First Edition: March 2, 2023

KHN: Judge To Fine California Each Day It Fails To Complete Prisoner Suicide Prevention Measures 
A federal judge said this week that she will begin fining California potentially tens of thousands of dollars daily after more than 200 prison inmates killed themselves during eight years in which state corrections officials failed to complete court-ordered suicide prevention measures. Addressing a chronic tragedy that has plagued the state for decades, Chief U.S. District Judge Kimberly Mueller said she will start the fines April 1 — $1,000 a day for each of 15 unmet safeguards until all the state’s 34 adult prisons are in full compliance. (Thompson, 3/1)

KHN: After People On Medicaid Die, Some States Aggressively Seek Repayment From Their Estates 
Fran Ruhl’s family received a startling letter from the Iowa Department of Human Services four weeks after she died in January 2022. “Dear FAMILY OF FRANCES RUHL,” the letter began. “We have been informed of the death of the above person, and we wish to express our sincere condolences.” The letter got right to the point: Iowa’s Medicaid program had spent $226,611.35 for Ruhl’s health care, and the government was entitled to recoup that money from her estate, including nearly any assets she owned or had a share in. If a spouse or disabled child survived Ruhl, the collection could be delayed until after their death, but the money would still be owed. (Leys, 3/2)

KHN: California’s Massive Medicaid Program Works For Some, But Fails Many Others
Newborns. Former inmates. College students. Expectant moms. People with disabilities. Foster kids. Homeless people. Single dads. Your neighbor. Your co-worker. You. California’s Medicaid program, called Medi-Cal, serves a whopping 15.4 million people, offering care from cradle to grave: Half of all births are covered by Medi-Cal, as are more than half of all stays in nursing homes. Everything about Medi-Cal is massive, from its upcoming fiscal year budget of $139 billion to the expansive list of benefits and services it offers. The way the program works — or doesn’t — could spell life or death for many enrollees. (Hart and Wolfson, 3/2)

KHN: Information Blackout Shrouds New Reports Of Deaths, Injuries, And Abuse At Montana State Hospital
Jennifer Mitchell remembered getting a call nearly two years ago that her 69-year-old husband, Bill, had crashed his car and had been committed to the Montana State Hospital, the state-run psychiatric hospital for adults about 20 miles from their home in Butte. Physicians thought Bill Mitchell had dementia and could be a danger to himself or others, according to medical records. But once he was admitted, his wife really began to worry. She couldn’t visit him because of covid-19 restrictions, and she couldn’t get details about the care or the medicine he was receiving. “I tried to get an idea of what he was taking, not taking. I could not get answers,” Jennifer said. (Bolton, 3/2)

The Wall Street Journal: More Younger People Are Getting Colorectal Cancers, And Doctors Don’t Know Why
A larger share of people are being diagnosed with colorectal cancer at a younger age and at a more dangerous stage of the disease, a report showed. Doctors aren’t sure why. The American Cancer Society said Wednesday that about 20% of new colorectal cancer diagnoses were in patients under 55 in 2019, compared with 11% in 1995. Some 60% of new colorectal cancers in 2019 were diagnosed at advanced stages, the research and advocacy group said, compared with 52% in the mid-2000s and 57% in 1995, before screening was widespread. (Abbott, 3/1)  

CNN: Colorectal Cancer Rising Among Adults Younger Than 55, Report Shows
The new report also says that more people are surviving colorectal cancer, with the relative survival rate at least five years after diagnosis rising from 50% in the mid-1970s to 65% from 2012 through 2018, partly due to advancements in treatment. That’s good news, said Dr. Paul Oberstein, a medical oncologist at NYU Langone Perlmutter Cancer Center, who was not involved in the new report. The overall trends suggest that colorectal cancer incidence and death rates have been slowly declining. (Howard, 3/1)

