First Edition: November 21, 2017

Kaiser Health News: Massachusetts Grabs Spotlight By Proposing New Twist On Medicaid Drug Coverage
In the absence of new federal policies to tame break-the-bank drug prices, Massachusetts’ state Medicaid program hopes to road-test an idea both radical and market-driven. It wants the power to negotiate discounts for the drugs it purchases and to exclude drugs with limited treatment value. “This is a serious demonstration proposal,” said Sara Rosenbaum, a health policy expert and professor at George Washington University. “They’re not simply using [this idea] as an excuse to cut Medicaid. They’re trying to take a step toward efficiency.” (Luthra, 11/21)

Kaiser Health News: Doctor’s Rx For A Stiff Knee: A Prescription For 90 Percocet Pills
I recently hobbled to the drugstore to pick up painkillers after minor outpatient knee surgery, only to discover that the pharmacist hadn’t yet filled the prescription. My doctor’s order of 90 generic Percocet exceeded the number my insurer would approve, he said. I left a short time later with a bottle containing a smaller number. When I got home and opened the package to take a pill, I discovered that there were 42 inside. (Andrews, 11/21)

Kaiser Health News: Displaced Puerto Ricans Face Obstacles Getting Health Care
The federal government has granted people affected by the devastating hurricanes that wracked coastal states and Puerto Rico 15 extra days to sign up for health coverage under the Affordable Care Act. But Puerto Ricans who fled to the mainland after the destruction face problems well beyond timing. (Andalo, 11/21)

The Hill: GOP Senator: ObamaCare Fix Could Be In Funding Bill
Sen. Lamar Alexander (R-Tenn.) expressed optimism about a bipartisan effort to stabilize ObamaCare markets, saying his bill could be included in the upcoming funding package if it had President Trump's blessing. "I think if the president supports it, it'll be a part of the end-of-the-year package," Alexander told CNBC in an interview published Monday. (Sullivan, 11/20)

The Associated Press: Health Nominee Reaped Big Earnings From Drug Industry Tenure
Newly disclosed financial records show that President Donald Trump's nominee to become Health and Human Services secretary reaped big earnings during his tenure as a top pharmaceutical executive. As a top drug industry veteran from 2007 to 2017, former Eli Lilly and Co. executive Alex Azar built a substantial financial portfolio now worth $9.5 million to $20.6 million, and he was paid nearly $2 million in his final year at the company. (Braun, 11/20)

The Hill: HHS Nominee Azar Made Millions Working For Drugmaker Lilly
Alex Azar, who was previously president of the U.S. division of pharmaceutical giant Eli Lilly and Co., has a net worth of at least $8.7 million, according to documents filed with the Office of Government Ethics and analyzed by The Hill. Azar was paid nearly $2 million in his final year at Eli Lilly, according to the documents, which only date back to the previous 12 months. The company also paid him a $1.6 million severance package. (Weixel, 11/20)

Politico: Azar Received Millions From Eli Lilly In Last Year, Disclosures Show
Multiple Senate Democrats, and independent Vermont Sen. Bernie Sanders, have already declared their opposition to Azar's nomination because of his ties to the drug industry. The Health, Education, Labor and Pensions Committee is set to hold the first confirmation hearing on his nomination Nov. 29. After leaving Indianapolis-based Lilly, Azar leaned heavily on his industry experience to find new work. He collected $46,500 in speaking fees for four events, including ones hosted by the National Association of Specialty Pharmacy and pharma-focused tech company Veeva Systems. Azar also valued his consulting firm's worth at between $15,001 and $50,000. The firm's clientele included the National Pharmaceutical Council and drug company UCB Inc. (Cancryn, 11/20)

The Wall Street Journal: Veterans Affairs Chief Wants Bigger Role For Private Health Care
The top official at the Department of Veterans Affairs said he wants private-sector providers to play a larger role in veterans’ health care, a view likely to draw opposition for a Trump cabinet member who has enjoyed rare bipartisan support. David Shulkin said in an interview that he wants to make the VA’s hospital system compete with private-sector providers for military veteran customers, which he said would give veterans greater choice over their health care. (Kesling and Nicholas, 11/20)

The Hill: Fight Erupts Over Tax Credit For 'Orphan' Disease Drugs
Republicans are seeking to roll back a tax credit for drugs that treat rare diseases, alarming patient groups who fear the move would slow the development of new treatments. The so-called orphan drug tax credit would be repealed in the tax-reform bill that passed the House last week. Patient groups are lobbying to preserve the credit, as are some drug companies. (Sullivan, 11/21)

The Hill: Facing 'Hard Decisions,' Health Centers Plead For Restored Funding
Community health centers are scrambling to make contingency plans as they anxiously wait to see if Congress will renew billions of dollars in federal funding that expired on Sept. 30. Often situated in medically underserved areas, the health centers provide care to some 26 million of the nation’s most vulnerable people. They’re required to take any patient who seeks care, regardless of whether they can pay. (Roubein, 11/21)

