First Edition: October 3, 2019

Kaiser Health News: Walmart To Give Workers Financial Incentives To Use Higher-Quality Doctors
Worried its employees aren’t getting good enough care from doctors in their insurance networks, Walmart next year will test pointing workers in northwestern Arkansas, central Florida and the Dallas-Fort Worth area toward physicians it has found provide better service. If the employees use these “featured providers,” they will pay less out of pocket, Walmart officials said Thursday. (Galewitz, 10/3)

Kaiser Health News: Tenn. Block Grant Experiment Would Boost Federal Funding, State Medicaid Chief Says
Tennessee wants to be the first state to test a radical approach for federal financing of Medicaid, the federal-state health care program for low-income people. The proposal, Tennessee Medicaid Director Gabe Roberts said, would increase the federal government’s contributions by millions of dollars and allow Tennessee to improve care for enrollees, perhaps offering additional services such as limited dental care for some people. But critics fear the plan will harm the poor. (Galewitz, 10/2)

The Associated Press: Trump Will Find Friendly Florida Crowd Amid Impeachment Talk
President Donald Trump is leaving Washington for the first time since House Democrats ramped up their impeachment inquiry -- and he’s heading straight into the warm embrace of a Republican stronghold. Trump is due to visit The Villages, a sprawling retirement hub about an hour north of Orlando that is a must-stop for GOP candidates. The president plans to announce an executive order to protect Medicare during his visit Thursday and address an invitation-only group. (Farrington, 10/3)

The Washington Post: Health Insurance Premiums For Federal Employees, Retirees To Go Up An Average Of 5.6 Percent Next Year
Federal employees and retirees on average will pay 5.6 percent more for their health-care premiums in 2020, but will have more plans from which to choose, the government announced Wednesday. Officials said the increase is similar to what other large employers have reported or estimated for 2020 — in the 4.5 to 6.5 percent range. The hike also is in line with recent increases in the Federal Employees Health Benefits Program, although well above the 1.5 percent for 2019. (Yoder, 10/2)

Frontline and The Associated Press: Trump Admin Shifting To Privatize Migrant Child Detention
Sheltering migrant children has become a growing business for the Florida-based government contractor, as the number of minors in government custody has swollen to record levels over the past two years. More than 50 babies, toddlers and teens were closely watched on this day inside the clean, well-lit shelter surrounded by chain link fences. The children, many in matching black pants and gray sweatshirts, are officially under the custody of the federal government. But a joint investigation by The Associated Press and FRONTLINE has found that the Trump administration has started shifting some of the caretaking of migrant children toward the private sector and contractors instead of the largely religious-based nonprofit grantees that have long cared for the kids. (Burke and Mendoza, 10/3)

CBS News: Planned Parenthood Has Been Building A Secret Abortion "Mega-Clinic" In Illinois
After over a year of secret construction, Planned Parenthood announced its newest abortion facility on Wednesday: an 18,000-square-foot mega-clinic in southern Illinois. The new location is just 13 miles away from Missouri's last remaining abortion clinic, a facility in St. Louis fighting to keep its license. Since August 2018, Planned Parenthood has used a shell company to construct the facility, leaving no public trace that the former medical office would become one of the largest abortion clinics in the country. CBS News first visited the site in August, while it was still being built. (Smith, 10/2)

The Associated Press: New Abortion Clinic Being Built In Illinois, Near St. Louis
“While health care access in Missouri continues to hang on by a thread, Illinois is well-positioned to serve as a health care hub in the region,” said Yamelsie Rodriguez, president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri. Planned Parenthood has been battling Missouri’s health department for months to try and keep open its St. Louis clinic. The state has refused to renew its license to perform abortions, citing concerns that include “failed abortions” that required additional surgeries. (Salter, 10/2)

NPR: Planned Parenthood To Open Large New Facility In Illinois Near Missouri Border
Planned Parenthood announced it will continue to provide "medication abortion and a full range of family planning services, including birth control, annual exams, cancer screenings, STI testing, and HIV prevention, including PrEP." The new facility will also provide access to surgical abortions, in addition to the services previously listed. (Zialcita, 10/2)