Reuters: US Panel Backs GSK Vaccine, Heating Up RSV Vaccine Race
A panel of outside advisers to the U.S. health regulator on Wednesday backed GSK's respiratory syncytial virus (RSV) vaccine, setting it up for a race with rival Pfizer to become the first approved U.S. shot against the disease. The Food and Drug Administration's (FDA) advisory committee voted unanimously in favor of the vaccine's effectiveness in preventing lower respiratory tract disease caused by RSV in adults aged 60 and above, and voted 10 to 2 for its safety. The panelists seemed significantly more confident about the demographic profile used during the GSK study in comparison to Pfizer's RSV vaccine, which was recommended by the FDA panel on Tuesday. (Mandowara and Esunny, 3/1)

CIDRAP: FDA Panel Recommends GSK's RSV Vaccine For Ages 60 And Up 
GSK's vaccine, called RSVPreF3 (Arexvy), is a recombinant product that contains a glycoprotein antigen based on the RSV A subgroup and is given with a proprietary adjuvant—the same one in GSK's Shingrix shingles (herpes zoster) vaccine—designed to boost the immune response. It is administered as a single 0.5-milliliter dose. The group based its efficacy assessment on clinical trials that enrolled nearly 25,000 people, half of whom, as the control group, received a saline injection. Overall efficacy was 82.6% against lower respiratory tract illness, with an efficacy of 94.1% against severe disease. Efficacy was high for both RSV A and RSV B and was even higher, at 93.8%, in the oldest age-group in the study, those ages 70 to 79. (Schnirring, 3/1)

The Washington Post: ‘Havana Syndrome’ Not Caused By Energy Weapon Or Foreign Adversary, Intelligence Review Finds 
The mysterious ailment known as “Havana syndrome” did not result from the actions of a foreign adversary, according to an intelligence report that shatters a long-disputed theory that hundreds of U.S. personnel were targeted and sickened by a clandestine enemy wielding energy waves as a weapon. The new intelligence assessment caps a years-long effort by the CIA and several other U.S. intelligence agencies to explain why career diplomats, intelligence officers and others serving in U.S. missions around the world experienced what they described as strange and painful acoustic sensations. The effects of this mysterious trauma shortened careers, racked up large medical bills and in some cases caused severe physical and emotional suffering. (Harris and Hudson, 3/1)

Reuters: Cardinal Health, McKesson Prevail In Georgia Families' Opioid Trial
Drug distributors Cardinal Health Inc, McKesson Corp and JM Smith Corp on Wednesday prevailed at trial in Georgia in a case brought by families of opioid addicts accusing the companies of acting as drug dealers. A jury in Glynn County Superior Court handed down the verdict after two days of deliberations, according to Courtroom View Network, which carried live video of the trial. It was the first trial of opioid claims brought by individual plaintiffs, rather than government entities. (Pierson, 3/1)

The New York Times: Opioid Distributors Cleared Of Liability To Georgia Families Ravaged By Addiction 
Over the past month in a southeast Georgia courtroom, three generations of families testified about how their lives had been savaged by addiction to prescription opioids: A young man recounted huddling in a locked room with his brothers, while his father, waving a shotgun, ransacked the house for pills. A mother described holding her granddaughter, while her dopesick daughter rammed a car into the house. A young woman told of her rape at age 14 by a drug dealer, while her mother nodded out. They ticked off overdose deaths: grandparents, parents, siblings, spouses. And a baby, whose mother injected Dilaudid throughout her pregnancy and who shook uncontrollably throughout his monthlong life. (Hoffman, 3/1)

Stat: Report Finds Medicare Part D Plans Improperly Authorized Opioids
A government watchdog found that Medicare drug plans improperly authorized thousands of prescriptions for certain powerful opioids over a recent four-year period, a failure that cost taxpayers $86 million as the opioid crisis was raging across the U.S. (Silverman, 3/2)

