First Edition: April 24, 2019

Kaiser Health News: Amid Opioid Prescriber Crackdown, Health Officials Reach Out To Pain Patients
A pharmacist in Celina, Tenn., was one of 60 people indicted on charges of opioid-related crimes last week, in a multistate sting. John Polston was charged with 21 counts of filling medically unnecessary narcotic prescriptions. He was also Gail Gray’s pharmacist and the person she relied on to regularly fill her opioid prescriptions.“I take pain medicine first thing in the morning. I’m usually up most of the night with pain,” she said. “I hurt all the time.” (Farmer, 4/24)

California Healthline: The Homeless Are Dying In Record Numbers On The Streets Of L.A.
A record number of homeless people — 918 last year alone — are dying across Los Angeles County, on bus benches, hillsides, railroad tracks and sidewalks. Deaths have jumped 76% in the past five years, outpacing the growth of the homeless population, according to a KHN analysis of the coroner’s data.Health officials and experts have not pinpointed a single cause for the sharp increase in deaths, but they say rising substance abuse may be a major reason. (Gorman and Rowan, 4/23)

The New York Times: For First Time, Pharmaceutical Distributor Faces Federal Criminal Charges Over Opioid Crisis
Law enforcement officials have long tried to stem the opioid crisis in America with criminal charges for street dealers and cartel kingpins who traffic in drugs like fentanyl and oxycodone. Now, for the first time, federal authorities are bringing the same kind of felony drug-trafficking charges against a major pharmaceutical distributor and two of its former executives for their role in fanning the crisis. Prosecutors said the former executives at the company, Rochester Drug Cooperative, ignored red flags and shipped tens of millions of oxycodone pills and fentanyl products to pharmacies they knew were distributing drugs illegally. Their sales soared, as did the compensation of the chief executive. (Rashbaum, 4/23)

The Associated Press: Indictment: Ex-CEO Ignored Red Flags As Opioid Crisis Raged
Laurence Doud III, the retired CEO of the Rochester Drug Co-Operative, operated in the fringes of the drug business, obliterating red flags to turn his small New York firm into a supplier of last resort for independent pharmacies whose dubious practices got them cut off by other distributors, an indictment unsealed Tuesday alleges. Apparently in pursuit of bigger profits for the company and fatter bonuses for himself, Doud encouraged his sales force to sign up new customers with no questions asked, picking up competitors' rejects as he boasted that his company was "the knight in shining armor" for independent pharmacies, the indictment said. (Sisak, 4/23)

Reuters: U.S. Brings First Criminal Case Against Major Drug Distributor Over Opioids
The U.S. government on Tuesday filed its first criminal charges against a major drug distributor and company executives over their alleged roles in fueling the nation's opioid epidemic by putting profits ahead of patients' safety. Rochester Drug Co-operative Inc (RDC), one of the 10 largest U.S. drug distributors, agreed to pay a $20 million fine and enter a five-year deferred prosecution agreement to resolve charges it turned a blind eye to thousands of suspicious orders for opioids. (Stempel, 4/23)

The Wall Street Journal: Upstate New York Drug Distributor Settles Charges In Opioid Case
From about 2012 to about March 2017, the company acknowledged in the 30-page filing, it violated federal law when it distributed addictive prescription opioids such as oxycodone and fentanyl to pharmacies it knew were dispensing for “illegitimate purposes.” These pharmacies included ones Rochester’s own compliance department flagged for being linked to diversion of prescription opioids. Some pharmacies accepted high amounts of cash payments from patients while others dispensed to out-of-area patients. (Hopkins, 4/23)

The Washington Post: Rochester Drug Cooperative Faces Federal Criminal Charges Over Opioid Distribution
The charges against the country’s sixth-largest drug wholesaler are sure to send a shudder through the small group of firms that control narcotics distribution in the United States. To date, prosecutors and the Drug Enforcement Administration have used only civil penalties against these middlemen in their effort to force the companies to report and block suspicious orders of painkillers by pharmacies. “This prosecution is the first of its kind: Executives of a pharmaceutical distributor and the distributor itself have been charged with drug trafficking — trafficking the same drugs that are fueling the opioid epidemic that is ravaging this country,” said U.S. Attorney Geoffrey S. Berman. (Bernstein, 4/23)