The Washington Post: As Missouri Restricts Abortion, Planned Parenthood Opens Massive New Clinic Across The Border
Missouri has some of the most severe abortion restrictions in the country, while neighboring Illinois has expanded access to its residents. Planned Parenthood operates the only remaining abortion provider in Missouri, located in St. Louis. That clinic will remain open, according to the organization. (Epstein, 10/2)

CBS News: Inside Missouri's Last Abortion Clinic
One of the most difficult places to get an abortion is Missouri, a state home to just one abortion clinic and a bevy of restrictions for patients and their providers. CBS News was granted exclusive access to the lone clinic in St. Louis and spent weeks reporting on what it's like for women seeking the procedure. Sarah allowed CBS News to document her experience getting an abortion in the state, asking her real name not be used. "This has been a really emotional process for me," Sarah told CBS News correspondent Meg Oliver in June. "It's been really hard." (Oliver and Smith, 10/2)

The Associated Press: US Judge: Injection Sites Don’t Violate Federal Drug Laws
A federal judge ruled Wednesday that supervised injection sites designed to prevent overdoses do not violate federal drug laws, giving advocates in Philadelphia and perhaps elsewhere a boost in their efforts to open them. U.S. District Judge Gerald A. McHugh said there’s no evidence that Congress intended 1980s-era drug laws to cover sites where people could inject drugs and have medical help nearby if they need it. (Dale, 10/2)

The New York Times: Act Outlawing Drug Houses Doesn’t Apply To Injection Sites, Judge Rules
Wednesday’s ruling comes as health experts have increasingly proposed supervised injection sites as a way to reduce drug overdoses, which health officials said killed more than 68,000 people last year, and an average of three people a day in Philadelphia. The Justice Department, which had sued Safehouse in February, vowed after the ruling that it would continue to try to block other cities from opening injection sites, which its lawyers have argued are illegal. (Bogel-Burroughs, 10/20)

NPR: Judge Rules Planned Supervised Injection Site Does Not Violate Federal Drug Laws
Most studies show that the supervised injection sites can drive down fatal overdoses. These sites are credited with restricting the spread of infectious diseases. And advocates say the facilities help move more people into treatment. The American Medical Association has endorsed launching supervised injection site pilot programs. (Allyn, 10/2)

The Washington Post: Judge Rules Philadelphia Supervised Injection Site Does Not Violate Federal Law
“No credible argument can be made that facilities such as safe injection sites were within the contemplation of Congress” when lawmakers adopted the initial drug law in 1986 or when they amended it in 2003, McHugh wrote. (Bernstein, 10/2)

The Wall Street Journal: Federal Judge Rules In Favor Of Supervised-Injection Site For Drug Users
Wednesday’s ruling could help lift a cloud that has hung over these planned sites, often known as supervised-injection sites, which cities such as New York, San Francisco and Philadelphia have supported as a way to stop overdose fatalities. The sites would allow drug use under supervision of people who can treat overdoses and potentially help steer drug users toward treatment. (Kamp, 10/2)

The Associated Press: Company Claims Oklahoma Judge Miscalculated Opioid Award
An Oklahoma judge made a $107 million miscalculation when he ordered consumer products giant Johnson & Johnson to pay $572 million to help clean up the state’s opioid crisis, attorneys for the company argue in a court filing. The company also is asking for a reduction in the judgment based on pre-trial settlements totaling $355 million that the state reached with Oxycontin-maker Purdue Pharma and Israeli-owned Teva Pharmaceutical Industries Ltd. (Murphy, 10/2)

The Associated Press: AP Exclusive: Colleges Got $60M-Plus From OxyContin Family
Prestigious universities around the world have accepted at least $60 million over the past five years from the family that owns the maker of OxyContin, even as the company became embroiled in lawsuits related to the opioid epidemic, financial records show. Some of the donations arrived before recent lawsuits blaming Purdue Pharma for its role in the opioid crisis. But at least nine schools accepted gifts in 2018 or later, when states and counties across the country began efforts to hold members of the family accountable for Purdue’s actions. The largest gifts in that span went to Imperial College London, the University of Sussex and Yale University. (Binkley and McDermott, 10/3)

