax net impact of LPT		12,398			(457	)		11,598			(1,427	)
Adjusted losses and LAE	$	183,922		$	137,853		$	658,211		$	516,664

Loss ratio		66.9	%		61.1	%		63.4	%		62.1	%
Less: net impact of LPT		4.2	%		(0.2	)%		1.1	%		(0.2	)%
Adjusted loss ratio		62.7	%		61.3	%		62.3	%		62.3	%

Combined ratio		95.8	%		90.7	%		92.3	%		90.7	%
Less: net impact of LPT		4.2	%		(0.2	)%		1.1	%		(0.2	)%
Adjusted combined ratio		91.6	%		90.9	%		91.2	%		90.9	%

Tangible Stockholders’ Equity – We define tangible stockholders’ equity as stockholders’ equity less goodwill and intangible assets. Our definition of tangible stockholders’ equity may not be comparable to that of other companies and should not be viewed as a substitute for stockholders’ equity calculated in accordance with GAAP. We use tangible stockholders’ equity internally to evaluate the strength of our balance sheet and to compare returns relative to this measure.

($ in thousands)	December 31,
(unaudited)	2024		2023
Stockholders’ equity	$	793,999	$	661,031
Less: Goodwill and intangible assets		87,348		88,435
Tangible stockholders’ equity	$	706,651	$	572,596

	Three months ended December 31,						Twelve months ended December 31,
($ in thousands)	2024		2023		% Change		2024		2023		% Change
Industry Solutions		80,738		78,796	2.5	%		317,198		305,476	3.8	%
Global Property & Agriculture	$	31,681	$	25,996	21.9	%	$	311,402	$	273,191	14.0	%
Captives		57,765		40,375	43.1	%		241,902		167,624	44.3	%
Programs		52,151		35,694	46.1	%		218,407		178,726	22.2	%
Accident & Health		44,594		38,882	14.7	%		173,073		151,701	14.1	%
Transactional E&S		36,262		31,560	14.9	%		169,053		122,508	38.0	%
Professional Lines		39,130		40,145	(2.5	)%		159,785		154,565	3.4	%
Surety		46,034		30,157	52.6	%		152,429		106,056	43.7	%
Total gross written premiums⁽¹⁾	$	388,355	$	321,605	20.8	%	$	1,743,249	$	1,459,847	19.4	%
⁽¹⁾Excludes exited business

The MIL Network –

February 26, 2025

MIL-OSI: Flywire Acquires Sertifi to Accelerate Travel Business and Expand Offering to Support Over 20,000 Hotel Locations Globally
Source: GlobeNewswire (MIL-OSI)

Acquisition expands Flywire’s travel footprint into new subsegments of travel & hospitality, including large-scale branded hotels, luxury hotels, and boutique accommodations

Sertifi augments Flywire’s travel payments technology with dedicated hotel software integrations into large, global Property Management Systems and Events & Catering systems to automate critical hospitality workflow processes

Flywire gains the opportunity to accelerate the monetization of several billion dollars of payments volume that Sertifi’s platform has enabled annually

BOSTON, Feb. 25, 2025 (GLOBE NEWSWIRE) — Today, Flywire Corporation (Flywire) (Nasdaq: FLYW) a global payments enablement and software company, announced that it has acquired Sertifi, a vertical software and payments platform digitizing hospitality-specific workflows and associated payments. The acquisition is expected to build on Flywire’s existing Travel payments business by adding a new product category that has scaled adoption among some of the world’s largest hotel brands. Sertifi’s hospitality-specific integrations give Flywire immediate access to new subsegments of the global travel industry and they are expected to create additional value for Flywire’s extensive client roster. Sertifi has a successful track record of digitizing hotels’ workflows around events and group booking sales, and a solution that Flywire is expected to scale internationally by leveraging the strength of Flywire’s global go-to-market and partnership expertise around the world. Flywire acquired Sertifi for $330 million funded by a combination of cash and debt.

Sertifi provides a SaaS platform for the hotel and hospitality industry that empowers both global brands – like Marriott, Hilton, and Hyatt – as well as luxury independent hotels – like the Sage Hospitality Group and the Corinthia Hotel, London – to efficiently and securely sign contracts, exchange payment details in an industry-compliant way, and complete payments with their customers. Sertifi does this through deep integrations with leading Catering and Property Management Systems such as Amadeus’s Delphi, Salesforce, Oracle’s OPERA Cloud and OPERA 5, and Infor. Sertifi brings nearly two decades of experience in the hospitality and travel space and a diverse client base that spans 20,000 unique hospitality locations, and was recently named the “Best Payments Processing Software” in the 2025 HotelTechAwards for the second year in a row.

“The acquisition of Sertifi represents an exciting next phase of growth for our Travel vertical, where our deep industry expertise and global footprint continue to be key differentiators,” said Mike Massaro, CEO of Flywire. “By expanding into a large new subsegment of the hospitality industry with strong ecosystem alignment, and gaining a software solution in the early stages of its payments monetization journey, we are unlocking new growth and innovation opportunities for Flywire.”