Modern Healthcare: New Kansas Law May Spur Other States To Allow Skinny ACA Health Plans
Kansas' new law allowing the sale of health plans that can turn away people with pre-existing medical conditions has heightened concerns that more states may move to allow leaner, cheaper plans that don't comply with Affordable Care Act rules. So far, three states have passed laws allowing their Farm Bureaus to bypass ACA rules and sell health plans that are free from any state insurance regulation. Kansas became the latest last week. The state's Democratic governor let the bill become law without her signature in the hope of winning GOP support for a bill to expand Medicaid to low-income adults, though that remains uncertain. (Meyer, 4/23)

The Hill: House Dems To Hold Hearing On 'Medicare For All' Next Week 
The House Rules Committee will hold a hearing on "Medicare for All" legislation next week, a step forward for the legislation that is gaining ground in the progressive wing of the party. The hearing on Tuesday will examine a bill from Reps. Pramila Jayapal (D-Wash.) and Debbie Dingell (D-Mich.) that has over 100 co-sponsors in the House. (Sullivan, 4/23)

The Hill: Dem Primary Voters Rank Health Care As Top Issue
Health care issues are most important to likely Democratic primary voters, according to a new poll. Twenty-five percent of the voters surveyed in the Morning Consult poll say health care issues are most important, closely followed by 22 percent who chose economic issues. Supporters of Democratic presidential candidate Pete Buttigieg, mayor of South Bend, Ind., are more likely to say health care issues are most important to them than backers of former Vice President Joe Biden and Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.), pollsters found. (Hellmann, 4/23)

Reuters: U.S. Federal Judge To Block Trump's New Abortion Rule: Media, Activists
A federal judge in the U.S. state of Oregon will block a move by the Trump administration to cut off federal money to family planning clinics that offer abortion or refer women to abortion providers, activists and media reports said late on Tuesday. President Donald Trump's new Title X rule, set to take effect in May, would halt government funds for Planned Parenthood clinics that subsidize birth control for low-income women, and other clinics that provide abortions. (4/24)

The Associated Press: US Judge In Oregon To Block New Trump Abortion Policy
U.S. District Judge Michael McShane made the comments after more than three hours of arguments in a lawsuit brought by 20 states and the District of Columbia, The Oregonian/OregonLive reported . The states say the rule change, due to take effect May 3, is a transparent attack on Planned Parenthood and a violation of the Affordable Care Act, which prohibits "unreasonable barriers to the ability of individuals to obtain appropriate medical care." "At the heart of these rules is an arrogant assumption that the government is better suited to direct women's health care than their providers," Oregon Public Broadcasting quoted the judge as saying. (4/23)

The Hill: Oregon Judge Says He Will Block Trump Abortion Measures 
The changes, most of which are slated to go into effect May 3, also lift a requirement that Title X grant recipients counsel women on abortion as an option. The rules also would require that grant recipients be financially and physically separate from abortion providers, making hundreds of Planned Parenthood clinics across the country ineligible for the funding. While federal funds can't go toward abortions, the Trump administration has argued that money is fungible and any going to Planned Parenthood could indirectly support the procedure. (Hellmann, 4/23)

Politico: Oregon Judge Says He’ll Block Trump’s Abortion Rule
The American Medical Association, in a statement, said the rule would have created obstacles to health care for low-income patients. "We are pleased the judge shared the AMA’s concern about the physician-patient relationship that the rule would have jeopardized,” said the physician group's president Barbara McAneny. Nearly two dozen states and several medical provider and advocacy groups have filed a series of suits to block the Title X change. Similar arguments were heard last week in San Francisco, and additional hearings will be held this week in Maine and Washington state. (Colliver, 4/23)

The Associated Press: Planned Parenthood: States Should Oppose Trump 'Gag Rule'
It's time for states with leaders who support abortion rights to go on the offensive against Trump administration attempts to restrict abortion that would reduce access to health care, the president of Planned Parenthood said Tuesday. "States are a critical backstop at a time when we have the Trump-Pence administration stripping away women's health and rights and when we cannot depend on the Supreme Court," said Dr. Leana Wen. (Witte, 4/23)

