The Wall Street Journal: HealthCare.gov Contractor Optum Declares Its Job Done
The contractor tapped to rescue the flailing HealthCare.gov in the fall of 2013 declared its work finished Thursday and said it doesn’t plan to continue overseeing the website that sells subsidized insurance to millions of Americans as part of the federal health law. “Having achieved the goal of making HealthCare.gov a stable and reliable platform for people seeking coverage, Optum will not rebid to continue the role of senior adviser,” said Matt Stearns, a spokesman for the company, the technology unit of insurer UnitedHealth Group. “Our job has been completed.” (Radnofsky, 5/14)

The Hill: Majority Of Businesses Taking Steps To Avoid ObamaCare Tax
Nearly two-thirds of companies facing a new ObamaCare tax say they are changing their coverage to avoid the extra costs, according to a new survey. The so-called Cadillac tax, which applies to healthcare plans above a certain expense threshold, is one of the most pressing changes still to come under ObamaCare, according to a survey of about 600 members of the International Foundation of Employee Benefit Plans. (Ferris, 5/14)

The Washington Post: 1 In 4 Adults Had Insurance But Still Couldn’t Afford Medical Care
More than 1 in 4 adults who bought insurance for themselves or their families last year had to skip needed medical care because they couldn't afford it, according to a study released Thursday by Families USA, a consumer health group. Some signed up for coverage on the new health insurance exchanges under the Affordable Care Act and received financial assistance to help pay their premiums and some of their out-of-pocket costs. Others bought their plans directly from insurance companies. (Sun, 5/14)

California Healthline: Covered California Takes Conservative Fiscal Move Toward Self-Sufficiency
Covered California officials yesterday released a budget proposal for the 2015-16 fiscal year. As expected, the agency has scaled down its advertising and outreach budget, and cut back the large initial outlay for information technology services. (Gorn, 5/14)

The Associated Press: Ige Administration Plans Changes For Health Exchange
Gov. David Ige's administration says Hawaii's health insurance exchange will have to make changes to comply with federal Affordable Care Act. Deputy Chief of Staff Laurel Johnston said Wednesday the administration's plan calls for using the federal government's information technology to run the Hawaii Health Connector's troubled insurance exchange. (McAvoy, 5/14)

Des Moines Register: Minnesota Insurer To Join Iowa Obamacare Exchange
A Minnesota-based health-insurer plans to join two other carriers on Iowa's version of the Affordable Care Act insurance marketplace. Thursday morning's announcement from Medica means that moderate-income Iowans who qualify for federal subsidies under Obamacare will have at least three carriers to choose from for 2016. Such subsidies are only available to help pay premiums for policies purchased on the Affordable Care Act marketplace, known as healthcare.gov. (Leys, 5/14)

The Denver Post: Colorado Health Insurance Exchange Seeks Reimbursement From Medicaid
The state health insurance exchange's financial viability hinges on recovering millions of dollars in costs inflicted by Medicaid expansion, officials say, but Connect for Health Colorado wasn't set up to either count or collect reimbursement. "We right now have zero in terms of our Medicaid reimbursement," said Kevin Patterson, the exchange's new interim CEO. "Zero is not the right number." (Draper, 5/14)

The Denver Post: Colorado Health Insurance Exchange Board Raises Fees On Health Plans
The Connect for Health Colorado board of directors voted unanimously Thursday to raise the fees it charges on health insurance policies to bolster its finances as federal grants run out later this year. The state health insurance exchange raised the fee on 2016 plans purchased through its marketplace from the current 1.4 percent of premiums to 3.5 percent, the same rate charged on the federal exchange. (Draper, 5/14)

The Associated Press: Colorado Health Exchange May Increase Fees
The board of directors of Colorado's health insurance exchange is meeting Thursday to consider proposals that are likely to increase the cost to consumers. Connect for Health Colorado staff have proposed raising administrative fees it charges to cover the costs of the technological and other infrastructure needed to allow consumers to comparison shop for insurance and get advice and access to financial aid. Fees are now 1.4 percent of premiums and typically passed on by insurance companies to consumers. Staff said in a presentation to the board ahead of Thursday's meeting that the exchange also was seeking federal Medicaid reimbursements. (5/14)

The Associated Press: Scott Asks Agency Heads To Prepare For Government Shut Down
Gov. Rick Scott told agency heads to prepare for the worst Thursday, asking them to list only the state's most critical needs in the event the Legislature can't reach an agreement on a budget that doesn't expand health care to the poor. Scott sent the letter to agency heads the day after lawmakers said they were making progress on a budget impasse that they'll seek to resolve in a special session beginning June 1. (Farrington, 5/14)

Tampa Bay Times: Scott Orders Lists Of Critical State Needs, Hints At July 1 Shutdown
In some more Scott-speak not likely to endear him to Republican senators, Scott refers in his agency memos that he's building a budget without "controversial and divisive issues like Medicaid expansion or using Florida tax dollars to fund the federal low-income pool program." Both programs are Senate priorities, though Senate GOP leaders deny that their limited expansion of health care to the uninsured is an expansion of Medicaid. Scott's memorandum says the lists of critical service needs are needed because "it is possible that Florida Senate President Andy Gardiner and the Florida Senate will not agree to any budget without the specific expansion of Medicaid at a cost to state taxpayers of $5 billion over 10 years." (Bousquet, 5/14)

The Associated Press: Alaska House Finance Committee Stalls Medicaid Expansion Proposal
House Finance Committee co-chair Steve Thompson said Thursday that the panel is not comfortable moving ahead with plans to expand Medicaid coverage in Alaska at this time. The decision deals a blow to Gov. Bill Walker, who campaigned on expansion and made it a priority of his administration. It follows days of committee hearings that focused little on the bill and more on issues surrounding the Medicaid program, including a provider payment system plagued by bugs following its 2013 launch but has improved significantly, state health officials said. (Bohrer, 5/14)

