Modern Healthcare: 85% Medical-Loss Ratio In Final Managed Medicaid Rule
The CMS has finalized a long-awaited rule that will overhaul managed Medicaid, which has not been updated in a decade. The sweeping 1,425-page rule, which was proposed last May, caps insurer profits, requires states to more rigorously supervise the adequacy of plans' provider networks, encourages states to establish quality rating systems for plans, allows more behavioral healthcare in institutional settings and promotes the growth of managed long-term care. But the CMS deferred to state control for several issues. (Dickson and Herman, 4/25)

Kaiser Health News: Administration Says New Rules For Medicaid Plans Will Improve Service For Enrollees
The Obama administration tightened rules Monday for private insurance plans that administer most Medicaid benefits for the poor, limiting profits, easing enrollment and requiring minimum levels of participating doctors. For consumers the most visible change may eventually be quality ratings intended to reflect Medicaid plans’ health results and customer experiences. The administration agreed to move slowly on such a sensitive industry issue, saying it would develop the scores over several years. (Hancock, 4/26)

The Associated Press: Feds Issue New Standards For Medicaid Insurance Plans
The Obama administration Monday set new standards for Medicaid private insurance plans, which in recent years have become the main source of coverage for low-income people. The rules apply to insurers operating as Medicaid middlemen in 39 states and Washington, DC. Each state runs its own program, although the federal government pays most of the cost. Private insurers now provide coverage to about two-thirds of the more than 70 million Medicaid recipients, and the rules had not been updated for more than 10 years. (Alonso-Zaldivar, 4/25)

The Hill: Obama Administration Issues Sweeping New Medicaid Regulation
The regulation updates rules concerning what is known as Medicaid managed care, where states contract with private health insurers to provide benefits to low-income people through Medicaid, a system that has grown in recent years to 39 states and two thirds of enrollees. The final rule, issued Monday, imposes requirements on how much of insurers revenue must go towards paying medical costs, as opposed to administrative costs or profits. (Sullivan, 4/25)

Morning Consult: Long-Awaited Managed Care Rules For Medicaid, CHIP Are Final
Medicaid managed care services are offered by risk-based managed care organizations, which contract with state Medicaid programs to offer care to enrollees. Essentially, they are the private insurer alternative to traditional fee-for-service Medicaid. CMS hasn’t issued any new regulations to the program since 2002, but a lot has changed since then. Not only has the Medicaid program itself grown under the Affordable Care Act, but now about 80 percent of Medicaid enrollees are served through managed care delivery systems, according to CMS. (Owens, 4/25)

CQ Healthbeat: Medicaid Rule Requires Health Plans To Meet Financial Standards
Health insurers that participate in Medicaid will have to spend a minimum amount of the money they receive on medical care, under a new Centers for Medicare and Medicaid Services rule released late Monday. (Evans, 4/25)

The New York Times: Advisers To F.D.A. Vote Against Duchenne Muscular Dystrophy Drug
In a confrontation between the hopes of desperate patients and clinical trial data, advisers to the Food and Drug Administration voted on Monday not to recommend approval of what would become the first drug for Duchenne muscular dystrophy. The negative votes came despite impassioned pleas from patients, parents and doctors who insisted that the drug, called eteplirsen, was prolonging the ability of boys with the disease to walk well beyond when they would normally be in wheelchairs. (Pollack, 4/25)

The Wall Street Journal: FDA Panel Votes Not To Recommend Approval For Muscular Dystrophy Drug
“I felt this wasn’t a well-controlled study,” said panel chairman G. Caleb Alexander, an associate epidemiology professor at the Johns Hopkins School of Public Health. The panel members who abstained said they were undecided because they were moved by public testimony from parents who believed their children had been helped by the drug. The decision followed decidedly negative comments from FDA reviewers who concluded that the study fell far short of producing enough evidence. (Burton, 4/25)

The Associated Press: Muscular Dystrophy Drug Falls Short At High-Stakes Meeting
Federal health advisers voted against an experimental treatment for muscular dystrophy on Monday, the latest in a series of setbacks for the Sarepta Therapeutics' drug, which has become a rallying point for patients and families affected by the deadly disease. (Perrone, 4/25)

