First Edition: April 26, 2019

Kaiser Health News: Patients Caught In Middle Of Fight Between Health Care Behemoths
Cancer survivors Evalyn Bodick, 74, and Barbara Marsic, 63, are caught in the crossfire of one of the fiercest health care fights in the country. They fear they are about to lose access to the doctors they say have kept them alive. The reason: the latest skirmish in a nearly decade-old battle between two large health systems in Pennsylvania, the University of Pittsburgh Medical Center (UPMC) and Highmark Blue Cross Blue Shield. Both are nonprofit and both sell health insurance as well as provide care. Only a handful of companies nationwide do both. (Findlay, 4/25)

Kaiser Health News: Klobuchar Wants To Stop ‘Pay-For-Delay’ Deals That Keep Drug Prices High
Washington’s recent fixation with lowering drug costs has introduced Americans to once-insider terms like “pharmacy benefit managers” and “list prices.” During an April 22 CNN town hall event for Democratic candidates, Sen. Amy Klobuchar (D-Minn.) described a drugmaker practice that sounds a lot like bribery — drawing attention to yet another secretive process that lawmakers and experts say prevents patients from obtaining affordable prescription drugs. America, meet “pay-for-delay.” (Huetteman, 4/26)

California Healthline: Newsom: California Leads On Prescription Drugs
California regularly portrays itself as a national trendsetter on political issues, and Gov. Gavin Newsom is claiming that title on prescription drugs. Newsom has a plan to take on the drug industry, and at an April 17 news conference in Southern California, he declared that two other governors already want to join his effort.“California is leading the nation in holding drug companies accountable and fighting prescription drug prices,” Newsom said via a press release that day, marking his 100th full day in office. (Young, 4/26)

Kaiser Health News: Hospitals Chafe Under Medicare’s New Payment Rule For Off-Campus Clinics
Eric Lewis’ plans for expansion have derailed. As chief executive officer of Olympic Medical Center, he oversees efforts to provide care to roughly 75,000 people in Clallam County, in the isolated, rural northwestern corner of Washington state. Last year, Lewis planned to build a primary care clinic in Sequim, a town about 17 miles from the medical center’s main campus in Port Angeles. (Heredia Rodriguez, 4/26)

The New York Times: Judge Temporarily Blocks Trump Rule On Abortion Referrals
Judge Bastian wrote that the plaintiffs in the case had “submitted substantial evidence of harm” if the administration’s rule were to take effect. “Yet,” he wrote, “the government’s response in this case is dismissive, speculative and not based on any evidence presented in the record before this court.” The judge’s ruling granted an immediate preliminary injunction, preventing the imposition of the Trump administration rule, which was scheduled to take effect on May 3. (Belluck, 4/25)

Politico: Judge Freezes Trump Abortion Rule
U.S. District Court Judge Stanley Bastian, an Obama appointee, issued a nationwide injunction staying the changes from taking effect while several other legal challenges proceed. Bastian heard several hours of arguments Thursday from Washington state and the National Family Planning and Reproductive Health Association challenging the administration's Title X funding rule and arguments from the Justice Department defending the changes. (Ollstein, 4/25)

The Washington Post: Trump Abortion ‘Gag’ Rule Blocked By Federal Judge
A federal judge issued a nationwide injunction Thursday, temporarily blocking the Trump administration from imposing new anti-abortion restrictions on the use of federal family planning funds designed to assist 4 million low-income women. The rule, promulgated in March by the Department of Health and Human Services, would have barred programs receiving the money from saying or doing anything to advise or assist a patient about securing an abortion. Critics called it a “gag rule.” (Barbash, 4/25)

Reuters: U.S. Judge Blocks New Trump Abortion Rule For Health Clinics
"Today’s ruling ensures that clinics across the nation can remain open and continue to provide quality, unbiased healthcare to women," Washington state Attorney General Bob Ferguson said in a statement announcing the decision. Washington state was a named plaintiff in the case challenging restrictions proposed by the U.S. Health and Human Services Department (HHS) to its Title X program subsidizing reproductive healthcare and family planning costs for low-income women. (4/26)

