July 31, 2018
Today's early morning highlights from the major news organizations.
Kaiser Health News:
Missed Visits, Uncontrolled Pain And Fraud: Report Says Hospice Lacks Oversight
The report from the Office of Inspector General (OIG) at the Department of Health and Human Services sums up over 10 years of research into inadequate care, inappropriate billing and outright fraud by hospices, which took in $16.7 billion in Medicare payments in 2016. The Medicare hospice benefit aims to help patients live out their final days in peace and comfort: It pays for agencies to send nurses, aides, social workers and chaplains to visit patients who are likely to die within six months and who agree to forgo curative treatment for their terminal illness. Most of the time, this care takes place where the patient already lives — their home, nursing home or assisted living facility. (Bailey, 7/31)
Kaiser Health News:
For Many College Students, Hunger Can ‘Make It Hard To Focus In Class’
As students enter college this fall, many will hunger for more than knowledge. Up to half of college students report that they were either not getting enough to eat or were worried about it, according to published studies. “Food insecurity,” as it’s called, is most prevalent at community colleges, but it’s common at public and private four-year schools as well. Student activists and advocates in the education community have drawn attention to the problem in recent years, and the food pantries that have sprung up at hundreds of schools are perhaps the most visible sign. (Andrews, 7/31)
The New York Times:
Trump Spurns Medicaid Proposal After Furious White House Debate
Hoping to head off a full expansion of Medicaid under the Affordable Care Act, some senior officials in the Trump administration and Republican governors have been pushing hard for a smaller expansion to satisfy a growing political demand in their states. But President Trump decided on Friday to shut down the debate until after the midterm elections, administration officials said. The debate has divided the Trump administration between top officials at the Department of Health and Human Services and hard-liners, mainly at the White House, more determined to snuff out the Affordable Care Act. (Pear, 7/30)
The New York Times:
New V.A. Secretary Faces A Department In Turmoil
The Department of Veterans Affairs has experienced five months of tumult. Its previous secretary got into a political brawl with his staff and was fired by Twitter message. His first proposed replacement was scuttled by allegations of drunkenness. Then the acting secretary who took charge was accused of making false statements to Congress. In the department’s headquarters a block from the White House, political appointees who worked in the Trump campaign forced career officials out of key positions; inexperienced newcomers published an erroneous report about thousands of military suicides that never happened; and the department’s top technology official fended off calls from Congress to resign over his ties to Cambridge Analytica, the voter-profiling company. (Philipps, 7/30)
The Associated Press:
Robert Wilkie Sworn In As Trump’s Veterans Affairs Secretary
President Donald Trump said Monday during an Oval Office ceremony that Wilkie will work day and night “to protect those who protect us.” He also told Wilkie that hundreds of thousands of people are counting on him. The former Pentagon official was selected to replace Secretary David Shulkin, who was fired amid ethics charges and internal rebellion at the department over the role of private care for veterans. Wilkie was confirmed by an 86-9 vote in the Senate last week. He secured the backing of many Democrats after insisting he would not privatize the government’s second-largest department. (Ebbs, 7/30)
USA Today:
President Trump Swears In VA Secretary Robert Wilkie
"I want to congratulate you and congratulate you strongly,” Trump told Robert Wilkie, previously an undersecretary at the Pentagon, who was joined by family members in the Oval Office ceremony. "Since day one, my administration has been focused on serving the men and women who make freedom possible – our great veterans," the president said. "These American heroes deserve only the best and they will have it under Robert Wilkie – I have no doubt about it." (Slack, 7/30)
The Wall Street Journal:
Wilkie Sworn In As VA Head
