First Edition: Nov. 21, 2022

KHN: Audits — Hidden Until Now — Reveal Millions In Medicare Advantage Overcharges
Newly released federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage health plans for seniors, with some plans overbilling the government more than $1,000 per patient a year on average. Summaries of the 90 audits, which examined billings from 2011 through 2013 and are the most recent reviews completed, were obtained exclusively by KHN through a three-year Freedom of Information Act lawsuit, which was settled in late September. (Schulte and Hacker, 11/21)

KHN: Patient Mistrust And Poor Access Hamper Federal Efforts To Overhaul Family Planning 
Two years ago, after an emergency cesarean section at a Mississippi hospital, Sherika Trader was denied a tubal ligation. Trader, now 33, was told that to have her tubes tied, she had to have a second child or a husband’s permission, even though she wasn’t married. Jasymin Shepherd had heavy menstrual cycles because of a birth control pill prescribed after the birth of her son 13 years ago. The symptoms continued even after she stopped taking the medication. Last year, a doctor in Jackson responded by offering Shepherd, 33, a hysterectomy, which she didn’t want. (Rayasam, 11/21)

KHN: After Election Win, California’s AG Turns To Investigating Hospital Algorithms For Racial Bias
California Attorney General Rob Bonta sailed to victory in the Nov. 8 election, riding his progressive record on reproductive rights, gun control, and social justice reform. As he charts a course for his next four years, the 50-year-old Democrat wants to target racial discrimination in health care, including through an investigation of software programs and decision-making tools used by hospitals to treat patients. Bonta, the first Filipino American to serve as the state’s top prosecutor, asked 30 hospital CEOs in August for a list of the commercial software programs their facilities use to support clinical decisions, schedule operating rooms, and guide billing practices. In exchange, he offered them confidentiality. His goal, Bonta told KHN, is to identify algorithms that may direct more attention and resources to white patients than to minorities, widening racial disparities in health care access, quality, and outcomes. (Kreidler, 11/21)

The New York Times: Former Anti-Abortion Leader Alleges Another Supreme Court Breach 
As the Supreme Court investigates the extraordinary leak this spring of a draft opinion of the decision overturning Roe v. Wade, a former anti-abortion leader has come forward claiming that another breach occurred in a 2014 landmark case involving contraception and religious rights. In a letter to Chief Justice John G. Roberts Jr. and in interviews with The New York Times, the Rev. Rob Schenck said he was told the outcome of the 2014 case weeks before it was announced. He used that information to prepare a public relations push, records show, and he said that at the last minute he tipped off the president of Hobby Lobby, the craft store chain owned by Christian evangelicals that was the winning party in the case. (Kantor and Becker, 11/19)

The Hill: Senate Panel Reviewing Alleged 2014 Supreme Court Leak Of Alito Opinion
The Senate Judiciary Committee is reviewing the possible leak of a 2014 Supreme Court decision authored by Justice Samuel Alito after a New York Times article suggested the justice or his wife discussed the opinion on contraception and religious rights before it was released. Sen. Dick Durbin (D-Ill.), the chairman of the committee, said in a statement Saturday night that the allegations were serious and “highlight once again the inexcusable ‘Supreme Court loophole’ in federal judicial ethics rules.” (Dress, 11/20)

Politico: Senior Democratic Lawmakers Demand Answers On Alleged Supreme Court Leak 
Two senior Democrats in Congress are demanding that Chief Justice John Roberts detail what, if anything, the Supreme Court has done to respond to recent allegations of a leak of the outcome of a major case the high court considered several years ago. Sen. Sheldon Whitehouse (D-R.I.) and Rep. Hank Johnson (D-Ga.) are also interested in examining claims about a concerted effort by religious conservatives to woo the justices through meals and social engagements. They wrote to Roberts on Sunday, making clear that if the court won’t investigate the alleged ethical breaches, lawmakers are likely to launch their own probe. (Gerstein, 11/20)