Sertifi has executed on a unique opportunity in hotel workflows to put itself at the nexus of these powerful trends and capitalize on the secular growth in event bookings. The company’s solution simplifies and streamlines events contracting, group bookings, and their associated payments, empowering hotel sales staff to sell faster and deliver a better level of service to their consumers. Sertifi’s deep integrations into the hotel Property Management Systems place it in a unique position to act simultaneously as a revenue-maximizing tool and partner for further innovation to hotel operators everywhere. Flywire’s Travel leadership has developed leading direct distribution capabilities that could accelerate adoption of the Sertifi solution by hotels internationally.

Historically growing in double digits, Sertifi is expected to grow faster than Flywire’s company average, similar to its existing, fast-growing travel business. Flywire expects Sertifi to add approximately $35-40M of revenue with gross margins similar to those of Flywire in FY 2025. On the bottom line, Flywire expects Sertifi to have positive Adjusted EBITDA, however the anticipated margin percentage will be lower than Flywire’s overall Adjusted EBITDA margin, especially as Flywire expects to invest to grow the combined business for the future. More details will be shared on the upcoming earnings call scheduled for February 25th 2025.

Resources
- To learn more about Sertifi and to get a demo, please visit here.
- To learn more about Flywire’s solutions for the global Travel industry, please visit here.
About Flywire

Flywire is a global payments enablement and software company. We combine our proprietary global payments network, next-gen payments platform and vertical-specific software to deliver the most important and complex payments for our clients and their customers.

Flywire leverages its vertical-specific software and payments technology to deeply embed within the existing A/R workflows for its clients across the education, healthcare and travel vertical markets, as well as in key B2B industries. Flywire also integrates with leading ERP systems, such as NetSuite, so organizations can optimize the payment experience for their customers while eliminating operational challenges.

Flywire supports approximately 4,500 clients with diverse payment methods in more than 140 currencies across more than 240 countries and territories around the world. The company is headquartered in Boston, MA, USA with global offices. For more information, visit www.flywire.com. Follow Flywire on X , LinkedIn and Facebook.

Safe Harbor Statement

This release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, including, but not limited to, statements regarding Flywire’s expectations regarding the expected benefits and synergies of the acquisition of Sertifi, the benefits of Sertifi’s platform, financial results and margins, Flywire’s business strategy and plans, market size, growth and trends. Flywire intends such forward-looking statements to be covered by the safe harbor provisions for forward-looking statements contained in Section 21E of the Securities Exchange Act of 1934 and the Private Securities Litigation Reform Act of 1995. In some cases, you can identify forward-looking statements by terms such as, but not limited to, “believe,” “may,” “will,” “potentially,” “estimate,” “continue,” “anticipate,” “intend,” “could,” “would,” “project,” “target,” “plan,” “expect,” or the negative of these terms, and similar expressions intended to identify forward-looking statements. Such forward-looking statements are based upon current expectations that involve risks, changes in circumstances, assumptions, and uncertainties. Important factors that could cause actual results to differ materially from those reflected in Flywire’s forward-looking statements include, among others, the factors that are described in the “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” sections of Flywire’s Annual Report on Form 10-K for the year ended December 31, 2023, and Quarterly Report on Form 10-Q for the quarter ended March 31, 2024, which are on file with the Securities and Exchange Commission (SEC) and available on the SEC’s website at https://www.sec.gov/. Additional factors may be described in those sections of Flywire’s Annual Report on Form 10-K for the year ended December 31, 2024, expected to be filed with the SEC in the first quarter of 2025. The information in this release is provided only as of the date of this release, and Flywire undertakes no obligation to update any forward-looking statements contained in this release on account of new information, future events, or otherwise, except as required by law.

Contacts

Media Contact:

Sarah King
media@flywire.com

Investor Relations Contact:

Masha Kahn
IR@flywire.com

The MIL Network –
February 26, 2025
MIL-OSI: Definitive Healthcare to Present at the Raymond James 2025 Institutional Investors Conference

Source: GlobeNewswire (MIL-OSI)

FRAMINGHAM, Mass., Feb. 25, 2025 (GLOBE NEWSWIRE) — Definitive Healthcare Corp. (“Definitive Healthcare”) (Nasdaq: DH), an industry leader in healthcare commercial intelligence, today announced that its Chief Executive Officer, Kevin Coop, and its Chief Financial Officer, Rick Booth, will present at the Raymond James 2025 Institutional Investors Conference.

The Definitive Healthcare presentation is scheduled for Tuesday, March 4, 2025, at 3:25 p.m. Eastern Time. A live webcast of the presentation will be available on the Events page of the Definitive Healthcare investor relations website at https://ir.definitivehc.com/. A replay of the webcast will also be available for a limited time.

About Definitive Healthcare
At Definitive Healthcare, our mission is to transform data, analytics, and expertise into healthcare commercial intelligence. We help clients uncover the right markets, opportunities, and people, so they can shape tomorrow’s healthcare industry. Our SaaS products and solutions create new paths to commercial success in the healthcare market, so companies can identify where to go next. Learn more at definitivehc.com.

