First Edition: November 29, 2017

Kaiser Health News: Doctors Make Big Money Testing Urine For Drugs, Then Ignore Abnormal Results
Medicare and other insurers pay for urine tests with the expectation that clinics will use the results to detect and curb dangerous abuse. But some doctors have taken no action when patients are caught misusing pharmaceuticals, or taking street drugs such as cocaine or heroin. Federal pain guidelines say doctors should discuss test results with patients and taper medication if necessary. (11/29)

Kaiser Health News: The Ratcheting Cost Of The Pneumococcal Vaccine: What Gives?
Every November, like clockwork, she gets the same letter, said Dr. Lindsay Irvin, a pediatrician in San Antonio. It’s from the drug company Pfizer Inc., and it informs her that the price tag for the pneumococcal vaccine Prevnar 13 is going up. Again. And it makes her angry. 'They’re the only ones who make it,” she said. “It’s like buying gas in a hurricane — or Coke in an airport. They charge what they want to." (Luthra, 11/29)

Kaiser Health News: Teaching Teens The Perils Of Pot As Marketplace Grows
After Yarly Raygoza attended the drug prevention program at the Boys & Girls Club here last year, she used what she learned to talk a few friends out of using marijuana. The 14-year-old took the class again this year but worries that counseling her friends will become more difficult. Recreational marijuana is now legal in California, which could bring a massive boom in drug sales and advertising when stores can begin selling the drug to adults without a prescription in January. (Gorman, 11/29)

The Associated Press: Skeptical Democrats To Quiz Trump Health Pick On Drug Prices
Skeptical Democratic senators are getting a chance to question President Donald Trump’s pick for health secretary about what he’ll do about rising drug prices and the future of “Obamacare.” Alex Azar’s first confirmation hearing — before the Senate Health Education, Labor and Pensions Committee — was scheduled for Wednesday. The former drug company and government executive has the support of committee Republicans. He’s signaling that he wants to shift away from partisanship, and some prominent Democrats seem to be willing to give him a chance. (Alonso-Zaldivar and Kellman, 11/29)

Politico: Trump's Pick For Health Secretary Messages He's No Tom Price
To Republicans, President Donald Trump’s pick for Health and Human Services secretary is competence personified — an able manager who can get the agency back on track after the tumult of Tom Price’s brief tenure and forced resignation. To Democrats, Alex Azar is a pharmaceutical industry shill who knows a lot more about raising drug prices than lowering them. (Cancryn, 11/29)

The Wall Street Journal: Health-Care Clashes Loom Over Republican Legislative Agenda
Congress is headed for a showdown on whether to insert several pressing health measures in year-end bills, reviving partisan fights that threaten to derail Republicans’ goal to close out the year with a raft of legislative successes. The looming health-care issues include funding for a children’s health program, the possible delay of certain taxes by the Affordable Care Act and the fate of a bipartisan plan to bolster fragile insurance markets. (Armour and Peterson 11/29)

The New York Times: Republicans Clear Major Hurdle As Tax Bill Advances
Senate Republicans took a significant step toward passing a sweeping tax overhaul on Tuesday, with a key panel giving its approval and several wavering senators indicating they would support the tax package, helping clear the way for full Senate consideration later this week. ... Senator Lamar Alexander, Republican of Tennessee, said that Senate Republicans were increasingly united about repealing the requirement that most people have health insurance or pay a penalty. (Rappeport and Kaplan, 11/28)

The Washington Post: Senate Republican Tax Plan Clears Hurdle With Help From Two Key GOP Holdouts
In a private meeting with [Sen. Susan] Collins before lunch, and again in front of the larger group of Republicans, Trump signaled openness to Collins’s demands, which include paying federal subsidies to help lower-income Americans afford health coverage and allowing Americans to continue deducting up to $10,000 in property taxes from their taxable income. “It’s certainly progress,” said Collins, who played a central role in derailing GOP health-care bills this year. (DeBonis, Werner and Paletta, 11/28)

The Hill: Trump Backs Bipartisan Fixes To ObamaCare Markets
President Trump at a closed-door meeting with GOP senators on Tuesday said he would support two proposals meant to stabilize ObamaCare’s insurance markets in exchange for a repeal of the law's individual mandate, several Republicans in attendance said. The two bills would fund key ObamaCare insurer payments, and provide billions to help states create reinsurance programs for high-cost patients. (Hellmann, 11/28)

The New York Times: Millions Pay The Obamacare Penalty Instead Of Buying Insurance. Who Are They?
The Senate Republican tax bill includes the repeal of the Affordable Care Act’s individual mandate, the requirement that all Americans purchase qualifying health insurance or pay a penalty. The move could deal a serious blow to the health law. The repeal of the mandate could result in an estimated 13 million more people without insurance within 10 years, but may potentially lead to federal savings of $338 billion, money that would be used to help pay for broad tax cuts for individuals and businesses. Here’s who pays the mandate’s penalty and how much it costs. (Lai and Parlapiano, 11/28)