A longtime Washington insider, Mr. Wilkie has worked for decades at the Pentagon and in the defense contracting industry. He brings to the VA the expectation he can manage the complex bureaucracy of the second-largest department in the federal government, after the Department of Defense. He is President Trump’s second permanent VA secretary, taking over after the departure of David Shulkin, who was fired by the president earlier this year. While Mr. Wilkie awaited confirmation, the department was helmed by Peter O’Rourke, whose new role has yet to be defined by the department. A VA spokesman declined to comment further and said the VA had no announcements to make regarding personnel changes. (Kesling, 7/30)
The New York Times:
A Migrant Boy Rejoins His Mother, But He’s Not The Same
Before they were separated at the southwest border, Ana Carolina Fernandes’s 5-year-old son loved playing with the yellow, impish Minion characters from the “Despicable Me” movies. Now his favorite game is patting down and shackling “migrants” with plastic cuffs. After being separated from his mother for 50 days, Thiago isn’t the same boy who was taken away from her by Border Patrol agents when they arrived in the United States from Brazil, Ms. Fernandes said last week. (Jordan, 7/31)
The Associated Press:
ICE, Border Patrol At Senate Hearing On Family Separations
The Senate Judiciary Committee is demanding answers from federal immigration officials about the Trump administration's separation of migrant children from their families and its struggle to reunite them, a fraught effort that's drawn election-year criticism from both parties. But a hearing scheduled for Tuesday on the topic may have a wider focus after the committee's bipartisan leaders asked federal investigators to probe reports of sexual and other abuse of immigrants at government detention facilities. (Fram, 7/31)
USA Today:
Judge Orders Minors Transferred Out Of Immigration Detention Facility
A federal judge on Monday ordered the Trump administration to transfer all undocumented immigrant minors out of a detention facility in Texas due to allegations of abuse and over-medication against the children. U.S. District Judge Dolly Gee ruled that conditions at the Shiloh Residential Treatment Center in Manvel, Texas, violate a 1997 court settlement that dictates how the government must care for minors who entered the country illegally on their own or were separated from their parents. (Gomez, 7/30)
The New York Times:
How One Agency Built A Multimillion-Dollar Business In Migrant Children
When 17-year-old Destani Williams ran away from an upstate New York residential treatment program in May 2017 and was found dead a week later, it was but the latest in a string of troubling incidents at Cayuga Centers, a 166-year-old child-welfare agency. In the year leading up to her death, three workers were arrested on charges of abuse, and the agency was sued for negligence as a result. The local police in Auburn, N.Y., complained about hundreds of emergency calls to deal with runaway residents and violent incidents on the campus, which included residents injuring police officers, throwing chairs through windows and wielding shards of glass to cut staff members. (Robbins, 7/31)
The New York Times:
Manchin Is First Democrat To Meet With Kavanaugh As Parties Intensify Feud
Senator Joe Manchin III of West Virginia broke with his party on Monday to become the first Democrat to meet with Judge Brett M. Kavanaugh, President Trump’s Supreme Court pick, as the two parties escalated their feud over access to documents relating to the nominee. Mr. Manchin, who faces a tough fight for re-election in a state that Mr. Trump won handily in 2016, is central to the Democrats’ uphill battle to defeat Judge Kavanaugh’s nomination, and is under intense pressure at home from both sides. If he votes to confirm Judge Kavanaugh, he will infuriate Democratic voters. But if he votes against confirmation, he risks his own Senate seat. (Stolberg and Shear, 7/30)
The Washington Post:
Democrat Manchin Undecided On Kavanaugh After 2-Hour Meeting
The first Democratic senator to sit down with Supreme Court nominee Brett Kavanaugh said Monday he’s not ready to say how he’ll vote, but Kavanaugh did pick up the backing of Kentucky’s Rand Paul, the only Republican in the narrowly divided Senate to have outwardly wavered in possible support. Paul said he will back Kavanaugh despite misgivings about the judge’s views on surveillance and privacy issues. Few had expected Paul would oppose President Donald Trump’s choice in the end. (Freking, 7/30)
Reuters:
Democratic Candidates Embrace Gun Control Despite Political Risks