Politico: Justice Alito Denies Allegation Of A Leak In 2014 Case About Access To Birth Control
Justice Samuel Alito denied allegations Saturday from a former anti-abortion activist that his wife, Martha-Ann Alito, played a role in revealing the outcome of a pending Supreme Court case in 2014. An Ohio woman friendly with the Alitos who was a donor to a Supreme Court-connected nonprofit group and allegedly served as a conduit for the sensitive information has also denied the claim. The allegation comes six months after a stunning breach of Supreme Court secrecy — POLITICO’s publication of the draft ruling authored by Alito that overturned the landmark, 49-year-old precedent guaranteeing a federal constitutional right to abortion. (Gerstein, 11/20)

Reuters: Anti-Abortion Groups Ask U.S. Court To Pull Approval For Abortion Drugs 
The plaintiffs in Friday's lawsuit said the FDA improperly approved mifepristone for abortion in 2000 under an expedited process intended to allow patients quicker access to better treatments for an illness, even though pregnancy is not an illness, and waived a requirement to study it separately for pediatric patients. (Pierson, 11/18)

AP: Georgia Asks Court To Immediately Reinstate Abortion Ban
Georgia officials asked a court on Friday to immediately block a judge’s ruling striking down the state’s abortion ban. The ruling allowed the procedure to again be performed beyond about six weeks of pregnancy. Fulton County Superior Court Judge Robert McBurney’s decision earlier this week was “remarkable” and relied on a “wholly unsupported theory that has no basis in law, precedent, or common sense,” the state attorney general’s office said in court documents filed with the Georgia Supreme Court. (Thanawala, 11/18)

AP: Indiana Doctor: AG Shouldn't Get Abortion Patient Records 
Lawyers for an Indianapolis doctor who provided an abortion to a 10-year-old rape victim from Ohio told a judge Friday that Indiana’s attorney general should not be allowed to access patient medical records for an investigation into undisclosed complaints. Dr. Caitlin Bernard; her medical partner, Dr. Amy Caldwell; and their patients sued Republican Attorney General Todd Rokita on Nov. 3 to try to stop him from accessing the records. The doctors claim Rokita’s conduct “violates numerous Indiana statutes,” including a state requirement that his office first determine consumer complaints have “merit” before he can investigate physicians and other licensed professionals. (Rodgers, 11/18)

CBS News: Pence Says Fertility Treatments "Deserve The Protection Of The Law"
"I fully support fertility treatments and I think they deserve the protection of the law," Pence said in an interview with "Face the Nation" that aired Sunday. "They gave us great comfort in those long and challenging years that we struggled with infertility in our marriage." (Quinn, 11/20)

Becker's Hospital Review: Two Deaths Possibly Tied To Flawed Oracle Cerner VA EHR Rollout, House Members Say
Three members of Congress wrote a letter to the U.S. Department of Veterans Affairs expressing concerns that the problematic rollout of the Oracle Cerner EHR at the agency could have played a role in the deaths of two veterans. U.S. Reps. Mike Bost, R-Ill., Mike Carey, R-Ohio, and Troy Balderson, R-Ohio, said they had "grave concerns" after visiting the Chalmers P. Wylie VA Ambulatory Care Center in Columbus, Ohio. (Bruce, 11/18)

Military Times: Did VA’s Health Records Problems Cause Two Patient Deaths In Ohio?
In the first case, a veteran connected to the medical center in Columbus, who was prescribed an antibiotic after a hospital visit, never received the medication because “the electronic health record provided erroneous tracking information for the prescription.” The veteran later died of medical complications. Lawmakers said In the second case, a veteran missed a regular medical check-up but that information was not properly transferred into the new system. As a result, “no outreach was attempted to reschedule the appointment.” The man showed up several months later at the medical center suffering from alcohol withdrawal symptoms, and died a few days later. (Shane III, 11/16)