The Associated Press: Alabama House To Vote On Abortion Ban Next Week
Alabama lawmakers next week will debate one of the most stringent abortion restrictions in the nation. The House Rules Committee put the bill on the House of Representatives' debate schedule for Tuesday. The measure would make performing an abortion a felony with almost no exceptions. (Chandler, 4/25)

The New York Times: Judge Gives U.S. 6 Months To Account For Thousands More Separated Migrant Families
A federal judge on Thursday gave the Trump administration six months to locate thousands more children and parents who were potentially separated at the southern border under a policy intended to deter illegal immigration. Early this year, it came to light that many more children most likely had been forcibly separated from their parents even before a border-enforcement policy known as zero tolerance was officially unveiled in the spring of 2018. Under the policy, nearly all adults who entered the country illegally faced criminal prosecution, and any children accompanying them were placed in shelters or foster care. They often ended up hundreds or thousands of miles apart for weeks or longer. (Jordan, 4/25)

Reuters: Judge Gives U.S. Six Months To Identify Separated Migrant Children
"I am going to issue an order to do this in six months, subject to good cause," said U.S. Judge Dana Sabraw at a hearing in San Diego. "It is important for all government actors to have a time frame and I intend to stand on it." The American Civil Liberties Union, which brought a class action lawsuit on behalf of parents separated from their children, pressed Sabraw to give the government a firm deadline. (Hals, 4/25)

The Hill: Biden To Face Pressure On Medicare For All 
Former Vice President Joe Biden’s entry into the 2020 race is putting a renewed focus on the sharp divide between Democratic candidates who want to strengthen ObamaCare and those who prefer to make the leap to “Medicare for All.” For Biden, questions will center on whether he sticks exclusively with ObamaCare and his promise to improve on it or if he gives in to pressure from the left and gravitates toward Medicare for All, the progressive proposal backed by many of his opponents. (Hellmann, 4/26)

The Hill: CBO To Release Report On Single-Payer Health Care Next Week
The Congressional Budget Office (CBO) said Thursday that it will release a report on single-payer health care next week. The report from Congress’s nonpartisan scorekeeper, slated for release on May 1, is sure to draw close scrutiny from both sides as “Medicare for All” single-payer proposals are hotly debated among Democrats on Capitol Hill and on the presidential campaign trail. (Sullivan, 4/25)

The Hill: Warren Unveils Plan To Reward Hospitals That Make Childbirth Safer For Black Women
Sen. Elizabeth Warren (D-Mass.) on Wednesday proposed a plan to tackle high childbirth mortality rates among black women while speaking at a forum hosted by an advocacy organization for women of color. Warren, who is running for president, proposed giving bonuses to hospitals who lower maternal mortality rates and taking money away from hospitals who do not. (Frazin, 4/25)

Modern Healthcare: Medicaid, CHIP Enrollment For Kids Dropped By 861,000 In 2018
An estimated 861,000 fewer children were covered by Medicaid and the Children's Health Insurance Program in 2018 compared with the year before, according to an analysis by Georgetown University's Center for Children and Families drawing on new CMS data. Total Medicaid and CHIP enrollment totaled 72.4 million in January 2019, down about 2.2 million from January 2018, according to the CMS data. CMS Administrator Seema Verma tweeted that her agency's preliminary analysis suggests the improving U.S. economy is a factor in the enrollment declines in Medicaid and CHIP. (Meyer, 4/25)

The Associated Press: Arkansas Sues 3 Drug Distributors Over Opioid Crisis
Arkansas' attorney general on Thursday sued three drug distributors for their alleged role in the opioid crisis, claiming the companies failed to monitor and report suspicious shipments of opioids into the state. Attorney General Leslie Rutledge filed the lawsuit in Pulaski County Circuit Court against Cardinal Health, McKesson Corporation and AmerisourceBergen. The lawsuit claims the companies' conduct has cost consumers and the state millions of dollars in payments for opioid orders that were illegal, misrepresented, unfair or harmful to consumers. (4/25)

The Associated Press: AP-NORC Poll: Many Blame Drug Firms For Opioid Crisis
About two-thirds of Americans believe drug companies are to blame for the opioid crisis, although nearly as many hold drug users themselves responsible, a new poll finds. The Associated Press-NORC Center for Public Affairs Research poll showed many people also fault doctors who prescribed opioid pain pills and government officials who haven't done enough to expand addiction treatment and arrest drug dealers. (4/25)

