First Edition: March 9, 2015
Today's early morning highlights from the major news organizations.
Kaiser Health News:
Awake, And Safe, All Night Despite Dementia
In her Manhattan apartment, Josephina Deltejo is trying to coax her 84-year-old mother Brunhilda Ortiz to get ready to leave the house. As she does most nights, Deltejo makes up a story to get her mother, who has dementia, to cooperate. In Spanish, Deltejo asks her mother if she would rather go to Miami or the Dominican Republic. “She says she wants to go to the Dominican Republic,” Deltejo translates, and then she helps the older woman gather her things and go downstairs to a waiting van. The driver will bring her mother to the Elderserve At Night program at the Hebrew Home At Riverdale in the Bronx. It’s a kind of day camp–but at night, for people like Ortiz who suffer from Alzheimer’s disease. (Gotbaum, 3/9)
Kaiser Health News:
Health Exchange, Medicare Advantage Plans Must Keep Updated Doctor Directories In 2016
Starting next year, the federal government will require health insurers to give millions of Americans enrolled in Medicare Advantage plans or in policies sold in the federally run health exchange up-to-date details about which doctors are in their plans and taking new patients. Medicare Advantage plans and most exchange plans restrict coverage to a network of doctors, hospitals and other health care providers that can change during the year. Networks can also vary among plans offered by the same insurer. So it’s not always easy to figure out who’s in and who’s out, and many consumers have complained that their health coverage doesn’t amount to much if they can’t find doctors who accept their insurance. (Jaffe, 3/9)
The New York Times:
Some Supreme Court Justices Cite 2012 Argument Against Health Care Law As Defense For It Now
In 2012, the Supreme Court declared that Congress had put “a gun to the head” of states by pressuring them to expand Medicaid, and it said that such “economic dragooning” of the states violated federalism principles embedded in the Constitution. Now, in a separate case, comments by several justices indicate that they could uphold a pillar of the Affordable Care Act — insurance subsidies for millions of lower-income people — by invoking those same principles. (Pear, 3/8)
The Associated Press:
AP Analysis: 5 Reasons Why Health Overhaul Drama Plays On
President Barack Obama's health overhaul remains an all-consuming drama for many, even though millions of people are gaining insurance coverage through a law that's now 5 years old. During oral arguments last week in the latest Supreme Court case brought by the law's opponents, Justice Elena Kagan called it a "never-ending saga." Five reasons why the "Obamacare" epic plays on. (Alonso-Zaldivar, 3/8)
The Wall Street Journal's Washington Wire:
Insurance Subsidies And GOP Alternatives To Obamacare
If the challengers win–which seems less likely now, given the tenor of oral argument at the court on Wednesday–some states may seek to quickly establish their own exchanges or to work with the administration to develop a hybrid model under which states control their exchanges but farm out some of the back-end duties to the federal government. A plaintiffs’ victory also could give new momentum to those Republicans who want to replace the Affordable Care Act with another plan (a proposal that could attract a few Senate Democrats up for reelection in 2016 in states where Obamacare continues to be unpopular). (Litan, 3/6)
Los Angeles Times:
Oregon Abolishes Its Hopelessly Bungled Health Insurance Exchange
A bill dissolving Cover Oregon, the state's dysfunctional health insurance exchange, has been signed by Gov. Kate Brown. The measure, which had bipartisan support, transfers responsibilities for the Oregon exchange to the state Department of Consumer and Business Services. ... Cover Oregon was plagued by problems almost from its onset. No Oregonian was ever able to enroll online in a private plan under the Affordable Care Act because the state exchange never had a functioning website, forcing insurance seekers to file paper applications. (Masunaga, 3/7)
The Associated Press:
Report: Rural Hospitals Get Billions In Extra Medicare Funds
A law that allows rural hospitals to bill Medicare for rehabilitation services for seniors at higher rates than nursing homes and other facilities has led to billions of dollars in extra government spending, federal investigators say. Most patients could have been moved to a skilled-nursing facility within 35 miles of the hospital at about one-fourth the cost, the U.S. Department of Health and Human Services' inspector general said in a report being released Monday. Hospitals juggling tough balance sheets have come to view such "swing-bed" patients as lucrative, fueling a steady rise in the number of people getting such care and costing Medicare an additional $4.1 billion over six years, the report said. (Sedensky, 3/9)
The Washington Post:
Health Care For Veterans Goes High Tech
The charity [Give An Hour] now teams up regularly with technology firms to help veterans. It has worked with the likes of Google to reach more veterans through a series of video chats. It paired with Booz Allen Hamilton to analyze program data to better deliver services. And it is exploring a partnership with Doctor on Demand, an app that gives users 15-minute appointments with doctors, virtually. Technology is critical in overcoming the stigma around mental health issues, said [Barbara] Van Dahlen, who launched a national campaign to raise awareness about the topic in Washington last week. (Jayakumar, 3/8)
USA Today:
VA Doesn't Release 140 Vet Health Care Probe Findings
The Department of Veterans Affairs' chief watchdog has not publicly released the findings of 140 health care investigations since 2006, potentially leaving dangerous problems to fester without proper oversight, a USA TODAY analysis of VA documents found. It is impossible to know how many of the investigations uncovered serious problems without seeing the reports, but all concerned VA medical care provided to veterans or complaints of clinical misconduct. (Slack, 3/8)
The New York Times:
GOP Is Divided As Budget Bills Start Piling Up