Fairbanks (Alaska) News Miner: Committee Stalls Gov. Walker's Medicaid Expansion Proposal
After spending most of the last three days fretting over the failure of the Medicaid provider payment system that was installed in 2013, the House Finance Committee pulled the plug on Gov. Bill Walker’s Medicaid expansion bill Thursday. In a four-minute prepared statement, Fairbanks Republican Rep. Steve Thompson, the committee’s co-chair, said the committee will not hold any further meetings on House Bill 148 because the preceding days had “made it clear that Medicaid is a bigger problem than we knew.” (Buxton, 5/14)

Alaska Dispatch News: Alaska House Finance Committee Says It Won't Advance Medicaid Expansion
While legislators remain deadlocked on budget negotiations, debate continues on another topic of Gov. Bill Walker's special session call: Medicaid expansion. Republican legislative leaders appear unwilling to back down on the issue of expansion -- one of Walker's campaign promises -- as demonstrated by legislative action and inaction this week. The action comes in the House of Representatives, where after a week of contentious hearings, the Republican-led Finance Committee announced Thursday it would not be moving forward with the expansion proposal. (Forgey, 5/14)

Salt Lake Tribune: Herbert, Dunnigan Confident Utah Medicaid Expansion Plan On Track For July Deadline
[House Majority Leader Jim] Dunnigan traveled to Washington, D.C., two weeks ago with Gov. Gary Herbert, Senate President Wayne Niederhauser, House Speaker Greg Hughes and the sponsor of the Senate's Medicaid expansion bill, Sen. Brian Shiozawa, to meet with Obama administration officials on Utah's options. That group, and Lt. Gov. Spencer Cox, promised on the last day of the legislative session to come up with an acceptable compromise to dueling Senate and House Medicaid bills — Healthy Utah and Utah Cares, respectively — by the end of July. Dunnigan conceded that deadline is ambitious, but said Thursday he still believes it's doable. The idea is the full Legislature would be called into special session to consider the plan. Herbert, speaking at his monthly KUED news conference, said he, too, thinks the six are on track to make the end-of-July deadline. (Moulton, 5/14)

Deseret News: Solid Medicaid Expansion Solutions Still Absent As Deadline Looms
As state leaders continue to grapple with Medicaid expansion, Gov. Gary Herbert says they're on track to have a plan in place this summer, but other lawmakers are indicating the possibility of continued delay. House Majority Leader Jim Dunnigan, R-Taylorsville, a member of the legislative group assembled by the governor to have a plan for Medicaid ready by the end of July, suggested Thursday there's still a chance Utahns may need to keep waiting due to ongoing uncertainty with the federal government. “Certainly not now is still an option," Dunnigan said following a panel discussion on Medicaid expansion at the Capitol. "But that's not my goal. My goal is to find a solution." (McKellar, 5/15)

Georgia Health News: State Studying Design For Medicaid Waiver Plan
The state’s main health agency says it’s analyzing a new plan to cover more uninsured Georgians through a special Medicaid “waiver’’ program. Gov. Nathan Deal “has asked us to work on it,’’ Clyde Reese, commissioner of the state Department of Community Health, said Thursday. The plan for a Medicaid waiver was generated by Grady Health System as an alternative to Medicaid expansion under the Affordable Care Act, a step that has been firmly rejected by Deal and state legislative leaders. (Miller, 5/14)

Bloomberg: The Texas Approach To Emergency Treatment
The Affordable Care Act was supposed to cut emergency visits by giving more patients access to primary care doctors, but a survey released on May 4 by the American College of Emergency Physicians showed the opposite has happened: Seventy-five percent of ER doctors reported an increase in patients over the past year, in part because there aren’t enough primary care doctors to see newly insured patients. That’s good news for companies like Adeptus Health, based in Lewisville, Texas, which owns the First Choice Emergency Room chain. Adeptus has 52 emergency centers in Texas and an additional 12 in Colorado affiliated with the University of Colorado Health system. It’s paying lobbyists in other states, including Arizona and Ohio, to push for regulatory changes that would allow it to open ERs there. The company also has lobbyists in Washington. (Etter, 5/15)

The Tennessean: Would Insure Tennessee Have Hurt Hospitals? Reports Stir Debate
A pair of reports pointing at the Affordable Care Act for piling additional burdens on hospitals have stirred conversation about whether Insure Tennessee would have sent more people to the emergency room. A recent study by the American College of Emergency Physicians found that, according to three-fourths of emergency room doctors, the number of people coming to the ER has increased since January 2014. Separately, a Kentucky Hospital Association report said federal policies will negatively affect the state's hospitals. (Fletcher, 5/14)

The Hill: Top Republican Drafts Bill To Replace ObamaCare
As Republicans debate how to respond to a Supreme Court ruling on ObamaCare next month, Sen. Bill Cassidy (R-La.) promises to have a plan for what happens next. The freshman senator plans to introduce a bill called the Patient Freedom Act in late May, which is meant to serve as "part two" to the GOP’s response to the looming court case, King v. Burwell. Cassidy’s plan, which would let states opt out of ObamaCare mandates and instead receive tax credits for health savings accounts, would work in tandem with the GOP’s more immediate response in case the court rules against ObamaCare. (Ferris, 5/14)

The Hill: GOP Chairman: No ObamaCare Extension If Court Cripples Law
House Budget Committee Chairman Tom Price (R-Ga.) said Thursday that he does not support an idea backed by Senate Republican leadership to temporarily extend ObamaCare subsidies if the Supreme Court cripples the law. ... A plan from Sen. Ron Johnson (R-Wis.) to continue the subsidies until 2017 has been co-sponsored by Senate Republican leaders; Price becomes one of the most prominent Republicans to come out against the idea. (Sullivan, 5/14)

