First Edition: September 27, 2019

Kaiser Health News: KHN Files Lawsuit To Force Feds To Disclose Medicare Advantage Audits
Kaiser Health News is suing the U.S. Centers for Medicare & Medicaid Services to release dozens of audits that the agency says reveal hundreds of millions of dollars in overcharges by Medicare Advantage health plans. The suit, filed late Thursday in U.S. District Court in San Francisco under the Freedom of Information Act, seeks copies of 90 government audits of Medicare Advantage health plans conducted for 2011, 2012 and 2013 but never made public. CMS officials have said they expect to collect $650 million in overpayments from the audits. Although the agency has disclosed the names of the health plans under scrutiny, it has not released any other details. (Schulte, 9/27)

The Associated Press: Senate Sends Trump Stopgap Spending Bill, Averting Shutdown
The Senate passed a temporary government-wide funding bill on Thursday that staves off the risk of a government shutdown through Nov. 21. The measure would buy additional time for lawmakers to work to unclog a $1.4 trillion bundle of yearly spending bills that is hung up amid fights over President Donald Trump’s border wall and abortion. Those measures face a variety of obstacles, and it’s not clear whether Congress will pass them. (Taylor, 9/26)

The Wall Street Journal: Senate Passes Short-Term Spending Measure
The stopgap bill, which passed the House last week, would keep the government open through Nov. 21 as lawmakers of both parties try to pass new annual-spending legislation. A White House official said Mr. Trump would sign the temporary bill by Tuesday, but the exact timing was unclear. The measure also extends a number of health-care programs and other expiring measures, including the National Flood Insurance Program. (Duehren, 9/26)

The Hill: Democrats To Force Vote On Trump Health Care Rule
Senate Democrats took action this week that will force a floor vote on a Trump administration rule that loosens ObamaCare waiver restrictions. The move by Democrats, led by Sen. Mark Warner (Va.), paves the way for a recorded vote on whether to roll back a rule that makes it easier for insurance plans to qualify for waivers from ObamaCare’s requirements. (Carney, 9/26)

USA Today: Cases Of Vaping Lung Disease Jump To 805 With 12 Deaths, But Cause Remains A Mystery, CDC Says
The inquiry will focus on the products, where they were purchased and how they were used. "We do not yet know the specific cause of these lung injuries," the CDC said in a statement. "The investigation has not identified any specific e-cigarette or vaping product (devices, liquids, refill pods, and/or cartridges) or substance that is linked to all cases." (Stanglin, 9/26)

The Associated Press: US Vaping Illness Count Jumps To 805, Deaths Rise To 13
Over the summer, health officials in a few states began noticing reports of people developing severe breathing illnesses, with the lungs apparently reacting to a caustic substance. The only common factor in the illnesses was that the patients had all recently vaped. As a national investigation started and broadened, reports have increased dramatically. (Stobbe, 9/26)

The New York Times: Vaping-Related Illnesses Climb To 805, C.D.C. Says
Based on 373 cases where data on the patients was available, the C.D.C. says that nearly three-quarters were male, two-thirds were 18 years to 34 years old and 16 percent were younger than 18 years. (Grady, 9/27)

The Wall Street Journal: Vaping-Related Lung Illnesses Rise 52%, CDC Says
“All reported cases have a history of e-cigarette product use or vaping,” the CDC said in a release. The CDC, the Food and Drug Administration and local authorities have opened up investigations into lung injuries linked to vaping over the past few weeks. The FDA is conducting a criminal probe. (Chin, 9/26)

The Washington Post: CDC Reports 805 Cases Of Vaping-Related Lung Injury
Federal officials said Thursday that at least 805 people in 46 states and the U.S. Virgin Islands have fallen sick with mysterious vaping-related lung injuries as the growing outbreak stretches to include virtually all of the United States. Twelve deaths have been confirmed in 10 states: California (two), Florida, Georgia, Illinois, Indiana, Kansas (two), Minnesota, Mississippi, Missouri and Oregon. (Sun, 9/26)