The New York Times: Amid Measles Outbreak, Quarantine Is Ordered At U.C.L.A. And California State-Los Angeles
More than 200 university students and employees in Los Angeles were given quarantine orders on Wednesday and Thursday, just days after a measles outbreak was declared in Los Angeles County. U.C.L.A. and California State University, Los Angeles, have been working with county health officials to identify and contact students and employees who may have been exposed to measles this month. Those at risk of having contracted measles were given health officer orders — legal orders issued by county officials — to stay home and avoid contact with other people as much as possible. (Fortin, 4/25)

The Associated Press: Quarantines At 2 LA Universities Amid US Measles Outbreak
"One person with a confirmed measles case can expose thousands of people to measles," the county's public health department director Dr. Barbara Ferrer said at a news conference Thursday. Los Angeles County public health officials issued quarantines of 24 to 48 hours until proof of immunity is established, officials said. Some people may need to be quarantined for up to a week. (4/26)

The Washington Post: Measles Outbreak: Quarantine Issued At Two LA Universities Affecting Hundreds Of Students And Staff
The orders come amid a surge of measles outbreaks across the country — a reported 695 cases overall spanning 22 states — the highest number in a single year since the disease was declared eliminated in 2000, the Centers for Disease Control and Prevention reported Wednesday. In a statement late Wednesday, Health and Human Services Secretary Alex Azar said the United States is seeing “a resurgence of measles, a disease that had once been effectively eliminated from our country. . . . Measles is not a harmless childhood illness, but a highly contagious, potentially life-threatening disease.” (Brice-Saddler, 4/25)

The New York Times: Over 20 Million Children A Year Miss Out On First Dose Of Measles Vaccine
Nearly 170 million children worldwide, including more than 2.5 million in the United States and half a million in Britain, missed out on the first dose of the measles vaccine during the past eight years, opening the door to global outbreaks of the disease, a Unicef report said on Thursday. “The ground for the global measles outbreaks we are witnessing today was laid years ago,” Henrietta Fore, the executive director of Unicef, the United Nations agency for children, said in a statement. “The measles virus will always find unvaccinated children,” she added. (Magra, 4/25)

Reuters: Genzyme And Vaccines Push Up Sanofi's First-Quarter Results
Sanofi upheld a long-awaited return to growth on Friday with higher profits and revenues for the first quarter, once again led by a stellar sales increase at its rare diseases Genzyme unit. The French drugmaker, which also posted a strong performance at its vaccines division and a new slide in diabetes confirmed its full-year outlook. Pressure on pricing for high cholesterol treatment Praluent was expected to continue this year in the United States, chief financial officer Jean-Baptiste de Chatillon, told reporters. (4/26)

The Wall Street Journal: Amgen, Astellas To Pay $125 Million To Settle Kickback Claims
Amgen Inc. and Astellas Pharma Inc.’s U.S. unit have agreed to pay a total of $125 million to resolve kickback allegations that they violated federal law by using charities to pay for Medicare patients’ out-of-pocket costs for the companies’ own drugs, federal prosecutors said. The two separate settlements are part of a long-running Justice Department investigation into the financial support drug companies provide to charities that help patients pay for prescription drugs. (Chin, 4/25)

The Associated Press: CVS Moves Into Dental Care With Teeth-Straightening Service
CVS Health is venturing into dental care with plans to offer a relatively new teeth-straightening service. The drugstore chain said Thursday that it will add SmileDirectClub locations to hundreds of its stores, where customers can get started on getting their teeth straightened without an in-person visit with a dentist or orthodontist. That lack of an office visit has drawn criticism from orthodontists. (4/25)

The New York Times: E.P.A. Proposes Weaker Standards On Chemicals Contaminating Drinking Water
After pressure from the Defense Department, the Environmental Protection Agency significantly weakened a proposed standard for cleaning up groundwater pollution caused by toxic chemicals that contaminate drinking water consumed by millions of Americans and that have been commonly used at military bases. Standards released by the agency on Thursday eliminated entirely a section that would have addressed how it would respond to what it has described as “immediate threats posed by hazardous waste sites.” Those short-term responses, known as removal actions, can include excavating contaminated soil or building a security fence around a toxic area. (Lipton and Turkewitz, 4/25)