The Hill: Senate Panel Launches Probe Into ObamaCare Subsidies
A Senate panel announced an investigation Thursday into ObamaCare insurance subsidies, which Republicans claim have been improperly paid out without verification. Sen. Rob Portman (R-Ohio), who chairs the Senate Homeland Security subcommittee on investigations, is demanding proof the Obama administration has been thoroughly checking a person's income level and legal status before handing out subsidies. (Ferris, 5/14)

Fox News: Senate Panel Probes Obamacare Aid Confusion, As Customers Learn They Owe IRS
The Senate's top investigative committee has launched an inquiry into the system that's supposed to ensure ObamaCare tax credits go to the right customers for the right amounts -- amid concerns that many Americans are getting inflated or improper subsidies. (Edson, 5/14)

And in other news from Capitol Hill -

The Hill: House Panel Easily Approves Bill To Speed Medical Cures
A House subcommittee on Thursday easily advanced a bipartisan measure aimed at smoothing the path for new medical cures. The House Energy and Commerce health subcommittee sent the bill on to the full committee with a voice vote and no amendments. A markup is expected next week. The 21st Century Cures bill has been gaining steam, and negotiators including Chairman Fred Upton (R-Mich.), ranking member Frank Pallone Jr. (D-N.J.) and Rep. Diana DeGette (D-Colo.) had kind words for each other Thursday. (Sullivan, 5/14)

Raleigh News & Observer: Report: NC Ranks Poor For Nursing Home Quality
North Carolina ranks among the 11 states with the lowest-quality nursing homes, according to a report issued Thursday by the Kaiser Family Foundation. ... Of the 416 nursing homes in North Carolina, 41 percent have a low quality score of 1 or 2 on a 5-point system. In neighboring South Carolina, only 32 percent got scores of 2 or lower, while in Virginia it was 36 percent. (Murawski, 5/14)

Columbus Dispatch: Ohio Fares Poorly In New Study Of Nursing Homes
Ohio is one of 11 states where at least 40 percent of nursing homes have low ratings under the federal government’s recently revamped five-star system, according to a new study. ... But the federal rating system is flawed, said Peter Van Runkle, executive director of the Ohio Health Care Association, a trade-industry group. The problem, he said, is that the system boils down the quality of nursing homes to a handful of measures “when what matters will be different for every person.” One of Ohio’s biggest struggles is low-staffing levels. (Pyle, 5/14)

Charlotte Observer: Star Ratings Show SC Nursing Homes Outperforming Those In NC
South Carolina’s nursing homes are more likely to get high rankings from the federal star system than those in North Carolina or nationwide, according to a new analysis from the Kaiser Family Foundation. The foundation looked at quality ratings for more than 15,500 nursing homes certified by Medicaid and/or Medicare, including 416 in North Carolina and 188 in South Carolina. The federal government issues five-star quality ratings (look up individual homes here). The ratings are based on state health inspections, staffing and other quality measures. (Doss Helms, 5/15)

Houston Chronicle: Texas Ranks Last In U.S. In Nursing Home Care
As a tough nursing home licensing bill moved through the Legislature in Austin, elder care officials and advocates for the elderly expressed concern Thursday after a new analysis of federal data showed that Texas has the largest share of low-rated nursing homes in the nation. Fifty-one percent of the state's 1,193 nursing homes that receive Medicare or Medicaid earned only one or two stars out of a five-star rating system, the Kaiser Family Foundation found when looking at the Nursing Home Compare database compiled by the Centers for Medicare and Medicaid Services. The study was released Thursday. (Deam, 5/14)

And on the hospital front -

Fox News: Patient Dumping In America: Hospitals Discharging Sick Homeless Back Onto The Street
The problem of homeless patient dumping— or failing to make continued care arrangements when a patient is well enough to leave the hospital but too ill to return to the streets— is only fueling Southern California’s homeless problem, argue advocates familiar with the issue. (Cartensen, 5/14)

The Wall Street Journal: Actavis Has Discussed Settling Federal Probe Of Warner Chilcott Sales Tactics
Drug maker Actavis PLC has held discussions with the Justice Department about resolving an investigation into the marketing tactics at a division, including allegations of improper payments to doctors, according to a regulatory filing and court documents. (Loftus, 5/14)

Reuters: Actavis Says Warner Chilcott Unit Held Talks To Settle U.S. Probe
Drug maker Actavis Plc said its Warner Chilcott unit held talks with U.S. government officials to discuss a potential resolution of an investigation into the unit's sales activities, according to a regulatory filing. ... Warner Chilcott said the company and several of its employees in the sales organization received subpoenas in 2012 from the United States Attorney for the District of Massachusetts. The subpoenas demanded information related to sales and marketing activities, payments to people who are in a position to recommend drugs, medical education and employee training, including physician remuneration, in connection with certain Warner Chilcott products. (5/14)

Reuters: PharMerica To Pay $31.5 Million In Drug Dispensing Probe: Justice Department
PharMerica will pay the United States $31.5 million to resolve allegations that it improperly dispensed controlled drugs without a prescription and submitted false Medicare claims for these drugs, the U.S. Department of Justice said on Thursday. (5/14)

The Washington Post: VA Remains Work In Progress Year After Scandal Broke
More than a year after a scandal erupted over the cover-up of long wait times at VA care facilities, the effort to reform the agency is a long way from finished. The flurry of legislation that started shortly after the cover-up was exposed continues, often with VA employees the target. The bills reveal differing congressional philosophies but don’t always break along party lines. And the first law to emerge in the wake of the scandal is now the subject of a constitutional challenge. (Davidson, 5/14)