CQ: Funding Cuts To Hospitals Imminent Unless Congress Acts
Billions of dollars in cuts to a federal program that helps hospitals cover the cost of caring for the uninsured will begin to take effect in a matter of weeks if Congress does not delay them. The House recently included a postponement in cuts to what's known as disproportionate share hospital, or DSH, payments in its bill to reauthorize funding for the Children’s Health Insurance Program (HR 3922). But the Senate hasn't followed suit thus far, leaving hospitals in the dark about whether they will start to see funding slashed in the first quarter of 2018. (Williams, 11/20)

The Washington Post: 597 Days. And Still Waiting.
On the 597th day, the day he hoped everything would change, Joe Stewart woke early. He took 15 pills in a single swallow. He shaved his head. And then he got down to the business of the day, which was the business of every day, and that was waiting. He looked outside, and saw his mother there in a green sedan, engine running. So many months he had waited for this moment, and now it was here. Time for his Social Security disability hearing. Time to go. (McCoy, 11/20)

NPR: U.S. Surgeon General Says Working Together Is Key To Combating Opioid Crisis
About a month ago, President Trump declared the opioid epidemic a public health emergency. He's spent a lot of time talking about the severity of the drug crisis. But he's spent less time outlining the specific steps he'll take to fight it. Today, a White House analysis declared that the true cost of the opioid epidemic in 2015 was more than half a trillion dollars. (Jochem, 11/20)

Los Angeles Times: Drugs Made In Mexican 'Superlabs' Are More Potent Than Ever, Fueling The Addiction Epidemic
Ten years ago, the average gram of meth available in the U.S. was 39% pure. Today, it is being sold in a nearly pure state, manufactured in Mexican "superlabs" and smuggled across the border to feed an epidemic of addiction. The drug is being peddled alongside fentanyl, a synthetic opioid 50 times stronger than heroin, and carfentanil, an elephant tranquilizer that can kill a human with just a speck or two. (Davis, 11/20)

Los Angeles Times: For Opiate Addiction, Study Finds Drug-Assisted Treatment Is More Effective Than Detox
Say you're a publicly-insured Californian with an addiction to heroin, fentanyl or prescription narcotics, and you want to quit. New research suggests you can do it the way most treatment-seeking addicts in the state do — by undergoing a medically-supervised "detoxification" that's difficult, expensive and highly prone to failure. (Healy, 11/20)

The New York Times: Skin Cancers Rise, Along With Questionable Treatments
John Dalman had been in the waiting room at a Loxahatchee, Fla., dermatology clinic for less than 15 minutes when he turned to his wife and told her they needed to leave. Now. “It was like a fight or flight impulse,” he said. His face numbed for skin-cancer surgery, Mr. Dalman, 69, sat surrounded by a half-dozen other patients with bandages on their faces, scalps, necks, arms and legs. (Hafner and Palmer, 11/20)

The New York Times: New Gene Treatment Effective For Some Leukemia Patients
A new way of genetically altering a patient’s cells to fight cancer has helped desperately ill people with leukemia when every other treatment had failed, researchers reported on Monday in the journal Nature Medicine. The new approach, still experimental, could eventually be given by itself or, more likely, be used in combination treatments — analogous to antiviral “cocktails” for H.I.V. or multidrug regimens of chemotherapy for cancer — to increase the odds of shutting down the disease. (Grady, 11/20)

Stat: Our Bodies Are Full Of Bugs. This MIT Engineer Wants To Manipulate Them To Treat Disease
Our bodies are full of bugs. They’re everywhere, hanging out on our skin, reproducing in our gut, growing on the glistening surface of our eyes. These bacteria, it turns out, don’t just beget other bacteria. They also beget scientific paper after scientific paper, which, in turn, beget headline after headline. But for all our talk of microbiomes, we aren’t all that great at shaping them, says Dr. Timothy Lu, an associate professor of biological engineering and electrical engineering at the Massachusetts Institute of Technology. (Boodman, 11/21)

The Washington Post: Risk Of Stillbirth Is Double In Pregnant Women Who Sleep On Their Backs, Study Finds
Pregnant women might increase their risk of a stillbirth if they sleep on their backs during their third trimester, a new study has found. The research, published Monday in the British Journal of Obstetrics and Gynaecology, is the largest of its kind and the clearest evidence yet that sleeping conditions during pregnancy could have significant effects on the fetus. (Wan, 11/20)

The Associated Press: Big Tobacco’s Anti-Smoking Ads Begin After Decade Of Delay
Decades after they were banned from the airwaves, Big Tobacco companies return to prime-time television this weekend — but not by choice. Under court order, the tobacco industry for the first time will be forced to advertise the deadly, addictive effects of smoking, more than 11 years after a judge ruled that the companies had misled the public about the dangers of cigarettes. (Perrone, 11/21)