Investor Contact:
Brian Denyeau
ICR for Definitive Healthcare
brian.denyeau@icrinc.com
646-277-1251

Media Contact:
Bethany Swackhamer
bswackhamer@definitivehc.com

The MIL Network –

February 26, 2025
MIL-OSI USA: Tillis, Kelly Introduce Bipartisan Legislation to Increase Access to Plasma-Based Medicines

US Senate News:

Source: United States Senator for North Carolina Thom Tillis

WASHINGTON, D.C. – Today, Senators Thom Tillis (R-NC) and Mark Kelly (D-AZ) introduced the bipartisan Preserving Life-saving Access to Specialty Medicines in America (PLASMA) Act, legislation to ensure individuals with rare diseases and immunodeficiencies have access to necessary plasma-based medicines.

“It is critical patients with rare diseases and immunodeficiencies have uninterrupted access to the life-saving plasma-based medicines they need,” said Senator Tillis. “This commonsense legislation increases access to these innovative medications and ensures they remain affordable for the thousands of Americas who rely on them.”

“Patients with rare diseases and immune disorders rely on plasma-based medicines to stay healthy, but right now, too many are facing rising costs and supply challenges,” said Senator Kelly. “By protecting access to these lifesaving medicines, we’re making sure patients can get the treatments they need affordably and without disruption.”

“The Alpha-1 Foundation is proud to endorse The PLASMA Act in support of patients with rare diseases, like Alpha-1 antitrypsin deficiency and immunodeficiencies to have access to necessary plasma-based medicines,” said Scott Santarella, President & CEO, Alpha-1 Foundation. “It is vital for our community to have continued access to this life-saving plasma therapy that they receive on a weekly basis.”

Representative Richard Hudson (R-NC) introduced companion legislation in the House of Representatives.

“All Americans impacted by rare diseases deserve to have innovative, high-quality health care,” said Representative Hudson. “My legislation will increase access to plasma medicines for our nation’s most vulnerable patients and help save lives.”

Background:

North Carolina is home to one of the world’s largest plasma production facilities and more than 30 plasma donor centers across the state, which provide life-saving measures for thousands of Americans.

The PLASMA Act would include plasma-derived medicines in a phase-in process for the Part D redesign the Inflation Reduction Act already has in place for other drugs Congress recognized as unique. Beginning in 2031, manufacturers would pay the full rebate amount following annual rebate increases, protecting vulnerable beneficiaries’ supply of plasma-derived medicines and avoiding skyrocketing costs for patients.

In the United States, over 125,000 patients living with rare and life-threatening diseases rely on sustained access to plasma derived medicinal products to treat their lifelong health conditions. These rare and chronic diseases include Primary Immunodeficiencies, Chronic Inflammatory Demyelinating Polyneuropathy, and Alpha-1 Antitrypsin Deficiency; for most patients there are no effective, alternative therapies available.

The PLASMA Act is endorsed by top national and international health organizations, including the Immune Deficiency Foundation, Plasma Protein Therapeutics Association, Alpha-1 Foundation, and GBS | CIDP Foundation International.

Full text of the legislation is available HERE.

MIL OSI USA News –

February 26, 2025
MIL-OSI United Nations: World News in Brief: Conflict in DR Congo, Europe’s ‘cradle to cane’ crisis, millions may go hungry in Chad

Source: United Nations MIL OSI b

25 February 2025 Peace and Security

Ongoing fighting in the eastern Democratic Republic of the Congo (DRC) between Rwanda-backed M23 rebels and Congolese troops has claimed more lives and forced even more families from their homes.

In an alert on Tuesday, UN aid coordinators OCHA said that six humanitarian workers have been killed since January – the latest victim was shot during clashes last week near a hospital in Masisi Territory about 80 kilometres west of Goma, in North Kivu.

The same clashes reportedly killed three other civilians and injured a child, according to OCHA, which said that more than 100,000 people have been forced to flee their homes due to further clashes last week in Lubero Territory, 250 kilometers north of Goma.

Rape and other violations reported

Because of the insecurity several local health facilities have had to suspend activities. Humanitarian partners on the ground also report that there have been widespread human rights violations amid the fighting, including rape, OCHA said.

Meanwhile, local officials in South Kivu report schools are gradually re-opening in Kalehe Territory, located some 65 kilometres north of the provincial capital Bukavu.

Unexploded ordnance remains a problem in many areas affected by recent fighting, including two schools in the city of Minova, north of Bukavu, according to humanitarian partners.

The head of UN Peacekeeping Operations expressed concern over the humanitarian crisis and loss of life in the DRC during a press conference in South Sudan’s capital, Juba, on Monday.

Jean-Pierre Lacroix stressed that there is no military solution to the crisis and reiterated that while “it’s encouraging to see progress and involvement from stakeholders…the priority is a cessation of hostilities, implementation of decisions from the Luanda Process, and ensuring humanitarian access.”