Reuters: Provention Prices Diabetes Drug Above Analysts' Estimates At $13,850 Per Vial 
Provention Bio Inc. has priced its diabetes drug teplizumab at $13,850 a vial, it said on Friday, a day after receiving U.S. approval and far higher than some analysts' expectations. ... The U.S. Food and Drug Administration on Thursday approved use of the drug for patients, with stage 2 of type 1 diabetes, to delay the onset of insulin dependence in those aged 8 years and above. (Mahobe and Srinivasan, 11/18)

AP: 'Viral Jambalaya': Early Flu Adding To Woes For US Hospitals
As Americans head into the holiday season, a rapidly intensifying flu season is straining hospitals already overburdened with patients sick from other respiratory infections. More than half the states have high or very high levels of flu, unusually high for this early in the season, the government reported Friday. Those 27 states are mostly in the South and Southwest but include a growing number in the Northeast, Midwest and West. (Stobbe and Tanner, 11/18)

NBC News: How Bad Is Flu? CDC Reports Most Of The U.S. With High Or Very High Flu Levels
Influenza continues its fast and furious spread across the U.S., the Centers for Disease Control and Prevention reported Friday. Most of the worst of respiratory illnesses remain concentrated in Southern states like Alabama, South Carolina, Tennessee and Virginia. There are signs that flu is ramping up in other areas such as Colorado, New Mexico and Texas, according to the CDC. (Edwards, 11/18)

CIDRAP: Flu Rises To High Levels Across Most Of US
Flu activity is at high or very high levels in 30 states as the nation approaches the Thanksgiving holiday, with H3N2 still dominant but with a growing percentage of 2009 H1N1 viruses, the US Centers for Disease Control and Prevention (CDC) said [Friday] in its weekly update. (11/18)

The Washington Post: RSV, Covid And Flu Push Hospitals To The Brink — And It May Get Worse
When Christina Anderson’s mother started having chest pains in October, they rushed to the nearest emergency room in their hometown of Ottumwa, Iowa. Because of her mother’s ovarian cancer diagnosis, Anderson assumed they would be seen within a reasonable time. Instead, their trip became a nine-hour odyssey. “When we first walked in, it was packed and unlike anything I’ve ever seen,” Anderson said. “I saw people laying across the chairs; some slumped over who had been there for hours before we arrived, and some even got frustrated and left because they couldn’t wait anymore.” (Malhi, 11/20)

The Boston Globe: Anxieties Rising As Supply Of Antibiotic Used For Children’s Infections Falls Short
“I got an automated call from CVS saying we don’t have your medication, and I was on hold forever. The next three hours were beyond hellacious,” said Jennifer Cronin, an Ashland mother who frantically tried to fill an amoxicillin prescription Thursday for her 4-year old son’s ear infection. (Lazar, Freyer and Bartlett, 11/20)

CNBC: Pfizer Says Omicron Booster Is Better Against New Subvariants Like BQ.1.1 Than Old Shots
Pfizer said its omicron booster triggers a stronger immune response against a number of emerging Covid subvariants circulating in the U.S. The booster triggered more antibodies against omicron sublineages BQ.1.1, BA.4.6, BA.2.75.2 and XBB.1 in adults older than 55 compared with a fourth dose of the original vaccines, according to new data released by the company on Friday. Antibodies are a key part of the immune system that block the virus from invading cells. (Kimball, 11/18)

AP: Pfizer Booster Spurs Immune Response To New Omicron Subtypes 
Pfizer said Friday that its updated COVID-19 booster may offer some protection against newly emerging omicron mutants even though it’s not an exact match. (Neergaard, 11/18)

The New York Times: Will Covid Boosters Prevent Another Wave? Scientists Aren’t So Sure
As winter looms and Americans increasingly gather indoors without masks or social distancing, a medley of new coronavirus variants is seeding a rise in cases and hospitalizations in counties across the nation. The Biden administration’s plan for preventing a national surge depends heavily on persuading Americans to get updated booster shots of the Pfizer-BioNTech and Moderna vaccines. Now some scientists are raising doubts about this strategy. (Mandavilli, 11/18)

