The Washington Post: Republicans Seize On Obamacare Woes To Help Save Congressional Majority
Republicans have found an issue on which they can play a rare bit of offense in their quest to hang on to their Senate and House majorities: Obamacare. Criticism of the landmark health-care law has been a staple of GOP campaigns since its party-line passage in 2010. But unlike six years ago, in the first election after the passage of the Affordable Care Act, Republicans aren’t running a national campaign against federal government overreach. Instead, they’re lobbing localized attacks in key states on issues plaguing the state insurance exchanges mandated by the law. (DeBonis and Weigel, 9/19)

The Washington Post: Skyrocketing Obamacare Premiums Still Lower Than Employer-Sponsored Insurance
People who warn that President Obama's health-care law is in dire straits often point to rising health insurance premiums as proof. Sen. John McCain (R-Ariz.) has called premium increases on Affordable Care Act exchanges "astronomically high." Sen. Ron Johnson (R-Wis.) says premiums have "skyrocketed." But are these growing premiums actually high? A new analysis from the Urban Institute found that the average unsubsidized premiums in the Affordable Care Act exchanges, commonly known as Obamacare, are actually 10 percent lower than the full premiums in the average employer plan nationally in 2016. (Johnson, 9/19)

Morning Consult: Employer Premiums Higher Than ACA Rates, Report Says
The analysis found that nationally, the average second-lowest silver plan premium on an Obamacare exchange is 10 percent lower than the average employer-sponsored premium. The researchers made adjustments for actuarial value, or the percent of costs covered by the insurer, as well as utilization and age distribution. (Owens, 9/19)

The Baltimore Sun: Maryland Health Exchange Launches New Mobile App For Enrollment 
Maryland health exchange officials have launched a new app specifically designed to help people enroll in health insurance on their phones and tablets. The move is a response to the high rate of people using mobile devices — more than a third — to visit the state's online marketplace for health insurance. (Cohn, 9/19)

The (Baton Rouge, La.) Advocate: Medicaid Expansion Enrollment Tops 300K In Louisiana
Louisiana leaders say that hundreds of residents newly added to the state's Medicaid rolls have received potentially life-saving treatment since the health care program was expanded earlier this year. Twenty-four women are getting breast cancer treatment after positive screenings, 160 adults have been diagnosed with diabetes and are receiving treatment and more than 100 patients had polyps removed after they were found during colonoscopies. ... More than 305,000 adults have been been added to Medicaid since the state expanded eligibility for the health care program in July. (Crisp, 9/19)

New Orleans Times-Picayune: Louisiana Medicaid Expansion: 10 Things John Bel Edwards Wants You To Know
Two and half months after Medicaid expansion came to Louisiana, Gov. John Bel Edwards' administration is touting figures that show people are taking advantage of broader access to health care. ... Louisiana is the first state in the Deep South to implement Medicaid expansion, but the 31st state in the nation to adopt the program. (O'Donoghue, 9/19)

Denver Post: ACLU Sues Colorado Medicaid Over Denial Of Treatment For Thousands Of Hep C Patients 
Colorado’s Medicaid department was slapped with a federal class-action lawsuit Monday led by a Denver man denied treatment for the life-threatening hepatitis C virus because he has government insurance. ... Colorado covers the 12-week, $40,000 prescription only for people whose livers have reached stage two in scarring, on a scale of zero to four. (Brown, 9/19)

The Philadelphia Inquirer: Aetna, Three Other Firms Appeal Long-Term Care Loss In Pa.
Four losing bidders have protested the Pennsylvania Department of Human Services' award last month of three-year contracts to manage long-term care for Medicaid beneficiaries, the agency said Monday. Pennsylvania's Community HealthChoices represents a major overhaul of how the state pays for  nursing home stays, home care, and other supports for the elderly and the physically disabled older than 21. The affected population totals about 420,000, including 120,000 to 130,000 seniors. (Brubaker, 9/19)

The New York Times: F.D.A. Approves Muscular Dystrophy Drug That Patients Lobbied For
The Food and Drug Administration approved the first drug to treat patients with the most common childhood form of muscular dystrophy, a vivid example of the growing power that patients and their advocates wield over the federal government’s evaluation of drugs. The agency’s approval went against the recommendation of its experts. The main clinical trial of the drug was small, involving only 12 boys with the disease known as Duchenne muscular dystrophy, and did not have an adequate control group of boys who had the disease but did not take the drug. A group of independent experts convened by the agency this spring said there was not enough evidence that it was effective. (Tavernise, 9/19)

The Wall Street Journal: FDA Approves Sarepta’s Muscular Dystrophy Drug
The circumstances of the approval at the agency were highly unusual, and included sharp internal protests that were ultimately resolved by FDA Commissioner Dr. Robert M. Califf. An advisory committee to the FDA in April voted 7-3, with 3 abstentions, that the data for the drug weren't enough for agency approval. ... Sarepta officials said Monday that the drug’s cost would be based on the patient’s weight. For the average-size child, the company said, the annual cost would be $300,000. (Burton, 9/19)

Kaiser Health News: FDA Approves First Drug To Treat Rare Form Of Muscular Dystrophy
Exondys 51 doesn’t cure Duchenne muscular dystrophy and will only help a minority of patients. It is designed for the 13 percent of patients with a particular genetic mutation that prevents them from making dystrophin, a key protein that keeps muscles intact. Without that protein, muscles weaken so that children are unable to walk and must use wheelchairs by the time they’re teens. Eventually, the disease can fatally weaken the heart and muscles needed to breathe. Patients often die in their 20s or 30s. (Szabo, 9/19)

Boston Globe: FDA Approves Duchenne Drug, Overturning Staff And Advisers 
Approval of the medicine, which will be sold under the brand name Exondys 51 starting as early as this fall, came after hundreds of patients and their families lobbied for a new approach, packing an emotionally charged FDA advisory committee meeting in April to clamor for Sarepta’s experimental treatment. “These kids have hope now,” said Christine McSherry of Pembroke, whose 20-year-old son Jett benefitted from Sarepta’s treatment, called eteplirsen, in the clinical trial. “It’s wonderful for the next generation of kids with this terrible disease. It opens the door for more research and more treatments for Duchenne and other genetic diseases.” (Weisman, 9/19)

