First Edition: July 23, 2019

Kaiser Health News: Missouri Firm With Silicon Valley Ties Faces Medicare Billing Scrutiny
In many ways, Essence Group Holdings Corp. is a homegrown health care success story. Founded locally, it has grown into a broader company backed by a major Silicon Valley investor. Essence now boasts Medicare Advantage plans for seniors with some 60,000 members in Missouri and across the Mississippi River in Illinois. It ranks among the city’s top 35 privately held companies, according to the St. Louis Business Journal. And market research firm PitchBook Data values the company at over $1.64 billion. (Weber and Schulte, 7/23)

Kaiser Health News: Retiring Abroad? Prepare To Possibly Mix And Match Health Insurance
When Karen Schirack, 67, slipped on her way into her house in January and broke her left femur in multiple places, she had a decision to make. Should she get surgery to repair the fractured thigh bone and replace her hip near Ajijic, Mexico, where she has lived for 20 years, or be airlifted back to her home state of Ohio for surgery and rehab? As the number of American retirees living overseas grows, more of them are confronting choices like Schirack’s about medical care. If they were living in the United States, Medicare would generally be their coverage option. But Medicare doesn’t pay for care outside the U.S., except in limited circumstances. (Andrews, 7/23)

California Healthline: Child Drowning Rates Drop As Communities Adopt Stricter Building Codes
Some welcome news at the height of summer swimming season: Children are far less likely to drown in California than they were in the 1980s — and child drowning rates have continued to fall even in the past decade, according to data from the Centers for Disease Control and Prevention. The nation as a whole has experienced a similar, though less dramatic, decline, with drowning rates for children age 14 and younger now about one-third of what they were in the early 1980s. (Reese, 7/22)

The Associated Press: Kamala Harris Proposes Bill To Invest In Safe Drinking Water
Sen. Kamala Harris is introducing legislation designed to ensure all Americans, particularly those in at-risk communities, have access to safe, affordable drinking water, the latest response to burgeoning water crises across the country. The California Democrat and presidential candidate’s “Water Justice Act” would invest nearly $220 billion in clean and safe drinking water programs, with priority given to high-risk communities and schools. As part of that, Harris’ plan would declare a drinking water infrastructure emergency, devoting $50 billion toward communities and schools where water is contaminated to test for contaminants and to remediate toxic infrastructure. (Summers, 7/22)

Politico: How Andrew Yang Would Improve Veterans' Services
2020 presidential candidate Andrew Yang on Monday unveiled a wide-ranging proposal to improve services for veterans, including updates to the education, employment and health care benefits troops receive after leaving the military. (Feldscher, 7/22)

Politico: Ousted Planned Parenthood Chief Called Abortion ‘The Fight Of Our Time’
Deposed Planned Parenthood chief Leana Wen vowed in a memo before taking her post that she would treat abortion “as the fight of our time,” calling into question her claim that she was ousted as CEO last week for seeking to depoliticize Planned Parenthood’s signature issue. “We are facing [the] real probability that 1/3 of women of reproductive age—25 million—could be living in states that ban or criminalize abortion,” Wen wrote in an October 2018 internal memo where she laid out her agenda. “[W]e need to fight with everything we have.” (Diamond, 7/22)

The Washington Post: New Federally Funded Clinics Emphasize Abstinence, Natural Family Planning
Thousands of California women and teenagers seeking free or discounted reproductive health services through a federal program could find themselves in clinics that focus on abstinence and natural family planning as methods of birth control. Operated by the California-based Obria Group, the health centers appear to be modeled after faith-based crisis pregnancy centers, designed to persuade women to continue their pregnancies, but with a twist: Obria’s clinics encourage young clients to use online apps, developed with funding from religious conservatives, to “move them away from sexual risks as their only option in life, to an option of self-control.” (Cha, 7/22)

The Washington Post: Trump Says He Wants To Meet With Schumer ‘ASAP’ On Conditions At The Border
President Trump said late Sunday night that he wants to set up a meeting with Senate Minority Leader Charles E. Schumer about conditions at the U.S.-Mexico border following the New York Democrat’s tour of migrant detention centers that he called “inhumane.” Trump called for a meeting “ASAP” in tweets that came two days after Schumer and a group of U.S. senators toured several detention facilities. (Wagner, 7/22)

