First Edition: May 18, 2023

KFF Health News: A Covid Test Medicare Scam May Be A Trial Run For Further Fraud 
Medicare coverage for at-home covid-19 tests ended last week, but the scams spawned by the temporary pandemic benefit could have lingering consequences for seniors. Medicare advocates around the country who track fraud noticed an eleventh-hour rise in complaints from beneficiaries who received tests — sometimes by the dozen — that they never requested. It’s a signal that someone may have been using, and could continue to use, seniors’ Medicare information to improperly bill the federal government. (Jaffe, 5/18)

KFF Health News: Thousands Face Medicaid Whiplash In South Dakota And North Carolina 
Until recently, Jonathon Murray relied on Medicaid to pay for treatments for multiple health conditions, including chronic insomnia. Murray, a 20-year-old restaurant worker from the college town of Brookings, South Dakota, said that without his medication, he would stay awake for several nights in a row. “I’d probably not be able to work that much because I’d be tired but couldn’t fall asleep,” he said. (Zionts, 5/18)

NBC News: Appeals Court Appears Skeptical Of Keeping Full Access To Abortion Pill Mifepristone
The federal judges who heard arguments Wednesday in the fight over access to the most commonly used abortion pill in the U.S. questioned the Biden administration's position that the drug mifepristone should remain widely available. The hearing at the 5th U.S. Circuit Court of Appeals in Louisiana included arguments from the Justice Department and drugmaker Danco Laboratories on one side and a group of doctors and medical professionals who oppose abortion on the other. The three-judge panel heard the case after the Supreme Court said the status quo on mifepristone's availability should remain in place while the appeals process plays out. (Gregorian and Junod, 5/17)

Politico: Six Surreal Moments From The 5th Circuit Argument On The Abortion Pill 
Judge Jennifer Walker Elrod focused on FDA decisions that allowed doctors to prescribe the drug and send the pill by mail without ever seeing the patient in person — a policy that began in 2021 as a pandemic accommodation and later became permanent. Referring to the practice as “the telemedicine situation” and the “mail business thing on the computer,” Elrod expressed skepticism that these remote options are safe. She asked Justice Department attorney Sarah Harrington how doctors can determine how far along a patient is in pregnancy or whether they may have an ectopic pregnancy without an in-person examination. (Ollstein and Gerstein, 5/17)

Reuters: Factbox: Who Are The Judges Who Will Decide The Appeal Over The Abortion Pill? 
All three of the judges on the 5th U.S. Circuit Court of Appeals panel that will hear the Biden administration's appeal to keep the abortion pill mifepristone on the market are staunchly conservative, with a record of opposing abortion rights. Here is a look at their records. (Pierson and Thomsen, 5/17)

CNN: South Carolina House Passes Six-Week Abortion Ban After Hours Of Contentious Debate
South Carolina House members approved a controversial bill late Wednesday that would ban most abortions as early as six weeks into pregnancy, after having spent the last two days in contentious debate on the legislation. Lawmakers had been called back for a special session this week by Republican Gov. Henry McMaster to continue work on Senate Bill 474, known as the “Fetal Heartbeat and Protection from Abortion Act,” which bans most abortions after early cardiac activity can be detected in a fetus or embryo, which can commonly be detected as early as six weeks into pregnancy, before many women know they are pregnant. (Kashiwagi, 5/17)

AP: Michigan Protects Workers From Retaliation For Having An Abortion 
Michigan companies will be prohibited from firing or otherwise retaliating against workers for receiving an abortion under a bill signed Wednesday by Democratic Gov. Gretchen Whitmer that amends the state’s civil rights law. Michigan’s Elliott-Larsen Civil Rights Act had previously only protected individuals against employment discrimination if the abortion was to “save the life of the mother.” Legislation signed Wednesday will extend those protections to anyone who terminates a pregnancy, regardless of reasoning. (Cappelletti, 5/17)

Modern Healthcare: Emergency Abortions Mired In Legal Questions A Year After Roe Reversal
Almost a year since the landmark Supreme Court ruling that allowed states to ban abortion, confusion and fear reign as clinicians confront the risks of criminal charges amid evolving rules and uneven enforcement of laws that sometimes contradict each other. “We have chaos, and we just have to live with the chaos,” said Harvard Law School professor and former Maine Attorney General James Tierney (D). “Physicians and hospitals are very nervous. They don’t know what to do.” The legal cases that ensue will take years to litigate, and the underlying uncertainty isn't likely to abate until the high court weighs in again. (Hartnett, 5/17)

