First Edition: Aug. 11, 2023

KFF Health News: Your Exorbitant Medical Bill, Brought To You By The Latest Hospital Merger 
When Mark Finney moved to southwestern Virginia with his young family a decade ago, there were different hospital systems and a range of independent doctors to choose from. But when his knee started aching in late 2020, he discovered that Ballad Health was the only game in town: He went to his longtime primary care doctor, now employed by Ballad, who sent him to an orthopedist’s office owned by Ballad. That doctor sent him to get an X-ray at a Ballad-owned facility and then he was referred to a physical therapy center called Mountain States Rehab, which was now owned by Ballad as well. (Rosenthal, 8/11)

KFF Health News: New Alzheimer’s Drug Raises Hopes — Along With Questions 
The FDA has approved Leqembi, the first disease-modifying treatment for early-stage Alzheimer’s and a precursor condition, mild cognitive impairment. Medicare has said it will pay for the therapy. Medical centers across the country are scrambling to finalize policies and procedures for providing the medication to patients, possibly by summer’s end or early autumn. It’s a fraught moment, with hope running high for families and other promising therapies such as donanemab on the horizon. Still, medical providers are cautious. “This is an important first step in developing treatments for complex neurodegenerative diseases, but it’s just a first step,” said Ronald Petersen, director of the Mayo Clinic’s Alzheimer’s Disease Research Center in Rochester, Minnesota. (Graham, 8/11)

KFF Health News: A Blood Test That Screens For Cancer: Does It Do More Harm Than Good? 
By summer 2021, Gilbert Milam Jr. was living a good life. A nationally renowned rapper who performs under the name Berner, Milam was also enjoying the global expansion of Cookies, a brand of cannabis products and clothing that he co-founded and was running as CEO. But Milam was haunted by a family history of cancer, including his mother’s death from stomach cancer at 54. So, at age 37, he told his physician in San Francisco that he wanted to take every precaution against being diagnosed too late to live a full life. As it happened, his doctor said there was a new test to try. (Kreidler, 8/11)

KFF Health News: On Abortion Rights, Ohio Is The New Kansas 
Ohio voters — in a rare August election — turned out in unexpectedly high numbers to defeat a ballot measure that would have made it harder to pass an abortion-rights constitutional amendment on the ballot in November. The election was almost a year to the day after Kansas voters also stunned observers by supporting abortion rights in a ballot measure. (8/10)

The Hill: Biden Administration Warns States On Post-Pandemic Medicaid Coverage Losses
The Biden administration this week sent letters to state health officials, warning that many are failing to meet federal requirements about determining Medicaid coverage for tens of millions of people in the wake of the pandemic public health emergency. The Centers for Medicare and Medicaid Services (CMS) has expressed concern for months that many states are rushing through the process, resulting in people losing coverage for “procedural” reasons even though they may still be eligible. (Weixel, 8/10)

Politico: Biden Administration Warns States As Millions Lose Medicaid
The Centers for Medicare and Medicaid Services is ramping up pressure on states that may be failing to meet federal requirements as they renew Medicaid coverage for millions of people for the first time since the start of the pandemic. The agency has for months been mum about its behind-the-scenes communications with states, but on Wednesday made public letters it sent to state Medicaid officials warning that they may be running afoul of federal law and regulations. The letters, which were sent to all 50 states and Washington, D.C., identified three key areas of concern: high rates of people losing Medicaid because of paperwork problems, long call center wait times and slow application processing. (Messerly, 8/10)

Stat: Supreme Court Blocks Purdue Bankruptcy Plan That Shields Sacklers
The U.S. Supreme Court blocked a nationwide settlement with Purdue Pharma that was designed to shield members of the Sackler family — who own the company that makes OxyContin — from civil lawsuits over the fallout of the long-running opioid crisis. The move came in response to a request from the Biden administration to halt a bankruptcy plan that had been reached with numerous state and local governments around the country. (Silverman, 8/10)

AP: US Suicides Hit An All-Time High Last Year 
About 49,500 people took their own lives last year in the U.S., the highest number ever, according to new government data posted Thursday. The Centers for Disease Control and Prevention, which posted the numbers, has not yet calculated a suicide rate for the year, but available data suggests suicides are more common in the U.S. than at any time since the dawn of World War II. (Stobbe, 8/11)

The New York Times: Research Trials Halted At Columbia’s Psychiatric Center After Suicide 
Federal regulators have suspended research on human subjects at the Columbia-affiliated New York State Psychiatric Institute, one of the country’s oldest research centers, as they investigate safety protocols across the institute after the suicide of a research participant. A spokesperson for the U.S. Department of Health and Human Services, Kate Migliaccio-Grabill, confirmed on Wednesday that the agency’s Office for Human Research Protections was investigating the psychiatric institute “and has restricted its ability to conduct H.H.S.-supported human subject research.” (Barry, 8/10)