The Associated Press: Judge Denies Republicans' Attempt To Join Abortion Lawsuit
A federal judge on Tuesday rejected Wisconsin Republican lawmakers' attempt to intervene in a Planned Parenthood lawsuit challenging the state's abortion restrictions, saying in a strongly worded order that they presented no evidence that the Democratic attorney general wouldn't adequately defend the laws. U.S. District Judge William Conley wrote in his ruling that the lawmakers failed to demonstrate a right to intervene and that allowing them to join "would likely infuse additional politics into an already politically-divisive area of the law and needlessly complicate this case." (4/23)

The Associated Press: Wisconsin Governor Will Veto Republican-Backed Abortion Bill
Democratic Wisconsin Gov. Tony Evers promised to veto a Republican-authored bill that could send doctors to prison for life if they fail to give medical care to babies born alive after a failed abortion attempt. Republicans are sending similar bills in other states to liberal-leaning governors in an attempt to energize conservative voters. North Carolina's Democratic governor vetoed a similar bill last week. Democrats in the U.S. Senate blocked a similar measure in February, leading President Donald Trump to say "they don't mind executing babies." (4/23)

The Washington Post: Medicare Proposes Higher Payments For Innovative Cancer Treatment
Medicare officials on Tuesday proposed increasing reimbursements for a groundbreaking but costly cancer therapy used for patients whose blood cancers don’t respond to other treatments. Seema Verma, administrator of the Centers for Medicare and Medicaid Services, said the proposed changes are necessary because “Medicare’s antiquated payment systems” have not kept up with the development of “transformative technologies.” She said she is concerned inadequate payments might be prompting hospitals to limit Medicare patients’ access to needed therapies. (McGinley, 4/23)

Stat: Biotechs Fill More Of The Pipeline As Pharma Spends More On R&D  
If you weren’t already aware, the era of emerging biotechs has arrived. Last year, these companies accounted for 72% of 2,853 late-stage drugs in the collective industry pipeline, up from 65% of 2,083 medicines in 2013. Meanwhile, 47% of the therapies launched in the U.S. in 2018 were attributed to emerging biotechs, which were defined as spending less than $200 million annually on R&D and having less than $500 million in revenue. (Silverman, 4/23)

Stat: With Real Estate Deal, Sanofi Genzyme Boosts Its Bottom Line 
Sanofi Genzyme (SNY) makes most of its money developing really complicated drugs for rare diseases. But for the next decade it will make a nice little profit in a far simpler way: by flipping its real estate. The Cambridge-based drug maker turned heads last year when it leased two whole buildings — about 900,000 square feet — at Cambridge Crossing, a huge mixed-use development that’s underway north of the MBTA’s Lechmere Station. (Logan, 4/23)

Politico: Cancer Group Launches $4.5M Campaign To Boost Medicaid Expansion
The American Cancer Society’s advocacy arm is launching a $4.5 million campaign that aims to break GOP resistance to Medicaid expansion in several states debating whether to join the program. The initiative launching Tuesday — which the group detailed exclusively to POLITICO and is its largest-ever education campaign — comes amid Democrats' reinvigorated push for coverage expansion after health care-fueled 2018 midterm victories. The campaign will largely focus on Alabama, Georgia, Kansas and North Carolina, where 1.2 million low-income people could gain coverage if state leaders expanded Medicaid under the Affordable Care Act. (Pradhan, 4/23)

The New York Times: Walgreens Raises Tobacco-Buying Age To 21, Strengthening A Consensus
The drugstore chain Walgreens will stop selling tobacco products to customers under 21, the company announced on Tuesday. The decision came weeks after the Food and Drug Administration accused the company of repeatedly selling tobacco products to minors — and amid similar moves by competitors and lawmakers around the country to curb teenage vaping. (Zraick and Rueb, 4/23)

The Wall Street Journal: Walgreens, Rite Aid To Raise Tobacco Buying Age To 21 And Older
The new chainwide policy for Walgreens will start Sept. 1, the company said Tuesday. Walgreens’s move is its most recent step in its effort to further prevent youth access to tobacco products, including a policy implemented last October that requires verification regardless of age, the company said. “We’ve seen positive results from other recent efforts to strengthen our policies related to tobacco sales, and believe this next step can be even more impactful to reduce its use among teens and young adults,” Richard Ashworth, Walgreens president of operations, said in a statement. (Al-Muslim, 4/23)

