First Edition: Monday, Sept. 30, 2024

KFF Health News: The Medicare Advantage Influence Machine
Federal officials resolved more than a decade ago to crack down on whopping government overpayments to private Medicare Advantage health insurance plans, which were siphoning off billions of tax dollars every year. But Centers for Medicare & Medicaid Services officials have yet to demand any refunds — and over the years the private insurance plans have morphed into a politically potent juggernaut that has signed up more than 33 million seniors and is aggressively lobbying to stave off cuts. (Schulte and Hacker, 9/30)

KFF Health News: California Voters Consider Tough Love For Repeat Drug Offenders
California voters are considering whether to roll back some of the criminal justice reforms enacted a decade ago as concerns about mass incarceration give way to public anger over property crime and a fentanyl crisis that has plagued the state since the covid-19 pandemic hit. Proposition 36, on the November ballot, would unwind portions of a 2014 initiative, known as Proposition 47, that reduced most shoplifting and drug possession offenses to misdemeanors that rarely carried jail time. (Thompson, 9/30)

KFF Health News: Journalists Weigh In On Racial Trauma, Medicaid Expansion, And Opioid Settlements
KFF Health News and California Healthline staffers made the rounds on national and local media recently to discuss topical stories. Here’s a collection of their appearances. (9/28)

North Carolina Health News: In The Wake Of Deadly Helene, Western NC Thirsts For Water 
The powerful remnants of Hurricane Helene that deluged western North Carolina with fierce winds and raging stormwaters left a wide swath of the state in desperate need of potable water. As of early Sunday afternoon, 145 water systems were either without power, suffering infrastructure damage or under boil-water alerts, depriving individuals, businesses and health care systems of a fundamental resource. (Blythe and Atwater, 9/30)

ABC News: 54 People Rescued From Roof Of Tennessee Hospital Due To Floodwaters From Hurricane Helene 
At least 54 people were trapped on the roof of a hospital in Tennessee on Friday after floodwaters due to Hurricane Helene quickly surrounded the medical center. Everyone was rescued safely, Sen. Bill Hagerty said in a statement. Unicoi County Hospital -- located in the northeastern part of the state on the border with North Carolina -- took on so much flooding that those inside could no longer be safely evacuated and had to relocate to the roof. (Kekatos, 9/27)

The Washington Post: How An ‘AquaFence’ Temporary Wall Protected Tampa’s Hospital From Helene 
As surging water from Hurricane Helene inundated the Tampa Bay area Thursday, Tampa General Hospital stayed dry, thanks to a temporary floodwall that protected the hospital. In a video posted by the hospital, which sits on an island in Hillsborough Bay, a fence several feet tall keeps the floodwaters at bay as Helene churns through the area. (Raza, 9/27)

The Wall Street Journal: Exclusive: Americans Are More Reliant Than Ever On Government Aid 
Americans’ reliance on government support is soaring, driven by programs such as Social Security, Medicare and Medicaid. That support is especially critical in economically stressed communities throughout the U.S., many of which lean Republican and are concentrated in swing states crucial in deciding the presidential election. Neither party has much incentive to dial back the spending. The country hasn’t always been this reliant on government support. In 1970, government safety-net money accounted for significant income in fewer than 1% of America's counties, new research by the bipartisan think tank Economic Innovation Group finds. (Zitner, Kamp and McGill, 9/30)

Reuters: US Medicare Says Part D And Advantage Premiums Will Fall In 2025
Average premiums and benefits for Medicare's prescription drug program and private Medicare plans are projected to remain stable in 2025 with premiums slightly declining, the Centers for Medicare and Medicaid Services said on Friday. The premiums are of interest to consumers enrolled in Medicare Advantage plans run by private insurers who are then paid by the government, and the health plans themselves, who set premiums and benefits based on the reimbursement rates. (Aboulenein, 9/27)

The New York Times: Biden Officials Stave Off Sticker Shock On Medicare Drug Premiums 
The Biden administration on Friday announced that next year older Americans would face lower average monthly premiums for their prescription drugs, a feat achieved by pouring billions of dollars into subsidies for insurers. The move avoided a potential minefield of higher costs affecting the nation’s most stalwart voters weeks before the presidential election. In a savvy response to the specter of huge spikes in costs, administration officials decided months ago to funnel money from a Medicare trust fund to offset rate increases that could have cost millions of people hundreds of dollars more a year. (Robbins and Abelson, 9/27)