Military Times: Important PACT Act Deadline Extended Amid Tech Issues
The Department of Veterans Affairs extended a deadline for payouts linked to legislation aimed at helping veterans who were exposed to toxic substances during their military service after technical issues complicated the application process. The Promise to Address Comprehensive Toxics Act — better known as the PACT Act — was signed by President Joe Biden on Aug. 10, 2022, broadening VA health care benefits to veterans exposed to burn pits and other toxic substances. Veterans and survivors now have through 11:59 p.m. Eastern Time on Monday, Aug. 14, to file — or submit an “intent to file” — to be eligible to have their benefits backdated a year to when the bill was signed. After that date, applicants will only be eligible to receive payouts back to their date of filing. (Lehrfeld, 8/10)

Military.com: Hundreds Of Thousands Of Vets Have Filed Claims As PACT Act Celebrates 1st Year 
In the last year since the PACT Act went into effect, the Department of Veterans Affairs has expanded benefits and health care to hundreds of thousands of veterans, with more expected to qualify as they develop illnesses related to exposure to burn pits and other battlefield toxins. By Thursday, the anniversary of the Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics, or PACT Act, the VA had received 843,448 claims under the legislation and enrolled 113,719 veterans in VA health care as a result of the law. (Kime, 8/10)

Modern Healthcare: HHS To Boost Nursing Workforce, Training With $100M Investment
The funds will be split among dozens of recipients nationwide across five different program areas. “We're doing this because we got marching orders directly from President Biden who said, ‘This is unacceptable,’” HHS secretary Xavier Becerra said at a media briefing Thursday. The agency is especially focused on addressing burnout, bottlenecks in nursing education and the lack of mental health providers, Becerra said. More than $34 million will go to 56 universities and health systems that will participate in a recently announced advanced nursing education workforce program. (Devereaux, 8/10)

Modern Healthcare: Violence In Healthcare Surges But Security Fixes Remain Complex
Worsening violence in healthcare settings presents providers with a vexing dilemma: How to maintain safety and security for staff and patients without creating unwelcoming, closed environments in what are meant to be places of healing. Abuses committed against personnel in hospitals and other facilities aren’t a new problem, but statistics show a worrying upward trend. And America’s gun violence epidemic isn’t sparing the nation’s healthcare providers, as several recent high-profile incidents demonstrated. (Hartnett, 8/10)

Chicago Tribune: 11-Day Strike At Loretto Hospital Ends
About 200 Loretto Hospital workers will return to work after their union reached a tentative contract agreement with hospital leadership Thursday, following an 11-day strike. The union SEIU Healthcare Illinois and Loretto announced Thursday evening that they reached the tentative agreement, which provides wage increases and a Juneteenth paid holiday. (Schencker and Arougheti, 8/10)

Modern Healthcare: Cano Health To Lay Off 700 Employees, Explores Sale
Membership-based primary care provider Cano Health is laying off 700 employees, exiting four markets and exploring a sale, the company said Thursday. ... Around 40% of the layoffs are tied to the company's pending exit from markets in California, New Mexico, Illinois. and Puerto Rico. Cano said it plans to exit the three states, where it has a total of 5,000 members and 17 medical centers, by the fall. It plans to exit Puerto Rico, where it serves 8,000 members, by 2024. (Perna, 8/10)

Stat: Large Hospital System Sues Multiplan For Low-Balling Medical Claims
AdventHealth, a large religious-affiliated hospital system, has sued MultiPlan, alleging the company has worked with health insurers to create a “cartel” that systematically underpays hospitals and doctors for care that is delivered out of an insurance company’s network. (Herman, 8/10)

Axios: UnitedHealth Cutting Back On Prior Authorizations
Starting next month, UnitedHealthcare says it will move forward with plans to drop prior authorization requirements for a range of procedures, including dozens of radiology services and genetic tests, among others. UnitedHealth is among the health insurance giants who have announced plans to cut back on prior authorization as federal regulators consider tougher curbs on the practice. (Reed, 8/10)

Modern Healthcare: Kaiser, UnitedHealth To Earn Big Medicare Advantage Star Bonuses, KFF Says
Kaiser Permanente will receive the biggest per-member bonus from the Medicare Advantage star ratings program in 2023, an analysis found. The Centers for Medicare and Medicaid Services will pay the integrated health system's insurance arm $523 per member for its high performance in the federal quality bonus program, according to a report published by KFF Wednesday. (Tepper, 8/10)