Aftab Pureval, a Democrat seeking to unseat a Republican congressman in Ohio, knows the political risks in calling for gun restrictions – and taking on the powerful National Rifle Association, which has spent more than $115,000 supporting his opponent over the years. But after a spate of school shootings, including February's massacre at a high school in Parkland, Florida, Pureval believes voters in the Republican-leaning district have had enough of congressional inaction. (7/30)
The Associated Press:
States Suing Trump Administration, Company Over 3D Guns
Eight states are filing suit against the Trump administration over its decision to allow a Texas company to publish downloadable blueprints for a 3D-printed gun, contending the hard-to-trace plastic weapons are a boon to terrorists and criminals and threaten public safety. The suit, filed Monday in Seattle, asks a judge to block the federal government’s late-June settlement with Defense Distributed, which allowed the company to make the plans available online. Officials say that 1,000 people have already downloaded blueprints for AR-15 rifles. (Rubinkam, 7/30)
The Wall Street Journal:
Eight States Sue To Block Release Of Plans For 3D-Printed Firearms
“These downloadable guns are unregistered and very difficult to detect, even with metal detectors, and will be available to anyone regardless of age, mental health or criminal history,” said Bob Ferguson, Washington state’s attorney general who filed the suit on behalf of the other states. (Elinson, 7/30)
NPR:
Fraud And Neglect Are Problems In Hospice Industry, Federal Report Finds
We all hope for a little peace at the end of life, for ourselves and for our loved ones. Hospice services can play a big role, relieving pain and providing spiritual and emotional support. But a federal report published Tuesday synthesized patient and Medicare payment data going back to 2005 and found that, as the hospice industry expands, some hospice providers are bilking Medicare and neglecting patients. The report calls for the Centers for Medicare and Medicaid Services, which is a key player in the funding of hospice services, to increase its level of scrutiny to improve the detection of these problems. (Jaffe, 7/31)
The New York Times:
After Doctors Cut Their Opioids, Patients Turn To A Risky Treatment For Back Pain
An injectable drug that the manufacturer says is too dangerous to use along the spine is growing in popularity for back pain as doctors turn away from opioids. The anti-inflammatory drug, called Depo-Medrol and made by Pfizer, is approved for injection into muscles and joints. Once a drug is approved, however, doctors may legally prescribe it however they see fit. And doctors have long given Depo-Medrol shots, or the generic equivalent, close to the spinal cord for painful backs, necks and conditions like spinal stenosis. (Kaplan, 7/31)
The New York Times:
Vaginal Laser Treatments Can Cause Burns And Scarring, The F.D.A. Says
The Food and Drug Administration on Monday announced that it had warned several companies to stop marketing laser devices for procedures billed as “vaginal rejuvenation,” saying they were dangerous and deceptive treatments. The agency originally permitted the lasers and related energy-based devices onto the market for treatment of serious conditions, like cancer, genital warts, or surgery including hysterectomies. (Kaplan, 7/30)
The Washington Post:
‘Vaginal Rejuvenation’ Laser Treatments Can Cause Burns And Pain, FDA Warns
The agency said that it has approved such devices, which commonly use laser beams or radiofrequencies, for specific gynecologic uses, including the destruction of precancerous cervical or vaginal tissue and the removal of genital warts. But the agency has not cleared the devices for symptoms related to menopause, urinary incontinence or sexual function. The FDA noted in a safety alert issued Monday that vaginal "rejuvenation" often is used to describe nonsurgical procedures intended to treat symptoms such as vaginal laxity, atrophy or dryness, and pain during intercourse or urination. During menopause, levels of estrogen decline, which may lead to symptoms such as pain during sexual intercourse. (McGinley, 7/30)
Stat:
FDA Cracks Down On 'Vaginal Rejuvenation' Devices, Citing Potential For Serious Harm