The Associated Press: Cities Push Opioid Lawsuits Against Family That Owns Purdue
Local government lawsuits against the family that owns Purdue Pharma should be allowed to proceed even as the company attempts to reach a nationwide settlement in bankruptcy court over the toll of the opioids crisis, according to a court filing on Wednesday. The filing by 19 cities and towns in Connecticut, Massachusetts, New Jersey and Virginia comes amid acrimonious settlement negotiations with the maker of the painkiller OxyContin that is now playing out in a bankruptcy court in White Plains, New York. (Mulvihill, 10/2)

Los Angeles Times: MLB And Players’ Union Mull Testing For Opioids While Easing Marijuana Penalties
The league would “absolutely” like to add opioid testing for next season, said Dan Halem, the league’s deputy commissioner. Tony Clark, the executive director of the players’ association, said the union plans to work with the league to assess “all of our drug protocols relating to education, treatment and prevention.” The parties have discussed whether to loosen baseball’s restrictions on marijuana — not specifically as a trade-off for opioid testing, but as part of the annual review of the sport’s drug policy, according to three people familiar with the talks but not authorized to comment publicly on them. (Shaikin, 10/2)

The New York Times: A Doctor Who Prescribed 500,000 Doses Of Opioids Is Sent To Prison For 40 Years
A Virginia doctor who prescribed more than 500,000 doses of opioids in two years was sentenced to 40 years in prison on Wednesday for leading what prosecutors called an interstate drug distribution ring. The overprescription of painkillers is one of the roots of the nation’s opioid crisis, and patients of Dr. Joel Smithers traveled hundreds of miles from neighboring states to pick up oxymorphone, oxycodone, hydromorphone and fentanyl, according to law enforcement officials. They said he prescribed controlled substances to every patient in the Martinsville, Va., practice he opened in August 2015. (Hassan, 10/2)

NPR: Doctor Gets 40 Years For Illegally Prescribing More Than Half A Million Opioid Doses
The sentence is lighter than it could have been. Smithers was facing up to life in prison and a fine of more than $200 million, according to officials at the U.S. Justice Department. Smithers was convicted by a jury in May on more than 800 federal drug charges — including one count of possessing with the intent to distribute controlled substances and one count of maintaining a place for the purpose of unlawfully distributing controlled substances. (Booker, 10/2)

The New York Times: Lung Damage From Vaping Resembles Chemical Burns, Report Says
The lung damage in some people who have become ill after vaping nicotine or marijuana products resembles a chemical burn, doctors from the Mayo Clinic reported on Wednesday. ... “All 17 of our cases show a pattern of injury in the lung that looks like a toxic chemical exposure, a toxic chemical fume exposure, or a chemical burn injury,” said Dr. Brandon T. Larsen, a surgical pathologist at the Mayo Clinic in Scottsdale, Ariz. “To be honest, they look like the kind of change you would expect to see in an unfortunate worker in an industrial accident where a big barrel of toxic chemicals spills, and that person is exposed to toxic fumes and there is a chemical burn in the airways.” (Grady, 10/2)

Stat: As Vaping Injuries Climb, Doctors Struggle To Wean Youth Off Nicotine 
Banning the sale of vapes and their accouterments — as the governor of Massachusetts ordered temporarily — may send a clear warning message, but it doesn’t mean that those who are already addicted know how to quit. E-cigarettes might have been viewed as a way of giving up the old-fashioned equivalent, but it turns out the newfangled version can be just as hard, if not harder, to quit. (Boodman, 10/3)

The Associated Press: Utah Issues Emergency Rule Amid Vaping-Related Illnesses
Utah health officials enacted an emergency rule Wednesday restricting the sale of flavored e-cigarettes and requiring warnings about unregulated THC products amid an outbreak of lung illness related to vaping. All tobacco sellers will be required to post notices about the danger of vaping unregulated THC, the high-producing ingredient in marijuana that’s been linked to most lung-damage cases in Utah. (10/2)

The Associated Press: Michigan Ban On Flavored Vaping Products Starts
Stores throughout Michigan have stopped selling flavored electronic cigarettes to comply with a ban that started Wednesday. Court of Claims Judge Cynthia Stephens declined to stop the ban with an injunction Wednesday. But she says she’ll hold another hearing on Oct. 8. Store owners are suing, saying the prohibition will cripple their business. (10/2)

