First Edition: March 23, 2023

KHN: Legal Questions, Inquiries Intensify Around Noble Health’s Rural Missouri Hospital Closures 
A year after private equity-backed Noble Health shuttered two rural Missouri hospitals, patients and former employees grapple with a broken local health system or missing out on millions in unpaid wages and benefits. The hospitals in Audrain and Callaway counties remain closed as a slew of lawsuits and state and federal investigations grind forward. (Tribble, 3/23)

KHN: Being ‘Socially Frail’ Comes With Health Risks For Older Adults 
Consider three hypothetical women in their mid-70s, all living alone in identical economic circumstances with the same array of ailments: diabetes, arthritis, and high blood pressure. Ms. Green stays home most of the time and sometimes goes a week without seeing people. But she’s in frequent touch by phone with friends and relatives, and she takes a virtual class with a discussion group from a nearby college. (Graham, 3/23)

KHN: Fresh Produce Is An Increasingly Popular Prescription For Chronically Ill Patients
When Mackenzie Sachs, a registered dietitian on the Blackfeet Reservation, in northwestern Montana, sees a patient experiencing high blood pressure, diabetes, or another chronic illness, her first thought isn’t necessarily to recommend medication. Rather, if the patient doesn’t have easy access to fruit and vegetables, she’ll enroll the person in the FAST Blackfeet produce prescription program. FAST, which stands for Food Access and Sustainability Team, provides vouchers to people who are ill or have insecure food access to reduce their cost for healthy foods. Since 2021, Sachs has recommended a fruit-and-vegetable treatment plan to 84 patients. Increased consumption of vitamins, fiber, and minerals has improved those patients’ health, she said. (Graf, 3/23)

The New York Times: Wyoming Judge Temporarily Blocks The State’s New Abortion Ban 
The new ban, enacted earlier this month, was the legislature’s attempt to circumvent the constitutional guarantee of freedom in health care choices by declaring in the law that abortion is not health care. On Wednesday, Judge Owens questioned that assertion. “I’m just still hung up on abortion not being health care,” she said to the lawyer defending the laws for the state, Jay Jerde, a special assistant attorney general for Wyoming. “An abortion can only be performed by a licensed medical professional, so what authority does the legislature have to declare that abortion is not health care when our laws only allow a licensed medical professional to administer one?” she asked. (Belluck, 3/22)

Kansas City Star: Kansas House Passes ‘Born Alive’ Abortion Bill
The Kansas House Wednesday passed a bill that requires physicians to care for infants born alive during an abortion, despite no evidence this has happened in Kansas in decades. The chamber voted 88 to 34 to approve the “born alive” bill and send it to the state Senate. Similar legislation has been pursued at the federal level and in Republican-led statehouses nationwide. (Bernard, 3/22)

The Boston Globe: State Officials Issue Guidance To Mass. Pharmacies: Stock Abortion Pills 
State officials on Wednesday reminded Massachusetts pharmacies that they must stock all reproductive health medications including mifepristone, a drug that can safely end a pregnancy in its early stages and whose availability is the subject of dueling lawsuits. In a statement, the state Department of Public Health said the “clarifying guidance” came from the state Board of Registration in Pharmacy. (Andersen, 3/22)

Oklahoman: Excerpts: Oklahoma Supreme Court Justices' Deep Division Over Abortion
The Oklahoma Supreme Court was deeply divided over the abortion question, with the 5-4 majority ruling on Tuesday that the state constitution protects a woman’s right to have an abortion to save her own life. The majority opinion states that the court did not rule on elective abortions. The majority opinion was accompanied by six separate concurring and dissenting opinions. (Casteel, 3/22)

North Carolina Health News: Docs Visit Legislature To Oppose Abortion Limits
Since legislators returned to Raleigh in late January, physicians opposed to any new restrictions on abortion in North Carolina have been making themselves visible at the General Assembly. Leading the opposition to any new legislation are obstetrician-gynecologists (known as OB-GYNs), who have the closest contact with people who face the decisions about whether to continue a pregnancy. (Hoban, 3/23)