Houston Chronicle: Medicare Advantage Undergoing Aggressive Changes From Biden
New rules went into effect this summer designed to stop insurance companies that administer Medicare Advantage plans from denying care that typically would be covered by Medicare. That follows changes earlier this year on how medical costs are assessed and new restrictions limiting how Medicare Advantage plans, which typically offer additional coverage such as vision and dental and put limits on out-of-pocket costs, are marketed to seniors. (Osborne, 8/10)

AP: Some 'Obamacare' Plans Could See Big Rate Hikes After Lawmakers Fail To Agree On Reinsurance Program 
Some Affordable Care Act health plans could see big rate hikes in 2024 after Virginia lawmakers failed to reach agreement on a widely supported program that reduced premiums this year, state officials and insurance companies said this week. At issue is the state’s relatively new reinsurance program, which the General Assembly voted to create in 2021. Launched this calendar year, the program works by essentially pooling certain expensive claims and using mostly federal and some state money to cover them. By reducing risks and costs to insurers, it aims to lower premiums in the “Obamacare” individual marketplace — and did so successfully this year, according to state data. (Rankin, 8/10)

Becker's Hospital Review: 18% Of Healthcare Employees Use ChatGPT Regularly At Work
Less than one year after ChatGPT's debut took the digital aspect of many industries by storm, 18 percent of healthcare employees say they use the tool frequently, according to a July LinkedIn poll conducted by Becker's. Of the 1,617 respondents, 23 percent reported they use the tool but do so infrequently, and 58 percent reported not using it at all. Becker's does not have detailed insight into the respondents' roles or organizations in LinkedIn polls outside of the information that is publicly available. (Hollowell, 8/10)

The Washington Post: As Hospitals Use AI Chatbots And Algorithms, Doctors And Nurses Say They Can’t Be Replaced
Every day Bojana Milekic, a critical care doctor at Mount Sinai Hospital, scrolls through a computer screen of patient names, looking at the red numbers beside them — a score generated by artificial intelligence — to assess who might die. On a morning in May, the tool flagged a 74-year-old lung patient with a score of .81 — far past the .65 score when doctors start to worry. He didn’t seem to be in pain, but he gripped his daughter’s hand as Milekic began to work. She circled his bed, soon spotting the issue: A kinked chest tube was retaining fluid from his lungs, causing his blood oxygen levels to plummet. (Verma, 8/10)

The Wall Street Journal: Some 911 Call Centers Still Haven’t Adapted To The Cellphone
Decades after the debut of the cellphone, some 911 centers are still struggling to modernize their communications infrastructure—the result of funding scarcity and hesitation over the high stakes of making changes. But the continued use of legacy systems, installed when pay phones dotted city corners and every household had a landline, has led to a host of challenges for call center operators, including misrouted calls, potentially increasing response times. (Bousquette, 8/10)

USA Today: Survey: Drug Shortages Are Widespread, Hospitals Ration Care
Hospital pharmacists said drug shortages have forced 1 in 3 health systems to delay, cancel or ration care or switch to alternate drugs to continue to treat patients. And 99% are reporting some drug supply shortages, an American Society of Health-System Pharmacists survey of more than 1,000 pharmacists released Thursday found. (Alltucker, 8/10)

Stat: What To Know About Compounded Versions Of Wegovy, Ozempic
As demand for Ozempic and Wegovy surges, a little-noticed warning about the medicines was issued recently by regulators. In late May, the U.S. Food and Drug Administration said it received a “few” adverse event reports concerning compounded versions of the injectable medicines, which both contain the same active ingredient, known as semaglutide. Wegovy is approved for weight loss, while Ozempic is prescribed for diabetes and is also sometimes used to treat obesity. (Silverman, 8/10)

Stat: Where Are Patients Getting Their Prescriptions For GLP-1 Drugs?
As a new class of diabetes and obesity medications has soared in popularity, so have the online outlets built to get them in the hands of patients. A new analysis of claims data from Trilliant Health suggests that collectively, telehealth companies — in particular, cash-pay options that market directly to consumers — could account for many of the patients with insurance claims for GLP-1 prescriptions in 2022. (Palmer, 8/10)

ABC News: Percentage Of US Adults With Long COVID Falls To 6%: CDC
In early June 2022, 7.5% of Americans aged 18 and were experiencing long COVID, a condition that occurs when patients still have symptoms at least four weeks after they have cleared the infection. In some cases, symptoms can be experienced for months or years. By mid-June 2023, that figure had fallen to 6%, according to a new report published Thursday by the Centers for Disease Control and Prevention. (Kekatos, 8/10)