The Associated Press: Lawmakers: Future Of Over-Budget Denver VA Hospital Unclear
The chairmen of the House and Senate Veterans committees said Thursday the future of an over-budget VA hospital under construction in Denver is unclear because the Veterans Affairs Department hasn't come up with an acceptable plan for funding it. Sen. Johnny Isakson of Georgia and Rep. Jeff Miller of Florida also criticized the VA for not punishing those responsible for the overrun. The rare joint statement shows how unhappy Congress is with the project and with the VA's response. (Elliott, 5/15)

Reuters: U.S. Report Shows Mixed Progress On Curbing Foodborne Pathogens
U.S. cases of two deadly types of foodborne pathogens have fallen sharply since 2008, but rates of other key types of foodborne bugs have increased, according to the latest report on nine pathogens tracked by health officials. "The picture is mixed," said Dr. Patricia Griffin of the U.S. Centers for Disease Control and Prevention's division of foodborne diseases, adding, "Most of it is not good news." Despite making progress in certain areas, U.S. health officials have made no progress in curbing overall rates of Salmonella and Campylobacter - two pathogens that cause the highest number of illnesses in people. (Steenhuysen, 5/14)

The Wall Street Journal: When E. Coli Becomes A Business Opportunity
Dozens of companies are sprouting to help U.S. food makers tackle a wave of new federal safety regulations and intensified enforcement of the nation’s food laws. The startups are racing to capitalize on the need by farms and food processors to step up vigilance of food-borne pathogens after a string of outbreaks in the last decade have sickened thousands, prompting a major overhaul of U.S. food safety laws and stepped-up criminal prosecutions of executives at companies implicated in the cases. (Newman, 5/14)

In other health and science news -

The New York Times: U.S. Introduces New DNA Standard For Ensuring Accuracy Of Genetic Tests
The federal government opened the door to a new era of genetic medicine on Thursday by introducing a standard way to ensure the accuracy of DNA tests used to tailor treatments for individual patients. Scientists have identified hundreds of genetic mutations that appear to increase the risk of diseases, including cancer, Alzheimer’s and cystic fibrosis. But laboratories often report different results when they analyze genes obtained from samples of the same blood or tissue, because of variations in their testing equipment and methods. (Pear, 5/14)

The San Francisco Chronicle: Vaccination Bill Passes California Senate; Opponents Vow Fight
Opponents of a proposed law that would mandate vaccination for all California schoolchildren vowed to continue fighting the legislation Thursday after it easily won approval by the state Senate. (Allday, 5/14)

The San Jose Mercury News: Vaccine Exemptions: California Senate Overwhelmingly Passes SB 277, Abolishing Most Opt-Outs
A controversial bill that abolishes "personal belief exemptions" for vaccinations won overwhelming approval in the California Senate on Thursday, bolstering supporters' hopes that it will also clear the Assembly and be signed into law. (Krieger, 5/14)

Reuters: California Senate Votes To End Beliefs Waiver For School Vaccinations
California parents who do not vaccinate their children would have to home-school them under a bill passed Thursday by the state Senate, the latest move in a battle between public health officials and "anti-vaxxers" who fear vaccines are dangerous. The bill, which eliminates the so-called personal beliefs exemption allowing parents to forego vaccinations if opposed to them for any reason, was introduced after a measles outbreak at Disneyland last year that sickened more than 100 people. (Bernstein, 5/14)

NPR: Calif. Moves Closer To Banning Vaccine 'Personal Belief' Exemptions
California's state Senate has passed a bill to eliminate "personal belief exemptions" that currently allow parents to opt out of having their school-age children vaccinated. SB 277, sponsored by Democratic Sens. Richard Pan of Sacramento and Ben Allen of Santa Monica, passed 25 to 10 and now advances to the Assembly. (Neuman, 5/14)

The Associated Press: Bentley Calls Stripped-Down Alabama Budget 'Irresponsible'
Gov. Robert Bentley on Thursday lashed out at a committee-passed General Fund budget, calling it irresponsible and accusing lawmakers of indicating they don't care about the people of Alabama. The House Ways and Means General Fund Committee approved the stripped-down budget Thursday morning, with deep cuts to state agencies after lawmakers were unable to reach an agreement on tax bills to fill a fiscal shortfall. The vote comes after weeks of Bentley warning that cuts could cause the layoff of state employees, the end of some services for the mentally ill and the closure of state trooper posts, state parks and prison facilities. ... The committee-approved budget would cut funds to Medicaid, the Department of Mental Health, the Department of Human Resources and state prisons by 5 percent in total funding. (Chandler, 5/14)

Montgomery Advertiser: Bentley Promises Veto Of Austerity General Fund Budget
Gov. Robert Bentley promised Thursday to veto an austerity General Fund budget approved by a House committee earlier in the day, saying it would devastate the state. ... Virtually every state agency would see budget cuts of at least 9 percent. The proposal also includes cuts of 5 percent to the state's Medicaid Agency and Department of Corrections, which in the past have been shielded from budget cuts. If enacted, the budget could lead to layoffs of more than 1,000 state workers, severe cuts to Medicaid services — impacting more than 1 million Alabamians — and the consolidation of state prisons, which could exacerbate a dangerous prison overcrowding crisis. (Lyman, 5/14)

Al.com: Alabama House Panel Approves Budget Cutting Medicaid, Prisons, Mental Health
A state budget plan that would force cuts in Medicaid, mental health, prisons and other services was passed by a House of Representatives committee today after the chairman said there's little support for tax increases. Gov. Robert Bentley said he would veto the plan in its current form. "This budget is unworkable. It's irresponsible. It really hurts people," Bentley said. (Cason, 5/14)

The Associated Press: Gov. Brown Proposes Record $115.3 Billion Budget For California
Gov. Jerry Brown on Thursday proposed a record $115.3 billion California spending plan that would send billions more to public schools, freeze in-state undergraduate tuition and establish a new state tax credit for the working poor. ... The budget also includes...$62 million to begin enrolling low-income immigrants in Medi-Cal, California’s version of Medicaid, on the assumption that President Barack Obama will prevail in a court battle over his executive order. (Lin, 5/14)