The Washington Post: USDA Proposes SNAP Change That Would Push 3 Million Americans Off Food Stamps
The U.S. Department of Agriculture proposed new rules Tuesday to limit access to food stamps for households with savings and other assets, a measure that officials said would cut benefits to about 3 million people. In a telephone call with reporters, U.S. Secretary of Agriculture Sonny Perdue and Acting Deputy Under Secretary Brandon Lipps said the proposed new rules for the Supplemental Nutritional Assistance Program (SNAP) were aimed at ending automatic eligibility for those who were already receiving federal and state assistance. (Reiley, 7/23)

Bloomberg: Trump Administration Moves To End Food Stamps For 3 Million
“We are changing the rules, preventing abuse of a critical safety net system, so those who need food assistance the most are the only ones who receive it,” he added. Conservatives have long sought cuts in the federal food assistance program for the poor and disabled. House Republicans tried to impose similar restrictions on the food stamp program last year when Congress renewed it but were rebuffed in the Senate. The proposed change in rules for the Supplemental Nutrition Assistance Program -- often called by its former name, food stamps -- would deliver on the goal as the administration has agreed to a deal to lift caps on federal spending. (Dorning, 7/23)

The Wall Street Journal: When The Safety Net Pays For Itself
The U.S. spends trillions every year on a social safety net for people in all steps of life, from childhood to retirement. A new study from two Harvard University economists, Nathaniel Hendren and Ben Sprung-Keyser, examines 133 U.S. policy changes over the past half-century, including the creation of Medicare, Medicaid expansions, the introduction of food stamps, as well as dozens of state and local programs. (Oh and Adamy, 7/22)

The Wall Street Journal: Consumers Will Be Able To Pay For Doctor Visits On Their Phones, Via Anthem
Health insurers are racing to roll out new digital tools that give them a deeper role in health care, aiming to reduce costs and improve convenience for consumers. The latest sign is a new app from Anthem Inc. that is set to be introduced next week in one state, but later reach the big insurer’s full geographic territory. The app will let consumers, including those who don’t have its insurance, schedule and pay for medical visits through their smartphones, as well as learn potential diagnoses and text with doctors. (Wilde Mathews, 7/22)

Colorado Sun: In Rural Colorado, Emergency Medical Services Struggle To Keep Money-Losing Ambulances Rolling
Rural and mountain emergency medical services are trying just about anything to keep their money-losing ambulances running across Colorado’s rugged or remote terrain. High costs, low reimbursement rates and scarce job applicants are forcing ambulance services to consolidate with fire responders, take on new tasks between emergency runs, and outsource fast-growing transport runs to bigger metro hospitals. (Booth, 7/22)

The Wall Street Journal: IRS Greenlights Tax Breaks For Buyers Of 23andMe Genetic Tests
Buyers of 23andMe Inc.’s genetic-testing kits will now have an easier time paying for the service with tax-advantaged health accounts after a favorable IRS ruling. The decision offers more clarity to consumers and reduces the cost of the company’s service. It also highlights differences between the tax law’s permissive definition of medical care and health regulators’ more restrictive approach to direct-to-consumer testing products. The Internal Revenue Service made the ruling in May and will release a redacted version next month. The Wall Street Journal reviewed the document before 23andMe disclosed it Monday. (Rubin and Marcus, 7/22)

The Associated Press: FDA Approves 9 Generic Versions Of Nerve Pain Drug Lyrica
The U.S. Food and Drug Administration has approved the first generic copies of a popular, pricey pill for nerve pain. The agency on Monday said it approved nine generic versions of Pfizer Inc.’s Lyrica. It is also used for seizures and fibromyalgia, a condition that causes chronic, widespread pain. Lyrica, approved in 2004, is Pfizer’s second bestseller, with sales last year of $4.6 billion. The heavily advertised drug costs about $460 to $720 per month without insurance, depending on the pharmacy. Prices can vary widely. (Johnson, 7/22)