The Boston Globe: Steward Health Care CEO Ralph De La Torre Resigns
Dr. Ralph de la Torre, a former heart surgeon who built and became the face of Steward Health Care and its network of neglected hospitals, is stepping down from the company Tuesday and will no longer serve as board chairman and chief executive, the company said in a statement to the Globe Saturday. ... A Steward spokesperson did not say on Saturday if de la Torre will remain a major shareholder in the company he helped found in Boston in 2010. (Arsenault and Bartlett, 9/28)

Modern Healthcare: Hospitals On Defense As Congress Weighs Pay, 340B, M&A Bills
With an election fast approaching and a consequential healthcare package forming in Congress, hospitals are finding themselves in the unusual position of playing defense. Just a few years ago, Congress was acting aggressively to shore up health system finances and hailing hospital workers as heroes combating the COVID-19 pandemic. Now, while lawmakers still praise their local hospitals, they are increasingly advancing bills that would cost health systems money, demand greater transparency and restrict operations. (McAuliff, 9/27)

The Wall Street Journal: Why Drug Distributors Are Buying Cancer Specialists 
Drug middlemen are duking it out to buy their customers. Most Americans pick up their prescription drugs at the local pharmacy, but many pricey medications are bought directly by medical providers. Think, for example, of a chemotherapy infusion delivered at a doctor’s office. The intermediaries selling drugs to those doctors run a pretty good business. Now, the big three U.S. drug wholesalers—McKesson, Cencora and Cardinal Health —are taking control of the doctors, too, to lock them in as customers. (Wainer, 9/27)

Modern Healthcare: CommonSpirit's Gains Offset By Claim Denials, Payer Payments
CommonSpirit Health blamed challenges with payers — namely claim denials and reimbursement delays — for an increase in expenses that offset the system's financial gains in fiscal 2024. The health system on Thursday reported an operating loss of $875 million due to a 7% increase in expenses during the fiscal year that ended June 30. In a news release, CommonSpirit said it will take a “firm stance” in contract negotiations with health plans to make sure payers absorb a share of inflation and providers are fully paid for the care they deliver. (Devereaux, 9/27)

The Boston Globe: Beth Israel Lahey Health Announces Layoffs
Beth Israel Lahey Health, the organization behind more than a dozen New England hospitals, said Friday that hospitals across its system were laying off an unspecified number of workers. A spokesperson for the system declined to say which facilities were losing jobs, nor the type of roles they were cutting. (Gerber, 9/27)

Modern Healthcare: KKR-Backed Brightline Layoffs Hit Clinicians, Clinical Managers
Pediatric mental health startup Brightline is restructuring its business, shrinking its geographic footprint and laying off a portion of its employees. The company confirmed the layoffs in an email but declined to disclose how many people or what percentage of its employees were affected. Co-founder and CEO Naomi Allen wrote in a blog post the company is pivoting from a virtual-only care model to a hybrid approach with plans to open in-person clinics. (Perna, 9/27)

Crain's Detroit Business: Corewell Health East Nurses File Paperwork For Union Vote
Nurses at Corewell Health’s eight Southeast Michigan hospitals filed paperwork Friday to unionize under the International Brotherhood of Teamsters. The union gathered at least 50% of required signature cards from the roughly 8,000 nurses at Corewell’s hospitals in Grosse Pointe, Troy, Dearborn, Farmington Hills, Taylor, Trenton, Wayne and Royal Oak and delivered them to the National Labor Relations Board. (Walsh, 9/27)

AP: WeightWatchers CEO Sima Sistani Is Stepping Down 
WeightWatchers is shaking up its leadership. WW International announced Friday that CEO Sima Sistani would leave her role effective immediately. Tara Comonte, a WeightWatchers board member and former Shake Shack executive, was made interim chief executive. (Philips, 9/28)

Modern Healthcare: Epic Lawsuit Heats Up Over Unreleased Particle Dispute Results
Epic Systems is pushing back against Particle Health. Particle Health, a startup that helps providers and health technology companies aggregate and share data, filed a suit Monday alleging the electronic health record giant is using its market power to prevent the development products that would compete with Epic's payer platform. Particle also alleges Epic used its influence to obtain a favorable ruling from Carequality, the national interoperability framework used by more than 50,000 healthcare organizations. (Perna, 9/27)

Modern Healthcare: Ransomware Attacks Against Providers Have Doubled Since 2021
The number of healthcare providers affected by ransomware attacks is steadily growing. More than two-thirds of healthcare providers reported a ransomware attack in the past year compared with 60% in 2023, according to a survey released Thursday from cybersecurity company Sophos. In 2021, only 34% of providers said they were affected by an attack. (Turner, 9/27)