The San Jose Mercury News: Health And Social Service Advocates Cry Foul Over Brown's Revised Budget
Gov. Jerry Brown's revised budget would boost spending on health and social services by about $1.7 billion over the current year, but it left advocates screaming for more to restore cuts made during the Great Recession. (Richman, 5/14)

The Associated Press: Budget Gets A Boost From Improved State Revenue Forecast
Struggling to close hefty budget shortfalls, [Louisiana] lawmakers got an assist Thursday when the state income estimating panel added nearly $179 million to two years of financial forecasts. Action from the Revenue Estimating Conference was a welcome change for Gov. Bobby Jindal's administration and lawmakers. In the past year, the forecasting panel has made multiple downgrades to financial projections that forced cuts and short-term budget fixes. (DeSlatte, 5/14)

The Associated Press: NC Budget Decisions Aren't As Painful With $400M Cushion
North Carolina budget-writers aren't making as many cuts compared to other years since the Great Recession. It made for a less painful process as House Republicans rolled out Thursday portions of a spending plan for the next two years. Budget panels met to hear spending proposals for six categories of government, led by public education and health. Lawmakers offered amendments before subcommittees approved their proposals, with the last panel wrapping up early Thursday evening. (Robertson, 5/15)

The Associated Press: Committee Plans To Reject Governor's Family Care Plan
[Wisconsin] lawmakers plan to reject a proposal in Gov. Scott Walker's budget that would expand the state's Family Care program and end the IRIS program, the leaders of the Legislature's finance committee said Thursday. ... Family Care, a Medicaid program, provides managed long-term care for the elderly and disabled designed to keep them in their homes. About 41,000 people are enrolled in the program. IRIS, which stands for Include, Respect, I-Self-Direct, is a related long-term care program that provides self-directed assistance with bathing, dressing and other needs. About 11,000 people are enrolled in that program. Both programs are currently available in 57 of Wisconsin's 72 counties and are scheduled to expand to an additional seven counties this calendar year.

The Boston Globe: Hospital Industry Split Over Health Care Legislation
The hospital industry in Massachusetts is sharply divided on proposed legislation that could make it harder for health systems to continue the wave of mergers and acquisitions that have been altering the medical landscape. (Dayal McCluskey, 5/14)

The Seattle Times: Inslee Signs Law That Sheds More Light On Medical Prices
Supporters of greater transparency in health-care costs celebrated a victory Thursday with Gov. Jay Inslee’s signing of legislation that will expand a database of medical prices available to the public. The new law improves upon a measure passed last year that created the all-payer claims database by requiring for the first time that Washington insurance companies share their cost data. Previously the database had access only to limited price information. (Stiffler, 5/14)

Stateline: Keeping The Mentally Ill Out Of Hospitals
Community Access is not a bed and breakfast, although it feels that way when you walk through its unmarked door off Second Avenue on Manhattan’s Lower East Side. Also known as Parachute NYC, this quiet seven-bedroom facility is one of four publicly funded mental health centers in New York City (located in Manhattan, Brooklyn, Queens and the Bronx) that provide an alternative to hospital stays for people on the verge of a mental health crisis. Parachute’s respite centers have no medical staff, no medications, no locks or curfews and no mandatory activities. They are secure, welcoming places where people willingly go to escape pressure in their lives and talk to trained “peer professionals” who can relate to what guests are going through because they are recovering from mental illness themselves. (Vestal, 5/15)

Miami Herald: State Leaders Look To Pass Mental Health Reform — In 2016
As they reviewed legislative issues affecting children, [Florida] lawmakers and state agency heads said this week they will push again in 2016 for two key bills that died in the abrupt end to this spring’s regular session. An overhaul of the state’s mental-health system and an upgrade of early-learning programs topped a list of legislative priorities at Wednesday’s meeting of the Florida Children and Youth Cabinet in Stuart. (Menzel, 5/15)

Kansas Health Institute: Direct Primary Care Not Subject To State Insurance Regulation Under New Law
Starting July 1, primary care physicians in Kansas may see patients who pay them a flat monthly fee without fearing that such agreements are subject to state insurance laws. Josh Umbehr, a doctor who runs a Wichita practice that has gained notoriety for practicing under the no-insurance “direct primary care” model, pushed the Legislature to pass a bill that specifies such plans are not health insurance. Gov. Sam Brownback announced last week he had signed the bill. (Marso, 5/14)

The Boston Globe: MassHealth On Massive Hunt To Verify Eligibility
Locate 1.2 million people. Find even the thousands of them who don’t speak English or don’t have a place to live. Get them to fill out a 26-page application. Process those forms. And get it done by the end of the year. (Freyer, 5/15)

The Associated Press: Missouri Legislature Enters Final Day Of Session In Turmoil
The most prominent measure hanging in the balance would reauthorize $3.6 billion of annual taxes on medical providers that are due to expire Sept. 30. An extension is necessary to avoid punching a large hole in Missouri’s $9.4 billion Medicaid health care program for low-income residents. If the reauthorization fails Friday, some legislators suggested that a special session would be needed to try again to pass the bill. (Lieb, 5/15)

The Connecticut Mirror: Can The State Build A Better System To Get Your Medical Records To Your Doctors?
Connecticut doctors and hospitals have received close to $300 million in federal funds to adopt and use electronic health records, but the state still lacks a way to ensure they can be shared quickly and easily among medical providers. (Levin Becker, 5/15)

The Associated Press: Louisiana House Backs Ban On Abortions Based On Gender
Louisiana would prohibit abortions based on gender under a bill that won overwhelming, bipartisan passage Thursday from the state House despite questions about whether provisions that allow for lawsuits and damage claims go too far. (DeSlatte, 5/14)