Bloomberg: Fierce Debate At FDA On Whether Drug Decision Sets New Standard 
“It sets a precedent for patient advocate involvement and potential power; it sets a precedent for the degree of flexibility that FDA can show if they want to,” said Ritu Baral, an analyst at Cowen & Co. The decision makes rare disease drug development more unpredictable, she said. (Cortez and Edney, 9/19)

Stat: Sarepta To Charge $300,000 A Year For Duchenne Drug
The newly approved Sarepta Therapeutics drug for Duchenne muscular dystrophy will cost about $300,000 a year for the average patient in the United States, which is less than what some Wall Street analysts had expected. Sarepta CEO Dr. Edward Kaye said the pricing was “in the middle of the range” for rare disease drugs. “And given the sensitivity to pricing, we tried to be reasonable when looking at all the costs,” he said on a phone call Monday with securities analysts. (Silverman, 9/19)

Stat: Brothers Find Joy In FDA Approval Of Drug For Their Rare Disease
Max and Austin Leclaire have lived a lot of hard days together. The brothers have Duchenne muscular dystrophy, a rare degenerative disease that wastes their muscles and will likely take their lives at an early age. Over the last few years, they found glimmer of hope in an experimental drug, called eteplirsen. Max was able to get on the drug in 2011. Austin started on it three years later in another clinical trial. Both boys believe it has helped slow their physical decline. And Max has remained able to walk, although not easily, beyond the age when boys with Duchenne usually lose the use of their legs. (Delviscio, 9/20)

Stat: Behind The Sarepta Drug Approval Was Intense FDA Bickering
The run-up to Monday’s approval of a Sarepta Therapeutics drug to treat Duchenne muscular dystrophy was marked by unusual bickering inside the Food and Drug Administration, where debate over a key scientific question morphed into a formal dispute, and the head of the drug review division was accused of being too intensely involved in the process for evaluating the medicine.Ultimately, the decision to greenlight the drug fell to the FDA Commissioner, Dr. Robert Califf. (Silverman, 9/19)

Stat: Did The FDA Set 'A Dangerous Precedent' With Its Latest Drug Approval?
The experimental drug that federal regulators approved Monday will only be used by a few thousand patients.But the approval may have set a precedent that could rocket through the health care system, opening the door for drug makers to get more medicines to market — even with scant evidence that they work. The Food and Drug Administration’s decision elated families struggling with Duchenne muscular dystrophy, a rare and deadly disease. It sent the stock of the drug maker, Sarepta Therapeutics, soaring. (Garde, 9/19)

Meanwhile, Stat offers a closer look at the woman who pushed for the drug's approval —

Stat: Storm Swirls Around FDA Drug Cop Who Approved Sarepta Drug
She’s been attacked by parents of dying children, vilified by consumer groups, and grilled by Congress, but over the past 30 years, Dr. Janet Woodcock has risen to become the top drug cop at the Food and Drug Administration — and managed to stay there. “She sticks to her guns,” said Marc Boutin, chief executive officer of the National Health Council, a coalition of patient advocates, pharmaceutical companies, and others. “She’s tough as nails.” That may be an understatement. (Kaplan, 9/20)

The Washington Post: CDC Lifts Zika Travel Advisory For One Florida Zone
Federal health officials on Monday lifted their Zika travel advisory that had urged pregnant women to avoid an area north of downtown Miami called Wynwood. They made the call because no new cases of locally transmitted virus have been reported there since early August. The announcement from the Centers for Disease Control and Prevention comes after Florida Gov. Rick Scott announced earlier in the day that no evidence of Zika's spread has been documented in the Wynwood area for 45 days. The CDC's travel advisory remains in effect for the state's other active zone of transmission, Miami Beach. The area covered by that travel warning was tripled in size late Friday to cover nearly two-thirds of that tourist hot spot. (Sun, 9/19)

The Associated Press: Miami's Wynwood Cleared Of Zika; Focus Shifts To Miami Beach
With health authorities declaring a win against Zika in Miami's Wynwood arts district, their emphasis shifts to the remaining transmission zone on nearby Miami Beach, where residents have objected to the aerial pesticide spraying crediting with halting infections. No new cases of Zika have been reported in Wynwood since early August, and on Monday health officials declared it to be no longer a zone of active local transmission. (9/20)

Tampa Bay Times: Gov. Rick Scott Declares Wynwood Area 'Zika-Free'; CDC Says 'Don't Let Guard Down' 
"Everybody should be coming back here and enjoying themselves," [Gov. Rick] Scott said during a news conference at Wynwood Walls, an outdoor venue showcasing colorful street murals, where he was joined by business owners, elected officials and representatives from the health department. (Smiley and Chang, 9/19)

Morning Consult: CDC Eases Zika Guidance For Miami-Dade County Neighborhood
Pregnant women and their partners should continue to take steps to prevent mosquito bites when visiting the area and may consider delaying nonessential travel to the county if they are concerned about potential exposure to the Zika virus, the CDC now says. (McIntire, 9/19)

Health News Florida: More Mosquitoes Test Positive For Zika In Miami Beach 
The Florida Department of Agriculture and Consumer Services said Friday that another mosquito sample in Miami-Dade County has tested positive for the Zika virus. The positive test came from the same area of Miami Beach where four other samples have previously tested positive for Zika, department officials said. The agency said it has taken 3,200 samples, consisting of more than 52,000 mosquitoes, since May. (9/19)

The New York Times: Predict Zika’s Spread? It’s Hard Enough To Count The Cases
How far will the Zika outbreak spread, and for how long? Predicting Zika’s course in the continental United States is difficult. Health experts have never confronted a virus quite like this one: a mild infection that can nonetheless devastate unborn infants, and that is transmitted by both mosquitoes and sex. Even tracking cases is hard because so few cause symptoms. (McNeil, 9/19)