The Associated Press: Revamped OxyContin Was Supposed To Reduce Abuse, But Has It?
Dr. Raeford Brown was uniquely positioned to help the U.S. government answer a critical question: Is a new version of the painkiller OxyContin helping fight the national opioid epidemic? An expert in pain treatment at the University of Kentucky, Brown led a panel of outside experts advising the Food and Drug Administration on opioids that have been reformulated to deter snorting and injecting. (7/22)

The Wall Street Journal: Death Rates Rising For Young, Middle-Aged U.S. Adults
Death rates are rising for young and middle-aged U.S. adults, and the outcomes for whites, blacks and Hispanics are diverging, according to a new government analysis. The report by the Centers for Disease Control and Prevention, to be published Tuesday, adds new detail to a grim picture of worsening health trends across the nation, as the opioid epidemic and stalled progress against heart disease have dragged down life expectancy. (McKay, 7/23)

The New York Times: Where Rabies Is Entrenched
Rabies has been known since antiquity, and has been completely preventable since Pasteur developed a vaccine more than a century ago. But the World Health Organization still considers it “a neglected disease of poor and vulnerable populations.” Why? Rabies, one expert has written, “became a neglected disease when it was eliminated from Europe and North America.” The vast majority of the estimated 59,000 human deaths each year from rabies are in Africa and Asia, in countries with large populations of free-roaming dogs that provide a so-called reservoir for the virus. (Gorman, 7/22)

The New York Times: Rabies Kills Tens Of Thousands Yearly. Vaccinating Dogs Could Stop It.
Seven young men sprinted down paths, darting behind houses and vaulting low walls. Each one carried a long-handled net. From yards, alleys and streets the din of canine outrage filled the air, announcing the invasion of the neighborhood. Some dogs hid, others retreated a bit before resuming their chorus of barking. The most wary fled long before the catchers got near. Too bad. Getting caught could be the best thing that ever happened to them. (Gorman, 7/22)

The New York Times: Five Things To Know About Rabies
Nearly 60,000 people a year die from rabies around the world. The cause is almost always a bite by a rabid dog. Most of the deaths are in Africa and Asia. In Western Europe, the United States and other countries, the rabies variant that lives in populations of dogs has been eradicated, but people can still catch rabies from skunks, raccoons, bats and other animals. Bats are now the most common cause of rabies in the United States, but less than one percent of bats have rabies, and their contact with humans is infrequent. Only one to three people die each year from rabies in the United States. (Gorman, 7/22)

The New York Times: Discrimination Is Hard To Prove, Even Harder To Fix
When it comes to lawsuits alleging discrimination, the wheels of justice sometimes turn even more slowly than usual. “It’s a difficult process, more difficult than it needs to be,” said Jeff Vardaro, a civil rights attorney in Columbus, Ohio. These cases can become complex and expensive, and defendants and their attorneys have incentives to drag them out. Over the past year or so, I have reported on several suits involving older adults’ complaints of discrimination based on age, sex and disability status, all of which are prohibited under federal law. (Span, 7/22)

The Associated Press: Study: Millions Should Stop Taking Aspirin For Heart Health
Millions of people who take aspirin to prevent a heart attack may need to rethink the pill-popping, Harvard researchers reported Monday. A daily low-dose aspirin is recommended for people who have already had a heart attack or stroke and for those diagnosed with heart disease. But for the otherwise healthy, that advice has been overturned. Guidelines released this year ruled out routine aspirin use for many older adults who don't already have heart disease — and said it's only for certain younger people under doctor's orders. (7/22)

The Associated Press: Weight Loss Among Fat-Acceptance Influencers A Fraught Topic
Fashion and lifestyle blogger Maui Bigelow has always been curvy and built a social media presence by embracing every pound. Until the worst happened. At nearly 380 pounds, her health took a dive. She was diagnosed with a blood cancer and multiple uterine fibroids that couldn't be treated due to her weight. That's when she decided to have bariatric surgery, a weight loss procedure. (7/22)