The Associated Press: NY Hospital Pays $19 Million To Settle Medicare Lawsuit
Federal prosecutors say the Westchester Medical Center has settled a lawsuit that alleged it paid kickbacks for referrals and overcharged Medicare. The hospital in Valhalla agreed to pay nearly $19 million. The U.S. attorney's office said the medical center helped open a cardiology practice specifically to generate referrals to the hospital, then maintained a financial relationship with the practice, violating kickback laws. (5/14)

The Baltimore Sun: Right-To-Die Group Convicted Of Assisting In Minnesota Suicide
The national right-to-die group Final Exit Network was convicted Thursday of assisting in the suicide of a Minnesota woman, after a Baltimore doctor who helped lead the organization and was present for the woman's death testified against the group. Jurors, who deliberated for about 90 minutes, also found the group guilty of interfering with a death scene. The group faces a maximum fine of $33,000. Sentencing was set for August. It was the first time Final Exit Network has been convicted for its actions. (5/14)

The Associated Press: CDC Study Of Indiana HIV Cases Shows Most Are Same Strain
A genetic analysis of HIV samples taken from about half the people infected in the largest HIV outbreak in Indiana history shows nearly all of them have the same strain of the virus, a finding one health expert says is a sobering reminder of how rapidly HIV can spread among intravenous drug users. (5/14)

The Baltimore Sun: University Of Maryland Medical System To Acquire Medicaid Manage Care Firm
The University of Maryland Medical System is poised to enter the Medicaid and Medicare managed care market in the state with an agreement to acquire Riverside Health Inc. Timonium-based Riverside employs about 100 people and provides health coverage to 25,000 people enrolled in the Maryland HealthChoice program. (Cohn, 5/14)

Health Affairs: Medicaid Primary Care Parity
[T]he Affordable Care Act (ACA) required states to raise Medicaid primary care payment rates to Medicare levels in 2013 and 2014 .... Federal lawmakers failed to reauthorize the fee bump during the 113th Congress, ending in December 2014. ... As of January 1, 2015, sixteen states and the District of Columbia had decided to continue paying enhanced rates, while thirty-four states had declined. Although the program is over, the debate about whether it worked--and should, therefore, be reinstated in some form--continues. Evaluators have been challenged by the program's later-than-planned start and short duration, which many believe made it impossible to detect program impacts. Another challenge to measuring the program's impact is that it was intended to improve access to care--a variable that is difficult to measure directly. (Tollen, 5/11)

JAMA Internal Medicine: Use Of Nondisclosure Agreements In Medical Malpractice Settlements By A Large Academic Health Care System
We performed a retrospective review ... for [medical malpractice] claims closed before (fiscal year 2001-2002), during (fiscal year 2006-2007), and after (fiscal years 2009-2012) the implementation of tort reform in Texas. We studied The University of Texas System .... During the 5 study years, The University of Texas System closed 715 malpractice claims and made 150 settlement payments. For the 124 cases that met our selection criteria, the median compensation paid by the university was $100 000 .... A total of 110 settlement agreements (88.7%) included nondisclosure provisions. All the nondisclosure clauses prohibited disclosure of the settlement terms and amount, 61 (55.5%) prohibited disclosure that the settlement had been reached, 51 (46.4%) prohibited disclosure of the facts of the claim, 29 (26.4%) prohibited reporting to regulatory agencies. (Sage, Jablonski and Thomas, 5/11)

JAMA Surgery: Hospital-Level Factors Associated With Mortality After Endovascular And Open Abdominal Aortic Aneurysm Repair
Endovascular technology [which threads a catheter through blood vessels] has become ubiquitous in the modern care of abdominal aortic aneurysm (AAA), yet broad estimates of its efficacy among variable hospital and regional settings is not known. [Researchers sought to] perform a preliminary analysis of hospital [size and type] on mortality following open AAA repair (OAR) and endovascular AAA repair (EVAR). ... Our data demonstrate that outcomes for both OAR and EVAR appear to depend greatly on hospital-level effects. Academic institutions appear to have better outcomes after elective AAA repair overall, and in particular after EVAR. In contrast, hospital size appears to have a more significant effect on 30-day mortality for OAR cases than for EVAR cases. These data make a preliminary argument in favor of AAA centers of excellence that deserves further investigation. (Hicks et al., 5/13)

The Kaiser Family Foundation: Reading The Stars: Nursing Home Quality Star Ratings, Nationally And By State
In 2008, the Centers for Medicare and Medicaid Services (CMS) launched the Five-Star Quality Rating System on its Nursing Home Compare website .... This issue brief presents national and state-level analysis of nursing homes quality scores based on these five-star ratings and discusses relevant policy considerations.... More than one-third of nursing homes certified by Medicare or Medicaid have relatively low overall star ratings of 1 or 2 stars, accounting for 39 percent of all nursing home residents. Conversely, 45 percent of nursing homes have overall ratings of 4 or 5 stars, accounting for 41 percent of all nursing home residents. For-profit nursing homes, which are more prevalent, tend to have lower star ratings than non-profit nursing homes. Smaller nursing homes (with fewer beds) tend to have higher star ratings than larger nursing homes. (Boccuti, Casillas and Neuman, 5/14)

Urban Institute: Health Insurer Responses To Medical Loss Ratio Regulation
One of the Affordable Care Act’s early market reforms, starting in 2011, required health insurers to spend 80 percent or more of premiums on medical claims or quality improvement in aggregate. Using data submitted by insurers from 2010 to 2012, we found that the new regulations on medical loss ratios (MLRs) led to substantially higher MLRs in the individual market overall, driven by increases among insurers who started with MLRs less than 80 percent in 2010. The increase in MLR occurred in part through increasing the amount of claims paid for health care, while holding premium growth in check, and represented increased value for consumers. In addition, the MLR rule created an incentive for insurers to reduce their administrative overhead costs as a share of premiums. We find evidence suggesting insurers did indeed become more efficient, with minimal disruption to the market.(Clemans-Cope, Garrett and Wissoker, 5/13)