The Associated Press: Marijuana Vape Sales Lag As Lung Illnesses Rise In US
Vaping products, one of the fastest-growing segments of the legal marijuana industry, have taken a hit from consumers as public health experts scramble to determine what’s causing a mysterious and sometimes fatal lung disease among people who use e-cigarettes. The ailment has sickened at least 805 people and killed 13. Some vaped nicotine, but many reported using oil containing THC, marijuana’s high-inducing ingredient, and said they bought products from pop-up shops and other illegal sellers. (Flaccus and Peltz, 9/26)

Los Angeles Times: Why Flavored Vaping Products Are This Era’s Big Tobacco Menthol Cigarettes
High schoolers rallying in downtown Los Angeles this week chanted “Fight the flavor” as they showed their support for banning the flavored tobacco products that health experts say are fueling an epidemic of nicotine addiction among youths. Among the demonstrators was Jennyfer Cortez, 16, who said she tried an e-cigarette for the first time five years ago because it tasted like blueberries, her favorite fruit. She didn’t like vaping because it made her cough, but she has seen her peers vape at their lockers, in the school bathroom and sometimes even in class. (Karlamangla, 9/26)

The Associated Press: NY Could Add Menthol To Flavor Ban As Vaping Groups Sue
New York officials want to add menthol to the state’s first-in-the-nation ban on the sale of flavored e-cigarettes as the vaping industry seeks to block it, according to the governor’s office. Democratic Gov. Andrew Cuomo said he’s directing his administration to take steps to include menthol in a ban that currently excludes tobacco and menthol flavors. The state health commissioner could hold an emergency meeting as soon as next week to update the ban, according to Cuomo’s office. (9/26)

The Associated Press: GM Reverses Course, Says Strikers Will Keep Health Coverage
“This is an attempt to do what’s right for our employees,” GM spokesman Dan Flores said. It’s normal procedure in strikes for the cost of health care to shift from the company, which is largely self-insured, to the union. It says on the union website that the UAW will pick up the cost of the premiums. But the timing of when GM ends the health care and when the union takes over is at issue. The UAW said the benefits lapsed, but did not give a date. (Krisher, 9/26)

The New York Times: G.M. Restores Workers’ Health Coverage As Strike Continues
In a letter to G.M. on Thursday, Terry Dittes, the union vice president leading the negotiations, complained that the automaker was “toying” with the lives of union members with the back and forth on health coverage. “There is no doubt that public sentiment sees these actions of G.M. as a shameful act!” Mr. Dittes wrote. In the contract talks, the union is pushing G.M. to increase pay for temporary and less-senior workers, reopen plants it has idled and allot more future production to factories in the United States instead of those it operates in Mexico. G.M. would like to limit wage increases and cut health care costs. (Boudette, 9/26)

USA Today: GM Tells Striking Union Members It Will Continue Their Health Coverage
GM said Thursday that it "has chosen to work with our providers to keep all benefits fully in place for striking hourly employees, so they have no disruption to their medical care, including vision, prescription and dental coverage. "If they have an insurance claim, they should submit it. GM will continue to provide them the coverage they rely on given the circumstances," the company said. The company set no end date. (Lawrence, 9/26)

The Associated Press: Trump Administration Accuses California Of Water Pollution
San Francisco’s mayor disputed any connection between homeless people and water quality, and she and others accused President Donald Trump of using the Environmental Protection Agency to punish the heavily Democratic state. (Flesher, 9/26)

The New York Times: E.P.A. Accuses California Of ‘Significant’ Air And Water Problems
It is the latest in a series of aggressive actions that the Trump administration has taken against California since the state surprised the E.P.A. by signing a deal with four automakers that opposed a federal plan to roll back a national vehicle tailpipe pollution standard. (Friedman, 9/26)