Kansas News Service: Small Planes And Secrecy: Pilots Fly People To Kansas And Other States For Abortions
The pilot, clad in a blue windbreaker, pulls his single-engine, four-seater prop plane onto the tarmac. The small municipal airport sits in a state where abortion is now banned in virtually all cases. But a short flight away in Kansas, it remains legal. That’s launched a wave of travel from across the South and Midwest in pursuit of pills and procedures no longer legal in many places. Michael — who asked to only use his first name — is part of a growing group of hobby pilots who have begun ferrying people across state lines to get abortions and gender-affirming medical care, flouting local restrictions and bans. (Conlon, 3/23)

Stat: Bancel, Sanders Spar Over What Moderna Owes The Government
Moderna CEO Stéphane Bancel and Senate health committee Chair Bernie Sanders shook hands amicably before Wednesday’s hearing examining the company’s vaccine pricing strategy began. That’s about where the goodwill ended between the two. Sanders, a Vermont Independent, promptly highlighted the $12 billion the federal government spent on research, development, and procurement of Moderna’s Covid-19 vaccine. (Cohrs, 3/22)

The Washington Post: White House To Disband Covid-19 Team
The White House will shut down its covid response team after the public health emergency ends in May, with some staffers already departing and national coordinator Ashish Jha likely to leave the administration once his team is disbanded, according to multiple current and former officials who spoke on the condition of anonymity to describe internal operations. (Diamond and Pager, 3/22)

The Washington Post: More Testing Of Nursing Home Staff Would Have Reduced Covid-19 Deaths, Study Says
Insufficient coronavirus testing of nursing home staff was a driver of waves of coronavirus infections and deaths of elderly residents in 2020, the most vulnerable time before vaccines became available, according to a study published Wednesday. The study, in the New England Journal of Medicine, found that 1.1 million more staff tests per week nationwide would have saved 427 lives each week during the worst time of nursing home outbreaks, from November 2020 to mid-January 2021. ... The nursing home industry’s top trade association said this week that it was hamstrung by a lack of tests and prioritization from government leaders. (Rowland, 3/22)

Modern Healthcare: Hospitals Re-Evaluate Policies As State Mask Mandates End 
After three years of strict federal and state policies, health systems are regaining the ability to make their own decisions on the use of masks and other personal protective equipment. As a result of declining COVID-19 infection and mortality rates nationwide, most states have ended executive orders and emergency mandates requiring universal masking for patients, visitors and workers in healthcare settings. (Devereaux, 3/22)

CIDRAP: Global Flu Activity Declines With Greater Influenza B Proportions
In Europe, half of the countries are still reporting widespread activity, though in North America, flu has declined to levels normally seen at this point of the season. The WHO report roughly covers the end of February and into the first week of March. (Schnirring, 3/22)

The New York Times: Biden Plan To Cut Billions In Medicare Fraud Ignites Lobbying Frenzy 
“How’s the knee?” one bowler asked another across the lanes. Their conversation in a Super Bowl ad focused on a Biden administration proposal that one bowler warned another would “cut Medicare Advantage.” “Somebody in Washington is smarter than that,” the friend responded, before a narrator urged viewers to call the White House to voice their displeasure. The multimillion dollar ad buy is part of an aggressive campaign by the health insurance industry and its allies to stop the Biden proposal. It would significantly lower payments — by billions of dollars a year — to Medicare Advantage, the private plans that now cover about half of the government’s health program for older Americans. (Abelson and Sanger-Katz, 3/22)

Modern Healthcare: Intermountain Health Operating Income Fell 82% In 2022
Intermountain Health's merger with SCL Health bolstered the nonprofit health system's financial performance by $4 billion last year, the company disclosed Tuesday. Net income grew 6.5% to $2.63 billion in 2022 while revenue rose 29.6% to $13.94 billion. (Hudson, 3/22)