San Jose Mercury News: As Zika Spreads In California, Leaders Call For More Money, Education
California needs to be better prepared for the Zika virus and do more to educate people about how it spreads, especially since federal funding has stalled, state and local health officials determined last week. The call for a massive education campaign came during a town hall meeting in downtown Los Angeles on Thursday, sponsored by state Sen. Ed Hernandez, D-West Covina. Hernandez said concerns about Zika are growing, especially since the number of people who have it in the Golden State continues to climb. As of Friday, 282 people had tested positive for Zika, or 22 more cases than the week before, according to the California Department of Public Health. (Abram, 9/19)

The Wall Street Journal: CDC Study Finds Increased Use Of Powerful Antibiotics At U.S. Hospitals
A new study by the Centers for Disease Control and Prevention found more widespread use by U.S. hospitals of powerful antibiotics designed to fight infections when less-robust antibiotics fail, a “worrisome” development as bacteria grow increasingly immune to treatment, the researchers said. Medical experts said the study, which examined prescribing between 2006 and 2012, appeared to be the first national, multiyear estimate of U.S. hospital antibiotic use. The results underscore other studies that point to the rising use of antibiotics once considered a last resort, even as calls for cautious prescribing grow more urgent. Antibiotic overuse gives evolving bacteria more opportunities to adapt and develop drug resistance. (Evans, 9/19)

Miami Herald: Antibiotic Use Is Making Us Sicker But Doctors Still Prescribe Them In High Frequencies 
Despite evidence that prolific use of antibiotics could actually be making us get sicker, hospitals are still prescribing them at high rates. A new study shows that prescription rates did not decrease between 2006 and 2012, despite growing evidence that many drugs given to patients were not actually necessary. It found that the length of time patients took the drugs didn’t change, but that use of particular drugs did go up. (Welsh, 9/19)

Cincinnati Enquirer: Skip Antibacterial, Use Plain Soap And Water
In 2013 the FDA issued a proposed rule requiring safety and efficacy data from manufacturers, consumers, and others if they wanted to continue marketing antibacterial products containing those ingredients, but very little information has been provided. That’s why the FDA is issuing a final rule under which OTC consumer antiseptic wash products (including liquid, foam, gel hand soaps, bar soaps and body washes) containing the majority of the antibacterial active ingredients – including triclosan and triclocarban – will no longer be able to be marketed. (Byrnes, 9/19)

In other news from the Centers for Disease Control and Prevention, the agency wants to build awareness about the dangers of sepsis —

The New York Times: Could It Be Sepsis? C.D.C. Wants More People To Ask
Between one million and three million Americans are given diagnoses of sepsis each year, and 15 percent to 30 percent of them will die, Dr. Frieden said. Sepsis most commonly affects people over 65, but children are also susceptible. ... Sepsis develops when the body mounts an overwhelming attack against an infection that can cause inflammation in the entire body. ... Sepsis appears to be rising. The rate of hospitalizations that listed sepsis as the primary illness more than doubled between 2000 and 2008, according to a 2011 C.D.C. study. (Rabin, 9/19)

The Hill: Planned Parenthood No Longer 'Hangup' Of Spending Deal 
Planned Parenthood is no longer at the center of the fight to avert a government shutdown, multiple sources said Monday.  Aides from both parties say funding for a Planned Parenthood partner in Puerto Rico is no longer stalling talks on the government's short-term spending bill, though lawmakers have been cautious not to say they’ve reached an official deal. Republicans in both chambers have for months pushed a funding package to fight the Zika virus that would have restricted funding from going to Planned Parenthood partner ProFamilias. (Ferris, 9/19)

Morning Consult: Stopgap Spending Bill Delayed By Zika, Internet, SEC Language
A partisan dispute over $1.1 billion in emergency funding to fight the Zika virus is close to resolved, according to Sen. Bill Nelson (D-Fla.) and a Democratic leadership aide. The new language, according to the aide, would enable a Planned Parenthood affiliate in Puerto Rico to access federal funding, as Democrats have demanded. Nelson said separately that in return, some of the funding provided for Zika would be offset, but he didn’t know how much. (McIntire, 9/19)

In other news from Capitol Hill —

Politico: House Panel To Vote On Contempt Charges For StemExpress
A House panel will vote Wednesday on whether to begin contempt proceedings against StemExpress, a human tissue procurement company that used to work with Planned Parenthood. The House Select Investigative Panel on Infant Lives will vote to hold the company and CEO Cate Dyer in contempt of Congress for not complying with subpoenas to turn over documents on its fetal tissue processing, Chairwoman Marsha Blackburn (R-Tenn.) announced Monday evening. The panel would have to vote to send the resolution to the full House — a matter that is unlikely to take place until after the November election. (Haberkorn, 9/19)

The New York Times: Deaths, Fraud Allegations And An Inquiry Into A Long Island V.A. Hospital
Along the winding drive through the 300-acre compound of Long Island’s only veterans’ medical center, banners line the road stating the presumed values of the institution: integrity, commitment, advocacy, respect and excellence. But in recent months, a series of troubling failings and allegations of wrongdoing have called into question the care being provided to thousands of the nation’s military personnel by the Northport Veterans Affairs Medical Center, in Northport, N.Y., with charges of abuse that include widespread billing fraud and the failure to report the death of a patient for months after his body was found in a building on the complex. (Rebelo and Santora, 9/19)

San Antonio Press Express: Health Initiative Eyes Improvement For Veteran Access To Care 
A top Veterans Affairs official said Monday that an initiative to remove bureaucratic entanglements in the veterans health care system will speed access to care for veterans in the Rio Grande Valley, and could act as a model for the rest of the country. The conclusion of a 90-day initiative to streamline community care programs for veterans has already decreased the denial rate for claims from 50 percent to 10 percent, and officials say they expect other improvements in the months ahead. (Nelson, 9/19)

