First Edition: March 21, 2019

Kaiser Health News: Health Plans For State Employees Use Medicare’s Hammer On Hospital Bills
States. They’re just as perplexed as the rest of us over the ever-rising cost of health care premiums. Now some states are moving to control costs of state employee health plans. And it’s triggering alarm from the hospital industry. The strategy: Use Medicare reimbursement rates to recalibrate how they pay hospitals.  If the gamble pays off, more private-sector employers could start doing the same thing. “Government workers will get it first, then everyone else will see the savings and demand it,” said Glenn Melnick, a hospital finance expert and professor at the University of Southern California. “This is the camel’s nose. It will just grow and grow.” (Appleby, 3/21)

Modern Healthcare: New Hampshire's Medicaid Work Requirement Challenged In Court
Three advocacy groups sued the Trump administration Wednesday to challenge New Hampshire's approved work requirement for Medicaid beneficiaries. The lawsuit, filed on behalf of four named plaintiffs, said the administration is trying to "bypass the legislative process and act unilaterally to fundamentally transform Medicaid… threatening irreparable harm to the health and welfare of the poorest and most vulnerable in our country." (Meyer, 3/20)

The Wall Street Journal: Third Lawsuit Filed Over Medicaid Work Requirements
The administration approved a package of changes to New Hampshire’s Medicaid program, including the new work requirements, in November. It aims to overhaul Medicaid state by state, after a wholesale revamp of the program sank in 2017 with Republicans’ failed attempt to repeal the Affordable Care Act. A spokesman for the Centers for Medicare and Medicaid Services declined to comment on the lawsuit. The official said the administration remains committed “to considering proposals that would give states more flexibility to engage with their working-age, able-bodied citizens.” (Hackman, 3/20)

The Hill: Trump Officials Take Bold Steps On Medicaid
The Trump administration is pulling out all the stops to encourage red states to make conservative changes to Medicaid without congressional input. Administration officials are pushing ahead and granting approvals to states seeking to impose work requirements on Medicaid recipients, even in the face of legal challenges and large-scale losses in the number of people covered. (Weixel, 3/20)

The Hill: Analysis: Data Contradicts HHS Claims On Arkansas Medicaid Work Requirements 
Most of the 18,000 people who lost Medicaid coverage in Arkansas as a result of new work requirements have not found new jobs, according to an analysis of state data. The analysis from the left-leaning Center on Budget and Policy Priorities also found that most of those unemployed people are still uninsured. (Weixel, 3/20)

Los Angeles Times: Fentanyl Overdose Deaths In The U.S. Have Been Doubling Every Year
If you want to know what it means for something to grow exponentially, consider the death toll of fentanyl. This powerful synthetic opioid seemingly came out of nowhere and is now killing tens of thousands of Americans each year. A new report from the Centers for Disease Control and Prevention details the meteoric rise of a drug that was first approved by the Food and Drug Administration back in 1968. It shows that fentanyl’s role as a driver of the opioid epidemic can be traced to late 2013. (Healy, 3/20)

The Washington Post: Fentanyl Drug Overdose Deaths Rising Most Sharply Among African Americans
The synthetic opioid fentanyl has been driving up the rate of fatal drug overdoses across racial and social lines in the United States, with the sharpest increase among African Americans, according to a new analysis by the Centers for Disease Control and Prevention. The death rate among African Americans from fentanyl-involved drug overdoses rose 141 percent each year, on average, from 2011 to 2016, the study showed, with a particularly dramatic spike starting in 2014. The death rate for Hispanics rose 118 percent in that period every year on average, and 61 percent for non-Hispanic whites. The CDC did not have reliable data on Asian Americans and Native Americans. (Achenbach, 3/21)

NPR: Steep Rise In Fentanyl-Linked Deaths Marks Opioid Epidemic's Third Wave
Increased trafficking of the drug and increased use are both fueling the spike in fentanyl deaths. For drug dealers, fentanyl is easier to produce than some other opioids. Unlike the poppies needed for heroin, which can be spoiled by weather or a bad harvest, fentanyl's ingredients are easily supplied; it's a synthetic combination of chemicals, often produced in China and packaged in Mexico, according to the U.S. Drug Enforcement Administration. And because fentanyl can be 50 times more powerful than heroin, smaller amounts translate to bigger profits. (Bebinger, 3/21)