The Associated Press: Sanders Has Heart Procedure, Cancels Campaign Events For Now
Bernie Sanders’ campaign said Wednesday that the Democratic presidential candidate had a heart procedure for a blocked artery and was canceling events and appearances “until further notice.” The 78-year-old Vermont senator experienced chest discomfort during a campaign event Tuesday and sought medical evaluation. Two stents were “successfully inserted,” and Sanders “is conversing and in good spirits,” according to the campaign. He’s recovering at a Las Vegas hospital. (Riccardi and Neergaard, 10/2)

The Wall Street Journal: Bernie Sanders Had Stents Inserted To Open Artery Blockage
Mr. Sanders later tweeted to thank well-wishers and said he was “feeling good.” He also said his experience underscored the need for his Medicare for All health-care proposal. (Collins, 10/2)

The New York Times: Bernie Sanders Is Hospitalized, Raising Questions About His Candidacy
Mr. Sanders has largely avoided scrutiny of his age and his health. But he and his rivals will now be under increasing pressure to release detailed medical records as Democratic voters try to settle on the best candidate to take on President Trump, who is himself 73. Mr. Sanders, Mr. Biden and Senator Elizabeth Warren, who is 70, have all said they would release their records before the first voting starts in February. (Ember and Martin, 10/2)

NPR: Bernie Sanders Has Heart Procedure, Cancels Events Until Further Notice
The news comes as Sanders was preparing for Wednesday campaign events in Nevada, including a "Medicare for All" town hall in Las Vegas. It also comes less than two weeks before the next Democratic primary debate, on Oct. 15 in Ohio. As of January 2016, Sanders had "no history of cardiovascular disease," according to a letter from Sanders' doctor released as part of his 2016 presidential campaign. (Kurtzleben, 10/2)

The Washington Post: How Serious Is Bernie Sanders’s Heart Problem? This Is The Stent Procedure His Doctors Just Performed.
The medical problem Sanders experienced — though it can be serious if untreated — is a common affliction in men his age. And the procedure he underwent is one of the most routine performed by cardiologists. “This is a common procedure. It’s very safe. People recover quickly,” said Steven Nissen, chair of cardiovascular medicine at Cleveland Clinic. “I’ve treated businessmen who go back to work the next day. I’ve had patients in the U.S. Senate who have gotten right back to work. Although, if Bernie were my patient, I might tell him not to work 16 hours a day for a little while, just to make sure recovery goes well.” (Wan, 10/2)

The New York Times: Is Age Only A Number, Even When You’re Running For President?
Presidential campaigns always reflect the hopes and fears — or, as political strategists call them, the “kitchen table conversations” — of the voters who cast the ballots. And this year, along with health care costs and college affordability, stagnant wages and immigration, the contest also reflects another issue, one that strikes at the heart of a country where the highest share of the electorate will be older than 65 since at least 1970: How old is too old? (Lerer, 10/2)

The Associated Press: 2020 Democrats Put Focus On Guns Amid Impeachment Fever
Democratic presidential candidates reiterated their call for gun control Wednesday and urged Americans to keep up the fight for change, sidestepping the issue of impeachment in Washington and whether it will divert lawmakers. (Ronanye and Price, 10/2)

The New York Times: After Hospitals’ Big Donation To N.Y. Democrats, A $140 Million Payout
With Medicaid costs soaring in New York, the Greater New York Hospital Association was pushing for the seemingly impossible: more state reimbursement money. It was a big ask, and for years, it had gone nowhere. Medicaid spending already represented a massive and ever-growing share of the state budget, and Gov. Andrew M. Cuomo had taken steps to keep the program in check. Then things changed. (Goodman, 10/3)

NPR: 'Why Is There Nothing Left?' Pension Funds Failing At Catholic Hospitals
The case highlights a more widespread problem: Because of a loophole, many religious organizations are not covered by a federal guarantee that protects most other workers' pensions, so the workers can get left with nothing. By one estimate, more than 1 million workers and retirees from religious organizations lack this federal protection. (Arnold, 10/3)

USA Today: Thousands Of California Seniors Are 'One Disaster Away' From Homelessness. What Can The State Do?
Homelessness experts say California’s low-income seniors are especially vulnerable because of the state's housing affordability crisis: With fixed income and high rent prices, an illness or job loss can quickly put them on the streets. The state already accounts for about a quarter of the nation's homeless population, according to the U.S. Department of Housing and Urban Development, and 69% of the 130,000 homeless Californians were unsheltered on a single night last year. (Lam, 10/2)