Cleveland Plain-Dealer: DEA Head: Heroin Crisis Won't Be Solved Just By Throwing Addicts In Prison 
The head of the U.S. Drug Enforcement Administration says that the answer to the explosion of deaths attributed to heroin, fentanyl and other powerful opioids isn't as simple as locking the problem away in prison cells. Chuck Rosenberg, the former federal prosecutor who now heads the DEA, made the remark Monday while meeting with a small group of reporters in Cleveland, a city within a county that saw a record number of drug overdose deaths in August.  (Ferrise, 9/19)

Columbus Dispatch: As Heroin Wrecks Lives, Addicts’ Parents Fight Shame, Fear 
Everyone has heard about how heroin abuse damages the spirit and ruins the physical health and mental functioning of those in its grip. But less talked about is how parents of an addict keep moving forward when their lives are in free fall. Or how they juggle the challenge of helping their child while not enabling the disease. (Pyle, 9/20)

Los Angeles Times: FDA Asks Coders To Create An App That Matches Opioid Overdose Victims With Lifesaving Rescue Drug
In a bid to stanch the death toll of the nation’s epidemic of opioid drug use, the Food and Drug Administration is calling for the development of a cellphone app that could quickly bring lifesaving medication to the rescue of a person in the throes of a potentially deadly overdose. The FDA on Monday challenged computer programmers, public health advocates, clinical researchers and entrepreneurs to create an application that can connect opioid users and their friends and loved ones to someone nearby who has a dose of the prescription drug naloxone. (Healy, 9/19)

The Washington Post: Overdosing On Heroin And Searching For Naloxone? The FDA Wants An App For That.
The last time the government launched a competition to solve a public health crisis, Americans were saved from salmonella in fresh produce.The winning scientists received $500,000. Now, the federal Food and Drug Administration is tackling a more deadly foe — the nationwide opioid crisis — and its calling on a different band of heroes for help. (Mettler, 9/19)

The Washington Post: Opioid Epidemic Encourages States To Open Recovery High Schools
This summer, Melvin Matos did something that he once thought he would never do: graduate from high school. He’d started drinking at 14 and quickly moved on to pills and pot. By the time he turned 16, Matos could see where his life was heading: Some of his buddies already had died because of drugs and drink. After a stint in rehab, Matos enrolled at the William J. Ostiguy High School in Boston, one of five public “recovery high schools” in Massachusetts. There, in addition to his academic classes, he participated in group therapy and 12-step meetings, submitted to regular drug tests and formed friendships with kids facing struggles similar to his. (Wiltz, 9/19)

In other news on the opioid epidemic —

The Washington Post: Federal Drug Testing Rules Race To Catch Up To Illegal Prescription Drugs
The federal drug-testing program had its beginnings one cloudy January afternoon when two men shared a joint. At the time, they were operating three 130-ton locomotives. A few minutes later, after blowing through a railroad signal light just north of Baltimore, they collided with an Amtrak train packed with passengers, many of them college students heading back to school after their winter break. Three Amtrak passenger cars were destroyed, 16 people died and 174 were injured. ... Twenty-five years later, the test remains the same, but illegal drug use has changed significantly. The 21st century has become the era of addiction to prescription painkillers — drugs with familiar brand names such as OxyContin, Percocet, Vicodin, Fentanyl and Valium. (Halsey, 9/19)

Columbus Dispatch: Coroner Investigates Overdose Deaths To Help Save The Living 
Coroner Anahi Ortiz wants to use clues from those deaths to save others' lives. And there's no area where she's making a bigger impact than in the heroin and opiate crisis, local officials say. Over the past 18 months, Dr. Ortiz, 58, has held monthly overdose death reviews with professionals countywide to look for gaps in the system. In March, she convened a summit of top minds to come up with solutions to the crisis. She also created a task force that over the next two years will implement a plan based on ideas from the summit. (Pyle, 9/20)

Stat: As Profitable Fentanyl Industry Expands In China, US Negotiates To Halt The Deadly Trade
Top American and Chinese enforcement officials are negotiating how to fight the rampant trade in synthetic drugs manufactured here and blamed for a deadly wave of spiked opioids in the United States. A 14-member delegation from the US Drug Enforcement Agency, led by Deputy Chief of Operations Lizette Yrizarry, spent a week in China in August, meeting with Narcotics Control Bureau and Public Security Bureau officials, DEA officials said. (McLauglin, 9/20)

Denver Post: Facing Surge In Opioid Abuse And Overdose Deaths, Colorado Distributes 2,500 Doses Of Narcan 
Facing a surge in opioid abuse and related overdose deaths, Colorado authorities on Monday unveiled a plan to distribute the life-saving drug naloxone — known by its trade name, Narcan — to first responders across the state’s hardest hit areas...The initiative will send 2,500 dual-dose packages of the handheld opioid blocker to law enforcement and other first responders in 17 counties with high rates of drug overdose deaths. It comes at a time when officials say someone in Colorado dies of an overdose roughly every nine and a half hours and the rate of opioid deaths has surpassed that of traffic fatalities.  (Paul, 9/19)

Kansas City Star: Study: Opioid Use Down In States With Medical Marijuana 
States that allow medical marijuana to be used to treat pain show a decline in the use of opioids, according to a new study. The study, published in the American Journal of Public Health, examined 69,000 traffic fatalities in 18 states from 1999 to 2013, focusing on differences between states that had legalized medical marijuana and those that had not. (Hotakainen, 9/19)

Kaiser Health News: Kratom Defenders Fight Plan To Ban Herb Used By People In Recovery
Since 2014, Karisa Rowland has gotten up every morning, removed a bag of kratom powder from her fridge, stirred about a teaspoonful into a mug of water and drunk it.In the past, Rowland, who lives a half hour south of Fort Worth, Texas, struggled with a serious prescription opioid dependence. After several back surgeries, she was using pills — hydrocodone, fentanyl and oxycodone — to deal with her chronic pain. Her morning ritual with kratom has helped her handle her pain without taking opioid drugs, she said. (Silverman, 9/20)