Stat: Advocates, Lawmakers: Biden Telehealth Rule Will Worsen Drug Crisis
Doctors, public health experts, and even Democratic members of Congress are sounding the alarm on a new Biden administration proposal to restrict access to a key addiction-treatment medication. The proposal would curtail access via telehealth to buprenorphine, a common and highly effective drug used to treat opioid use disorder. (Facher, 3/2)

Reuters: Biden Says Other Companies Will Slash Insulin Prices After Eli Lilly Move 
U.S. President Joe Biden said on Wednesday that other pharmaceutical companies will have to lower their insulin prices in the wake of Eli Lilly's decision to slash its prices for the popular diabetes treatment. Eli Lilly said on Wednesday it will cut list prices by 70% for its most commonly prescribed insulin products, Humalog and Humulin, beginning from the fourth quarter of this year. "Guess what that means?," Biden told Democrats gathered in Baltimore for an annual retreat. "Every other company making it, someone's gonna have to lower their price." (Hunnicutt, 3/1)

The Washington Post: As Eli Lilly Slashes The Price Of Insulin, Here’s What To Know
The company’s announcement Wednesday comes as the Biden administration has pressed the industry to rein in prices, which have skyrocketed in recent years and weighed on lower- and middle-income people with diabetes. Congress authorized a $35-per-month cap for some seniors with Medicare coverage, but that does not help those with private insurance struggling to afford the lifesaving medication. Here are some key questions about the decision and what it means for consumers. (Mark, 3/1)

The New York Times: Brokers Get Lush Trips and Cash Perks to Sell Costly Medigap Plans
Federal and state regulators are being urged to increase their oversight of insurance agents and brokers selling Medigap policies, the private supplemental coverage owned by millions of people with traditional Medicare that pays out-of-pocket costs. These brokers received paid vacations and cash bonuses to enroll customers in plans offered by specific companies, according to a report released Wednesday by Senator Elizabeth Warren, the Massachusetts Democrat. (Abelson, 3/1)

Reuters: Pfizer/BioNTech Seeks U.S. Nod For Updated COVID Vaccine As Booster In Kids Under 5 
Pfizer Inc and its German partner BioNTech SE have applied for emergency use authorization of their Omicron-adapted COVID-19 vaccine in the United States as a booster dose for children aged six months through four years, the companies said on Wednesday. The Omicron-adapted vaccine is currently authorized by the U.S. health regulator as the third dose of the three-dose primary course of vaccination in the country for children in this age group. (3/1)

AP: China Dismisses FBI Statement On COVID-19 Lab Leak Theory 
For the second day in a row, China on Wednesday dismissed U.S. suggestions that the COVID-19 pandemic may have been triggered by a virus that leaked from a Chinese laboratory. Responding to comments by FBI Director Christopher Wray, Foreign Ministry spokeswoman Mao Ning said the involvement of the U.S. intelligence community was evidence enough of the “politicization of origin tracing.” “By rehashing the lab-leak theory, the U.S. will not succeed in discrediting China, and instead, it will only hurt its own credibility,” Mao said. (3/1)

Iowa Public Radio: White-Tailed Deer Coronavirus Infections Could Prolong The Human Pandemic
Early in the COVID-19 pandemic, scientists worried cows and pigs might be potential victims or carriers of the coronavirus. Research by the U.S. Department of Agriculture quickly found the virus didn’t threaten that livestock. But when scientists began looking at one of the most common large wild species in the Midwest — white-tailed deer — they found the animals could catch and spread the virus. (Katie Peikes, 3/1)

Modern Healthcare: Cleveland Clinic Reports $1.25B Net Loss For 2022 
The Ohio-based organization reported a $1.25 billion net loss in 2022, compared with a $2.21 billion gain in 2021, according to unaudited results released Wednesday. Operating expenses jumped 13.6%, or by nearly $1.5 billion, to $12.45 billion, including a 13.8% rise in salaries and wages and a 13.7% jump for pharmaceuticals. (Hudson, 3/1)