CQ Healthbeat: Lawmakers Lobby For Rare Drug Approval, But Evidence Is Lacking
A Food and Drug Administration advisory committee on Monday heard arguments for the approval of a drug to treat Duchenne Muscular Dystrophy, a disease that affects young boys and currently has no approved treatment. The disease, which results in the loss of muscle use, affects one in 3500 boys. It is 100 percent fatal and most affected have a lifespan of fewer than 25 years. (Siddons, 4/25)

The Hill: ObamaCare Premiums Expected To Rise Sharply Amid Insurer Losses
Health insurance companies are laying the groundwork for substantial increases in ObamaCare premiums, opening up a line of attack for Republicans in a presidential election year. Many insurers have been losing money on the ObamaCare marketplaces, in part because they set their premiums too low when the plans started in 2014. The companies are now expected to seek substantial price increases. (Sullivan, 4/25)

Modern Healthcare: Ruling On Cost-Sharing Subsidies Could Rattle Insurers In Midst Of Rate-Setting
Another bombshell could soon drop on the Affordable Care Act insurance exchange market, and it might come at a highly vulnerable moment for Obamacare. Rosemary Collyer, U.S. District Judge for the District of Columbia, is expected to soon issue her ruling in U.S. House of Representatives v. Burwell, a case in which House Republicans claim the Obama administration is illegally funding the ACA's cost-sharing subsidies without a congressional appropriation. If, as some legal observers believe is possible or even likely, the George W. Bush-nominated Collyer decides against the administration, it would further rattle insurers who are facing multiple difficulties in the exchange business. (Meyer, 4/22)

The Des Moines Register: UnitedHealth Quits Iowa Obamacare Marketplace
Iowans who want to buy subsidized health insurance under the Affordable Care Act will no longer be able to choose a policy from the country’s largest carrier, but they can switch to the state's main health insurer for the first time. UnitedHealthcare will no longer sell individual health insurance policies in Iowa, the state insurance division announced Monday. ... In Iowa, UnitedHealthcare’s withdrawal could be offset by the entry of the state’s dominant health insurance carrier, Wellmark Blue Cross & Blue Shield. Wellmark previously has declined to sell policies on the Obamacare exchanges, but spokeswoman Traci McBee confirmed Monday that it will sell policies there for 2017. (Leys, 4/25)

Bloomberg: UnitedHealth Quits More Obamacare Markets, Exiting Kentucky
UnitedHealth Group Inc. will pull out of Kentucky’s individual marketplace for Obamacare plans, bringing to 26 the number of states the health insurer is quitting next year. The company plans to halt sales of individual plans in Kentucky for 2017, both inside and outside the state’s Affordable Care Act exchange, as well as the small-business exchange, UnitedHealth said in a letter to the state’s insurance department. (Tracer, 4/25)

Kaiser Health News: United’s Departure From Marketplaces Could Impact Consumers’ Costs, Access
UnitedHealthcare’s decision to quit insurance exchanges in about 30 states next year has patient advocates concerned that fewer options could force consumers to pay more for coverage and have a smaller choice of network providers. The company’s departure could be felt most acutely in several counties in Florida, Oklahoma, Kansas, North Carolina, Alabama and Tennessee that could be left with only one insurer, according to an analysis by the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.) (Galewitz, 4/26)

Kaiser Health News: Will Covered California Sell Health Coverage To The Undocumented?
California legislators are attempting to clear the way for undocumented immigrants to buy health insurance through the state’s insurance exchange — potentially setting a national precedent. The fusion of illegal immigration and the Affordable Care Act, two of the most highly charged elements on the periodic table of U.S. politics, could engender a combustible reaction, especially in an election year. (Ibarra, 4/26)