The Wall Street Journal: Study Raises New Questions About Fetal Ultrasounds
A new study suggesting that first-trimester fetal ultrasound may contribute to the severity of autism symptoms heightens a dilemma facing obstetricians: How to halt the widespread overuse of fetal ultrasound without scaring women away from this important medical procedure. The study, published Sept. 1 in the journal Autism Research, is the latest in a series of highly limited studies that raise questions about the safety of fetal ultrasound. (Helliker, 9/19)

In other news about children's health —

Sacramento Bee: Can Stand-Up Desks Help Kids Avoid Becoming Obese?
The study, published recently in the American Journal of Public Health, covered third- and fourth-grade students at three Texas elementary schools. Some sat at traditional desks, while others used a “stand-biased” desk, which had a footrest and stool so children could get off their feet when needed. After two years, those at standing desks experienced a 5.2 percent decrease in their body mass index percentile than those using traditional school desks. (BMI or body mass index is a measurement of body fat and an indicator of obesity.) The rates were adjusted for grade, race and gender. (Buck, 9/19)

CNN: Racial Divide Emerges In Rare Child Suicide Rates 
There has been a disturbing increase in suicide rates among elementary school-age black children in recent years in the United States, and yet researchers aren't quite sure why. When compared with early adolescents, younger children who die by suicide are more likely to be black boys who hang or suffocate to death, suggests a new paper published in the journal Pediatrics on Monday. (Howard, 9/20)

WBUR: Parents May Be Giving Their Children Too Much Medication, Study Finds 
The biggest mistake parents make is over dosing. Part of the problem is the spoons and measuring cups the parents use are not accurate, and researchers suggest using a syringe instead. (Neighmond, 9/19)

San Antonio Press Express: Why Teen Brains Need Later School Start Time 
Research findings show that teens' inability to get out of bed before 8 a.m. is a matter of human biology, not a matter of attitude. At issue here are the sleep patterns of the teenage brain, which are different from those of younger children and adults. Due to the biology of human development, the sleep mechanism in teens does not allow the brain to naturally awaken before about 8 a.m. This often gets into conflict with school schedules in many communities. (Wahlstrom, 9/19)

The Washington Post: Your Dog Can Make You Feel Better, And Here’s Why
Wayne Pacelle has a demanding job as president and chief executive of the Humane Society of the United States. This is one of the reasons he brings Lily, his beagle mix, to work with him. He is convinced that animals “are a necessary ingredient in our emotional well-being,’’ he says. “I deal with many stressful issues, and I see terrible cruelty,’’ he adds. “But when Lily puts her head on my lap, it calms me.’’ Pacelle can’t scientifically document the positive effects he gains from his connection with Lily (and Zoe, his cat.) But his experience supports what researchers who study human/animal interaction have concluded: Pets, especially dogs, seem to be good for our health. (Cimons, 9/19)

The Washington Post: Your Sweat Could Tell You When To Make A Baby — And More
You are ovulating. You are dehydrated. Your cholesterol  is too high. Or too low. You are depressed, stressed or your muscles are cramping. Time to get off the golf course and get the heart checked. Or keep playing, you are fine. A Cincinnati start-up is working on advanced wristbands, headbands and skin patches that will read markers and diagnose your health risks — or opportunities — from the sweat your body secretes. “This is the hard-science end of wearables,” said Robert Beech, chairman and co-founder of Eccrine Systems. (Heath, 9/19)

Los Angeles Times: Bright Light Boosts Testosterone In Men With Low Libido, Study Says
For men whose sex drive has stalled, Italian researchers have found in a small study that early morning exposure to bright light – a treatment widely used for seasonal depression --  revs up testosterone production and boosts sexual function and satisfaction. In a pilot trial that recruited 38 men diagnosed with problems of sexual desire and arousal, researchers at Italy’s University of Siena found that after two weeks, participants who spent a half-hour each morning in front of specially designed light box experienced increases in testosterone and a three-fold improvement in sexual satisfaction. (Healy, 9/19)

CNN: Vasectomy Not Linked To Prostate Cancer, Study Says
When men think of undergoing a vasectomy, they might have a few concerns: fears of pain, worries it won't work and concerns about their sex life afterward. Also common is the fear that the snip will increase their risk of cancer, namely of the prostate, with previous research finding a link between the two. But a new study is laying some of that fear to rest. There's new evidence that there is no association between having a vasectomy and developing prostate cancer. (Senthilingam, 9/19)

The Washington Post: If Probiotics Work For A Friend, Why Won’t They Work For You, Too?
Consumers can find probiotic supplements with such brand names as “Nature’s Bounty,” “Healthy Origins” and “Garden of Life” on store shelves. They claim to restore balance to the bacteria that normally live in the intestinal tract, thereby keeping your digestive system healthy and happy. Skeptics say many probiotics disappear after entering the digestive system. They affect different people in different ways. They note that research about the products hasn’t been done, hasn’t backed up manufacturers’ claims or might not be reliable because it was paid for or conducted by the manufacturers themselves. (Niiler, 9/19)

Orlando Sentinel: Early Menopause Linked To Higher Heart Disease, Death Risks 
Women who enter menopause early may be at greater risk for heart disease and premature death, a new analysis suggests. To reach this conclusion, Dutch researchers reviewed 32 studies involving more than 300,000 women. The investigators compared women who were younger than 45 at the start of menopause with those who were 45 and older when it began. Overall, heart disease risk appeared to be 50 percent greater for the women who were under 45 when menopause began. (Pallarito, 9/19)