He added that the UN Mission faces limitations in M23-controlled areas but continues to protect civilians and reduce violence in other areas, safeguarding hundreds of thousands of civilians daily.

Europe faces a ‘cradle to cane’ health crisis, warns WHO

And in a medical update on Tuesday, UN health agency WHO warned that countries across Europe and Central Asia have a major problem with “stagnating” healthcare systems.

According to the World Health Organization (WHO), almost 76,000 children in the region die before their fifth birthday every year.

In addition, non-communicable diseases claim the lives one in six people before they’re 70.

Wide regional variations

WHO’s latest European Health Report showed that under-five mortality ranged from 1.5 to 40.4 deaths per 1,000 live births across 53 countries in the region.

The top causes of death include pre-term birth complications, birth asphyxia and congenital heart anomalies.

Despite much progress in tackling non-communicable diseases across Europe and Central Asia, conditions such as heart and lung disease, stroke and diabetes remain by far the biggest killers.

At least 10 countries have achieved a 25 per cent reduction in premature mortality from these four non-communicable diseases.

Nonetheless, one in six people still die before they reach their 70th birthday from cardiovascular disease, cancer, diabetes or chronic respiratory disease, WHO said.

Chad: Nearly four million could go hungry during lean season

Humanitarians in Chad are warning about the impact of the forthcoming lean season on food security, amid already dire conditions, UN Spokesperson Stéphane Dujarric said on Tuesday.

A regional assessment found that some 2.4 million people are not getting enough to eat, which is expected to rise to 3.7 million people, or 20 per cent of the population, during the lean season from June to August.

More than two million children under the age of five are malnourished, including more than half a million who are suffering from severe acute malnutrition who are at risk of dying in the coming months without the appropriate treatment.

Additionally, nearly 300,000 pregnant and breast-feeding women are suffering from acute malnutrition.

Multiple shocks

Mr. Dujarric told journalists in New York that “this crisis is due to shocks, including natural catastrophes such as floods, which have destroyed croplands, in addition to the increasing price of basic commodities.”

Humanitarians warn that unless significant funding is received before the end of March, there will be no time to prevent a full-scale food security and nutrition crisis.

They are appealing for $1.45 billion to support operations in Chad this year but have so far received under $60 million, roughly four per cent.

MIL OSI United Nations News –

February 26, 2025
MIL-OSI Canada: Delivering care close to home in La Crete
Alberta’s government is committed to ensuring all Albertans have access to high-quality care when and where they need it, including in remote Alberta communities. The new La Crete Maternity and Community Health Centre will provide enhanced access to maternal health and advanced ambulatory care, underscoring the Alberta government’s dedication to meeting the health care needs of communities across the province.

“Every Albertan deserves high-quality health care close to home. This expanded access will ensure Albertans living in La Crete and the surrounding areas will receive timely, exceptional care when they need it most.”

Adriana LaGrange, Minister of Health

Alberta’s government first announced the project in 2021, with planning for the new facility beginning at that time and the design phase being completed in early February of this year. The construction phase of the project will see Alberta’s government invest $80 million over the next three years as part of a total investment of about $86 million for the project.

Designed to meet local needs, the facility will include a birthing centre, midwifery program, advanced ambulatory care and a two-vehicle ambulance bay to improve emergency services. These new services will offer Albertans in the northern community and its surrounding areas more timely and accessible care by improving maternal health, emergency response and overall health care options in the area.

“With shovels going in the ground, northern Albertans in La Crete are looking forward to having their very own maternity and community health centre. I am pleased that we are now entering the construction phase for this new facility within the community, keeping Peace Country a beautiful place to raise a family.”

Dan Williams, MLA for Peace River

In addition to the existing public health services, residents will have access to expanded services including pre- and post-natal care on site. This health facility, expected to open in 2027, is the result of a close collaboration with the La Crete community to address its unique health care needs. It will be operated by Covenant Health. As Alberta’s government continues to refocus the health care system, working closely with local leadership will ensure these services are aligned with community priorities.

“This much-needed facility will make a real difference for families in the community, providing essential care closer to home. Its opening can’t come soon enough.”

John Knelsen, reeve, Mackenzie County

The centre will also include a laboratory for timely blood testing and storage, as well as diagnostic imaging services, including ultrasound. Dedicated space will also be available for counselling and psychiatrist referrals to support individuals, families and groups.

“This is an exciting milestone for the community of La Crete, surrounding areas and Covenant Health. Guided by our values of compassion, respect and stewardship, we look forward to welcoming and integrating our new employees while providing seamless, high-quality health care for the community.”

Patrick Dumelie, CEO, Covenant Health

Alberta’s government will continue investing in future projects that provide Albertans in rural and remote communities with access to high-quality care, both now and in the future.