Modern Healthcare: Bright Health Under Supervision In Tennessee
Bright Health Group can add Tennessee to the growing list of states concerned about its ability to meet its financial obligations. Tennessee regulators placed the struggling health insurance company under supervision in November, according to Tennessee Department of Commerce and Insurance filings. Bright Health has been prohibited from spending more than $10,000 at a time without approval from Tennessee. The state also reserved the right to initiate legal, liquidation or delinquency proceedings against the company. (Tepper, 3/22)

NBC News: Congress Members Send Letter To HCA About Conditions At Florida Hospital After NBC News Report
Two Washington lawmakers have requested information from HCA Healthcare Inc., the nation’s biggest hospital company, about conditions and practices at its Bayonet Point Hospital in Hudson, Florida, following a February report by NBC News in which insiders detailed extensive deficiencies at the facility. (Morgenson, 3/22)

Stat: Senators Interrogate Health Secretary On Alzheimer's Drug Coverage
The future of Alzheimer’s treatments and coverage hung heavily over lawmakers’ Wednesday hearing with Health and Human Services Secretary Xavier Becerra. Dotted throughout the hearing room for Becerra’s testimony on the president’s proposed health care budget for 2024 were purple-clad advocates for Alzheimer’s disease treatments, who Democrats and Republicans alike acknowledged repeatedly throughout the hearing. But while senators from both parties pushed for speedy approvals and Medicare coverage of new drugs for the disease, they unsurprisingly diverged on how to manage the costs. (Owermohle, 3/22)

WMFE: Alzheimer's Study Explores New Drug's Potential To Delay Or Prevent Symptoms
In the past two years, the FDA has approved the first two drugs that treat the actual disease of Alzheimer’s, the most common form of dementia affecting more than 6 million people in the U.S. An ongoing study -- with participants in Central Florida -- examines whether one of those drugs can prevent or at least delay the appearance of symptoms. (Byrnes, 3/22)

Stat: Drugmakers Push Back On A Clever Tactic Employers Use To Avoid Paying For Specialty Medicines 
In the face of rising drug prices, health plan sponsors have quietly used a clever, but questionable tactic over the past few years to deflect costs. And now, some pharmaceutical companies are pushing back. (Silverman, 3/22)

Fierce Healthcare: Patients Want Their Medical Test Results Immediately, Even When It's Bad News, Survey Finds
Nearly every patient wants to see their lab test results as soon as possible, even if their provider has not yet reviewed the results, according to new data in a new study. In a survey of 8,000 patients who accessed their test results via an online patient portal account, 96% of patients preferred receiving immediately released test results online. That percentage stayed at around 95% even for patients who received non-normal results through the online patient portal. (Landi, 3/22)

Modern Healthcare: North Carolina Medicaid Expansion Bill Passes
After a yearslong battle to expand Medicaid in North Carolina, the Republican-led state General Assembly advanced the policy on a bipartisan vote Wednesday. (Nzanga, 3/22)

The Hill: Why Millions Of People Could Lose Medicaid Next Month 
Health officials are bracing for chaos as states begin to determine — for the first time in three years — who is eligible for Medicaid, as a key pandemic policy of guaranteed eligibility ends. Advocates warn that without a safety net, millions of vulnerable people will fall through the cracks and lose coverage. The Biden administration is giving states a year to go through the once-routine process of sorting through Medicaid rolls, though some are moving much faster. Arkansas for instance will speed through the redetermination process in only six months, citing cost concerns and the goal of Gov. Sarah Huckabee Sanders (R) to push people to “escape the trap of government dependency.” (Weixel, 3/22)

NPR: California Could Ban Red Dye No. 3 And Other Ingredients Used In Processed Foods
A California assembly member has introduced legislation that would ban processed food items that contain potentially harmful ingredients that are used in several brands of fruit cups, chewy candies and cookies and cakes. Under Assembly Bill 418, Red Dye No. 3, as well as titanium dioxide, potassium bromate, brominated vegetable oil and propylparaben would be outlawed in the manufacturing, distribution or sale of foods in the state. (Archie, 3/23)