The Atlantic: Remember That DNA You Gave 23andMe?
23andMe is not doing well. Its stock is on the verge of being delisted. It shut down its in-house drug-development unit last month, only the latest in several rounds of layoffs. Last week, the entire board of directors quit, save for Anne Wojcicki, a co-founder and the company’s CEO. Amid this downward spiral, Wojcicki has said she’ll consider selling 23andMe—which means the DNA of 23andMe’s 15 million customers would be up for sale, too. 23andMe’s trove of genetic data might be its most valuable asset. (Brown, 9/27)

The Wall Street Journal: Exclusive: Glenview Capital Plans Push For Changes At CVS
A major hedge-fund investor will meet top executives of CVS Health on Monday to propose ways the struggling healthcare company can improve its operations, the potential start of an activist stance by the fund, according to people close to the matter. The slated meeting, between CVS and hedge fund Glenview Capital Management, comes amid signs investors are turning restless with a company that remains among the best-recognized in the healthcare industry but has seen its shares tumble 24% this year to date. (Zuckerman and Mathews, 9/29)

Reuters: Sanofi-Regeneron's Dupixent Wins FDA's Nod For 'Smoker's Lung' 
The U.S. Food and Drug Administration has approved Sanofi and Regeneron's blockbuster drug Dupixent for patients with a chronic lung disease, commonly known as "smoker's lung", the companies said on Friday. (Roy, 9/27)

Los Angeles Times: Newsom Signs Bill Requiring Health Insurance Companies To Cover IVF
Gov. Gavin Newsom signed a bill on Sunday that requires large health insurance companies to cover in vitro fertilization — a win for reproductive health advocates amid nationwide concerns about the future of access to fertility treatments. The bill also expands healthcare benefits to LGBTQ+ families seeking to have children, changing the definition of infertility for insurance purposes to include “a person’s inability to reproduce either as an individual or with their partner without medical intervention.” (Mays, 9/29)

Los Angeles Times: Newsom Signs Bill Pushing For Narcan In Workplace First Aid Kits
Workplaces in California could eventually be required to stock their first aid kits with naloxone or another medication that can stop an opioid overdose under a bill signed this week by Gov. Gavin Newsom. ... Assembly Bill 1976 requires California regulators to craft rules requiring first aid kits in workplaces to contain naloxone or any similar medication approved by the Food & Drug Administration. Such a proposal would have to go before a state board for possible adoption by Dec. 1, 2028. (Alpert Reyes, 9/28)

Los Angeles Times: Boy Who Died In Blisteringly Hot P.E. Class Inspires New Law To Protect Students During Extreme Weather
When 12-year-old Yahushua Robinson died while running during a P.E. class in triple-digit temperatures, his mother could not help but feel like the tragedy was preventable. Now, a little more than a year later, Gov. Gavin Newsom has signed a bill aimed at ensuring all California students are better protected during heatwaves. (Harter, 9/28)

AP: California Governor Signs Bills To Protect Children From AI Deepfake Nudes
California Gov. Gavin Newsom signed a pair of proposals Sunday aiming to help shield minors from the increasingly prevalent misuse of artificial intelligence tools to generate harmful sexual imagery of children. The measures are part of California’s concerted efforts to ramp up regulations around the marquee industry that is increasingly affecting the daily lives of Americans but has had little to no oversight in the United States. (Nguyen, 9/29)

AP: California Gov. Newsom Vetoes Landmark AI Safety Bill 
California Gov. Gavin Newsom vetoed a landmark bill aimed at establishing first-in-the-nation safety measures for large artificial intelligence models Sunday. The decision is a major blow to efforts attempting to rein in the homegrown industry that is rapidly evolving with little oversight. The bill would have established some of the first regulations on large-scale AI models in the nation and paved the way for AI safety regulations across the country, supporters said. (Nguyen, 9/29)

Bloomberg: California Governor Rejects Health Warnings On Gas Stoves
California Gov. Gavin Newsom on Friday vetoed a bill that would have required gas stoves sold in the state to come with warning labels about their air pollution emissions and health risks. Similar bills also failed to gain traction this year in Illinois and New York. Gas stoves are particularly popular in California. While about 38% of households nationwide use natural gas for cooking, some 70% of households in California do, according to a 2020 survey conducted by the US Energy Information Administration. (Hirji, 9/28)

Politico: California 2026 Governor Hopefuls Come Out Strong For Single-Payer Health Care 
Four California governor hopefuls made big promises on single-payer health care but skimped on details Sunday during a candidate forum at a health workers’ union conference in San Francisco. The candidates — state Sen. Toni Atkins, Lt. Gov. Eleni Kounalakis, state Schools Superintendent Tony Thurmond and former state Controller Betty Yee — all said they supported establishing a single-payer health care system in California, renewing aspiration for a lofty goal progressives have tried but failed to accomplish on state and national stages. (Katzenberger, 9/29)