Politico: Biden Indicates He’s Willing To Make A Debt Ceiling Compromise 
President Joe Biden on Wednesday left the door open to expanding some work requirements as part of a debt ceiling deal, committing only to opposing new restrictions that affect health care programs. “I’m not going to accept any work requirements that’s going to impact on medical health needs of people,” he said, before adding that “it’s possible” a deal could expand work rules for other federal programs. (Cancryn and Daniels, 5/17)

Stat: Senators Probing Largest Medicare Advantage Plans Over How Algorithms Factor In Care Denials
Senators warned the country’s largest Medicare Advantage insurers at a hearing on Wednesday that they must abide by Medicare’s coverage rules and cannot rely on algorithms to deny care that patients need. Congress is ramping up its oversight, too. Lawmakers in both parties have asked UnitedHealth Group, Humana, and CVS Health’s Aetna for internal documents that “will show how decisions are made to grant or deny access to care, including how they are using [artificial intelligence],” said Sen. Richard Blumenthal, the top Democrat on a subcommittee with the power to investigate government affairs, during the hearing. (Herman and Ross, 5/17)

Stat: House Panel Takes First Steps Toward Reining In Hospitals With ‘Site-Neutral’ Changes
A key House panel on Wednesday advanced several health care bills on Wednesday, including its first step toward a controversial effort to equalize Medicare payments between hospitals and physician offices. The Energy and Commerce health subcommittee passed a provision that would ensure Medicare pays the same amount to doctors who administer drugs whether they’re given in a hospital or a physician’s practice. (Cohrs, 5/17)

Modern Healthcare: House Panel Advances Bill To Promote PBM Transparency
Pharmacy benefit managers would be subject to new transparency rules under legislation that cleared a key House subcommittee on Wednesday. The Transparent PRICE Act of 2023, which received a unanimous vote in the the House Energy and Commerce Committee's Health Subcommittee, would require PBMs to annually provide employers with detailed data on prescription drug spending, including acquisition costs, out-of-pocket spending, formulary placement rationale and aggregate rebate information. The bill also would order the Government Accountability Office to report on group health plan pharmacy networks, including those owned by health insurance companies. (Nzanga, 5/17)

Stat: FTC Widens Probe Into Pharmacy Benefit Managers To Include Group Purchasing Organizations
The Federal Trade Commission is widening its probe into pharmacy benefit managers and their impact on drug pricing by looking into a pair of group purchasing organizations that are owned by these industry middlemen, but are not well understood outside the industry. By seeking documents from Zinc Health Services and Ascent Health Services, the agency is attempting to unravel what critics complain is an opaque set of business practices and relationships. Pharmacy benefit managers are linchpins in the pharmaceutical pricing system, and are under increased scrutiny for allegedly driving up consumer costs. (Silverman, 5/17)

The Washington Post: U.S. Overdose Deaths Plateau In 2022, But Still Exceed 100,000
Drug overdose deaths in the United States plateaued in 2022 but still topped 100,000 — stark proof that the nation remains in the throes of a staggering crisis killing hundreds of Americans daily. According to provisional data released Wednesday by the Centers for Disease Control and Prevention, at least 105,452 people succumbed to overdoses in 2022, a number poised to increase because of the lag time in reporting deaths by state agencies. The CDC is estimating that number could top 109,000. The death count mirrors 2021, when drugs such as illicit fentanyl, cocaine and methamphetamine killed more than 107,000 people — a record high for the nation. (Ovalle, 5/17)

AP: Drug Overdoses In The US Slightly Increased Last Year. But Experts See Hopeful Signs 
“The fact that it does seem to be flattening out, at least at a national level, is encouraging,” said Katherine Keyes, a Columbia University epidemiology professor whose research focuses on drug use. “But these numbers are still extraordinarily high. We shouldn’t suggest the crisis is in any way over.” (Stobbe, 5/17)

The Washington Post: Walgreens To Pay San Francisco $230 Million To Settle Opioid Lawsuit 
San Francisco has a reached an almost $230 million settlement with Walgreens over the company’s role in the opioid epidemic, which has plagued the city and ravaged communities across the United States. At a news conference Wednesday, San Francisco City Attorney David Chiu said it was the largest award to a local jurisdiction against an opioid defendant in the country; $200 million of the fund will go toward local efforts to alleviate the opioid crisis. (Ables, 5/18)

San Francisco Chronicle: Lawmakers Favor Treatment Over Punishment With Fentanyl Bills
As California faces a fentanyl overdose crisis, lawmakers are proposing tackling the crisis from two different angles: treatment and punishment. While policy proposals focused on treatment for drug overdoses and addiction have been sailing through the Legislature, ones that would increase punishments for drug dealing have been watered down or stalled. (Bollag, 5/17)