The Washington Post: EPA Tells California It Is ‘Failing To Meet Its Obligations’ To Protect The Environment
“The agency is aware of the growing homelessness crisis developing in major California cities, including Los Angeles and San Francisco, and the impact of this crisis on the environment,” Wheeler wrote. “Based upon data and reports, the agency is concerned that California’s implementation of federal environmental laws is failing to meet its obligations required under delegated federal programs.” Under extraordinary circumstances, the EPA can take over enforcement of federal pollution laws. (Eilperin, Dennis and Dawsey, 9/26)

NPR: Trump's EPA Blames California Homeless Crisis For Poor Water Quality
Wheeler asked Newsom to respond in 30 days about what the state plans to do about it. A spokesman for the governor also responded to the letter. "The president is abusing the powers of the presidency and weaponizing government to attack his political opponents. This is not about clean air, clean water or helping our state with homelessness," said Nathan Click, spokesman for Newsom. "This is political retribution against California, plain and simple." (Fessler and Zialcita, 9/26)

The Wall Street Journal: Trump Administration Fires Another Volley At California
The EPA letter escalates the president’s feud with California, the country’s most populated state with roughly 40 million residents. He recently visited the Bay Area for the first time since his election. Mr. Trump has repeatedly attacked San Francisco over its homelessness problem. The city is represented in Congress by House Speaker Nancy Pelosi (D., Calif.), who routinely clashes with the president. Mr. Trump has suggested that California policies are to blame for the crisis, in keeping with his broader clash with Democratic leaders in the state on issues such as immigration and climate change. (Stech Ferek, 9/26)

Los Angeles Times: EPA To California: You're Also 'Failing' To Meet Water Pollution Standard
In a letter to California Gov. Gavin Newsom, Environmental Protection Agency Administrator Andrew Wheeler threatened possible enforcement action if the state did not improve the way it deals with lead, arsenic and human waste in its water. Wheeler wrote that officials in San Francisco, Los Angeles and the state as a whole “do not appear to be acting with urgency to mitigate the risks to human health and the environment that may result from the homelessness crisis.” (Díaz and Phillips, 9/26)

The Wall Street Journal: Democratic Presidential Candidates Compete To March To California’s Drum
On a Thursday evening in June, Governor Gavin Newsom signed a budget making California the first state to expand government health care to some adult immigrants living Illegally in the U.S. That same night, thousands of miles away at a presidential primary debate in Florida, all 10 Democratic candidates on stage raised their hands to signal that they would like to do the same nationwide. ... In the race for the Democratic presidential nomination, California has become a rallying point, with its liberal policies that frequently defy those of the Trump administration, serving as a proxy for the direction candidates would like to take the nation. (Lazo and Glazer, 9/27)

The Washington Post: NIH Awards Nearly $1 Billion In Research Grants To Battle Addiction, Chronic Pain 
The National Institutes of Health awarded nearly $1 billion on Thursday to battle addiction and chronic pain, the largest financial commitment to one program ever by the government’s premier biomedical research center. About 50 million adults suffer from chronic pain, and in 2018 about 10.3 million people aged 12 and older abused opioids, including heroin, NIH said. “We have effective tools, such as medication-assisted treatment, but we still need better ways to treat opioid addiction and manage pain in an effective, personalized way,” Health and Human Services Secretary Alex Azar said in a news release. (Bernstein, 9/26)

Stat: FDA Clarifies How It Will Regulate Digital Health, Artificial Intelligence 
The Food and Drug Administration has issued new guidelines on how it will regulate mobile health software and products that use artificial intelligence to help doctors decide how to treat patients. The guidelines, contained in a pair of documents released Thursday morning, clarify the agency’s intent to focus its oversight powers on AI decision-support products that are meant to guide treatment of serious or critical conditions, but whose rationale cannot be independently evaluated by doctors. (Ross, 9/26)