Los Angeles Times: California Abortion Clinics Worry About Security Amid Protests
A bill signed into law by Gov. Gavin Newsom on Saturday takes a statewide approach to deterrence, increasing criminal penalties for those who harass or threaten patients entering abortion clinics. The legislation goes further than a decades-old federal law that makes it illegal to threaten or harass people outside of abortion clinics and churches. (Mays, 9/29)

Austin Bureau: Texas AG Ken Paxton Sues Austin Over Abortion Travel Grants
Texas Attorney General Ken Paxton is suing to stop the city of Austin from covering travel expenses for residents who seek abortions out of state. In a lawsuit filed Friday, Paxton argued that the Texas Constitution prohibits gifts without a public benefit. He said there is no public benefit to the city initiative and therefore the policy is illegal. (Goldenstein, 9/27)

The Texas Tribune: Texas Committee Asks To Review Abortion-Related Deaths
Texas’ maternal mortality committee should be allowed to review abortion-related deaths and have more voices from impacted communities at the table, the group’s chair said at a Friday meeting. These comments represent the committee’s most forceful critique yet of the system by which the state reviews deaths related to pregnancy and childbirth. Dr. Carla Ortique, a Houston OB/GYN who chairs the committee, called for the reversal of recent legislative changes that redrew committee membership and began the process to remove Texas from the federal maternal mortality tracking system. (Klibanoff, 9/27)

The 19th: The Future Of Abortion In North Carolina Could Come Down To Hundreds Of Votes
With its 12-week cutoff and just over a dozen clinics, North Carolina is one of only two states in the South to allow abortion beyond six weeks of pregnancy. Some providers say a stricter ban could force them to halt services altogether. If the state passed a ban at six weeks, which is before many people know they’re pregnant, it could cut their patient volume so much that they wouldn’t make enough money to stay open. “That would mean imminent failure,” said Calla Halle, who operates A Preferred Women’s Health Center, a network of abortion clinics with two outposts in North Carolina and two more in Georgia, where abortion is outlawed after six weeks.  (Luthra, 9/30)

Vox: Abortion Groups Are Raising More Money Than Ever. Where Exactly Is It Going? 
This past year, abortion funds say they’re fighting for their lives, unable to raise enough money to meet demand. A few are fundraising with new state-level partners, but increasingly, funds have had to tell callers they’ve run out of resources, leaving people to scramble for other options or carry unwanted pregnancies to term. (Cohen, 9/30)

Fox News: COVID Lockdowns Led To Spike In Kids’ Vision Problems, 1 In 3 Now Nearsighted
As many as 30% of children and teens across the world were nearsighted in 2023, a new study has revealed. Diagnoses of nearsightedness (myopia) are expected to worsen over the next two decades, according to the findings, which were published in the British Journal of Ophthalmology. By 2050, nearly 740 million young individuals worldwide are expected to have the condition, lead study author Dr. Yajun Chen, a professor at Sun Yat-sen University in China, told Fox News Digital. (Rudy, 9/30)

CIDRAP: COVID Numbers Decline Slightly Across US; RSV, Flu Activity Low 
In several weekly updates published today, the US Centers for Disease Control and Prevention (CDC) said seasonal influenza and RSV (respiratory syncytial virus) activity are low nationally, and COVID-19 activity is elevated but declining. (9/27)

CBS News: Minnesotan Dies After Rabies Exposure From Bat, Health Officials Say
 State health officials say that a Minnesotan has died due to rabies exposure, a rare occurrence that has only happened four times since 2000. The Minnesota Department of Health says the person who died was 65 years old. They were exposed to a bat in western Minnesota in July, and the rabies diagnosis was confirmed in September. (9/27)

The Washington Post: D.C. Opioid Overdose Deaths Decline As Part Of National Trend 
D.C. opioid deaths are down significantly for the first time since fentanyl overwhelmed the drug supply in 2018, recent data shows, but officials are wary of declaring victory against the crisis. There have been about a quarter fewer opioid-related fatalities in the first half of this year compared with the same period last year, according to a report this month from the Office of the Chief Medical Examiner. (Portnoy, 9/29)

The Washington Post: D.C. 911 Officials Tout Staffing Improvements As Scrutiny Intensifies
Leaders at D.C.’s 911 agency say a recent recruitment push to offset seemingly chronic understaffing has paid off and the city is on track to have a fully staffed call center next year. Between a 31-member training class soon to graduate and planned job offers, officials with the Office of Unified Communications said, the agency is set to see its call-taker vacancies drop to about 11 next month, a sea change from the 57 call-taker vacancies when Heather McGaffin became director in February 2023. (Gathright, 9/29)