Nature: Why Is COVID Life-Threatening For Some People? Genetics Study Offers Clues
An analysis of DNA from more than 24,000 people who had COVID-19 and required treatment in intensive care has yielded more than a dozen new genetic links to the risk of developing extreme illness from the disease. The study, which was published on 17 May in Nature1 and has more than 2,000 authors, highlights the role of the immune system in fueling the later stages of particularly severe COVID-19. The results could one day contribute to the development of therapies for COVID-19 — and potentially other diseases that cause acute respiratory distress or sepsis. (Ledford, 5/17)

Bloomberg: Where Things Stand With Long Covid And Its Aftermath
Covid-19’s devastating toll is often measured by hospitalizations and deaths, but the effects of the pandemic run far deeper and wider. (Gale, 5/17)

Modern Healthcare: VA Renegotiates Electronic Health Record Deal With Oracle Cerner
The Veterans Affairs Department has renegotiated its agreement with Oracle Cerner to hold the electronic health record company more accountable, the VA said on Thursday. The new contract has been restructured from a single, five-year term to five, individual one-year terms, said Dr. Neil Evans, acting director of the VA's Electronic Health Record Modernization Integration Office, in an email. Evans said the new agreement “dramatically increases VA’s ability to hold Oracle Cerner accountable across a variety of key areas.” (Turner, 5/17)

Military.com: Fewer Tricare Pharmacy Patients Renewed Auto Refills After Confirmation Requirement 
Five percent of Tricare users who previously received automatic prescription refills by mail didn't renew their drugs under a new policy requiring them to confirm the orders, according to the Defense Health Agency. Those patients either disenrolled or didn't consent to renew their prescription between January and the end of March, which was the first three months of the new refill policy, DHA spokesperson Peter Graves told Military.com by email. (Miller, 5/17)

The Boston Globe: Hospital Injuries To Patients And Health Care Workers Rose Significantly During Pandemic
The amount of misery and abuse suffered by hospital patients, and the workers who cared for them, jumped significantly during the COVID-19 pandemic, new data from the Massachusetts health department show. From patients who developed severely damaged skin, known as pressure ulcers, which often appear while bed-ridden for hours without being moved, to caregivers and security officers being assaulted by patients, the numbers paint a sobering picture of the heavy toll exacted by the pandemic on the state’s health care system and the people in it. (Lazar, 5/17)

Philadelphia Inquirer: Temple University Doctor's Blood Clot Treatment Device Approved By FDA
Riyaz Bashir was frustrated with the tools he had to treat blood clots in the lungs. So the Temple University Hospital cardiologist invented a new device to treat the nation’s third leading cardiovascular cause of death. Last month, the Food and Drug Administration approved his invention. Bashir believes the device is a significant milestone in the treatment of pulmonary embolism, which occurs when a blood clot gets stuck in one of the arteries in the lung. Blood then can’t reach the oxygen it needs to carry to the heart, brain and the rest of the body. (Gutman, 5/17)

The Hill: Apple To Release More Accessible Features For Users With Visual, Speech Impairments 
Apple Inc. unveiled an array of new features to make its products more accessible to users who suffer from cognitive, visual and speech impairments. In a news release Wednesday, Apple said its new features which include Assistive Access, Live Speech, Personal Voice and Point and Speak, will “draw on advances in hardware and software,” including ensuring user privacy and expanding on the company’s “long-standing commitment to making products for everyone.” (Oshin, 5/17)

CNN: Children As Young As 4 Can Learn What To Do In A Medical Emergency, American Heart Association Says
Leading heart health organizations are urging schools and parents to teach young children life-saving skills such as how to call 911 and how to administer CPR. On Wednesday, the American Heart Association, the European Resuscitation Council and the International Liaison Committee on Resuscitation published a scientific statement in the journal Circulation that details evidence showing schoolchildren as young as 4 know how to call for help in a medical emergency and that, by age 10 to 12, children can administer effective chest compressions when performing cardiopulmonary resuscitation, better known as CPR. (Howard, 5/17)

The Washington Post: When Too Much Exercise Is Bad For Your Heart 
Exercise is, without question, good for our hearts. But can we potentially get too much of a good thing? A growing body of science, including a new report of the health of almost 1,000 longtime runners, cyclists, swimmers and triathletes, finds that years of heavy endurance training and competition may contribute to an increased chance of developing atrial fibrillation, especially in men. (Reynolds, 5/17)