In their first major test of governing this year, Republicans stumbled, faltered — and nearly shut down the Department of Homeland Security. And that vote may have been the easy one. In April, physicians who treat Medicare patients face a drastic cut in pay. In May, the Highway Trust Fund runs dry. In June, the charter for the federal Export-Import Bank ceases to exist. Then in October, across-the-board spending cuts return, the government runs out of money — and the Treasury bumps up against its borrowing limit. (Parker, 3/8)
Los Angeles Times:
Sen. Robert Menendez, Likely To Face Corruption Charges, Denies Wrongdoing
A law enforcement official confirmed that criminal charges were expected, but said no action was imminent because prosecutors have been hamstrung by attempts to compel members of the Menendez staff to discuss a series of phone calls the senator allegedly exchanged with federal Medicare and Medicaid officials on behalf of Melgen. At that time in 2012, the doctor was locked in a dispute with government officials who alleged he was overbilling Medicare and Medicaid. Melgen, one of the nation's top-billing ophthalmologists, was paid $21 million from Medicare and Medicaid in 2012, more than any other doctor in the country. He eventually became the subject of a fraud investigation, with the FBI raiding his medical offices in 2013. He has not been charged in that investigation. (Serrano, Tanfani and Memoli, 3/6)
The Wall Street Journal:
U.S. Plans To File Criminal Charges Against New Jersey Sen. Menendez
The investigation has focused on the senator’s financial connections to a Florida doctor and close friend, Dr. Salomon Melgen, who is facing a probe into his billing practices. The FBI has examined whether the senator improperly sought to help the doctor in that inquiry and whether Mr. Menendez may have improperly used his influence with the Department of Homeland Security on behalf of the doctor on an unrelated issue, according to people familiar with the investigation. (Barrett and Grossman, 3/6)
NPR:
Supporting A Spouse With Alzheimer's: 'I Don't Get Angry Anymore'
Greg and Mary Catherine O'Brien will celebrate their 38th wedding anniversary next month. She knows him better than anyone — his moods and sense of humor, his devotion to their three children and his love of Cape Cod. When Greg was diagnosed with early-onset Alzheimer's five years ago, Mary Catherine had already started to notice little differences in his behavior, she says. Now, as his symptoms continue to worsen, she takes a moment to reflect on how the disease is changing their marriage, sometimes in unexpected ways. (Hersher, 3/7)
The New York Times:
Visiting Nurses, Helping Mothers On The Margins
[Nurse] home visiting programs, paid for through the Affordable Care Act, are at the heart of a sweeping federal effort aimed at one of the nation’s most entrenched social problems: the persistently high rates of infant mortality. The programs have spread to some 800 cities and towns in recent years, and are testing whether successful small-scale efforts to improve children’s health by educating mothers can work on a broad national canvas. Home visiting is an attempt to counter the damaging effects of poverty by changing habits and behaviors that have developed over generations. (Tavernise, 3/8)
The New York Times:
F.D.A. Approves Zarxio, Its First Biosimilar Drug
The Food and Drug Administration has approved the first so-called biosimilar drug for use in the United States, paving the way for less expensive alternatives to an entire class of complex and costly drugs. The drug, called Zarxio, produced by Sandoz, is used to help prevent infections in cancer patients receiving chemotherapy. It is a close copy of an existing medication called Neupogen, made by Amgen. It was approved in Europe in 2009 as Zarzio but has not been used in the United States, in part because no regulatory pathway existed to bring biosimilars — approximate copies of drugs in a class known as biologics — to market. (Tavernise and Pollack, 3/6)
The Wall Street Journal:
U.S. Clears First Copycat Biotech Drug, Jolting Sector
The Food and Drug Administration approved the first copy of a biotechnology drug for the U.S. market, firing the starting gun on a new industry that could help the U.S. curb its $376 billion in yearly drug spending. The drug is a rival version of Neupogen, an Amgen Inc. treatment prescribed to chemotherapy patients. The copycat medicine, Zarxio from Novartis AG , is the first approved under a new regulatory framework designed to introduce competition for costly biotech drugs, which are produced in living cells and typically administered by infusion or injection. (Rockoff and Loftus, 3/6)
The Washington Post's Wonkblog:
The FDA Just Approved A New Kind Of Drug That Could Pave The Way To Cheaper Medicine
Federal regulators on Friday approved the sale of the first-ever biosimilar drug in the United States, opening the door to a cheaper class of drugs that could expand patient access to life-saving treatments. The FDA approved Novartis AG's copycat version of Neupogen, a biologic cancer drug that recorded $1.2 billion in worldwide sales last year. Novartis already sells biosimilar versions of the drug in more than 40 countries, but Friday's announcement will allow the company to start selling the drug in the United States. (Millman, 3/6)
Los Angeles Times:
Health Benefits Are A Promise School Districts Find Hard To Keep
California school districts once viewed lifetime healthcare coverage for employees as a cheap alternative to pay raises. That decision is coming back to haunt school leaders, and districts are scrambling to limit the lucrative benefit promised decades ago. The price tag for retiree healthcare obligations has reached about $20 billion statewide — an amount systems are not prepared to absorb. (Torres, 3/7)
The Washington Post:
Maryland Weighs ‘Death With Dignity’ Legislation
Terminally ill patients and those who have cared for them asked Maryland lawmakers on Friday to give people facing death the right to end their lives on their own terms. The emotional testimony comes as the Maryland General Assembly weighs a “Death With Dignity” bill, a measure that would allow doctors to prescribe lethal medications to terminally ill patients. (Wiggins, 3/6)