Quick facts
- The new facility will provide integrated health services for about 9,200 people living in La Crete and the surrounding areas.
- Covenant Health will assume operations of the existing health facility and continuing care centre by fall 2025.
  - Plans for Covenant Health to operate the new health facility were announced in April 2022.
  - To foster transparency and dialogue, Covenant Health and Alberta Health Services hosted a town hall for affected staff and La Crete community members on Jan. 30, 2025.
Related information
- Covenant Health
Related news
- Covenant Health to operate new La Crete health centre (April 3, 2022)
- New maternity, community health centre for La Crete (Aug. 11, 2021)
MIL OSI Canada News –
February 26, 2025
MIL-Evening Report: England subsidises drugs like Ozempic for weight loss. Could Australia follow?
Source: The Conversation (Au and NZ) – By Jonathan Karnon, Professor of Health Economics, Flinders University

Nomad_Soul/Shutterstock

People with a high body weight living in England can now access subsidised weight-loss drugs to treat their obesity. This includes Wegovy (the weight-loss dose of Ozempic, or semaglutide) and Mounjaro (one of the brand names for tirzepatide).

These drugs, known as GLP-1 agonists, can improve the health of people who are overweight or obese and are unable to lose weight and keep it off using other approaches.

In Australia, the government subsidises the cost of semaglutide (Ozempic) for people with diabetes.

But it is yet to subsidise semaglutide (Wegovy) on the Pharmaceutical Benefits Scheme (PBS) for weight loss.

This is despite Australia’s regulator approving GLP-1 agonists for people with obesity, and for overweight people with at least one weight-related condition.

This leaves Australians who use Wegovy for weight loss paying around A$450–500 out of pocket per month.

But could Australia follow the England’s lead and list drugs such as Wegovy or Mounjaro on the PBS for weight loss? Doing so could bring the price down to $31.60 ($7.70 concession).

Australia has already knocked back Wegovy for subsidies

The Pharmaceutical Benefits Advisory Committee (PBAC) reviews the submissions pharmaceutical companies make for their drug therapies to be subsidised through the PBS.

For every such recommendation, PBAC publishes a public document that summarises the evidence and the reasons for recommending that the drug should be added to the PBS – or not.

In November 2023, PBAC reviewed Novo Nordisk’s submission. It proposed including semaglutide on the PBS for adults with an initial BMI of 40 or above and a diagnosis of at least two weight-related conditions. At least one of these related conditions needed to be obstructive sleep apnoea, osteoarthritis of the knee, or pre-diabetes.

Sleep apnoea was one of the weight-related conditions in the original application.
JPC-PROD/Shutterstock

However, PBAC concluded semaglutide should not be subsidised through the PBS because it didn’t consider the drug cost-effective at the price proposed.

PBAC referred to evidence on the long-term benefits from weight loss for people at increased risk of developing heart disease, diabetes or having a stroke. However, it didn’t factor these effects into its calculations when estimating the cost-effectiveness of semaglutide.

The committee suggested a future submission could focus on patients with either pre-existing cardiovascular (heart) disease, type 2 diabetes, or at least two markers of “high cardiometabolic risk”. This could include hypertension (high blood pressure), high cholesterol, chronic kidney disease, fatty liver disease or pre-diabetes.

What did England decide?

The National Institute for Health and Care Excellence (NICE) has a similar role to the PBAC, informing decisions to subsidise medicines in England.

As a result of NICE’s recommendation, semaglutide is subsidised in England for adults with at least one weight-related condition and BMI of 30 or above. Patients must be treated by a specialist weight-management service and prescriptions are for a maximum of two years.

More recently, NICE approved another GLP-1 agonist, tirzepatide, for adults with at least one weight-related condition and a BMI of 35 or above.

This approval didn’t restrict prescriptions to those treated in a specialist weight-management service. However, only 220,000 of the 3.4 million who meet the eligibility criteria will receive tirzepatide in the next three years. It is not clear how the 220,000 patients will be selected.

The limits on tirzepatide will reduce the impact of GLP-1 agonists on the health budget. It is also intended to inform the broader roll-out to all eligible patients.

For both semaglutide and tirzepatide, NICE noted that clinicians should consider stopping the treatment if the patient loses less than 5% of their body weight after six months of use.

Australians who use Wegovy for weight loss or heart disease pay A$450–$500 out of pocket per month.
antoniodiazShutterstock

Why did they reach such different decisions?

NICE assessed the use of GLP-1 agonists for a broader population than PBAC: people with one weight-related condition and a BMI of 30 or above.

Another difference was that NICE’s cost-effectiveness analysis included estimates of the longer-term benefits of these drugs in reducing the risk of diabetes, cardiovascular (heart) disease, stroke, knee replacement and bariatric surgery.

The proposed prices of the GLP-1 agonists in England and Australia are not reported. We can only observe the estimated health benefits. These are represented as the additional number of “quality-adjusted life years” (QALYs) associated with using the drugs. One QALY is the equivalent of one additional year of life in best imaginable health.

