First Edition: June 4, 2015

Kaiser Health News: Bringing Doctors To Patients Who Need Them Most
Jennifer Vargas’ path toward becoming a doctor took her from UCLA to Guadalajara before it ultimately led back home, to California’s vast Inland Empire east of Los Angeles. When the Chino Hills, Calif. native graduated from medical school in Mexico, her first choice for residency training was Riverside County’s public medical center, which serves among the fastest growing and most medically deprived parts of California. It was just what she wanted: To serve a vulnerable patient population facing high barriers to care, particularly immigrant patients from Mexico who would benefit from a Spanish-speaking physician. (Wang and de Marco, 6/4)

Kaiser Health News: KHN Video: Supreme Court’s Decision In King v. Burwell Could Affect Your Pocketbook
The Affordable Care Act is once again before the Supreme Court. This time it’s not about whether the government can force you to have health insurance or pay a penalty. It can. That is so “2012.” (6/4)

The Wall Street Journal: Doctor-Pay Trove Shows Limits Of Medicare Billing Data
The trove of Medicare data released Wednesday shows a wide cast of characters in the top ranks of the highest-reimbursed doctors, and reveals as much about the limits of the newly public billing records as it does about medical practice. (Weaver, Beck and Winslow, 6/3)

The Wall Street Journal: New Medicare Data Offer A More Complete Picture
Newly disclosed Medicare data reveal $12.4 billion in 2012 payments to physicians and other medical providers that were redacted from an earlier version of the data release. The 16% increase in payments accounted for in the new data—which now total $90 billion—reflects bills Medicare paid for services doctors and other providers performed on very small numbers of patients, though some of those services include very-high-cost treatments. The federal agency had previously excluded the data, citing privacy concerns, because the number of Medicare beneficiaries for these providers was lower than 11. (Weaver and McGinty, 6/3)

The Wall Street Journal: Taxpayers Face Big Medicare Tab For Unusual Doctor Billings
Ronald S. Weaver isn't a cardiologist. Yet 98% of the $2.3 million that the Los Angeles doctor's practice received from Medicare in 2012 was for a cardiac procedure, according to recently released government data. The procedure is rarely used by the nation's heart doctors. Patients are strapped to a bed with three large cuffs that inflate and deflate rhythmically to increase blood flow through the arteries—a last resort to treat severe chest pain in people who can't have surgery. The government data show that out of the thousands of cardiology providers who treated Medicare patients in 2012, just 239 billed for the procedure, and they used it on fewer than 5% of their patients on average. ... Dr. Weaver's clinic administered it to 99.5% of his Medicare patients—615 in all—billing the federal health-insurance program for the elderly and disabled 16,619 times, according to the data. (Carreyrou, Stewart and Barry, 6/3)

The Wall Street Journal: Cancer Doctors Ring Up Big Medicare Bills For Tarnished Drug Procrit
Many cancer doctors now use a drug called Procrit sparingly. It was approved in 1989 for anemia and became a popular treatment for that side effect of chemotherapy. But regulators later learned Procrit can speed tumor growth and hasten death in cancer patients. Today, use of this class of drug—best known as EPO, a substance Lance Armstrong took illicitly to pedal faster and longer—is sharply restricted. One Florida oncology group stands out for how much it bills Medicare for the pricey drug. (Weaver, Wilde Mathews and McGinty, 6/3)

The Wall Street Journal: A Fast-Growing Medical Lab Tests Anti-Kickback Law
A fast-growing Virginia laboratory has collected hundreds of millions of dollars from Medicare while using a strategy that is now under regulatory scrutiny: It paid doctors who sent it patients' blood for testing. Health Diagnostic Laboratory Inc. transformed itself from a startup incorporated in late 2008 into a major lab with $383 million in 2013 revenues, 41% of that from Medicare. (Carreyrou and McGinty, 6/3)

The Wall Street Journal: How Medicare ‘Self-Referral’ Thrives On Loophole
In a letter to a friend, the manager of a Florida urology practice worried in 2010 that her company would attract federal scrutiny for its frequent use of an expensive bladder-cancer test. The manager’s concern involved a program at 21st Century Oncology Holdings Inc.—a national chain of cancer practices—that gives its urologists a financial incentive to order the test from a central in-house lab. A federal law since the 1990s has prohibited “self-referral,” in which doctors can profit from Medicare-reimbursed procedures they order. But 21st Century Oncology and many physician groups around the country have found ways to do it anyway, exploiting an exception to the law in ways its writers didn’t anticipate. (Carreyrou and Adamy, 6/3)