The FDA said it had reviewed adverse event reports and medical literature and catalogued “numerous cases” in which use of the devices resulted in vaginal burns, scarring, pain during intercourse, and chronic pain. In some cases, the FDA said, the devices are being marketed specifically to women who have gone through treatment for breast cancer and are experiencing early menopause. “The deceptive marketing of a dangerous procedure with no proven benefit, including to women who’ve been treated for cancer, is egregious,” Gottlieb said. And, he added, the misleading marketing of unproven treatments might keep some women from receiving appropriate, evidence-based care for their conditions. (Thielking, 7/30)
Stat:
At Sanofi, A Flu Expert Sees Potential For Improved Vaccines
Sanofi is one of the world’s leaders in influenza vaccine production, through its vaccine arm Sanofi Pasteur. And if anyone at Sanofi knows vaccines, it’s Dr. Gary Nabel, the company’s chief scientific officer, who happens to be a former head of the National Institutes of Health’s Vaccine Research Center. When Nabel dropped by STAT for a visit, we thought we’d explore some flu vaccine-related issues. (Branswell, 7/31)
The Washington Post:
E-Cigarette Maker Juul Targeted Teens With False Claims Of Safety, Lawsuit Says
When a San Diego-based mother posted an emergency alert on Nextdoor, a community discussion app, she hoped a Good Samaritan could help, according to court filings. Her son was hysterical after losing a flash drive with his homework near the local McDonald’s, she wrote, uploading a photo along with the message. A neighbor quickly replied, explaining that the chewing-gum-sized object in the picture was not a flash drive: It was a Juul vaping device. (Paul, 7/30)
Stat:
A Shortage Of Cell And Gene Therapy Experts Sets Off Battle For Talent
Gene and cell therapy companies collectively raised $2.3 billion in equity financing in the first 4 1/2 months of this year, putting them on pace to exceed their $4.5 billion haul last year, according to a database maintained by the news organization BioCentury. For cancer alone, there are 753 cell therapies being developed worldwide, according to the Cancer Research Institute, a nonprofit group. Half of them have reached human testing. That’s the point at which it becomes essential for a company to have an experienced professional who knows how to oversee a manufacturing operation of far greater complexity than the kind traditionally used by pharma to make synthetic compounds. (Robbins, 7/31)
The Washington Post:
Assisted Suicide Is Controversial, But Palliative Sedation Is Legal And Offers Peace
Toward the end, the pain had practically driven Elizabeth Martin mad. By then, the cancer had spread everywhere, from her colon to her spine, her liver, her adrenal glands and one of her lungs. Eventually, it penetrated her brain. No medication made the pain bearable. A woman who had been generous and good-humored turned into someone hardly recognizable to her family: paranoid, snarling, violent. (Ollove, 7/30)
The New York Times:
Maybe You Were Thinking About Eating Raw Centipedes. Don’t.
Scientists in China now have hard evidence that eating raw centipedes is a really bad idea. That might go without saying in most parts of the world. But centipedes are an established remedy in traditional medicine in China. (McNeil, 7/30)
Politico:
World’s Doctor Gets Second Chance On Ebola
Nobody wants a deadly Ebola outbreak, but for the world health chief, the latest episode has been invaluable. The World Health Organization’s Tedros Adhanom Ghebreyesus this month declared an end to an Ebola outbreak that started in May in the Democratic Republic of the Congo, four years after the agency’s high-profile failure to contain the spread of the virus throughout West Africa. (Jennings, 7/29)
The Washington Post:
Helping Transgender Women Find Their Voice
It is vital to transgender women to find the feminine voice that matches their gender identity, gives them confidence and helps prevent harassment. ... The problem for transgender women is that finding a feminine voice is no easy task. As The Washington Post reported, testosterone, which transgender men take to build up their muscles and grow facial hair, also increases the size of their vocal folds, making their voices deeper. Estrogen, however, which most transgender women take, can’t shrink the vocal cords. (Nutt, 7/30)
The Associated Press:
Ex-Nurse Convicted Of Manslaughter In Diabetic Inmate Death
A former Mississippi jail nurse has been convicted of manslaughter in the death of a diabetic inmate who went a week without insulin. The Sun Herald reports a Warren County judge sentenced Carmon Sue Brannan on Monday to 15 years in prison. Brannon testified she thought 28-year-old William Joel Dixon of Lucedale was undergoing drug withdrawal the week before his death in 2014 in the George County jail. (7/30)