Committees estimate the amount of additional health spending required to gain QALYs, to see if it’s worth the public investment. Looking at the committees’ estimates of weight-loss drugs (without a two-year maximum):
- NICE reported a gain of 0.7 QALYs per patient receiving semaglutide for a target population with a BMI of 30 or more
- PBAC reported a gain of 0.3 QALYs, but for a population with a BMI of 40 and above.
Part of the explanation for the difference in estimated QALY gains is that PBAC did not consider the reduced risk of future weight-related conditions, only the impact on existing conditions.

In contrast, NICE referred to substantial cost offsets due to reduced weight-related conditions, in particular because some patients would avoid developing diabetes.

England and Australia’s estimates of the benefits of Wegovy differed.
Matt Fowler KC/Shutterstock

Time to rethink PBAC’s focus?

Both NICE and PBAC are clearly concerned about the impact of GLP-1 agonists on the health budget.

PBAC is trying to restrict access to a limited pool of people at highest risk. It is also being more conservative than NICE in estimating the expected benefits of GLP-1 agonists. This would require manufacturers to reduce their price in order for PBAC to consider these drugs cost-effective.

Maybe this approach will work and the Australian government will pay less for these drugs the next time it considers publicly funding them.

However, GLP-1 agonists are not on the agenda for the forthcoming PBAC meetings, so there is no timeline for when GLP-1 agonists might be funded in Australia for weight loss.

Read more:
People on Ozempic may have fewer heart attacks, strokes and addictions – but more nausea, vomiting and stomach pain

Jonathan Karnon receives funding from the National Health and Medical Research Council and the Medical Research Future Fund.

– ref. England subsidises drugs like Ozempic for weight loss. Could Australia follow? – https://theconversation.com/england-subsidises-drugs-like-ozempic-for-weight-loss-could-australia-follow-245367
MIL OSI Analysis – EveningReport.nz –
February 26, 2025
MIL-OSI USA: Construction Starts on 433-Unit Affordable Housing Project

Source: US State of New York

Governor Kathy Hochul today announced the start of construction on 1760 Third Avenue in East Harlem, a 433-unit affordable and supportive housing project in East Harlem that is the first residential project to get underway using capital financing through her landmark $1 billion mental health initiative. Funded by New York State Homes and Community Renewal and New York City Department of Housing Preservation and Development with support from the Office of Mental Health and the Office of Temporary and Disability Assistance, the $264 million project will transform a vacant former CUNY dormitory into affordable apartments, including 261 units of supportive housing for individuals living with mental illness.

“By investing state resources into communities like Harlem, we can create the modern, affordable apartments that New Yorkers need,” Governor Hochul said. “This development on Third Avenue will bring new life to a vacant building by transforming it into affordable apartments that over 400 households will be able to enjoy for generations to come.”

Breaking Ground, the project developer, will transform the vacant structure at 1760 Third Avenue into a 433-unit mixed-use development for households earning up to 60 percent of the Area Median Income. The redeveloped property will include 261 units reserved for formerly homeless individuals living with serious mental illness, with services provided by Breaking Ground.

The project will include a subset of units for young adults aging out of foster care or who have experienced homelessness. Onsite support services will include case management, medical and mental health care, benefits and entitlement counseling, and connections to employment.

The renovations to the building will incorporate sustainability measures such as energy-efficient rooftop air conditioners and hydronic heating system pumps that use water—rather than air—to transfer heat. The building will also feature water-conserving plumbing, efficient lighting, vegetative roofs and ENERGY STAR ® refrigerators to support cleaner living.

The outdoor spaces along Third Avenue will also be transformed, creating new public-facing areas with landscaping, seating, and community-focused spaces. Constructed in 1974, the 1760 Third Avenue building originally housed a Florence Nightingale Nursing Center. The structure was later converted into a dormitory for the City University of New York’s Hunter College and Baruch College.

The project received $75 million from HCR’s Supportive Housing Opportunity Program and a $24.6 million first mortgage structured as a 501(c)3 bond from its Housing Finance Agency. In addition, the development was awarded $126 million from the New York City Department of Housing Preservation and Development’s Supportive Housing Loan Program.

In the past five years, HCR has financed nearly 6,600 affordable homes in Manhattan. 1760 Third Avenue continues this effort and complements Governor Hochul’s $25 billion five-year Housing Plan which is on track to create or preserve 100,000 affordable homes statewide.

The State Office of Mental Health provided $21 million through Governor Hochul’s landmark $1 billion mental health initiative, which included funding to establish 3,500 units of specialized housing. So far, the mental health initiative has established nearly 1,300 new units including supportive housing and apartment treatment units, with 2,150 capital housing units in the pipeline. OMH has conditionally awarded more than $831 million in capital for community residence single room occupancy, supportive single room occupancy, and transitional residential units.

The project also received $10 million through the New York State Office of Temporary and Disability Assistance’s Homeless Housing and Assistance Program and a $2 million discretionary capital grant from New York City Council Member Diana Ayala from Fiscal Year 2024. The New York City Acquisition Fund provided an acquisition loan originated by the Low-Income Investment Fund. Wells Fargo is providing the construction letter of credit.