Stat: Pfizer CEO Says Covid Jabs Will Remain ‘Free,’ Despite Indirect Costs
As Pfizer prepares to hike the price of its Covid-19 vaccines, the company’s CEO, Albert Bourla, maintained at a conference this week that the jabs will continue to be “free for all Americans” because insurers are required to pay the extra cost. (Feuerstein, 11/18)

Houston Chronicle: U.S. Rep. Sheila Jackson Lee Calls For Funding For COVID, Flu Vaccines
U.S. Rep. Sheila Jackson Lee on Sunday asked Houstonians to get their vaccines and for the federal government to fund vaccine initiatives. The Centers for Disease Control and Prevention noted an early start to the flu season, and Jackson said, "We expect, in the next six weeks, a surge of flu comparable to an epidemic or pandemic." (Schuetz, 11/20)

The New York Times: The End Of Covid Vaccines At ‘Warp Speed’
The Biden administration has launched a last-ditch effort to restore the country’s edge. In a bid to resurrect Operation Warp Speed, President Biden asked the lame-duck session of Congress this week for $5 billion for next-generation vaccines and therapeutics, as part of a broader $9.25 billion pandemic spending request. But Republicans, having blocked requests for next-generation vaccine funding since the spring amid complaints about how the White House spent earlier pandemic aid allocations, have shown no signs of dropping their resistance. (Mueller, 11/18)

CIDRAP: NFL Games With Many In-Person Fans May Have Spiked COVID Cases 
A study of National Football League (NFL) home games attended by 1.3 million fans suggests that those with high attendance were tied to subsequent county-level COVID-19 surges during the 2020-2021 season. (Van Beusekom, 11/18)

Stat: MRNA Revolutionized The Race For A Covid-19 Vaccine. Could Cancer Be Next?
The unprecedented success of messenger RNA vaccines against the coronavirus is raising hopes that the technology could lead to new and better vaccines against a much older public health scourge: cancer. (Wosen, 11/21)

Houston Chronicle: Monkeypox Case Reported At Houston Elementary School
A person associated with an east Houston elementary school is believed to have contracted monkeypox, the Houston Independent School District said on Friday. The district announced a person with a "presumed positive" case of monkeypox had been identified at R.P. Harris Elementary School. The district didn't say if the person was a student or an employee. (Wayne Ferguson, 11/18)

CIDRAP: Study Describes Monkeypox In Women; CDC Warns Of Tpoxx Resistance
The first global case study of monkeypox in female patients suggests that as much as 25% of infections in women are not linked to sexual transmission. ... [And on Thursday], the Centers for Disease Control and Prevention (CDC) sent a Health Alert Network notice to health providers about two cases of Tpoxx resistance in people treated for monkeypox. Both had underlying immunocompromising conditions. (11/18)

Fierce Healthcare: Kaiser Permanente Inks Tentative Deal To Avert Nurses' Strike
About 22,000 nurses and nurse practitioners reached a tentative agreement with Kaiser Permanente on a new four-year contract that includes provisions for a 22.5% raise and increased staffing. The tentative deal averted what would have been the biggest private-sector nurses' strike in American history. Nurses working at nearly two dozen Kaiser Permanente locations planned a two-day strike that was set to begin on Monday. (Landi, 11/20)

Fierce Healthcare: UnitedHealthcare, AARP Team Up To Lower The Cost Of Hearing Aids
UnitedHealthcare and AARP are teaming up on a new program to reduce the cost of prescription and over-the-counter (OTC) hearing aids. ... Through AARP Hearing Solutions, which UnitedHealthcare is now administering, the nearly 38 million members of AARP can buy hearing aids through UnitedHealthcare Hearing. Prices start as low as $699 per hearing aid, according to the company, and members also get professional support from a licensed hearing professional plus personalized assistance from UnitedHealthcare Hearing during and after purchase. (Landi, 11/18)