Stat: FDA Slams Drug Maker For Not Telling Docs Its Sleeping Pill Is A Controlled Substance
At a time of heightened concern over abuse and dependence issues surrounding medicines, the Food and Drug Administration slammed a small drug maker for sending an email to physicians that appeared to “intentionally” omit any mention that its insomnia pill is a controlled substance. In a Sept. 13 warning letter sent to Galt Pharmaceuticals, the agency complained to the company that the email made numerous claims about the benefits of its Doral pill for treating insomnia. But the email completely failed to mention the warning and precaution language in the prescribing label about the withdrawal syndrome associated with benzodiazepines, such as Doral. (Silverman, 9/26)

The Washington Post: Should Federal Employees Have Paid Family Leave? The Senate Says No — For Now.
The Senate defeated a bid to authorize paid family leave for federal employees but on a narrow vote that supporters view as leaving an opening for the benefit to yet be approved. The Senate voted 48-47 on Wednesday against accepting House-passed language to turn into paid time the unpaid leave available to federal workers under the Family and Medical Leave Act. That law entitles them, along with many other workers, to up to 12 weeks per 12 months of unpaid time for parental leave and personal or family medical conditions. (Yoder, 9/26)

Politico: Tom Price Angling For Georgia Senate Appointment
Price, a former six-term Republican congressman, was appointed by President Donald Trump to serve as HHS secretary at the outset of his administration. He resigned in September 2017 after POLITICO revealed his use of private and government planes for travel. (Arkin, 9/26)

The Associated Press: Georgia's Price Seeks Senate Appointment After HHS Downfall
Kemp will soon get to pick a replacement for retiring Republican Sen. Johnny Isakson, who is stepping down in December because of health issues. Price is an orthopedic surgeon from Atlanta’s northern suburbs who represented Georgia’s 6th Congressional District from 2005 to 2017, before stepping down to join President Donald Trump’s administration. He served for roughly seven months as health secretary before being forced out in September 2017 over the travel expenditures. Trump was also angry with Republicans’ failure to repeal former President Barack Obama’s health care overhaul. (Nadler, 9/26)

The Associated Press: Military Sees Frustrating Trend As Suicides Spike
Military suicides surged this year to a record high among active duty troops, continuing a deadly trend that Pentagon officials say is frustrating and they are struggling to counter. The Army, Navy and Marine Corps all saw the rate of suicides go up as well as the overall numbers, with only the Air Force showing a decrease, according to data released by the Pentagon Thursday. Suicides among members of the Reserves and the National Guard also grew. (Baldor, 9/26)

The Wall Street Journal: Suicide Rate Among Active U.S. Troops Climbs 13%
Acting Army Secretary Ryan McCarthy and Army Chief of Staff Gen. James McConville called the report “disheartening and disappointing” in a joint statement. Veteran suicide rates rose 2% in 2017, according to the latest Department of Veterans Affairs numbers released last week. (Kesling, 9/26)

The Washington Post: Military Suicides: Pentagon Again Sees Rise In Suicide Rates Among Active-Duty Troops
Some 541 service members died by suicide in 2018, including 325 active-duty troops, the report said. The active-duty suicide rate was about 24.8 per 100,000 service members, up from 21.9 in 2017 and 18.7 in 2013. “Although the suicide rate among most of our military populations is comparable to civilian rates, this is hardly comforting, and our numbers are not moving in the right direction,” Elizabeth Van Winkle, the Pentagon’s executive director of force resiliency, told reporters on Thursday. (Lamothe, 9/26)

The New York Times: Woman Trying To End Sexual Assault At V.A. Centers Says She Is Attacked In One
A senior policy adviser on female veterans issues for the House said she was assaulted last week at the V.A. Medical Center in Washington by a man who slammed his body against hers and then pressed himself against her in the center’s cafe. The woman, Andrea Goldstein, a reserve Navy intelligence officer and a lead staff member for the Women Veterans Task Force on the House Veterans Affairs Committee, was waiting for a smoothie at a cafe in the busy center, which has one of the most celebrated women’s clinics in the Department of Veterans Affairs health system. (Steinhauer, 9/26)