CNN: FDA Hearing: How Should Stem Cell Clinics Be Regulated? 
Stem cells have the potential to divide and develop into many different cell types in the body. They are so enchanting and so promising -- they may help paralyzed patients regain use of their limbs or help the nearly blind to see -- that they have Food and Drug Administration officials scratching their heads. Officials are mulling regulations to address how stem cells are used in various medical and cosmetic procedures, to avoid any exploitation of and harm to patients, and they have asked for input from the public. (Howard, 9/19)

Georgia Health News: Nursing Home Company’s Problems Pile Up In Georgia 
Residents of Eastman Healthcare & Rehab, in south-central Georgia, have dealt with sewage backups, unsafe hot water, insect problems, toilets leaking or not flushing, and dietary mix-ups since January 2015, state and federal regulatory documents show. Regulators also found facility mismanagement of residents’ money at the Eastman facility. At one point, some residents’ Social Security checks were deposited, “in error, into the facility’s general operating account instead of the resident trust account.” (Miller, 9/19)

San Francisco Chronicle: Nursing Home Chain Accused Of Providing Unneeded Therapy 
A chain of 35 nursing homes, including three in the Bay Area, and its executives will pay $30 million to settle claims that they billed the government for therapy that their patients didn’t need. The Justice Department announced the settlement Monday with North American Health Care, headquartered in Dana Point (Orange County). Most of the company’s nursing homes are in California, including Petaluma Post-Acute Rehab, Apple Valley Post-Acute Rehab in Sebastopol and Linda Mar Care Center in Pacifica. (Egelko, 9/19)

Health News Florida: Judge Sides With AHCA On Alachua County Nursing Home 
An administrative law judge Friday upheld a decision by the state Agency for Health Care Administration to approve a new 103-bed nursing home in Alachua County, rejecting a challenge from a competing nursing home firm. The dispute stemmed from a preliminary AHCA decision to award what is known as a “certificate of need” for a nursing home proposed by Alachua County HRC, LLC. Obtaining certificates of need are critical regulatory steps in building nursing homes and hospitals. (9/19)

Modern Healthcare: Private Equity's Apollo Global Reportedly Vying For CHS Assets 
Apollo Global Management, a private equity group behind 18-hospital RCCH Health Partners, is in talks to acquire Community Health Systems' assets, according to Reuters. The story does not detail whether Apollo has an interest in buying all of CHS or select hospitals. Struggling CHS confirmed Monday that it has retained advisors to explore strategic options. CHS owns 159 hospitals. It is shedding hospitals to reduce debt and improve operating performance. (Barkholz, 9/19)

Nashville Tennessean: Community Health Systems, At A Crossroads, Mulls The Path Forward
Community Health Systems is pondering its future corporate structure as the health care heavyweight tries to manage a heavy debt load while pivoting to a new business strategy. The Franklin-based company, which previously focused on its fleet of hospitals in rural communities, has turned its attention to key metropolitan areas, such as Knoxville, Birmingham, Ala., and Fort Wayne, Ind., that also serve small towns. (Fletcher, 9/19)

New Hampshire Public Radio: Chief Medical Officer At New Hampshire Hospital To Step Down In 2017 
The chief medical officer at New Hampshire Hospital is planning to step down at the beginning of 2017, New Hampshire Department of Health and Human Services Commissioner Jeffrey Meyers announced Monday afternoon. Dr. David Folks, who also works for Dartmouth-Hitchcock, has been the top doctor at the state psychiatric hospital for the last eight years. The state did not immediately indicate why Folks was leaving. (McDermott, 9/19)

Concord (N.H.) Monitor: Days After Layoff Announcement, N.H. Hospital Chief Medical Officer Says He Will Resign Early Next Year
Following the recent news of layoffs at Dartmouth-Hitchcock Medical Center, New Hampshire Hospital Chief Medical Officer Dr. David Folks announced he is leaving the hospital in January. Folks has been chief medical officer at the state psychiatric hospital since 2008 and is a Dartmouth-Hitchcock employee. “Dartmouth-Hitchcock will immediately undertake a process to identify a new Chief Medical Officer before Dr. Folks leaves in four months,” said Department of Health and Human Services Commissioner Jeff Meyers in a statement Monday. (Nilsena nd Morris, 9/19)

The Star Tribune: Allina, Nurses Test Each Other's Resolve As Strike Enters 3rd Week 
Allina Health and its striking nurses challenged each other's staying power on Monday as the nurses' walkout reached its third week without a deal — or further talks — in sight. Allina reported that more than 500 of the 4,800 union nurses have called to say they want to return to work at the five affected hospitals. Meanwhile, the union said it received a report that an intensive care unit closed at Allina's flagship hospital, Abbott Northwestern in Minneapolis, amid turnover in replacement nurses. (Olson, 9/19)

St. Louis Post Dispatch: In Push For Nationwide Recognition And Influence, Ascension Launches Rebranding Effort 
Tony Tersigni, CEO of the nation’s largest nonprofit health system, is setting out to make Ascension a household name across the United States. Despite its size and influence, few consumers know Ascension by name — even in the St. Louis area where the Catholic health system is based and employs nearly 1,000 individuals. That’s why Ascension is launching a major rebranding campaign, starting Tuesday, that will eventually place the Ascension name on thousands of its health care facilities. (Liss, 9/20)

The CT Mirror: Ethics Board Says Wade’s Recusal Makes Anthem-Cigna Conflict Inquiry Moot 
The state’s ethics board Monday ended its examination of whether Insurance Commissioner Katharine L. Wade has a conflict disqualifying her from reviewing the acquisition of Cigna by Anthem, saying Wade’s voluntary recusal last week makes the question moot. The Citizen’s Ethics Advisory Board voted unanimously in a special meeting to drop consideration of a declaratory ruling that would have barred  Wade’s involvement reviewing a deal merging two of the nation’s largest health insurers. (Pazniokas, 9/19)

The Associated Press: Maryland Health Connection Introduces New Mobile App
Marylanders can now enroll in Maryland Health Connection health coverage right from their cellphone or tablet. The Maryland Health Benefit Exchange announced a new mobile app on Monday, ahead of open enrollment. Using the free “Enroll MHC” app, officials say consumers can apply, compare prices and ratings of various plans. They can also log in to view their notices and upload documents for verification using the camera on their devices. (9/19)