The Hill: Rite Aid To Raise Tobacco Buying Age To 21 
The moves come as more states debate raising the minimum purchasing age to 21. Senate Majority Leader Mitch McConnell (R-Ky.) said last week he would introduce legislation to raise the age nationwide. The Food and Drug Administration says the U.S. is facing a youth vaping epidemic, with 3.5 million middle and high school students smoking e-cigarettes in 2018. (Hellmann, 4/23)

Politico: Beer And Cigarette Makers Join The Pot Lobbying Parade
The push to legalize marijuana quickly transformed the cannabis industry into a multibillion dollar legal business. And now Fortune 500 companies and elite K Street lobbying firms have joined the green gold rush. Altria, the tobacco giant better known for Marlboros, recently took a $1.8 billion stake in the cannabis company Cronos Group. Constellation Brands, which makes Corona beer, has spent money on cannabis lobbying after making a major investment in Canopy Growth, a Canadian marijuana company. (Demko, 4/23)

Los Angeles Times: Measles’ Next Target In Los Angeles: Unvaccinated College Students
Los Angeles health officials warned this week that students and staff at UCLA and Cal State L.A. may be at risk of catching measles, an announcement that has raised questions about universities’ susceptibility to disease outbreaks. Not only can cramped dorm rooms and crowded classrooms be breeding grounds for contagion, but young adults in California are less likely to be vaccinated than other age groups, experts say. One of the people infected in L.A.’s measles outbreak is a UCLA student, university officials confirmed Tuesday. (Karlamangla, 4/23)

The New York Times: Measles Outbreak Declared In Los Angeles County
Public health officials in Los Angeles have declared a measles outbreak in the county, making it the latest metropolitan area to be hit by the illness and part of a national surge in cases rapidly approaching record numbers. Five cases of measles are being investigated by the Los Angeles County Department of Public Health. Though vaccination rates are typically high in California, a single case can easily spread — not only to those who are not vaccinated, but also to infants who cannot yet receive immunization and to elderly patients with suppressed immune systems. (Del Real, 4/23)

The Associated Press: Washington State Bill Limits Measles Vaccine Exemptions
Washington state lawmakers voted Tuesday to remove parents' ability to claim a personal or philosophical exemption from vaccinating their children for measles, although medical and religious exemptions will remain. The vote comes as the number of measles cases nationwide this year has passed 600. (4/23)

The Associated Press: Hospitals Sue Over New National Liver Transplant Policy
Hospitals and patients have sued to block a new nationwide liver transplant policy that they say will waste viable livers, lead to fewer transplants and likely cause deaths. The U.S. Department of Health and Human Services and the United Network for Organ Sharing hastily adopted the new policy and based it on faulty assumptions, according to the suit filed Monday in Atlanta federal court. (4/23)

The New York Times: Florida Moves Toward Arming Teachers, Despite Opposition From Parkland Students
A year ago, in the wake of horrific tragedy, Florida lawmakers reached a compromise that had once seemed politically impossible: They passed an array of gun restrictions after a young man killed 17 people at Marjory Stoneman Douglas High School in Parkland. Part of that compromise allowed certain school employees, but not classroom teachers, to carry firearms on campus. Then, late last year, a state commission investigating the Parkland shooting came to a conclusion that made even some of its members uncomfortable: Some of the deaths at Stoneman Douglas High might have been prevented if faculty inside the building had been armed. (Mazzei, 4/23)

The Wall Street Journal: Bill Allowing Teachers To Be Armed Passes Florida Senate
The measure is aimed at implementing recommendations by a state commission created in the wake of the shooting at Marjory Stoneman Douglas High School in Parkland, Fla., last year that left 17 people dead. It builds on a law passed last year that included new gun restrictions, including raising the minimum age to buy a firearm, and a guardian program that permitted the arming of certain school personnel, but not teachers. (Campo-Flores, 4/23)

Stat: 5 Names To Know At Apple: The People Leading Its Health Care Push 
Then there’s the talent that Apple is amassing. Over the past few years, the company has built out a formidable roster of physicians and medical researchers. A spokesperson for Apple wouldn’t say how many of the company’s roughly 130,000 employees are tasked with working on health — or provide much detail about the roles of the people leading its health push. But here are five of them whose work you should keep an eye on. (Robbins, 4/24)