Capital & Main: Amid The New Normal Of COVID, There’s An Old Normal Too
Whatever punch COVID and its variants have left, it’ll hit working poor families and people of color the hardest. That truth, which has repeatedly been demonstrated over the course of the pandemic, is one of the key takeaways from the 2023 California Health Interview Survey of more than 5,000 adults, teenagers and children across the state conducted in March and April. (Kreidler, 8/10)

Columbus Dispatch: Ohio Medical Board Suspends License Of Doc Who Made False COVID Claims
More than two years after Dr. Sherri Tenpenny told state lawmakers that the COVID vaccines cause people to become magnetized, the state medical board indefinitely suspended her license on technical grounds and fined her $3,000. (Bischoff, 8/10)

Reuters: Court Skeptical Of Biden Admin's Bid To Reverse Curbs On Social Media Contacts 
A federal appeals court on Thursday appeared skeptical of the Biden administration's bid to reverse a court order sharply limiting its ability to ask social media companies to remove content that it considers to be misinformation. Daniel Tenny, a lawyer with the U.S. Department of Justice, told a three-judge panel of the 5th U.S. Circuit Court of Appeals in New Orleans that U.S. officials never forced social media companies to remove posts about COVID-19, the 2020 election and other topics, as Louisiana and Missouri claimed in a lawsuit. Instead, he said, the government had informed the companies of certain posts that spread harmful misinformation. (Pierson, 8/10)

AP: Coal Miners Plead With Feds For Stronger Enforcement During Emotional Hearing On Black Lung Rule
Laboring to breathe, West Virginia coal miner Terry Lilly told federal regulators Thursday he is appreciative the U.S. government is finally considering a proposal to limit the poisonous rock dust causing a severe resurgence of black lung. But Lilly said the rule — a half-century in the making — will mean nothing if there aren’t strict enforcement mechanisms in place to ensure companies comply. (Willingham, 8/10)

Reuters: Judge Throws Out FDA Rule Regulating Premium Cigars Like Cigarettes 
A federal judge has vacated a 2016 rule from the U.S. Food and Drug Administration classifying premium cigars as tobacco products subject to the same federal law as cigarettes, following an earlier finding that the rule was arbitrary and capricious. U.S. District Judge Amit Mehta in Washington on Wednesday rejected the agency's argument that the so-called deeming rule could be sent back to the agency for further consideration without vacating it. He said that, in general, a rule that is found to be arbitrary and capricious under the federal Administrative Procedure Act must be vacated unless there are "exceptional" circumstances. (Pierson, 8/10)

Atlanta Journal-Constitution: Cannabis Lowers Blood Pressure In Older Adults, Study Finds
A study from 2020 found the number of Americans age 65 and older who smoke marijuana or enjoy edibles increased 75% from 2015 to 2018. Now, a newer study suggests that might be a good thing for some. The study by researchers at Ben-Gurion University of the Negev and its affiliated Soroka University Medical Center found that medical cannabis might reduce blood pressure in older adults. (Clanton, 8/10)

The Washington Post: What Is West Nile Virus And How Climate Change May Affect Its Spread 
The West Nile virus is more commonly contracted in warmer climates, where hot and tropical temperatures allow the mosquitoes that carry it to thrive. Health experts are increasingly concerned that climate change could worsen the spread of the virus in less common places — and even bring it to new ones. The virus, which is the leading cause of mosquito-borne disease in the continental United States, is particularly dangerous during mosquito season, starting in the summer through fall. “The number of West Nile virus-infected mosquitoes we’ve detected this season is the highest we’ve seen in years,” said Colorado’s state epidemiologist, Rachel Herlihy. (Suliman and Francis, 8/10)

Stat: TB Outbreak Tied To Bone Grafts Underscores Testing Shortcomings
One person has died and at least four have been sickened by tuberculosis in infected bone materials, an outbreak that has cast a spotlight on the shortcomings of testing for such tissue products. (Lawrence, 8/11)

The Washington Post: PFAS 'Forever Chemicals' Found In Period Underwear, Tampon Packaging 
New research has found “forever chemicals” in the lining of period underwear, the wrappers of tampons and in other menstruation products. ... Researchers from the University of Notre Dame studied more than 120 different menstruation products — menstrual cups, pads, underwear and tampons — sold in the United States. The research found forever chemicals in some, but not all, of the products. Although the researchers did not provide specific details, the study found that “a good fraction” of the period underwear products had detectable levels of PFAS in the lining, said Graham Peaslee, a physics professor at the University of Notre Dame who led the research. ... The study does not include the names of the different brands tested. (Amenabar, 8/10)