Kansas Health Institute: KU Researchers Aim To Improve Health Of Kansans With Disabilities 
University of Kansas researchers plan to use a $1.5 million federal grant to help Kansans with disabilities catch up to their non-disabled peers in several health categories. Jean Hall, director of KU’s Institute for Health and Disability Policy Studies, will lead a team of partners from nonprofit organizations and government agencies to improve physical activity, nutrition and oral health for Kansans with disabilities. Kansas is one of 19 states to get the grants from the Centers for Disease Control and Prevention. (Marso, 9/19)

The Associated Press: Oregon Orders Woman Spoon-Fed Despite Advanced Directive
Oregon officials are requiring a nursing facility to spoon-feed a woman despite her making clear that measures should not be taken to prolong her life. When former librarian Nora Harris was diagnosed with early onset Alzheimer’s disease in 2009, she and her husband hired an attorney to create an advance directive, a legal document used to guide medical care in case someone becomes incapacitated. Harris’ advance directive specifically addressed “tube” or intravenous feeding. She is now unable to communicate, and a judge says the facility must help her eat. (9/19)

Georgia Health News: Kidney Transplants: A Lifesaving System With Serious Shortcomings 
More than 5,000 Georgians are currently on that wait list — more than 10 times the number of people in the state waiting for a liver, pancreas, heart or lung combined, according to the Organ Procurement and Transplantation Network (OPTN). A kidney for transplant can come from either a deceased or a living donor (because a person can live with only one kidney). But whatever the source, there simply are too few kidneys to go around. And even if there were enough kidneys available, studies have shown that dialysis centers in the state are lax about recommending patients for the lifesaving surgery. (Beeson, 9/19)

Chicago Tribune: Walgreens Offers Dermatology Consultations Online 
The Deerfield-based drugstore chain announced Monday that it's offering so-called teledermatology services — dermatological consultations done through technology. Customers can create individual profiles on the new skin care section of the chain's website. They can then privately upload photos of their skin conditions, receive answers to medical questions and potentially get diagnoses, prescriptions and/or recommendations for over-the-counter products from board-certified dermatologists, often within 24 hours. (Schencker, 9/19)

Tampa Bay Times: Two On-Campus Students At UF Diagnosed With MRSA 
Two on-campus students at the University of Florida have contracted MRSA, university officials confirmed Monday. Both students live in the apartment-style Beaty Towers, which house 786 students, predominantly freshmen and sophomores. The first student, a Beaty East resident, was diagnosed Sept. 14, said UF spokeswoman Janine Sikes. Students in the residence hall were alerted to the staph infection in Sept. 15 email from housing director Lisa Diekow. The second case, afflicting a Beaty West resident, prompted a similar email there. (McNeill, 9/19)

Oakland Tribune: Oakland: Tuberculosis Case Reported At Skyline High School 
The Alameda County Public Health Department informed Oakland Unified School District that a person at the school was recently diagnosed with tuberculosis disease, said district spokesman John Sasaki. District and school staff are working closely with the health department to investigate the case and identify who may have been exposed to tuberculosis. Those who may have been exposed will be offered free testing and followed up with current public health guidelines. (Cameron, 9/19)

Sacramento Bee: Alice’s Embrace Envelops Alzheimer’s Patients With A Blanket Of Comfort
It’s long been known that tactile textures can ease anxiety for some Alzheimer’s patients. Known as fidget quilts, sensory blankets or “busy blankets,” they’re sold on craft sites such as Etsy and Pinterest. All are designed to keep fidgety fingers busy, and some come with contrasting fabric (i.e. corduroy, fake fur, suede) or attached objects such as buttons, pockets or zippers. Others are weighted to provide a firm presence on a lap or shoulders, based on therapy studies that show heavier blankets – up to 30 pounds – can be a quieting, self-soothing tool for patients with mental health disorders. (Buck, 9/19)

San Francisco Chronicle: Brown Signs Into Law Strict Limits On Super Pollutants
By targeting so-called super pollutants, California set an ambitious new course Monday in its fight against climate change that will have far-reaching impacts on some of the state’s bedrock industries, from freight shipping to dairy farming. Gov. Jerry Brown signed into law what he called the nation’s strictest plan to cut emissions of methane, black carbon and other short-lived pollutants that can trap far more heat than carbon dioxide... Under Senate Bill 1383, California set targets to reduce methane, tropospheric ozone, hydrofluorocarbons and black carbon emissions, giving the state Air Resources Board until Jan. 1, 2018, to determine how those goals will be met. (Gutierrez and Alexander, 9/19)

The Washington Post: If Trump Wins, Blame Obamacare
In the event of a victory by Donald Trump in November, political analysis will take on a forensic cast. How did establishment politics — first in the GOP primaries, then in a national electorate — come to die? ... If Trump succeeds in essentially turning out the midterm electorate in a presidential year — whiter, older, angrier — the main motivating issue may be the restriction of immigration. But the general atmosphere of contempt for government that helps Trump — of disdain for the weakness and incompetence of the political class — is due to the Affordable Care Act. More than six years after becoming law, the proudest accomplishment of the Obama years is a political burden for Democrats. (Michael Gerson, 9/19)

The Wall Street Journal: The Boys Who Beat The FDA
Miracles happen. The Food and Drug Administration on Monday approved a drug for muscular dystrophy after months of delay and bureaucratic infighting. This is a triumph for scientific innovation, and for young men who will live better and more independently—if the bureaucracy doesn’t strike back. FDA announced accelerated approval for eteplirsen by Sarepta Therapeutics more than 100 days after the agency’s legally mandated decision date. The therapy is the first for Duchenne muscular dystrophy patients, typically boys who lose the ability to walk around age 12 before heart or respiratory failure in their 20s. Ten of 12 boys in a clinical trial still walk after four years on eteplirsen—nearly two football fields farther than a control group. (9/19)