NPR: The Death Cap Mushroom Can Be Lethal. Now There's New Hope For An Antidote
They don't call it the "death cap" mushroom without good reason. It's one of the most poisonous mushrooms in the world. Eating only half a cap can shut down your liver – and if you don't get medical attention fast enough, that shroom just might turn out to be your last meal. Mushroom poisonings are tough to track reliably, but some scientists estimate that they cause about 10,000 illnesses and 100 deaths a year globally. Until now, effective treatments for death cap poisonings were few and far between with no proven antidote available. (Barnhart, 5/17)

The New York Times: Heat Will Likely Soar to Record Levels in Next 5 Years, New Analysis Says
Global temperatures are likely to soar to record highs over the next five years, driven by human-caused warming and a climate pattern known as El Niño, forecasters at the World Meteorological Organization said on Wednesday. ... “This will have far-reaching repercussions for health, food security, water management and the environment,” said Petteri Taalas, the secretary general of the meteorological organization. “We need to be prepared.” (Plumer, 5/17)

The New York Times: Texas Legislature Bans Transgender Medical Care For Children 
Over the opposition of Democrats and the loud protests at the Capitol this month, the Texas Legislature voted on Wednesday to approve a bill banning hormone and puberty blocking treatments, as well as surgeries for transgender children. The state is poised to become the largest state to ban transition medical care for minors. The final version of the bill included a limited exemption for those transgender children who were already receiving medical treatment before the bill’s passage, though it also required those patients to “wean” themselves off the medications over an unspecified period of time. (Montgomery and Goodman, 5/17)

AP: Here Are The Restrictions On Transgender People That Are Moving Forward In US States 
At least 17 states have now enacted laws restricting or banning gender-affirming care for minors: Alabama, Arkansas, Arizona, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Mississippi, Montana, North Dakota, Oklahoma, Tennessee, Utah, South Dakota and West Virginia. Federal judges have blocked enforcement of laws in Alabama and Arkansas, and several other states are considering bills this year to restrict or ban care. Proposed bans are also pending before Texas and Missouri’s governors. These bans have spread quickly, with only three states enacting such laws before this year. (DeMillo, 5/18)

The Hill: Supreme Court Leaves Illinois Assault Weapons Ban In Place
The Supreme Court declined to immediately block Illinois’s assault weapons and high-capacity magazine bans, leaving them in place, for now. A gun rights group and gun shop owner asked the justices to pause the law’s enforcement by intervening in the case ahead of an appeals court’s final ruling. The lawsuit also challenges an ordinance in Naperville, Ill., that bans the sale of assault rifles. (Schonfeld, 5/17)

AP: Minnesota Gets $60.5M In Settlement With E-Cigarette Maker Juul, Tobacco Giant Altria 
Minnesota settled its lawsuit against e-cigarette maker Juul Labs and tobacco giant Altria for $60.5 million, Attorney General Keith Ellison announced Wednesday, saying the total is significantly higher per capita than any other state that sued Juul over youth vaping and marketing practices. The state’s lawsuit was the first and still the only one of thousands of cases nationwide against the e-cigarette maker to reach trial. It settled just ahead of closing arguments last month, but the terms had to be kept confidential for 30 days until the formal papers were filed publicly with the court. (Karnowski, 5/17)

The Washington Post: Theranos Founder Elizabeth Holmes Must Report To Prison By May 30 
On Wednesday, U.S. District Court Judge Edward J. Davila ordered Elizabeth Holmes to report to prison no later than 2 p.m. on May 30. The order comes a day after the U.S. Court of Appeals for the 9th Circuit denied Holmes’s request to remain out of prison as she appeals her conviction. (Lerman and Mark, 5/17)

AP: Americans Urged To Cancel Surgeries In Mexico Border City After Meningitis Cases, 1 Death 
State and federal health officials are warning U.S. residents to cancel planned surgeries in a Mexico border city after five people from Texas who got procedures there came back and developed suspected cases of fungal meningitis. One of them died, officials said. The five people who became ill traveled to Matamoros, across the border from Brownsville, for surgical procedures that included the use of an epidural, an anesthetic injected near the spinal column, the Texas Department of State Health Services said Tuesday. Four remain hospitalized, and one of them later died. (5/18)

Reuters: EU, United States Launch Joint Health Task Force 
The European Union and the United States have launched a new joint health task force to cooperate on cancer, global health threats and related supply chains and infrastructure, officials told a press conference on Wednesday. The task force was set up on the heels of a cooperation agreement signed in June last year to tackle health emergencies like the COVID-19 pandemic. (5/17)