The Associated Press: Tennessee's Abortion Waiting Period Trial Goes To Judge
A federal judge will have to decide which experts to believe in a trial over Tennessee’s 48-hour waiting period law for abortions. Over the course of a four-day trial in Nashville that concluded Thursday, the state tried to show that the law, which requires women to make two separate trips to a clinic at least 48 hours apart, benefits women by allowing them time to reflect on their decisions. Attorneys representing five of the state’s seven abortion clinics argued the law provides no benefits and causes significant burdens. (Loller, 9/26)

The Associated Press: Johnson & Johnson Appeals Oklahoma's $572M Opioid Ruling
Consumer products giant Johnson & Johnson is appealing an Oklahoma judge’s $572 million order against the company and its subsidiaries for helping fuel the state’s opioid crisis. The company filed an appeal with the Oklahoma Supreme Court on Wednesday, arguing the ruling was an “unprecedented interpretation of Oklahoma public nuisance law.” (Murphy, 9/26)

The Associated Press: Judge In Opioid Litigation Won't Remove Himself From Case
Judge Dan Polster said in his order that he has done nothing over the past two years to favor cities and counties seeking money from the pharmaceutical industry to cover their costs of fighting the deadly crisis. Polster said he has merely acknowledged the massive toll of the opioid crisis and the responsibility, as opposed to the legal liability, of many parties in the epidemic. (Carr Smyth, 9/26)

The Wall Street Journal: Discount Retailer Fred’s Strikes Deals To Sell More Pharmacy Assets
Discount retailer Fred’s Inc. has reached two separate deals to sell some of its pharmacy assets, including 10 drugstores and inventory, to Walgreens Boots Alliance Inc. and ExpressRx Co. for a total of about $16.4 million. Walgreens is looking to buy pharmacy inventory from Fred’s for about $9.4 million, according to a filing Thursday in the U.S. Bankruptcy Court in Wilmington, Del. ExpressRx has agreed to purchase 10 Fred’s pharmacies for about $7 million. (Al-Muslim, 9/26)

Los Angeles Times: Mold Discovery Halts Elective Surgeries At L.A. County-USC Medical Center
Health officials have abruptly halted all elective surgeries at Los Angeles County-USC Medical Center after the discovery of mold contamination in a room used to sterilize surgical equipment. The Boyle Heights hospital, which is part of the L.A. County Department of Health Services system that serves as the safety net for millions of the county’s poorest and most vulnerable residents, will be unable to perform surgery and many other medical procedures for an estimated two weeks, according to an internal hospital email obtained by The Times. (Dolan and Mejia, 9/26)

Los Angeles Times: Stem Cells Of 56 Child Cancer Patients Lost At Children’s Hospital After Freezer Malfunction
A freezer malfunction at Children’s Hospital Los Angeles resulted in the loss of 56 children’s blood stem cells that were harvested at the beginning of each patient’s oncology therapy and stored in the event they could prove useful in the future. “We apologize for any distress or confusion that this has caused our patients and their families,” the hospital wrote in a statement. “If you have not received a letter or phone call from our team, your child is not impacted.” (Shalby, 9/26)

The Wall Street Journal: Comptroller Blasts New York City Over Lead-Inspection Failures
New York City agencies charged with preventing lead poisoning in children didn’t always go far enough to share information that would trigger in-home inspections for possible lead exposure, according to a report by Comptroller Scott Stringer. The findings, which were released Thursday and examine city data from 2013 through late 2018, show that the city didn’t inspect 9,671 buildings for lead where nearly 12,000 children lived and tested positive for elevated blood-lead levels. (West, 9/26)