Stat: Patient Groups Push Government To Enforce Price Estimates
People don’t receive bills after going to a grocery store or a mechanic’s shop. They know what things will cost them well before they leave. But in health care, patients get bills and “explanations of benefits” after the fact — usually creating confusion or shock as to how much they owe. (Herman, 11/21)

The Boston Globe: N.H. Doctor Allegedly Misread Mammograms, Ultrasounds Of Two Dozen Women Later Diagnosed With Breast Cancer
Patricia Eddy had always believed in early detection of breast cancer, and she was relieved when her mammograms in 2015, 2016, and 2017 revealed nothing suspicious. It wasn’t until later that she learned the alarming truth: Those three annual screening tests had shown signs of cancer, she said, but her New Hampshire radiologist, Dr. Mark Guilfoyle, had missed them every time. (Saltzman, Ostriker and Kowalczyk, 11/19)

The New York Times: Which To Choose: Medicare Or Medicare Advantage?
The two plans operate quite differently, and the health and financial consequences can be dramatic. Each has, well, advantages — and disadvantages. (Span, 11/20)

Axios: Middle-Class Seniors Will Have To Spend Down To Pay For Long-Term Care
Long-term care will become an increasingly elusive need for aging baby boomers in the next decade, forcing some to spend down their assets in order to qualify for Medicaid. (Goldman, 11/19)

Axios: Why Latino Elder Care Is So Challenging
Older Latinos — especially those who are noncitizens or live in poverty — are often kept from the health care resources advertised to help Americans age comfortably, researchers and advocates told Axios. (Moreno, 11/19)

AP: No More Mad Cow Worries, Banned Blood Donors Can Give Again 
U.S. Army veteran Matt Schermerhorn couldn’t give blood for years because he was stationed in Europe during a deadly mad cow disease scare there. Now, he’s proud to be back in the donor’s chair. Schermerhorn, 58, is among thousands of people, including current and former military members, who have returned to blood donation centers across the country after federal health officials lifted a ban that stood for more than two decades. (Aleccia, 11/20)

CIDRAP: Enoki Mushroom Listeria Outbreak Sickens People In 2 States
The US Centers for Disease Control and Prevention (CDC) yesterday announced a Listeria monocytogenes outbreak linked to enoki mushrooms that has hospitalized two people in Michigan and Nevada. Enoki mushrooms have long, thin stems and are a popular ingredient in Chinese, Japanese, and Korean food, usually eaten cooked in soups, stir fries, and hot pots. (11/18)

AP: Schools Struggle To Staff Up For Youth Mental Health Crisis 
Despite an influx of COVID-19 relief money, school districts across the country have struggled to staff up to address students’ mental health needs that have only grown since the pandemic hit. Among 18 of the country’s largest school districts, 12 started this school year with fewer counselors or psychologists than they had in fall 2019, according to an analysis by Chalkbeat. As a result, many school mental health professionals have caseloads that far exceed recommended limits, according to experts and advocates, and students must wait for urgently needed help. (Wall, Belsha and Ma, 11/18)

AP: 'Amazing': Mom Hears Late Daughter's Transplanted Heart 
An Indiana woman heard the heartbeat of her late daughter inside the chest of a 68-year-old Illinois man who received it in a transplant operation. Amber Morgan and Tom Johnson met for the first time Saturday, four years after he received a heart transplanted from the body of Andreona Williams, who was 20 when she died from asthma complications. (11/20)

USA Today: What Is Hyperbaric Oxygen Therapy, The Treatment Jay Leno Is Getting?
Jay Leno remained hospitalized Friday after he underwent surgery following a gasoline accident that resulted in serious burns to his face and hands. The injury took place after a gasoline fire erupted in the legendary comedian and "Tonight Show" host's garage over the weekend. While he was working on his car, a clogged fuel line uncorked, spraying fuel in his face and a nearby spark ignited the gasoline. (Neysa Alund, 11/18)