Brookings Institution/Leavitt Partners/Robert Wood Johnson Foundation: Origins And Future Of Accountable Care Organizations
The fragmented and misaligned state of the U.S. health care system has become a catalyst for payment and delivery system reforms. Traditional fee-for service (FFS) payment structures incentivize high volume rather than high quality care, and lead to the suboptimal provision of medical services across the disjointed provider landscape. Despite various attempts to improve care delivery, health care costs continue to rise. The Accountable Care Organization (ACO) model seeks to reverse these trends by promoting a simultaneous restructure of the payment and delivery systems to incentivize higher quality, lower cost care. This paper provides an overview of the accountable care movement; describes the structural classification of ACOs and various accountable care payment contracts; and provides a high-level trend analysis of where the ACO movement is heading. (Tu et al., 5/12)

Women's Health Issues/Kaiser Family Foundation: Medicaid At 50: Marking A Milestone For Women’s Health
When Medicaid was enacted 50 years ago, no one could have imagined that this relatively modest program would become the backbone of coverage for millions of low-income women. Today, Medicaid provides health and long-term coverage to more than 1 in 10 women. For women in particular, the program has served as a critical safety net by providing coverage for a wide spectrum of services that other government programs and private insurance did not, from contraceptives and pregnancy-related care to longterm care services and supports. Medicaid’s 50th anniversary is an opportune time to look back at some of the program’s achievements as they have affected women and to take stock of the challenges the program will continue to face in the coming years. (Salganicoff, Ranji and Sobel, 5/8)

Here is a selection of news coverage of other recent research:

Reuters: Inhaler Ban Boosts Costs For People With Asthma
A 2008 ban on chlorofluorocarbons (CFCs) has ended up being particularly costly for people with asthma. The ban changed the type of albuterol inhaler available in the U.S., and since then costs have gone up and inhaler use has gone down, according to a new study. Albuterol inhalers prevent and treat wheezing, shortness of breath, coughing, and chest tightness due to asthma or chronic obstructive pulmonary disease. Generic albuterol inhalers using CFCs were banned and were replaced by more expensive inhalers using hydrofluoroalkane (HFA). (Doyle, 5/11)

Reuters: Number Of Americans Using $100,000 In Medicines Triples: Express Scripts
More than a half-million U.S. patients had medication costs in excess of $50,000 in 2014, an increase of 63 percent from the prior year, as doctors prescribed more expensive specialty drugs for diseases such as cancer and hepatitis C, according to an Express Scripts report released on Wednesday. Of the estimated 575,000 Americans who used at least $50,000 in prescription medicines last year, about 139,000 used at least $100,000 worth of medication, nearly triple the 47,000 who hit that mark in 2013, the report said. (Berkrot, 5/13)

NBC News: Can A Weak Grip Predict Heart Disease?
Here's a surprisingly easy and low-tech way to predict who's most likely to have a heart attack or stroke: measure their grip. A large study of nearly 140,000 people from 17 different countries found a clear and consistent link between grip strength and death from any cause, but especially from heart attack and stroke. It is a better predictor than blood pressure and could be a cheap, quick way for doctors to screen out who needs the most attention. (Fox and Silverman, 5/13)

Time: More Than A Quarter Of American Adults Have Untreated Tooth Decay
New data on tooth decay and cavities among American adults reveal the sad state of our pearly whites. More than 25% of American adults ages 20 to 64 have untreated tooth decay, and 91% have one tooth — or more — that has been treated for tooth decay or needs to be. The latest findings published Wednesday from the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics show that while tooth decay and complete tooth loss have dropped among Americans since the 1960s, disparities still remain, and there’s room for improvement in our oral health. (Sifferlin, 5/13)

Reuters: Waiting To Call Ambulance Delays Heart Attack Treatment
Half of heart attack patients fail to immediately call an ambulance for help, delaying diagnosis and potentially worsening their survival odds, a Swedish study suggests. Researchers studied treatment timelines from symptom onset to diagnosis for about 450 people hospitalized for the deadliest type of heart attacks, known as ST-elevation myocardial infarction (STEMI), which are caused by prolonged blockage of blood supply to the heart. (Rapaport, 5/7)

Medscape: Patients Commonly Stop Antidepressants, Don't Tell Docs
About 20% of patients who are prescribed antidepressants stop taking them without telling their doctor, new research shows. Characteristics of those most likely to discontinue these medications include younger age, being diagnosed with anxiety or substance use disorder in addition to depression, and being treated in a general medical setting rather than by a psychiatrist or other mental health specialist. The findings are published in the May issue of Psychiatric Services. (Lowry, 5/11)

Medscape: Addiction Programs Need Help To Maximize ACA Benefits
Addiction treatment centers need help to fully realize the Affordable Care Act's (ACA's) promise of improved access to high-quality addiction treatment, new research suggests. The ACA "dramatically" expands health insurance for addiction treatment and provides "unprecedented" opportunities for service growth and delivery model reform, investigators led by Christina Andrews, PhD, MSW, assistant professor of social work, University of South Carolina, in Columbia, write. "Yet most addiction treatment programs lack the staffing and technological capabilities to respond successfully to ACA-driven system change." (Brooks, 5/11)

Reuters: Children Of Depressed Mothers At Risk For Behavior Problems
Children are more likely to develop behavioral or emotional problems if their mothers are chronically depressed, even if symptoms aren't severe, a French study finds. While previous research has linked clinical depression in mothers to mood disorders and other health problems in their children, the current study is among the first to make this connection even when mothers have milder symptoms that might not be diagnosed or treated by clinicians, said lead author Judith van der Waerden. (Rapaport, 4/24)