The Hill: Patient Groups Urge Senate To Reject ObamaCare Mandate Repeal
A coalition of 19 patient groups warned Republican senators on Tuesday against repealing ObamaCare’s individual mandate as part of tax reform. The coalition's letter, signed by groups including the American Cancer Society Cancer Action Network, the American Diabetes Association and the American Heart Association, warns of “coverage losses and higher premiums” from repealing the mandate.(Sullivan, 11/28)

USA Today/Milwaukee Journal Sentinel: Earning A Little More Than Threshold Could Boost Cost Of Health Insurance
In a health care system teeming with fine print, here’s an oddity that middle-class people who buy insurance on their own, rather than through an employer, need to know: You might want to take a pay cut next year. (Boulton, 11/28)

ProPublica: A Hospital Charged $1,877 To Pierce A 5-Year-Old’s Ears. This Is Why Health Care Costs So Much.
Two years ago, Margaret O’Neill brought her 5-year-old daughter to Children’s Hospital Colorado because the band of tissue that connected her tongue to the floor of her mouth was too tight. ... During a pre-operative visit, the surgeon offered to throw in a surprising perk. Should we pierce her ears while she’s under?O’Neill’s first thought was that her daughter seemed a bit young to have her ears pierced. Her second: Why was a surgeon offering to do this? ... Only months later did O’Neill discover her cost for this extracurricular work: $1,877.86 for “operating room services” related to the ear piercing — a fee her insurer was unwilling to pay. (Allen, 11/28)

ProPublica: Seven Ways Patients Can Protect Themselves From Outrageous Medical Bills
Experts in reducing charges for medical services say patients need to push for detailed answers up front about the true costs of their care. (Allen, 11/28)

The Washington Post: Former DEA Officials Call For Repeal Of Law That Weakened Enforcement
Three former Drug Enforcement Administration officials urged Democratic lawmakers Tuesday to repeal a 2016 law that effectively took away the agency’s most potent weapon against distributors and manufacturers of prescription opioids. The trio said the authority to instantly freeze shipments of powerful painkillers was the DEA’s most effective tool against giant companies that ignored legal requirements to report suspicious orders of the pills by pharmacies, doctors and others who diverted them for illegal use. Those “immediate suspension orders” not only protected the public from the most egregious abuse but deterred other companies as well, they said at a session held by Senate Democrats. (Bernstein and Higham, 11/28)

The Wall Street Journal: Inside Valeant’s Efforts To Be A Normal Drug Company
Normalcy hasn’t been the norm at Valeant for a while. The company has been Exhibit A of corporate turbulence since 2015, a span when its drug-price increases and accounting were attacked, top executives ousted and market cap nosedived 94%. That erased about $84 billion in worth, more than the equivalent of Caterpillar Inc. [CEO Joseph] Papa, the low-key drug-industry veteran hired 18 months ago to turn around Valeant, said it has returned to pharmaceutical-business-as-usual and is now on a path to recovery. The company noted recent growth in its Bausch & Lomb eye-care and Salix gastrointestinal-drug businesses, which combined represent about three-quarters of the company’s revenue. (Rockoff, 11/28)

The New York Times: A Failure To Heal
What happens when a clinical trial fails? This year, the Food and Drug Administration approved some 40 new medicines to treat human illnesses, including 13 for cancer, three for heart and blood diseases and one for Parkinson’s. We can argue about which of these drugs represent transformative advances (a new medicine for breast cancer, tested on women with relapsed or refractory disease, increased survival by just a few months; a drug for a type of leukemia had a more lasting impact), but we know, roughly, the chain of events that unfolds when a trial is positive. ... Yet the vastly more common experience in the life of a clinical scientist is failure: A pivotal trial does not meet its expected outcome. What happens then? (Mukherjee, 11/28)

The Washington Post: An 84-Year-Old Doctor Who Refuses To Use A Computer Has Lost Her Medical License
Aside from a fax machine and landline telephone, Dr. Anna Konopka, 84, doesn't have much technology in her office. Instead, her patients' records are tucked into two file cabinets, which sit in a tiny office next door to her 160-year-old clapboard house in New London, N.H. Records are meticulously handwritten, she said. ... Konopka said she felt forced to surrender her medical license in September after New Hampshire Board of Medicine officials challenged her record-keeping, prescribing practices and medical decision-making, according to court documents. She is specifically accused of leaving the dosage levels of a medication up to a young girl's parent and failing to treat the girl with daily inhaled steroids. (Eltagouri, 11/29)

The Associated Press: Court Tie Means Louisiana Planned Parenthood Keeps Funding
A deeply divided federal appeals court in New Orleans refused Tuesday to reconsider a ruling that lets Planned Parenthood facilities in the state continue to receive Medicaid funding. The vote was 7-7 among the 14 active judges on the 5th U.S. Circuit Court of Appeals, which currently has three vacancies. (McGill, 11/29)