Los Angeles Times: Sick: The Biggest Increase In Healthcare Costs In 32 Years
Healthcare is very much in the news, but for all the wrong reasons.On the one hand, we had Republican presidential nominee Donald Trump visiting the “Dr. Oz” show last week to reveal some tidbits about his physical condition (he’s fat). On the other, Democratic nominee Hillary Clinton had a bout of pneumonia but declared herself fit as a fiddle (we’ll see). The real story, however, wasn’t that the two oldest presidential candidates in U.S. history are showing their age but that the rest of us are still getting creamed by rising healthcare costs. (David Lazarus, 9/20)

Forbes: ObamaCare Medicaid Expansion: A Lot Of Spending Of Little Value
In new research published by the Mercatus Center, I analyze the causes and impact of the much higher-than-expected enrollment and spending associated with the Affordable Care Act (ACA) Medicaid expansion. Though unpredicted by Washington experts, the results were predictable. The federal government’s 100% financing of state spending on expansion enrollees has led states to boost enrollment and create high payment rates. (Brian Blase, 9/18)

Chicago Tribune: Health, Taxes And More: What Should Candidates Disclose?
Actuarial tables indicate Trump or Clinton has a higher risk of dying or being incapacitated in office than a younger candidate, everything else being equal. Even given the improved medical care and longer life spans of our time, it's not hard to make a case that they are too old to be taking on such a demanding job. So their health deserves particular attention. (9/19)

Health Affairs Blog: The Politics Of Medicare And Drug-Price Negotiation
Despite this election season’s divisiveness, both major parties’ presidential candidates have embraced the idea of authorizing Medicare Part D to negotiate directly with drug companies to set prescription drug prices. ... In theory, if the Centers for Medicare and Medicaid Services (CMS) could negotiate with pharmaceutical companies, the agency could leverage its purchasing power to pay less for drugs. The idea has received considerable media attention over the past few months and has broad public support, reflected in a recent poll showing 87 percent of Americans have a favorable view of the idea. Nevertheless, if history is any guide, politics may prevent a full repeal of the ban. (Theodore T. Lee, Abbe Gluck and Gregory Curfman, 9/19)

Los Angeles Times: Stopping Superbugs
On Tuesday, the U.N General Assembly will hold a high-level meeting to discuss one of the greatest contemporary threats to global public health. Not war, not Ebola, not Zika — but antibiotic-resistant microbes. Scientists and public health officials have been warning for decades that overuse of antibiotics would inevitably lead to a rise of bacteria that have adapted to the drugs and developed a resistance to them. This is no longer a distant threat. Old standby antibiotic treatments have lost the fight against some diseases and new strains of antibiotic-resistant bacteria are emerging with terrible frequency. We haven’t yet reached the post-antibiotic era, but we are fast approaching it. (9/20)

RealClear Health: Helping Veteran’s Health: Send In The Nurse Practitioners
In an effort to reduce delays and provide our veterans with access to proven, top-quality primary care, the VA has proposed a solid plan granting veterans direct access to nurse practitioners (NPs) and other advanced practice registered nurses (APRNs) in VA facilities. The proposal, supported by the VA and its top physician, Under Secretary for Health David J. Shulkin, veterans, caregivers, and concerned citizens alike, would modernize the VA system and allow the VA’s 4,800 nurse practitioners to practice to the full scope of their education and training--providing clinical assessments, ordering and interpreting diagnostic tests, making diagnoses, and initiating and managing treatment plans, including prescribing medications. (CMSgt. Robert L. Frank, 9/19)

Miami Herald: Where Were The Zika Skeeters Found?
The mosquito-borne disease remains a public threat, particularly in parts of Miami Beach. Yet, Miami-Dade County is keeping the public in the dark, denying residents and visitors public information that will help all make better-informed decisions on how to fight it. The Miami Herald, long a leader in the push to keep public information accessible, rightly filed suit last week to force the county to turn over reports pinpointing where infected mosquitoes were found. (9/19)

Columbus Dispatch: Heroin’s Signs, Long Seen In Other Cities, Now Visible In Columbus 
Not long after coming to central Ohio in 2006 to report on crime for The Dispatch, I noticed the absence of a drug that had plagued eastern cities like Philadelphia and Baltimore for years. When it came to the illegal drug trade, Columbus had its share of problems linked to cocaine and marijuana, but where, I wondered, was the heroin? No one in Ohio asks that question anymore. (Theodore Decker, 9/20)

St. Louis Post-Dispatch: A Systemic Approach To The Opioid Crisis
Last month, U.S. Surgeon General Dr. Vivek Murthy took an unprecedented step in addressing the opioid epidemic. In a letter addressed to every physician in America, he urged doctors to educate themselves, screen patients and destigmatize addiction. Meanwhile, in West Virginia, 29 people touched by the epidemic sued physicians, pharmacists and drug distributors for profiting from the opioid crisis at the expense of vulnerable patients. (Elizabeth Chiarello, 9/20)

East Bay Times/Oakland Tribune: Vote No On Prescription Drug Measure 
It takes more than good intentions to make a ballot measure worth passing. There are good reasons to be outraged at drug pricing by Big Pharma, which sets prices partly from a need to recover research costs but sometimes out of just greed. Proposition 61 proposes an answer, at least for state purchases for Medi-Cal: Prohibit the state from paying more for prescription drugs than the U.S. Department of Veterans Affairs, which generally pays about 25 percent less than other government agencies. But nobody can say definitively how this proposition would play out, or how it would affect the availability of some life-saving drugs. (9/19)

The Columbus Dispatch: Hospital-Expansion Gift Will Help Many Youngsters
Big Lots, the national retailer headquartered in Columbus, has a big heart. The company is donating $50 million to support a $730 million expansion of Nationwide Children’s Hospital, the centerpiece of which will be a Behavioral Health Pavilion. (9/20)