The Wall Street Journal: For Kids, Free Time Equals Screen Time—So Parents Fight Back
Children whining about being bored is an annoyance as old as time, but fewer parents these days are willing to push the kids out the door and yell, “Come back at dinner time!” The new parenting advice: Structure your child’s unstructured time. It’s a backlash against the advice that started bubbling up a decade ago to let children have unfettered downtime. The idea then was that boredom is a good thing, that it fosters in kids imaginative ways to fill the time. But that was before phones and “Fortnite” became ubiquitous. We all know now that when left to their own devices kids will, well, turn to their devices. (Jargon, 7/23)

The Associated Press: Democrats Seek Hearings Over Firing Of Iowa Agency Head
Democratic leaders in the Iowa Legislature called Monday for government oversight hearings on Gov. Kim Reynolds' refusal to discuss her reasons for asking the director of the Iowa Department of Human Services to resign. Senate and House Government Oversight Committee Democrats are calling for hearings on Jerry Foxhoven's sudden departure last month, and want him to explain what happened. (7/22)

The Associated Press: Fiancee Sues Over Principal's Death In Bone Marrow Procedure
A hospital failed to adequately monitor and treat a New Jersey high school principal as his oxygen level plummeted during a bone-marrow donation procedure in February, sending him into a coma and leading to his death several weeks later, a lawsuit filed Monday by his fiancee alleges. Westfield High School Principal Derrick Nelson died in April after lapsing into a coma during the procedure at Hackensack University Medical Center, which Sheronda Braker named in her suit. (7/22)

The Washington Post: After A Deadly Shooting, A Different Kind Of Recovery Takes Shape At One Of The Nation’s Oldest Methadone Clinics
For Regina Brown, hope for a clean life is pink and comes at the bottom of a little plastic cup. Each weekday, Brown rises early to stop at the Man Alive Lane Treatment Center before work. She takes a number and waits her turn before approaching a staffer sitting behind a plexiglass window. A small dose of methadone is passed through a hatch, and she gulps down the bitter liquid. Before she can leave, Brown must open her mouth to say “thank you” to the clinic worker — a practice to ensure patients won’t spit out the medication later to sell on the street. (Bui and Demkovich, 7/22)

The Associated Press: State: Doctor's Wife Mishandled Vaccines, Caused Outbreak
The Kentucky Board of Medical Licensure says a Mount Sterling doctor allowed his unlicensed wife to mishandle vaccines, causing an infection outbreak in patients across Kentucky, Indiana and Ohio. The Lexington Herald-Leader reports the board on Friday placed Dr. Paul E. McLaughlin on five years' probation. He also was ordered to pay $5,000 for delegating to someone without a medical license and contributing to a public health crisis. (7/22)

The Associated Press: Federal Lawsuit: $25M Fraud At Tennessee Senator's Clinic
A Tennessee senator and other officials at a now-shuttered pain clinic company are facing a federal lawsuit that claims they defrauded Medicare and Medicaid of more than $25 million. The complaint filed Monday in Nashville by federal and state authorities alleges that Comprehensive Pain Specialists, Republican state Sen. Steve Dickerson and others submitted claims for a variety of unnecessary procedures and falsified documents. (7/22)

The Washington Post: ‘Warehousing At Its Worst’: Rights Groups Say W.Va. School System Gives Inferior Education To Special-Needs Students
Disability rights groups are accusing West Virginia’s largest school system of providing an inferior education for students with disabilities and segregating them, according to complaints lodged with state officials. The rights groups filed complaints with the West Virginia Department of Education on behalf of three students in June, accusing Kanawha County Schools of failing to provide the students academic and behavioral supports related to their disabilities. (Truong, 7/22)

Los Angeles Times: L.A. Says It Got 21,631 Homeless People Into Housing. Is That Really True?
In the pervasive gloom that has surrounded the results of L.A. County’s annual homeless count, officials have repeatedly pointed to one bit of bright news: A record number of people got off the streets and into housing last year. The 21,631 people who were housed last year using millions of new tax dollars was 23% higher than in 2017 and double the number housed in 2014. Still, the population living on the streets, in vehicles and in shelters climbed 12% in the past year, putting the number of homeless people at nearly 59,000 countywide. (Smith, 7/20)