The Associated Press: EPA Issues Violation Notice To San Francisco
The Trump administration ratcheted up its feud with California on Wednesday as the Environmental Protection Agency issued a notice accusing San Francisco of violating the federal Clean Water Act. Last month, President Donald Trump warned of a potential violation notice, saying the city was allowing needles and human waste to go through storm drains to the Pacific Ocean -- an allegation fervently denied by city officials. The violation notice came in the form of a letter to Harlan Kelly, Jr., general manager of the city’s Public Utilities Commission. (10/2)

The New York Times: Bipartisan Report Says Trump’s Abuse Has Pushed Federal Science To A ‘Crisis’
Every president over the past two decades has, to some degree, undermined research and injected politics into science, the report said. But, it concluded, “Now, we are at a crisis point, with almost weekly violations of previously respected safeguards.” The report calls for stringent new standards to enshrine scientific independence. The study, to be formally released on Thursday, follows reports that President Trump’s acting chief of staff, Mick Mulvaney, pressured the commerce secretary to rebuke weather forecasters who appeared to contradict the president after he erroneously claimed a recent hurricane could affect Alabama. Earlier this summer a State Department intelligence analyst resigned in protest after the White House tried to edit scientific testimony about climate change and then blocked it from being entered into the permanent Congressional Record. (Friedman, 10/3)

Stat: FDA Challenges Testing Used By Lab That Found A Carcinogen In Zantac
As concerns mount over a possible carcinogen found in popular heartburn medicines, the Food and Drug Administration noted that an outside laboratory that discovered traces of the contaminant used a method “not suitable” for testing. As a result, the agency is suggesting the lab may have generated higher levels of the carcinogen than what might have been found otherwise. In a brief statement, the FDA contended that Valisure, which alerted agency officials to the presence of NDMA in heartburn pills such as Zantac, used higher temperatures in its testing than methods used by the agency. (Silverman, 10/2)

The Hill: Walmart Pulls Zantac From Shelves, Joining CVS, Walgreens 
Walmart joins CVS Health, Walgreens and Rite Aid in announcing it will no longer sell the drug. Sanofi, the company that makes Zantac, said that the FDA has found that the amounts of the carcinogen in its drug “barely exceed amounts found in common foods.” “We are working closely with the FDA and are conducting our own robust investigations to ensure we continue to meet the highest quality safety and quality standards,” the company said. (Axelrod, 10/2)

The Associated Press: Walmart To Test New Health Care Services For Workers
Walmart is rolling out a health care pilot program for its employees that will come up with a curated list of high quality providers but offer fewer choices than under the current plan. Through the program, Walmart will help employees connect with local doctors in areas like primary care, cardiology and obstetrics. It is working with Nashville-based data analytics company Embold Health, which will cull through vast amounts of data from public and private insurance plans to come up with recommended providers based on effectiveness and cost-efficiency. Walmart will in turn use that data to curate a list for employees. (D'Innocenzio, 10/3)

Stat: Judge Tosses Suits Alleging Lilly And Bayer Used Nurses To Push Drugs
In a boost for the pharmaceutical industry, a federal judge dismissed a pair of lawsuits that alleged two large drug makers devised schemes in which nurses were used illegally to promote their medicines and boost prescriptions, an arrangement that purportedly violated federal kickback laws. The ruling is also a win for the federal government as it attempts to implement a new policy for dismissing whistleblower lawsuits when declining to intervene, or join the case. A Department of Justice memo issued last year directed its attorneys to consider moving to dismiss lawsuits if they appear deficient or following an investigation of claims made by the whistleblower. (Silverman, 10/2)

Stat: Did Pfizer’s ‘Golden Ticket’ Funding Live Up To The Hype?
Traditionally, Golden Tickets lead to chocolate rivers or everlasting gobstoppers. For biotech startups, though, Golden Tickets lead to something with (potentially) fewer pitfalls: money from major pharmaceutical companies. On Thursday, Pfizer (PFE) announced it would give two startups, Neutrolis and Mediar Therapeutics, so-called Golden Tickets to LabCentral, a noted Cambridge, Mass., biotech incubator. (Sheridan, 10/2)