Modern Healthcare: AdventHealth Reports $839M Net Loss For 2022
A spike in operation expenses fueled by labor costs weighed down AdventHealth's financial performance last year, the nonprofit health system reported Tuesday. AdventHealth suffered a $837.92 million net loss for 2022, compared with a $1.51 billion gain the prior year. Revenue rose 5.5% to $15.7 billion and investment losses reached $1.16 billion. (Hudson, 3/1)

Modern Healthcare: Community Health Systems Selling 2 Hospitals To Novant
Novant Health will pay $320 million for two Community Health Systems hospitals in North Carolina, marking CHS’ exit from the Tar Heel State. (Kacik, 3/1)

Becker's Hospital Review: Texas Hospital Set To Close, Asks University Health To Take Over
San Antonio-based Texas Vista Medical Center, part of Dallas-based Steward Health Care, is set to close May 1, barring a takeover or significant relief package. Steward has asked San Antonio-based University Health System and Bexar County to take over the troubled hospital. However, both entities have so far declined. Texas Vista was already struggling financially when Steward acquired it in 2017, and the COVID-19 pandemic led to even more significant losses, according to a March 1 Steward Health news release. (Schwartz, 3/1)

Modern Healthcare: MercyOne-Genesis Health System Merger Closed
Trinity Health’s MercyOne and Genesis Health System have finalized their merger, the nonprofit health systems announced Wednesday. Under the agreement, Davenport, Iowa-based Genesis’ five hospitals and other operations will become part of MercyOne, a West Des Moines, Iowa-based health system that comprises 18 hospitals. (Kacik, 3/1)

Reuters: US Authorities Charge Healthcare Company Ontrak's Boss With Insider Trading 
U.S. authorities on Wednesday charged the head of the health care company Ontrak Inc with insider trading, marking the first criminal case involving the use of a special trading plan designed to help shield executives from such charges. Ontrak Chairman and CEO Terren Peizer sold more than $20 million of Ontrak stock between May and August 2021 while in possession of material non-public negative information related to the company's largest customer, authorities said. (Gillison and Singh, 3/1)

AP: States Move To Crack Down On Nurses With Bogus Diplomas 
Medical licensing officials in multiple states are scrambling to stop nurses with fraudulent academic credentials from caring for patients, after three Florida schools were accused of selling thousands of bogus diplomas. New York regulators told 903 nurses in recent weeks to either surrender their licenses or prove they were properly educated. Delaware and Washington state officials have yanked dozens of nursing licenses. Texas filed administrative charges against 23 nurses. More actions in additional states are expected. (Hill, 3/1)

Los Angeles Times: UC System Hospital Nurses Complain Of Overcrowding
Nurses at the Ronald Reagan UCLA Medical Center and UCSF Medical Center at Parnassus went public this week with complaints about overcrowding and staffing issues that they say have led to eroding conditions for patients. At the Ronald Reagan UCLA Medical Center, patients sometimes lie in hallways on gurneys for days at a time, said Dianne Sposito, an emergency room nurse at the hospital. (Evans, 3/1)

Becker's Hospital Review: The Hospital CEOs Throwing Their Weight Behind Gun Safety Efforts
In the wake of shootings across the U.S., about 50 leaders of some of the nation's largest health systems and hospitals are pledging efforts to address gun violence. The leaders are members of the newly formed National Health Care CEO Council on Gun Violence Prevention & Safety, which is united to tackle the issue. Council members have signed the following promise: "Guns are now the leading cause of death for kids. This needs to change. As healthcare leaders, we pledge to use the collective power of our voices and resources to curb this epidemic, and make our communities safer for everyone." (Gooch, 3/1)

The Boston Globe: ‘It Is Going To Be Disruptive.’ MassHealth Rolls Set To Shrink By 300,000, Healey Estimates
Approximately a third of the state’s population is about to have to re-enroll in MassHealth, a massive undertaking that state officials project will ultimately remove approximately 300,000 people from state-sponsored health insurance. (Bartlett, 3/1)