The Washington Post: Male Angst Prompts A New Fertility Service: Sperm Freezing
Gilbert Sanchez froze his sperm in January, shortly before his 25th birthday. He was healthy and at low-risk for fertility issues. But he wanted to be proactive — just as thousands of young women have been by putting their eggs on ice. Sanchez was headed to graduate school in the fall, and it might be years before he would have a steady job and the wherewithal for a family. He and his girlfriend worried about all the things that could go wrong — disease, war, natural aging — before they might be ready. (Cha, 4/25)

The Associated Press: Food Poisoning Remains Persistent Problem, US Report Finds
As recent illnesses tied to raw turkey, ground beef, cut melon and romaine lettuce suggest, U.S. food poisoning cases don't appear to be going away anytime soon. The Centers for Disease Control and Prevention said in a report Thursday that the frequency of several types of food poisoning infections climbed last year, but that the increases could be the result of new diagnostic tools that help identify more cases. (4/25)

The New York Times: Americans Are Among The Most Stressed People In The World, Poll Finds
Americans are among the most stressed people in the world, according to a new survey. And that’s just the start of it. Last year, Americans reported feeling stress, anger and worry at the highest levels in a decade, according to the survey, part of an annual Gallup poll of more than 150,000 people around the world, released on Thursday. “What really stood out for the U.S. is the increase in the negative experiences,” said Julie Ray, Gallup’s managing editor for world news. “This was kind of a surprise to us when we saw the numbers head in this direction.” (Chokshi, 4/25)

Stat: ‘We Need To ... Tell Our Story Better’: Head Of For-Profit Cancer Centers 
The for-profit hospital chain Cancer Treatment Centers of America may not have the perceived starpower or reputation of some other institutions that treat cancer patients — but it wields a big influence on how many Americans with cancer get their care. Tasked with shaping that influence is the chain’s new CEO, Dr. Pat Basu, who’s served in the Obama administration and worked for the giant health care company UnitedHealth Group and telemedicine provider Doctor on Demand. (Robbins, 4/26)

The New York Times: Cavities? Blame Nurture, Not Nature
Environmental factors are more important than genetics in determining who gets cavities, a new study reports. Australian researchers recruited 250 twin pairs when their mothers were still pregnant. They collected health and demographic data on them at 24 and 36 months’ gestational age, at birth, and at age 18 months. When they were 6 years old, the 172 twin pairs still in the study underwent dental examinations. (Bakalar, 4/26)

The Wall Street Journal: Psychedelics As A Path To Social Learning
How do psychedelic drugs work? And can psychedelic experiences teach you something? People often say that these experiences are important, revelatory, life-changing. But how exactly does adding a chemical to your brain affect your mind? The renaissance of scientific psychedelic research may help to answer these questions. A new study in the journal Nature by Gul Dolen at Johns Hopkins University and her colleagues explored how MDMA works in mice. (Gopnik, 4/25)

The Associated Press: Moms-To-Be Teach Each Other In Monthly Group Prenatal Visits
In a big room full of moms-to-be, pregnant women check each other's blood pressure and weight, a nurse-midwife measures their growing bellies, and they all join a seated circle for two hours of candid talk about what to expect when you're expecting. A young woman's revelation about her strange cravings for glue and fabric softener gets some chuckles, followed by the nurse's explanation that odd signs like that can signal iron deficiency. (4/25)

The New York Times: F.B.I. Raids Baltimore City Hall And Mayor Catherine Pugh’s Homes
What began with questions about bulk sales of an obscure children’s book series erupted on Thursday into a full-blown political scandal in Baltimore, where federal agents raided City Hall and two houses belonging to Mayor Catherine Pugh, the author of the books. Critics of the mayor renewed calls for her to resign. Local news stations aired images of agents from the F.B.I. and the Internal Revenue Service carrying out box after box of documents and other items seized from at least six locations, including Mayor Pugh’s second-floor office in City Hall and her two homes in northwestern Baltimore. The coordinated raids sought financial records related to the children’s books. (Williams, 4/25)