The Texas Tribune: Bills Call For Texas Teachers To Administer Lifesaving Overdose Drugs To Students
As illegal opioid use rises among young people, several bills filed by state lawmakers would require Texas teachers to be trained and equipped to treat fentanyl overdoses, both on campus and at school-related events. Several bills call for educators and school staff at public, charter and private schools, as well as those at colleges and universities, to know how to reverse deadly opioid overdoses with Narcan and other overdose medications known as “opioid antagonists.” (Simpson, 3/23)

St. Louis Post-Dispatch: Pelvic Exams On Unconscious Patients Could Be Banned In Missouri
The Missouri House Wednesday endorsed legislation prohibiting health care providers from performing certain exams on patients who are under anesthesia. On a 157-0 vote, the House forwarded the measure to the Senate, where a similar proposal has won approval at the committee level. Under current law, there is no prohibition on Missouri doctors or medical school students from legally performing pelvic, prostate and anal exams on patients when the patients are unconscious. (Erickson, 3/22)

Reuters: Florida Moves To Expand Teaching Ban On Sexual Orientation, Gender Identity
Florida is looking to expand its ban on teaching young children about sexual orientation and gender identity issues to include all students in its public schools under a new rule set for a vote by the state Board of Education next month. The proposed rule is the latest move by the administration of Republican Governor Ron DeSantis, who is expected to seek his party's 2024 nomination for president, to limit or prohibit instruction on topics conservatives consider inappropriate for the state's classrooms. (Bernstein, 3/22)

Las Vegas Review-Journal: Nevada Bill Would Require Equal Pay For Intellectually Disabled
Assembly Bill 259, introduced by Assemblywoman Tracy Brown-May, D-Las Vegas, would require providers of jobs and day training services to pay at least the state minimum wage to those with intellectual or developmental disabilities. (Hill, 3/22)

Journal Star: Illinois Boy Spends Week In Hospital With An Invasive Strep Infection
Samantha Moore had no idea her 9-year-old son was suffering from a strep infection until his foot swelled up and he became delirious. Colt Bearce is an active, healthy kid, so when he complained of feeling unwell after returning to the family's Macomb, Illinois, home from school Feb. 7, Moore wasn’t overly concerned. (Renken, 3/23)

Bloomberg: Spiked Drug Tests Undermining Opioid Treatment Efforts
Some patients addicted to opioids may be spiking their drug tests to mimic adherence to their treatment plans, undermining attempts to address an epidemic that looms larger than ever. About 8% of opioid patients could be spiking their urine samples with buprenorphine, a drug used to treat pain and opioid addiction, according to a JAMA Psychiatry study published Wednesday. Adding buprenorphine tablets or residue directly into urine can create the impression that patients have taken their medication when they haven’t. (Meghjani and Peng, 3/22)

NPR: New Tropical Mosquito Is Buzzing Across Florida
Eleven of the 17 non-native mosquitoes in Florida were discovered in the past two decades, with six of those detected in the last five years. The deadliest mosquitoes found in the U.S., Aedes aegypti, Aedes albopictus and Culex quinquefasciatus are all non-native species introduced from the tropics. (Allen, 3/22)

AP: What Made Beethoven Sick? DNA From His Hair Offers Clues 
Nearly 200 years after Ludwig van Beethoven’s death, researchers pulled DNA from strands of his hair, searching for clues about the health problems and hearing loss that plagued him. They weren’t able to crack the case of the German composer’s deafness or severe stomach ailments. But they did find a genetic risk for liver disease, plus a liver-damaging hepatitis B infection in the last months of his life. (Burakoff, 3/22)

Stat: Eating Disorders Study Calls Social Media 'Self-Perpetuating Cycle Of Risk'
Social media use is linked with body image concerns and eating disorders among young people, according to a new review of the scientific literature. But rather than social media being a direct cause of these issues, a “self-perpetuating cycle of risk” could be to blame, with more vulnerable teens and young adults succumbing to online pressures, the authors say. (Cueto and Gaffney, 3/22)