Stat: A Machine Learning Device, Meant For Chronically Ill, Moves Into Homes
A wearable device that uses machine learning to remotely track and analyze multiple vital signs has been cleared by the Food and Drug Administration, expanding the scope of home monitoring systems intended to keep chronically ill patients out of the hospital. Current Health, based in Edinburgh, Scotland, announced Wednesday it received clearance for an upper-arm wearable that measures a patient’s respiration, pulse, oxygen saturation, temperature and mobility. The product is capable of delivering continual updates on a patient so doctors can intervene quickly if the data signal an emerging problem. (Ross, 4/24)

The New York Times: Is Sex By Deception A Form Of Rape?
Abigail Finney was in her freshman year at Purdue University in Indiana in February 2017 when she fell asleep in her boyfriend’s dorm room. During the night he snuggled up to her in bed in the pitch black, his hand grazing her breast, and they began having sex. She soon stopped to go to the bathroom and, when she returned, discovered, to her horror, that it wasn’t her boyfriend who was in bed with her. Was it rape? (Ellin, 4/23)

Stat: More Than 8,500 Women Have Joined The 500 Women Scientists Database
In a new paper published Tuesday in the journal PLOS Biology, the researchers behind 500 Women Scientists report that their platform has been accessed more than 100,000 times. And among 1,200 participants surveyed about their experience, 11 percent said they had been contacted as a result of the database for media interviews, peer review, panels, and other opportunities. The group has ambitious plans to keep expanding its reach. They’re raising money to start a fellowship for women of color working to make science more open and accessible and they have already launched an affiliate group, 500 Women in Medicine. (Thielking, 4/23)

The Associated Press: Americans Getting More Inactive, Computers Partly To Blame
Americans are becoming increasingly sedentary, spending almost a third of their waking hours sitting down, and computer use is partly to blame, a new study found. Over almost a decade, average daily sitting time increased by roughly an hour, to about eight hours for U.S. teens and almost 6 1/2 hours for adults, according to the researchers. That includes school and work hours, but leisure-time computer use among all ages increased too. (4/23)

The New York Times: Putting Down Your Phone May Help You Live Longer
If you’re like many people, you may have decided that you want to spend less time staring at your phone. It’s a good idea: an increasing body of evidence suggests that the time we spend on our smartphones is interfering with our sleep, self-esteem, relationships, memory, attention spans, creativity, productivity and problem-solving and decision-making skills. (Price, 4/24)

ProPublica/The Sacramento Bee: California Tried To Fix Its Prisons. Now County Jails Are More Deadly.
On the night of Jan. 17, 2018, Lorenzo Herrera walked into the Fresno County Jail booking area and sat down for an interview. Yes, he had a gang history, an officer wrote on his intake form. But Herrera, 19, said he did not expect problems with others inside the gang pod he’d soon call home. His parents had encouraged him to barter for books and newspapers — anything he could to preoccupy himself until his trial on burglary and assault charges. His father, Carlos Herrera, offered advice: “Just be careful, and only trust yourself.” Herrera survived the violent chaos of the Fresno County Jail for 66 days, including living through a brawl that left another inmate unconscious. Then, on an afternoon in March, jail officers found him strangled. (Pohl and Gabrielson, 4/24)

The Associated Press: Transgender Inmate Sues Corrections Over Lack Of Treatment
A transgender inmate has filed a federal lawsuit against the Connecticut prison system for denying her transitional care and for housing her with male inmates. The Hartford Courant reports that Veronica May Clark says Department of Corrections officials have denied her medical and mental health care since she began her gender transition in prison. The suit seeks proper care and $500,000 in damages. (4/23)

The Associated Press: San Francisco Commission OKs Shelter Near Tourist Area
Port commissioners Tuesday night unanimously approved a proposal to lease land for a 200-bed temporary homeless shelter in the popular Embarcadero tourist area as the city struggles with a severe shortage of affordable housing. Supporters cheered as the commissioners voted unanimously to lease a port-owned parking lot to the city for two years to create the SAFE Navigation Center. There would be an option for a two-year extension under certain conditions. (4/23)