NPR: 'Here It Goes': Coming Out To Your Doctor In Rural America
Finding the perfect doctor can be a feat for anyone. And a poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health finds that 18 percent of all LGBTQ Americans refrain from seeing a physician for fear of discrimination. One of those people is 20-year-old Alex Galvan. The moment right before he told his doctor earlier this year that he is gay and sexually active felt like a nightmare. (Romero, 11/21)

NPR: Popular Surgery To Ease Chronic Shoulder Pain Called Into Question
Research investigating a popular form of surgery aimed at easing chronic shoulder pain doesn't fix the problem, a careful, placebo-controlled study suggests. In the condition known as shoulder impingement, certain movements, such as reaching up to get something off a shelf, for example, or even scratching your own back can be painful and get worse during a night of tossing and turning. (Neighmond, 11/20)

The Wall Street Journal: New Evidence For Critics Of Weight-Loss And Sports Supplements
Dietary supplements make lots of claims and consumers often believe them: The booming U.S. industry has grown from $9 billion in sales in 2007 to $15 billion this year, according to Euromonitor International, a market research firm. But a new study gives ammunition to critics of the supplements and their potential health risks. (Reddy, 11/20)

NPR: Spit Test May Help Reveal Concussion Severity
A little spit may help predict whether a child's concussion symptoms will subside in days or persist for weeks. A test that measures fragments of genetic material in saliva was nearly 90 percent accurate in identifying children and adolescents whose symptoms persisted for at least a month, according to a study published Monday in JAMA Pediatrics. That's in contrast to a concussion survey commonly used by doctors that was right less than 70 percent of the time. (Hamilton, 11/20)

The New York Times: The Psychology Of The Black Friday Shopping Mob
For the Black Friday faithful, the excitement begins on Thanksgiving, when eager shoppers line up outside big box and department stores for the chance to grab “doorbuster” sales and “prices slashed” merchandise when the doors open. Black Friday videos posted in recent years show shoppers shoving and shouting, with one temporary worker even trampled to death in 2008. What turns ordinary shoppers into dangerous mobs? Social scientists and psychologists are trying to find out. (Luccheshi, 11/21)

The New York Times: Lead Paint Failure May Bring Federal Monitor For Public Housing
Mayor Bill de Blasio said on Monday that he expected a federal monitor could be appointed to supervise the city’s vast Housing Authority, as he acknowledged that the city had failed for years to do required lead-paint inspections in thousands of public-housing apartments. “There was no attempt to deceive,” the mayor said at a news conference in Queens. “We’ve been able to get a fuller picture and what happened should not have happened.” (Goodman and Neuman, 11/20)

The Wall Street Journal: New York City Mayor Adds Oversight After Lead Lapses
New York City Mayor Bill de Blasio said he was increasing controls in the city’s public housing authority on Monday, nearly one week after a watchdog agency revealed that the housing authority hadn’t conducted inspections of lead paint required by federal and state rules for four years. “What happened should not have happened and will not happen again,” Mr. de Blasio said at a news conference in Queens on Monday, where he spoke publicly for the first time since a Department of Investigation report last week outlining the lapses. (Gay, 11/20)

The Associated Press: Nursing Home Tells Congress Irma Deaths Not Staff's Fault
A Florida nursing home under investigation for the deaths of 13 patients after Hurricane Irma says in a letter to Congress that staff members did everything possible but couldn't overcome a lack of power to the central air conditioner. In a letter released Monday, Rehabilitation Center at Hollywood Hills attorney Geoffrey D. Smith told the House Energy and Commerce Committee that employees followed proper procedures between the air conditioner losing power on Sept. 10 and when the deaths began Sept. 13. The committee is investigating the deaths as are local police detectives and the state. (11/20)

The Washington Post: Public Hospital Board Extends Contract Of Troubled Management Firm
The consulting company that recently lost its contract to run the District’s public hospital will stay on for up to two months as the hospital’s board seeks a new management company to take over, board members decided Monday. The unanimous vote by United Medical Center’s directors means that Veritas of Washington, which has overseen since 2016 the financially troubled hospital’s operations for a monthly fee of $300,000, could remain in charge through the end of 2017. (Jamison, 11/20)

The Associated Press: 2 Charged After Man Died From Septic Shock Due To Bed Sores
A Vermont man and his companion have been charged with manslaughter and Medicare fraud after authorities say his severely disabled son died of septic shock from infected bed sores in which his skin was “rotting away.” Fifty-one-year-old Jeffrey Kittredge and 42-year-old Jennifer Cote, of Montpelier, pleaded not guilty last week to charges in the July 2016 death of 20-year-old Jeffrey A. Kittredge II. (11/20)