The Washington Post: Albuterol For Children's Hospitals Scarce After Illinois Plant Shutdown
Children’s hospitals across the country lost a supplier of a common respiratory medicine with the sudden shutdown of an Illinois manufacturing plant last week, which specialists warned will prolong shortages of an important treatment for kids with RSV and asthma who show up in emergency rooms. Akorn, a company that has struggled under bankruptcy for two years and had been the subject of Food and Drug Administration enforcement actions, shut down its U.S. operations on Thursday, including manufacturing facilities in Illinois, New Jersey and New York. (Rowland, 3/1)

NBC News: Ozempic Shortages? Some Pharmacists Not Stocking Weight-Loss Drug
While many pharmacists across the U.S. have struggled to get their hands on Ozempic, some haven’t bothered. Nate Hux, the owner of Pickerington Pharmacy in Ohio, stopped stocking the diabetes drug — which has soared in popularity, particularly for its off-label use as a weight loss aid — last summer. (Lovelace Jr. and Abou-Sabe, 3/2)

CBS News: CDC Says 20,000 People May Have Been Exposed To Measles At Asbury University Religious Revival
An estimated 20,000 people attended a large religious gathering in Kentucky on the same days as a resident who was infected with measles last month, the Centers for Disease Control and Prevention said Wednesday, with potential contacts who may have been exposed to the highly transmissible virus now spanning multiple states and countries. (Tin, 3/1)

The Hill: Union Rep: Employees Reporting Illness After Working On Cleanup For East Palestine Derailment 
Workers that aided in the cleanup of the train derailment in Ohio have experienced lingering migraines and nausea, according to a union representative for workers that build and maintain railways for Norfolk Southern. Jonathan Long, a union representative for the Brotherhood of Maintenance of Way Employees Division of the International Brotherhood of Teamsters, said in a Wednesday letter to Ohio Gov. Mike DeWine (R) that around 40 workers were ordered by Norfolk Southern, which owns the train that derailed in East Palestine, Ohio, last month, to clean up the wreckage. (Neukam, 3/1)

The Washington Post: New State Bills Restrict Transgender Health Care — For Adults 
Republican state Sen. Jack Johnson stood on the Tennessee Senate floor last month to open the discussion on a bill he is co-sponsoring. The measure would limit gender-affirming care such as puberty blockers, hormone therapy and surgeries for minors. “Let’s put children first and look out for them first and let them make those decisions as adults,” he said. “I support your right to do so, when you’re an adult, not when you’re a child and you do not have the mental capacity to do so.” But Johnson is also backing another bill, HB1215, that would effectively cut off access to gender-affirming care for low-income people, including adults. (Javaid, 3/1)

AP: Indiana Senate Joins States Trying To Limit Transgender Care 
Indiana Republican state Senators voted Tuesday to advance a ban on all gender-affirming care for those under 18, the latest in this year’s movement by conservative states aiming to limit the rights of transgender youth. The bill passed the Senate 36-12, sending it to the House despite last week’s contentious committee hearing that primarily featured testimony from vocal opponents. Witnesses said the types of care the bill would ban, such as hormone therapy and puberty blockers, is vital and often life-saving for trans kids. (Rodgers, 3/1)

AP: California Bill Could Mean More Mentally Ill People Detained
More people in California could be detained against their will because of a mental illness under a new bill backed Wednesday by the mayors of some of the nation’s largest cities, who say they are struggling to care for the bulk of the country’s homeless population. Federal data shows nearly one-third of the country’s homeless population lives in California, crowding the densely populated coastal cities of the nation’s most populous state. California lawmakers have given local governments billions of dollars in recent years to address this, but often with mixed results that recently prompted a public scolding from Democratic Gov. Gavin Newsom. (Beam, 3/2)