The Associated Press: Senate Approves Health Care Expansion Bill
After a passionate debate, the Florida Senate passed a bill Wednesday that would let a half million people use billions in federal dollars to buy health insurance, and added new measures to address criticism from the House, chiefly that the program would end in three years. A majority of Republicans supported the controversial health care bill. Earlier this week, a state economist said the plan would save the state money. A top state health official warned it was unclear whether more or less people would gain coverage under the bill. (Kennedy and Fineout, 6/3)

The Associated Press: Gov. Scott Administration Under Fire In Health Care Fight
Key Republicans on Tuesday asserted that the administration of Florida Gov. Rick Scott was playing politics in a continuing fight over health care that has already derailed one legislative session this year. Scott, who has changed his stance on whether to expand Medicaid coverage twice now, is opposed to a plan pushed by Senate Republicans that would use federal money to provide private insurance to low-income Floridians. (Fineout, 6/3)

The Washington Post: How Hospitals Hope To Boost Ratings On Yelp, HealthGrades, ZocDoc And Vitals
Laura Markowski used to worry every time a text alerted her that a patient had posted a negative review online of a doctor at her health-care system. She’s in charge of “reputation management” at a group of hospitals and clinics in Virginia, and it’s her job to monitor complaints about rudeness, long waits, lack of face time with a doctor or something more serious. ... Markowski is part of a new and urgent effort by hospitals and health systems to track and control their online reputations. (Sun, 6/3)

USA Today: Big Business Backs Virtual Doctor Visits, As Texas Loses Fight For Limits
Video or telephone visits with doctors — the practice known as telemedicine — have survived one of their biggest legal challenges yet in Texas, but hurdles remain in Arkansas and some other states. The challenges come as telemedicine is gaining widespread support among major employers and many consumers. (O'Donnell, 6/3)

Los Angeles Times: MannKind's Inhaled Insulin Drug Proves Hard For Diabetics To Get
It took 10 years and $1 billion for MannKind Corp. in Valencia to get its breakthrough inhaled-insulin drug approved by U.S. regulators. Now comes the hard part: getting people with diabetes to use it. If Cynthia Goldstein's experience is any indication, it's not going to be easy. (Pfeifer, 6/3)

NPR: International Group Says Mammograms Of 'Limited' Value For Women In 40s
A federal health task force that has been criticized for its mammography recommendations now has scientific support from the World Health Organization. The WHO's International Agency for Research on Cancer has just finished its review of mammography to screen for breast cancer, and it, too, concludes that the value of these screening X-rays is "limited" for women in their 40s. (Harris, 6/3)

The Wall Street Journal: Connecticut Legislature Approves Budget
On the spending side, the budget restores $49.2 million in funding that was proposed to be cut from state departments focused on developmental, mental-health, addiction and social services. Those funds would pay for more Medicaid care, drug and addiction services and other programs. The budget will spend a total of $151.9 million more than what Mr. Malloy had proposed to spend earlier. (De Avila, 6/4)

Los Angeles Times: North Carolina Legislature Passes Bill Mandating 72-Hour Wait For Abortions
An abortion bill that would require women in North Carolina to wait 72 hours before having the procedure cleared the state Legislature on Wednesday and is now heading to the desk of Gov. Pat McCrory. The bill, which triples the state's mandatory 24-hour waiting period, cleared the house by a vote of 71 to 43. Under the law, doctors would be required to counsel patients on alternative options at least 72 hours before an abortion could take place. (Queally, 6/3)

The Washington Post: The Shocking Stories That Led Louisiana To Ban Charging Rape Victims Hefty Medical Fees
In 2013, a New Orleans college student went to the hospital at the urging of first responders after she awoke disoriented and naked in a public place and feared that she had been drugged and raped. They assured her that she wouldn’t be charged to be examined. But a year later, a $2,254 bill arrived in the mail, according to an extensive Times-Picayune investigation last year. There were many more women like her. (Phillip, 6/3)

The Associated Press: Appalachia Gripped By Hepatitis C Epidemic, Bracing For HIV
In a study last month, the Centers for Disease Control and Prevention found that hepatitis C cases across four Appalachian states — Kentucky, Tennessee, West Virginia and Virginia — more than tripled between 2006 and 2012. Kentucky leads the nation in the rate of acute hepatitis C, with 4.1 cases for every 100,000 residents, more than six times the national average, according to the CDC. (Galofaro, 6/4)