The Washington Post: The Long Five Minutes: Abortion Doulas Bring Comfort During A Complicated Time
“Do you support reproductive choices of all shapes and sizes?” the flier had read, posted online in early April. “Become an abortion doula.” More than 50 women had seen the flier on Facebook or Twitter and responded to the email address at the bottom, not entirely sure what an abortion doula was. Twenty-five had been selected for a weekend-long training at a Virginia abortion clinic, and now, one Saturday morning in May, they’d arrived to see whether they were right for the work. (Hesse, 11/28)

The Associated Press: Sex Assault Victims Billed For Rape Kits Will Be Reimbursed
Dozens of sexual assault survivors were improperly billed for their rape exams by a New York City hospital, the state’s attorney general said Tuesday. Attorney General Eric Schneiderman said that under an agreement with his office, the Brooklyn Hospital Center will reimburse patients who paid out of pocket for a rape kit and will inform rape survivors going forward that under a 2005 New York state law the rape kits can be billed to the state’s Office of Victim Services. (Matthews, 11/28)

The Wall Street Journal: Brooklyn Hospital Violated State Law On Rape Kits
A Brooklyn Hospital violated state law when it charged dozens of patients for sexual-assault evidence kits, New York Attorney General Eric Schneiderman said at a news briefing Tuesday. The Brooklyn Hospital Center conducted 86 forensic rape examinations—better known as rape kits—from January 2015 to February 2017. In 85 of those cases, the center billed the patient directly or their private insurance plan without letting the patient know they could receive the exam without charge. (Kanno-Youngs, 11/28)

Los Angeles Times: The World Is Off Track In Its Goal To Eliminate Malaria. Here's Why.
Progress toward the global elimination of malaria has stalled, according to a report to be published Wednesday by the World Health Organization. The world made big gains against malaria from 2000 to 2015, with annual infections falling 18% and annual deaths dropping 48%. The WHO was so encouraged by the declines that in 2015 it announced a goal of cutting malaria infections and deaths worldwide by at least 40% by 2020. (Simmons, 11/28)

The Washington Post: Marylanders Are Days Away From Being Able To Legally Buy Medical Marijuana
Within the next week, Rise is scheduled to begin selling a variety of cannabis products, such as flowers, patches and oils. Four of the state’s other eight dispensaries — including Potomac Holistics in Rockville — say they expect to have medical pot delivered and available for sale by Friday, marking the official launch in Maryland of an industry that is worth billions nationwide. Two said they expect to receive their initial batch of marijuana from Curio Wellness in Baltimore County, which did not return messages seeking comment. (Siegel and Nirappil, 11/28)

The New York Times: How Running May Or May Not Help The Heart
If 50 men run 3,510 marathons over the course of three decades, will their heart health suffer or improve? A new study delving into precisely that question concludes that the answer is simultaneously reassuring and complicated, with long years of endurance training seeming not to harm runners’ hearts, but also not necessarily to benefit them in the ways that the runners themselves probably expected. (Reynolds, 11/29)

The Associated Press: Michigan Wants All Lead Pipes Replaced Within 20 Years
Gov. Rick Snyder’s administration is planning to require the replacement of every underground lead service pipe in Michigan within 20 years while delaying by four years a deadline to implement the nation’s toughest lead limit for drinking water, in the wake of the Flint lead crisis. Under draft rules that environmental regulators want to finalize early next year, Michigan’s “action level” for lead in drinking water would gradually drop to 10 parts per billion by 2024, not 2020 as initially proposed. The current federal threshold of 15 ppb has been criticized by the governor as too weak. (Eggert, 11/29)

The Associated Press: Flint Utilities Official Pleads No Contest In Water Probe
The former utilities director in Flint, Michigan, has pleaded no contest to a misdemeanor in an investigation of the city’s lead-tainted water. (11/28)

The Associated Press: Special Court To Oversee Hundreds Of Deadly Asbestos Claims
The Montana Supreme Court on Tuesday ordered the creation of a special court to oversee hundreds of claims filed on behalf of people who became ill or died following exposure to asbestos from the now-closed W.R. Grace Inc. vermiculite mine in northwestern Montana. With at least 540 lawsuits pending and Grace’s bankruptcy proceedings complete, justices said there was sufficient need to create the Asbestos Claims Court under an act passed by lawmakers in 2001. (Hanson and Brown, 11/29)

The Associated Press: Lawsuit Seeks To Block California Desert Water Project
Environmental activists sued Tuesday to halt a plan to pump water from beneath the Mojave Desert and sell it to Southern California cities and counties. The lawsuit takes aim at the U.S. Bureau of Land Management for allowing Cadiz Inc. to build a 43-mile pipeline to transfer the water from its desert wells into the Colorado River Aqueduct so it can be sold to water districts. (Jablon, 11/28)