The Washington Post: Gov. Rick Scott Is Wrong
It has always been irrational for states to decline to expand their Medicaid programs under the Affordable Care Act. The 21 states that have refused to take advantage of this element of Obamacare have denied access to coverage for 4 million people, left billions in federal health-care dollars on the table and thrown the financial fate of their hospitals into doubt. But Florida Gov. Rick Scott (R) is taking irrational to new lengths. (5/14)

The American Prospect: Why Public Silence Greets Government Success
For nearly two months in the fall of 2013, [healthcare.gov] simply did not work; people desperate for coverage, in many cases because their old policies had just been canceled, had no practical way to buy insurance. ... But then the administration managed to pull off a technological rescue job almost as spectacular as the failure itself. More important, the Affordable Care Act began to deliver on its promise of helping millions of otherwise uninsured Americans get affordable, reliable insurance for the first time—while quite possibly contributing to a historic, unprecedented slowdown in health-care costs. But media and political attention to Obamacare’s successes have never rivaled the discussions of its failures, real or imagined. (Jonathan Cohn, 5/14)

Bloomberg View: Obamacare's Unpopularity Can't Kill It
The lesson of the unpopular Affordable Care Act, then, is that liberals should stop worrying so much about whether their programs have high public-approval ratings, or how to make government as a whole popular. All a popular program accomplishes for those inclined to hate government is to spawn a “keep your government hands off my Medicare” attitude. That is: People who hate government either based on ideology or short-term "thermostat" reactions to liberal presidents won't be deterred even if they like what government is doing. (Jonathan Bernstein, 5/14)

Charlotte Observer: What Luis Lang Might Never See
[Luis] Lang, by opting out of Obamacare, decided not to participate in a system that protects others. And now he was the one who needed help. Turns out, he’s getting it. Helms’ story went viral, and readers already have stepped up with more than $17,000 in contributions as of Thursday. Many of the good-hearted are self-described liberals who support Obamacare and hope that Lang learns a lesson. ... Lang was compelling not simply because he had rolled the dice on insurance and lost – there are sadly many examples of that – but because he blamed Obamacare and not himself. So his lack of repentance resulted in the help he’s now getting. (Peter St. Onge, 5/14)

The New York Times: An Abortion Ban’s Bogus Arguments
For the second time in two years, the House voted Wednesday to pass legislation that would ban almost all abortions 20 weeks or more after fertilization. The bill, called the Pain-Capable Unborn Child Protection Act, claims that “an unborn child is capable of experiencing pain at least by 20 weeks after fertilization,” though medical evidence does not support this. Of course, the bill is not really about scientific findings of any sort. It is simply another attempt by conservative Republicans to undercut women’s constitutionally protected reproductive rights. (5/14)

Bloomberg View: Abortion Shouldn't Be Left To The Extremes
But for now the extremes on both sides, and the politicians elected with their support, control the debate. Pro-choice politicians condemn the pro-life side, which justifies killing doctors who perform abortions. Pro-lifers pointed to the mindless extremism of the pro-choice side when a Planned Parenthood lobbyist in Florida testified that when abortions fail, the decision to kill or save the newborn should be left to the “patient and the health-care provider.” Most people would be shocked to learn that a baby born alive isn't given life-saving treatment in every case. (Margaret Carlson, 5/14)

Bloomberg: Two Ways To Keep A Lid On Medicare Cost Increases
Medicare costs are rising a bit faster than they have during the past few years. But by reinforcing some the changes that are already occurring, we can nip this increase in the bud -- and two developments show the way. (Peter R. Orszag, 5/14)

The Oklahoman: No Single Solution To Hospitals' Financial, Service Challenges
Passage of the Affordable Care Act, combined with other longstanding trends, has left many hospitals on precarious financial footing. Some will almost certainly close, including in Oklahoma. The good news is this doesn’t necessarily mean worse overall health outcomes for people in surrounding communities, according to researchers at the Harvard School of Public Health. (5/14)

Charlotte Observer: Clarity – Not Confusion – Needed On Mammograms
Women deserve clarity from the health-care community on the effectiveness of mammograms and the frequency they should have them. That is why it is distressing to those of us who diagnose and treat breast cancer to have to combat – again – clouded recommendations from the government. On April 20, the United States Preventive Services Task Force (USPSTF) released a draft “update” to its 2009 recommendations on breast cancer screening. No new developments have occurred since its previous flawed report that caused confusion and controversy. (Drs. Matthew Gromet and Nicole Abinanti, 5/14)

The New York Times: Kids Who Can’t See Can’t Learn
Last year, I went with a small group of ophthalmologists to a South Bronx middle school to conduct vision exams. One neatly dressed boy had trouble seeing the big E at the top of the chart. He hesitated and made mistakes on the second line, and then put his head down, embarrassed. “I don’t think you can see the chart,” I said. He told me he couldn’t remember ever having an eye exam. I thought he might be an anomaly. I was wrong. (Pamela F. Gallin, 5/15)

The New England Journal of Medicine: The $2.6 Billion Pill — Methodologic And Policy Considerations
At a press conference in Boston last November, the Tufts Center for the Study of Drug Development announced it had calculated that it costs pharmaceutical companies $2.6 billion to develop a new drug — up from the $802 million the Center estimated in 2003. ... The methods used to generate the $2.6 billion figure will require careful scrutiny once they are available for detailed review. The analysis was based on data that 10 unnamed drug makers provided on 106 unnamed investigational compounds that they had “self-originated.” The raw numbers on which the analysis is based are not available for transparent review — and are likely never to be divulged. ... But as risky as drug development is, the pharmaceutical and biotech industries remain among the most profitable sectors of the U.S. economy and actually spend only a small fraction of their revenues on truly innovative research. (Dr. Jerry Avorn, 5/14)