Stat: Did A Medical Education Course For Doctors Favor Fentanyl Products?
As the opioid crisis dawned in the U.S., continuing educational material that doctors are required to review may have contributed to the burgeoning problem, according to a newly published study. How so? The study compared a continuing medical education module, or course, that was funded by a drug maker that sold a fentanyl lollipop and lozenge with practice guidelines issued by a medical society. The scope of the two publications was not completely identical, but both focused on the use of opioids in treating non-cancer pain. And the study found the industry-funded course contained a “subtle bias.” (Silverman, 3/20)

The Associated Press: US Experts: Medicines For Opioid Addiction Vastly Underused
Medicines proven to treat opioid addiction remain vastly underused in the U.S., the nation's top medical advisers said Wednesday. Only a fraction of the estimated 2 million people addicted to opioids are getting the medications, according to a report by the National Academies of Sciences, Engineering and Medicine. The influential group, which advises the federal government, called for increased prescribing of the drugs and other changes to reduce barriers to their use. (3/20)

Stat: The Pharma-Backed Group With A Lot To Say On Trump’s Drug Rebate Pitch
RetireSafe, a Washington-based advocacy group with ties to the drug industry, appears to be behind a deluge of comments on HHS’ controversial proposal to end the current system of rebates used to negotiate the price of drugs. Roughly 18,000 comments have been submitted about the proposal, a number that far exceeds the normal submission rate for recent Trump administration drug pricing proposals. (Florko, 3/20)

The Wall Street Journal: Pfizer Adds To Big Pharma’s Gene-Therapy Deal Streak
Pfizer Inc. has agreed to pay as much as $636 million for the rights to gene therapies under development at French company Vivet Therapeutics, as it seeks to build its pipeline in this cutting-edge treatment. The U.S. drugmaker said Wednesday it had paid €45 million upfront for a 15% stake in Vivet. Further payments, which include the potential acquisition of Vivet, are dependent on the progress of the French company’s experimental therapies. (Roland, 3/20)

Stat: AbbVie Is Sued For Using Humira Patent Deals To Block Competition 
In a novel step, a New York union accused AbbVie (ABBV) and seven other drug makers of anticompetitive behavior for striking deals that resolved patent lawsuits, but also meant that lower-cost biosimilar versions of the Humira treatment would not be available in the U.S. for several years. In its lawsuit, Local 1500 of the United Food and Commercial Workers, which represents grocery store workers, alleged that AbbVie “abused the patent system” and “erected significant barriers to entry to block biosimilar competition” by filing dozens of patents for Humira, its franchise product. (Silverman, 3/20)

The Associated Press: Gillibrand 'Open To Improving' Opioids Bill After Criticism
Democratic presidential candidate Kirsten Gillibrand says she's "open to improving" a Senate bill that would limit opioid prescriptions for acute pain. The senator from New York was addressing criticism she received last week when she tweeted that she and Republican Sen. Cory Gardner of Colorado had introduced the bill "because no one needs a month's supply for a wisdom tooth extraction." (3/20)

The Associated Press: With Black Lung Fund In Jeopardy, Taxpayers Could Foot Bill
The Trump administration and coal industry allies are insisting that a federal black lung trust fund will continue to pay benefits to sick miners despite a drastic cut in funding. But the expected shortfalls will be covered by taxpayers instead of coal companies, adding more debt to the already struggling fund. And at least one Republican congressman from the coalfields has added his voice to the chorus of miners and advocates worried that the fund's promise to sick workers and their families ultimately might not be kept. (3/20)

Roanoke Times: Kaine, Warner Introduce Bill Aimed At Strengthening Mental Health Services For Veterans
Virginia’s U.S. senators, Tim Kaine and Mark Warner, are seeking to improve veterans’ access to mental health care. The two Democrats introduced the legislation in Congress on Monday along with Sens. Jon Tester, D-Mont., and Jerry Moran, R-Kan., in an effort to bolster the Department of Veterans Affairs’ mental health workforce; increase rural access to care; and expand access to alternative options such as animal therapy, outdoor sports and yoga. (Friedenberger, 3/19)