New York State Homes and Community Renewal Commissioner RuthAnne Visnauskas said, “This $264 million development is a testament to the power of innovation in addressing New York’s housing crisis. By transforming this former college dorm into affordable and supportive homes, we can provide security, stability, and a way forward for more than 430 individuals, families, and young people in need. 1760 Third Avenue exemplifies the Governor’s commitment to creating housing opportunities that are accessible, sustainable, and supportive for all New Yorkers, particularly the most vulnerable members of our community. We thank our partners, including Breaking Ground, for their collaboration on this important project.”

New York State Office of Mental Health Commissioner Dr. Ann Sullivan said, “Supportive housing provides critical services that enable people living with mental illness to live and thrive in their communities. The project to redevelop 1760 Third Avenue will fill an important need in the East Harlem area and will provide much needed housing stability for individuals experiencing homelessness, including 261 units for those living with mental illness. This project demonstrates Governor Hochul’s continued commitment to increasing specialized housing for New Yorkers living with mental illness.”

New York State Office of Temporary and Disability Assistance Commissioner Barbara C. Guinn said, “We are grateful to Governor Hochul for making landmark investments to expand supportive housing across New York State, recognizing that stable housing is the foundation for stable health, a stable life, and strong communities. The 1760 Third Avenue project will provide residents who have experienced homelessness with safe, affordable, energy-efficient apartments they can call home and onsite access to support services that will help them thrive in their community. Thank you to all our project partners and special thanks to Breaking Ground for their longtime leadership in providing supportive and transitional housing.”

Assemblymember Edward Gibbs said, “Today, we celebrate a major milestone in our collective effort to address the affordable housing crisis and provide supportive services to those who need it most. The groundbreaking of 1760 3rd Avenue marks a significant step forward in our mission to create a more just and equitable society. As we continue to address the affordable housing crisis, projects like this remind us that together, we can create a more just and equitable society for all. I’m honored to play a part in supporting this project, and I look forward to seeing the positive impact it will have on our community.”

New York City Council Member Diana Ayala said, “We are excited to celebrate the start of construction at 1760 Third Avenue. Our office was pleased to have invested $2 million in capital discretionary funding in this project and we look forward to welcoming residents home once construction is complete. Thank you to all our partners.”

Breaking Ground President and CEO Brenda Rosen said, “Transforming underutilizing buildings like 1760 Third Avenue into much-needed affordable and supportive housing is an unparalleled opportunity – not only for the individuals who will soon call it home but also for the future of adaptive reuse development in our city. We are grateful that our public and private sector partners share our vision to create hundreds of safe, stable homes while preserving and revitalizing existing infrastructure. As we begin renovations, we mark an exciting milestone in our commitment to expanding services in Harlem and ensuring more New Yorkers have access to the housing and support they need.”

Low Income Investment Fund Director Northeast Region Molly Anderson said, “LIIF was honored to work with NYS Homes and Community Renewal, NYC Department of Housing Preservation and Development, and NYS Office of Temporary and Disability Assistance to secure a $29.5 million acquisition and predevelopment loan in partnership with the New York City Acquisition Fund. This collaboration made a complex transaction a reality – and solidifies our relationship with a mission-aligned recipient, Breaking Ground, as we continue to strengthen historically underserved New York City communities such as East Harlem.”

Wells Fargo Head of Public Affairs Jason Rosenberg said, “We thank Breaking Ground and the many community partners and neighbors who participated in bringing a long-term supportive and affordable housing option to East Harlem, strengthening the community and making lives better. We were pleased to provide Breaking Ground with $24.9 million in construction financing which will help enable them to transform the property into permanent housing, plus a $500,000 grant from the Wells Fargo Foundation to provide amenities that will help residents feel at home for decades to come.”

New York City Department of Housing Preservation and Development Commissioner Adolfo Carrion, Jr. said, “It is truly fitting to see this building continue its service to this community, first in public health, then as a home for CUNY students and now by providing hundreds of affordable supportive homes and deepening our city’s commitment to affordable housing in Harlem. This success story is another example of the effective collaboration of the City and State, across multiple agencies, to bring dynamic programming, advance green construction design, and inclusive housing solutions to create investments that tackle the drivers of our housing crisis. HPD is proud to be part of the team and excited for the individuals and families that will call this place home”

Governor Hochul’s Housing Agenda

Governor Hochul is committed to addressing New York’s housing crisis and making the State more affordable and more livable for all New Yorkers. As part of the FY25 Enacted Budget, the Governor secured a landmark agreement to increase New York’s housing supply through new tax incentives for Upstate communities, new incentives and relief from certain state-imposed restrictions to create more housing in New York City, a $500 million capital fund to build up to 15,000 new homes on state-owned property, an additional $600 million in funding to support a variety of housing developments statewide and new protections for renters and homeowners. In addition, as part of the FY23 Enacted Budget, the Governor announced a five-year, $25 billion Housing Plan to create or preserve 100,000 affordable homes statewide, including 10,000 with support services for vulnerable populations, plus the electrification of an additional 50,000 homes. More than 55,000 homes have been created or preserved to date.