Bloomberg: Hackers Leak LA Kids’ Mental Health Records, Taunt Victims
Families of students in Los Angeles are learning this week that their kids’ medical records are appearing on the dark web thanks to a notorious ransomware crew that’s extorting academic institutions. Kids’ medical and mental health records, in addition to 2,000 student assessments, driver’s license numbers and Social Security numbers, were published after a breach last year at the Los Angeles Unified School District, said Jack Kelanic, senior IT infrastructure administrator. The district is the second-largest in the nation, with more than 600,000 pupils in 1,000 schools. (Murphy, 3/1)

Reuters: California Fertility Clinic Sued For Using Embryo With Deadly Cancer Gene 
A California couple sued a Pasadena-based fertility clinic on Wednesday, saying it allegedly implanted an embryo carrying a rare gene that causes deadly stomach cancer and then falsified records to cover up its mistake. In their lawsuit against HRC Fertility, filed in Los Angeles Superior Court, Jason and Melissa Diaz said their son, now a year old, will require total stomach removal surgery as a young adult to prevent or treat the cancer. They said they went to HRC Fertility specifically to avoid having a child with the gene, which Jason carries. (Pierson, 3/1)

Politico: DeSantis Is Championing Medical Freedom. GOP State Lawmakers Like What They See
The “medical freedom” movement, mostly known for its opposition to vaccine requirements, was long consigned to the fringes of libertarian and left-wing politics. Then came Ron DeSantis. The Florida governor and likely presidential candidate has secured a place for the movement in the conservative mainstream. And as a sitting governor, he has the opportunity to distinguish himself from other declared and potential candidates by putting his vision into practice. (Messerly, Mahr and Sarkissian, 3/1)

Bloomberg: Study Finds Forever Chemicals In Toilet Paper
So-called forever chemicals seem to be turning up everywhere. We wear them, clean our houses with them and, according to a new study, perhaps even wipe ourselves with them. The report, published this week in Environmental Science & Technology Letters, has found evidence of per- or polyfluorinated chemicals — also known as PFAS — in toilet paper. An academic team led by researchers at the University of Florida concluded that the bathroom staple might be a source of PFAS entering wastewater treatment systems. (Wanna, 3/2)

Politico: Cindy McCain Tapped As Head Of World Food Program 
Cindy McCain is set to take over as head of the United Nations’ World Food Program, putting the longtime political spouse at the top of the globe’s largest humanitarian group and on the frontlines of a growing global food crisis. The United Nations will announce McCain’s appointment Thursday, according to two people familiar with the matter. The move caps a sharp rise in the global food policy realm for McCain, a close political ally of President Joe Biden and the wife of the late Sen. John McCain (R-Ariz). (Hill, 3/1)

AP: Cambodia Says Recent Bird Flu Cases Not Spread By Humans 
Recent cases of bird flu discovered in two Cambodian villagers, one of them fatal, show no sign of human-to-human transmission, health officials in the Southeast Asian nation say, allaying fears of a public health crisis. (Cheang, 3/1)

The Washington Post: How A Cambodian Monkey-Smuggling Ring Could Worsen U.S. Lab Shortages 
An ongoing shortage of monkeys used in scientific and medical experiments is about to get worse, as fallout continues from a federal investigation into an alleged primate-smuggling ring in Cambodia. Several major companies are warning of supply constraints, delays and higher prices that they say could eventually lead to bottlenecks in drug testing. However, industry analysts have expressed skepticism that the situation in Cambodia will have major impacts on research, with one saying “this is just going to be another handful of sand in the gears.” (Johnson and Gilbert, 3/1)

San Francisco Chronicle: U.K. Considered Exterminating All Cats Early In The Pandemic
A former British health minister said the government considered culling all pet cats in the early days of the COVID-19 pandemic. James Bethell told Channel 4 News on Wednesday that there was serious concern that domestic cats could spread the novel coronavirus. (Vaziri, 3/1)