Politico: Pulse Check: FDA Commissioner Scott Gottlieb
Scott Gottlieb was nominated to run the FDA in March 2017. Two years — and nearly 500 press announcements — later, the productive and high-profile commissioner is preparing to step down in early April 2019. Gottlieb joined POLITICO's Dan Diamond to discuss why he's leaving FDA, his regulatory and communications strategy, his work on medical device safety, digital health, opioid abuse, the Trump administration's approach to science and the choice of Ned Sharpless as acting FDA commissioner, what Gottlieb would've pursued if he had more time at FDA and if he'll ever return to government. (3/20)

The Washington Post: Veterans Talking Veterans Back From The Brink: A New Approach To Policing And Lives In Crisis
The former Army soldier was slumped in the back seat of a sheriff’s department squad car when Shannon Teague and Tyrone “T-bone” Anderson arrived on the scene. A couple of hours earlier, high on meth, he’d been yelling “you will die” from the front porch of a transition house for homeless veterans. Teague made the introductions. Neither she nor Anderson wore a uniform, except for the patch on their jackets and the ID tags clipped to their shirts. “I’m a social worker, and this is my partner, T-bone,” she told the man. “We are from the VA. You’re not in trouble.” (Kuznia, 3/20)

The Associated Press: Army Bill For Public Records On Contaminant: About $300,000
The U.S. Army has put a price tag on releasing the results of water tests for a dangerous contaminant at military installations: nearly $300,000. In a March 12 letter, the Army told the Environmental Working Group, an advocacy group, that the military would charge the group $290,400 to provide records of water tests at 154 installations for a family of compounds known as PFAS, which federal authorities say appear linked to certain cancers and other health and developmental problems. (3/20)

The Associated Press: EPA Argues For Shifting Focus From Climate Change To Water
Unsafe drinking water, not climate change, is the world's most immediate public health issue, Environmental Protection Agency administrator Andrew Wheeler contended Wednesday. Environmental groups responded by saying the Trump administration was neglecting — or worsening — both health threats. Wheeler made his case for a shift in public focus in a CBS News interview that aired Wednesday, and in a speech later in the day in Washington on global water issues. (3/20)

The New York Times: Remember Chickenpox Parties? Kentucky Governor Says He Let His 9 Children Get The Virus
Amid a renewed national conversation about childhood vaccinations, Gov. Matt Bevin of Kentucky said this week that he and his wife made sure all nine of their children got chickenpox. “Every single one of my kids had the chickenpox,” Mr. Bevin said in an interview on Tuesday with a radio station in Bowling Green, Ky. “They got the chickenpox on purpose because we found a neighbor that had it and I went and made sure every one of my kids was exposed to it, and they got it. They had it as children. They were miserable for a few days, and they all turned out fine.” (Bosman, 3/21)

The Washington Post: Anti-Vaxxers Trolled A Doctors’ Office. Here’s What Scientists Learned From The Attack.
School was about to start. Doctors at a Pennsylvania pediatric practice wanted to remind parents to get their children vaccinated against human papillomavirus, or HPV, which can cause a variety of cancers. The doctors produced a 90-second video and posted it to the practice’s Facebook page. The video sparked positive feedback initially and resulted in more parents scheduling appointments for their children and adolescents to get the recommended vaccine. But three weeks later, anti-vaccine activists began inundating the Facebook page of Kids Plus Pediatrics, a Pittsburgh doctors group, with hostile messages. (Sun, 3/21)

Washington Post: New Zealand Bans All Assault Weapons In Response To Mosque Attacks
New Zealand will ban military-style semiautomatics and assault rifles, Prime Minister Jacinda Ardern announced Thursday, six days after attacks on two mosques in Christchurch that left 50 people dead. "On 15 March, our history changed forever. Now, our laws will too," Ardern said. "We are announcing action today on behalf of all New Zealanders to strengthen our gun laws and make our country a safer place." (Fifield, 3/20)