The FY25 Enacted Budget also strengthened the Pro-Housing Community Program which the Governor launched in 2023. Pro Housing Certification is now a requirement for localities to access up to $650 million in discretionary funding. Currently, 275 communities have been certified, including New York City.

MIL OSI USA News –

February 26, 2025
MIL-OSI USA: Cornyn, Hassan, Colleagues Introduce Bill to Ensure Veterans’ Access to High-Quality Mental Health Care
US Senate News:
Source: United States Senator for Texas John Cornyn

WASHINGTON – U.S. Senators John Cornyn (R-TX), Maggie Hassan (D-NH), Michael Bennet (D-CO), Bill Cassidy (R-LA), Susan Collins (R-ME), and Gary Peters (D–MI) today introduced the Veterans Mental Health and Addiction Therapy Quality of Care Act, which would require an independent organization outside of the government to conduct a study to assess the quality of care veterans receive for mental and addiction health treatment from providers within and outside the Department of Veterans Affairs (VA):

“The brave men and women who served our nation should never be denied access to the high-quality care they deserve,” said Sen. Cornyn. “This legislation recognizes the unique mental health challenges our veterans face and aims to improve the VA system by providing an independent evaluation of the quality of life we’re providing for our nation’s bravest.”

“Veterans deserve the health care that they have earned, and that includes mental health care,” said Sen. Hassan. “This bipartisan legislation will help veterans make informed choices about whether to seek mental health care through the VA or community providers, and will help identify potential areas of improvement for mental health care for veterans. I will continue to work to ensure that New Hampshire’s veterans who have sacrificed so much to keep our communities safe, secure, and free are able to access high-quality care.”

“Our veterans have sacrificed so much to keep us safe, and we must do everything we can to ensure they have the care and resources they’ve earned,” said Sen. Bennet. “Our bipartisan bill is an important step toward understanding the barriers veterans face and improving their access to high-quality substance abuse and mental health services.”

“Every veteran must receive the care and services they need to address the risk of suicide and addiction,” said Sen. Cassidy. “There is no room for failure.”

“Our veterans made the honorable decision to serve our country, and we have a responsibility to ensure they receive the best possible health care during and after their service,” said Sen. Collins. “Too many veterans face serious mental health struggles, including PTSD and addiction, yet they often encounter barriers to getting the care they need. By reviewing the quality of mental health and addiction treatment available to them—both within and outside the VA—this bipartisan legislation would help improve access to higher-quality care, so that fewer veterans are left without the support they deserve.”

“We must do everything we can to ensure veterans have access to the quality and affordable health care they need,” said Sen. Peters. “I’m proud to help lead this bipartisan bill that would assess the current state of mental health and addiction services available to veterans to determine any potential changes that are needed to deliver first-rate care for our nation’s heroes.”

This legislation was also cosponsored by Senators John Fetterman (D-PA) and Thom Tillis (R-NC).

Background:

The Department of Veterans Affairs is home to the nation’s largest integrated health care system that provides comprehensive health services to U.S. military veterans who are enrolled. However, recent estimates indicate that as many as 70% of VA-eligible veterans received their care from external providers. Given the high rate of veteran suicide due to mental and addiction health conditions, a study is needed to better understand if current practices provide our veterans with the best mental and addiction quality of care.

The Veterans Mental Health and Addiction Therapy Quality of Care Act would require an independent and objective organization outside of the VA to conduct a study to:
- Analyze the results of comparable instances of addiction and mental health care between inside and outside providers using objective criteria such as symptom scores and suicide risk;
- Ascertain to what extent outside providers are using evidence-based practices in the treatment of addiction and mental health issues;
- Identify potential gaps in coordination between internal and external providers in responding to individuals seeking addiction or mental health care;
- Evaluate the availability of coordinated care for veterans who have separate or related conditions which may be impacting their mental health;
- Assess providers’ military cultural competency;
- Gauge the ease and flexibility of sharing medical records with a veteran’s health care team;
- Consider to what extent providers are conducting outcome monitoring throughout a veteran’s treatment to track progress or lack thereof;
- And measure overall patient satisfaction.
The legislation is supported by the Disabled American Veterans Association, the American Psychological Association, and the Veteran Health Care Policy Initiative.
MIL OSI USA News –
February 26, 2025

Category: Health

Hospices receive multi-million pound boost to improve facilities

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February 26, 2025

20 million with HIV treated

Mistakes made

Aid efforts continue

Biting cold claims lives

Ongoing military operations in the West Bank

Enhancing bed-based addiction treatment services

Introducing exemptions

Refining regulatory requirements

Quick facts

Related information

Multimedia

Rape and other violations reported

Europe faces a ‘cradle to cane’ health crisis, warns WHO

Wide regional variations

Chad: Nearly four million could go hungry during lean season

Multiple shocks

Quick facts

Related information

Related news

Australia has already knocked back Wegovy for subsidies

What did England decide?

Why did they reach such different decisions?

Time to rethink PBAC’s focus?