The Associated Press: Lawyer: Baltimore Mayor To Decide Future Once She's 'Lucid'
The strongest voice calling for Mayor Catherine Pugh's immediate resignation is Republican Gov. Larry Hogan, who didn't mince words after the early Thursday raids: "Mayor Pugh has lost the public trust. She is clearly not fit to lead." Many Democrats, including those on Baltimore's demoralized City Council and state lawmakers, demanded that the first-term mayor put the interests of citizens above her own self-preservation after weeks of mounting scandal. (4/26)

The Wall Street Journal: FBI Raids Baltimore Mayor’s Homes, Office Amid Scrutiny Over ‘Healthy Holly’ Book Deals
Agents also went to the downtown law office of Ms. Pugh’s personal lawyer, Steven Silverman, and served a limited subpoena for original financial records belonging to Ms. Pugh that the firm had kept in a sequestered area, according to Mr. Silverman. He said in a statement that the firm complied with the subpoena. (Calvert and Viswanatha, 4/25)

The Associated Press: USC Medical Program Loses National Accreditation
The University of Southern California is losing national accreditation for a medical training program dogged by allegations of sexual misconduct. The Accreditation Council for Graduate Medical Education notified USC and Los Angeles County this week that their joint-run fellowship in cardiovascular disease will be stripped of accreditation next year. The decision is final and would effectively shut down the program, which had 15 slots for a three-year curriculum. (4/26)

Los Angeles Times: USC Cardiovascular Fellowship To Be Stripped Of National Accreditation
The panel did not publicly state the reasons for the action. But it comes a year after revelations that a medical resident had accused a fellow in the program of sexual assault and alleged officials didn’t take her case seriously. The ACGME also took the rare step of imposing immediate probation on Los Angeles County and USC, which together sponsor more than 60 programs with hundreds of medical residents and fellows, including the troubled cardiovascular disease fellowship. (Hamilton, 4/25)

The Associated Press: Many Fire-Prone California Towns Don't Plan For Evacuations
Wildfire surrounded Darrel Wilken and the three hospital patients in his car. But instead of evacuating Paradise, they were stuck in traffic along with thousands of others. Cars burned in front of them. Trees, homes and buildings exploded into flames as the gusting firestorm destroyed nearly everything around them. (4/25)

Los Angeles Times: After Inmate Dies Of Legionnaires', Stockton Prison Works To Kill Bacteria
California state officials have initiated a chlorine water treatment to clear out deadly bacteria that are the source of Legionnaires’ disease from several facilities in the Central Valley. The measure is part of a larger investigation into the source of two confirmed cases of the disease at a Stockton facility, one of which resulted in the death of an inmate in March. The treatment, which began Wednesday morning, came after environmental testing showed Legionella bacteria were present at the California Health Care Facility and the Northern California Youth Correctional Center, the state corrections department said in a news release. The process aims to disinfect water systems in about 115 buildings. (Diaz, 4/25)

The Associated Press: California Prison Escapes Double With New Community Programs
California's attempt to ease inmates back into the community is coming at a price: more prisoners, some with violent convictions, walking away before their time is up. Fifty of the state's more than 126,000 prisoners absconded last year, almost half of them from a program that allows male inmates to serve the final year of their sentences in community centers to get help with substance abuse, mental and other health issues, jobs, education, housing, family reunification and social support. (4/26)

The Washington Post: Kissing Bugs: Bloodsucking Insect Found In Delaware
It’s like “Sleeping Beauty” with a dose of nightmare fuel: A flat-bodied, six-legged insect moves toward you as you slumber, bound for the blood that surges around your eyes and lips. It crawls on your face. And the poop it leaves behind can be deadly. The triatomine bug, also known as the notorious kissing bug, has been an obscure threat in the United States, with the highest density in Latin America and some Western states. (Horton, 4/25)

The Wall Street Journal: Scientists Tackle Connecticut’s Tick Problem
A team of scientists is trying to get a better grasp of Connecticut’s tick population. With funding from the Centers for Disease Control and Prevention, researchers at the Connecticut Agricultural Experiment Station are for the first time actively collecting ticks statewide to test for organisms that cause human diseases, including Lyme disease. The new program, which started this month, is targeting 40 locations across Connecticut, mainly in state parks, forests and land trusts. Nearly 60% of the state is forested, making it a prime habitat for ticks. (Scott, 4/25)