The New York Times: N.Y. Declares That The End Of The AIDS Epidemic Is Near
There was a time when the diagnosis of H.I.V. was a death sentence, when thousands of New Yorkers, primarily gay men, succumbed to AIDS-related illnesses, and the end of the epidemic seemed both medically and mentally impossible. On Wednesday, however, Gov. Andrew M. Cuomo declared that New York is on track to meet its goal to end the AIDS epidemic in the state by 2020. (McKinley, 10/2)

Los Angeles Times: Health Officials Confirm First West Nile Virus Death In L.A. County This Year
A South Bay resident has died from a neuroinvasive illness caused by West Nile virus, marking the first confirmed death this year from the mosquito-borne disease in Los Angeles County. Public health officials confirmed Wednesday that the patient was hospitalized and died from a West Nile virus-associated illness that affects the central nervous system but did not provide details about the person’s age or when they got sick. (Cosgrove, 10/2)

Los Angeles Times: Vaccine Bill Protester Threw Blood On California Senators, Investigation Confirms
A red liquid thrown by a protester from the visitors gallery of the California Senate chamber in an “unanticipated attack” on state lawmakers during the final night of the legislative session was found to be blood, according to the state Senate. Secretary of the Senate Erika Contreras sent an email to staff members on Wednesday that said “lab tests confirmed that the substance thrown from the Senate gallery was human blood.” Safety precautions were taken in hiring a company certified in hazard cleanup to sanitize the chamber, and the blood tested negative for any blood-borne pathogens or infections, Contreras wrote. (Luna, 10/2)

Stateline: As Rural Groceries Fade Away, Lawmakers Wonder Whether To Act
Some states are trying to tackle their rural grocery gaps. Supporters of such efforts point to tax incentives and subsidies at various levels of government that have enabled superstores to service larger areas and squeeze out local independent grocers. Now, dollar stores are opening in rural regions and offering items at lower prices, posing direct competition to local groceries. Critics see that development as a threat to public health, since dollar stores typically lack quality meat and fresh produce. But every town and every store is different, making statewide solutions elusive. (Simpson, 10/2)

NPR: Twin Birth Rate Drops For First Time Since The '80s
For the first time in nearly 40 years, the twin birth rate in the U.S. is on the decline. According to a data brief published Thursday from the National Center for Health Statistics, twin births declined in the U.S. by 4% from 2014 to 2018. The decline follows decades of steady growth which began in the 1980s and lasted through the early 2000s. (Vaughn, 10/3)

The Wall Street Journal: Rates Of Twin Births In U.S. Drop After Decades Of Increases
Researchers say the decline may reflect advances in reproductive technologies that improved the likelihood of single births. Having twins heightens health risks for both the babies and the mother, so specialists see the decline as good news. (Abbott, 10/3)

The Washington Post: Is The Twin Boom Ending?
“It is difficult to know for sure from the data in the NCHS report what the recent drop is linked to. However, given that declines are concentrated among older mothers, some would argue that changes in reproductive technology are likely playing a role,” said Gretchen Livingston, a senior researcher at the Pew Research Center who is an expert on fertility and family demographics. (Eunjung Cha, 10/3)

The Associated Press: Man Sues Oregon Clinic Over Donated Sperm Used For 17 Kids
A man who says his donated sperm was used to father at least 17 children in violation of an agreement that allowed for no more than five has sued an Oregon fertility clinic. Dr. Bryce Cleary believes it’s possible that he has many more children from his sperm donations 30 years ago, the Oregonian/OregonLive reported. (10/2)

The New York Times: James Robinson, 79, Dies; Filled An Ambulance Gap In Brooklyn
The incident prompted Mr. Robinson to start a volunteer ambulance corps in Bedford-Stuyvesant that has answered calls ever since, cutting response times to only a few minutes. The group, one of more than 30 volunteer emergency service agencies in New York City today and one of nearly that many certified to give basic life support, has also trained more than 1,000 emergency medical technicians. Mr. Robinson, who was known as Rocky, died on Friday at 79. The cause was heart failure, said a son, Antoine Robinson. (Barron, 10/2)