Los Angeles Times: As U.S. Struggles To Pass Modest Gun Curbs, New Zealand Swiftly Bans Assault Weapons
The quick action was a stark contrast to the slow pace of making gun legislation in the United States. Firearms are part of the culture in both countries. New Zealand has 4.7 million people and 1.5 million guns, and the U.S. has 328 million people and between 265 million and 393 million guns. But when it comes to gun laws, there are some big differences. Most importantly, New Zealand’s constitution does not guarantee the right to own a gun. And though the gun lobby is influential in both countries, it is stronger in the U.S. “There is a lot of energy in the days after a mass shooting in America, but it tends to wane pretty quickly,” said John Donohue, a law professor at Stanford University who teaches on gun policy. (Kaleem, 3/21)

The Washington Post: As Zika Danger Wanes, Travel Warnings Are Eased For Pregnant Women
U.S. and international health officials are easing warnings against travel to regions with Zika virus because the threat has diminished markedly since the virus began to sweep across the globe four years ago. The World Health Organization designated Zika a global health emergency in 2016, and the Centers for Disease Control and Prevention told women who were pregnant or might become pregnant to stay away from nearly 100 countries or regions. The mosquito-borne virus can cause severe birth defects. (Sun, 3/20)

The New York Times: Sugary Drinks Tied To Shorter Life Span
Drinking sugary beverages is associated with a slightly increased risk for early death, a new study has found. Researchers used data from two large continuing health studies begun in the 1980s that include more than 118,000 men and women. Among many other health, behavioral and diet characteristics, the researchers collected data about their consumption of sugar-sweetened beverages, including noncarbonated fruit punches, lemonades and other sugary fruit drinks. (Bakalar, 3/21)

The New York Times: A Twin Inside A Twin: In Colombia, An Extraordinary Birth
A Colombian woman has given birth to a baby whose abdomen contained the tiny, half-formed — but still growing — body of her own twin sister. This type of birth, an example of “fetus-in-fetu,” is very rare but not unprecedented. The condition was described in a British medical journal in 1808 and is thought to occur in about one in every 500,000 births. In recent years, similar births have occurred in India, in Indonesia and in Singapore. (McNeil, 3/20)

ProPublica: How Rhode Island’s Emergency 911 System Failed Baby Alijah
Barbara’s son had just gotten out of the shower and gone back downstairs to where his 6-month-old son was napping when she heard a scream. Then came the pounding of feet on the stairs of their home in Warwick, Rhode Island. Conner handed her Alijah, who was limp. Barbara tried to stay calm as she carried her grandson into the living room. She’d watched medical shows on TV where they did CPR on babies. (Arditi, 3/20)

The Associated Press: Lawsuit: Vanderbilt Hospital Operated On Wrong Kidney
A Tennessee woman says Vanderbilt University Medical Center operated on the wrong kidney during her surgery in what federal officials call a "never event." The Tennessean reports Carla Miller says the error damaged her urinary system and she now needs dialysis for life. She's seeking more than $25 million in damages in a lawsuit filed Tuesday. Vanderbilt officials declined comment to the newspaper. (3/20)

The Washington Post: Disabled Residents In The D.C. Region Face Obstacles When Searching For Housing, Report Says
On a sunny afternoon on the first day of spring, Deepa Goraya opened her laptop and sat at her dining-room table in the bright Washington condominium she has never seen. Goraya, 34, a disability rights lawyer who is blind, prepared to do a Google search with screen-reader software — a program that reads each word on a website at blistering speed in a robotlike monotone. While unintelligible to the uninitiated, the reader is a vast improvement over research methods available to Goraya years ago, which included finding her mom or someone else willing to read to her. (Moyer, 3/20)

The Associated Press: Workers Stage 1-Day Strike At California Campuses, Hospitals
Members of a union representing research and technical workers walked picket lines Wednesday at University of California campuses and hospitals in a one-day strike amid a lengthening stretch of unsuccessful contract negotiations. About 10,000 members of University Professional and Technical Employees-Communications Workers of America were expected to take part statewide, spokesman Dan Russell said. (3/20)