New Orleans Times-PIcayune: 2 Hospitals Question Gov. John Bel Edwards' Medicaid Expansion Savings Projections
Two of Louisiana's privatized former charity hospitals are questioning the savings Gov. John Bel Edwards' administration is projecting from Medicaid expansion, which includes money the state can use to help offset cuts to TOPS funding. If the hospitals are right, and it turns out the Edwards administration's projections aren't conservative enough, hospital administrators at University Medical Center in New Orleans and Lafayette General Health say they fear it could cause a midyear shortfall -- and funding cuts -- to the public-private partner hospitals. (Litten, 4/25)

New Orleans Times-Picayune: Louisiana Medicaid Recipients Urged To Update Addresses
The Department of Health and Hospitals is asking people enrolled in two large state health care programs to make sure their addresses are up-to-date so they can begin receiving Medicaid cards. People enrolled in the Take Charge Plus and Greater New Orleans Community Health Connection, respectively, will be automatically enrolled in the Medicaid program. The income requirements for those two programs make all of its recipients eligible for the Medicaid expansion approved by Gov. John Bel Edwards on his first full day in office. (LItten, 4/25)

Reuters: Health Insurer Centene's Revenue Rises On Medicaid Enrollments
U.S. health insurer Centene Corp reported a near 36 percent jump in quarterly revenue, helped by higher enrollments in its Medicaid plans for low-income families and the acquisition of rival Health Net. (4/26)

STAT: Supreme Court Skeptical In Case Backed By Drug Makers
At the Supreme Court on Monday, there were signs that the pharmaceutical industry could end up on the losing side of a case with serious implications for medicine and drug prices. The case in question focused on the Obama administration’s rules for a new process to review patents. Drug makers, supporting the plaintiffs, are urging the court to change that process, which right now makes it easier to invalidate the patents that are crucial to their business. (Scott, 4/25)

Politico Pro: Supreme Court Grapples With Patent Reviews
The Supreme Court on Monday wrestled with the wonky issue of patent reviews in a case that has drawn heavy interest from the pharmaceutical and technology industries as they battle over reforming the nation's patent laws. (Tummarello, 4/25)

Marketplace: Turns Out Hedge Funds Have An Incentive To Control Drug Prices
The court heard oral arguments in a case involving patents, including drug patents. It used to be that to challenge one, you'd have to actually go to court. That was a slow, expensive business, so Congress created a fast track: a patent review board. ... Big Pharma doesn't like the review board. But organizations that want to bring down the price of prescription drugs for consumers love it, and they're being joined in their fight by people who aren't usually seen as champions of consumer rights — hedge fund managers. (Gorenstein, 4/25)

In other news from the Supreme Court —

Kaiser Health News: High Court Ruling May Hinder Plans’ Efforts To Recoup Consumers’ Legal Awards
Accidents happen, and if they’re someone else’s fault, you can go to court to try to get compensation for your medical expenses, lost wages, and pain and suffering. If you win, though, the pot of gold you receive may be considerably smaller than you expect: Your health plan may claim some or all of it as reimbursement for money it spent on your medical care. It’s completely legal and it happens all the time. But a recent Supreme Court decision gives consumers ammunition to push back. (Andrews, 4/26)

The Wall Street Journal: New York Insurers To Change Coverage Of Hepatitis C Drugs
Seven health-insurance companies in New York will change their criteria for covering costly drugs that cure chronic hepatitis C under the terms of agreements with the office of State Attorney General Eric Schneiderman. The agreements, expected to be announced Tuesday, require the insurers to cover hepatitis C medications for nearly all patients who have commercial insurance plans in the state. (Ramey, 4/25)

The Associated Press: NY: Insurers Must Pay For Maternal Depression Screening
New York state will soon require health insurers to cover depression screening for pregnant women and new mothers. The move follows a recommendation from a federal panel that insurers cover maternal depression screening without a co-pay or deductible. (4/25)

Elsewhere, in Ohio, a county begins covering sex reassignment surgery for its workers —

The Columbus Dispatch: Franklin County Workers’ Gender-Transition Surgeries Now Covered By Insurance
A Franklin County employee making a gender transition might have saved for months or years before coming up with enough money to pay for a mastectomy or sex reassignment surgery. Cost estimates vary, but they can stretch well into the thousands of dollars. Now, though, those employees can hand their doctors an insurance card. It’s covered. (Rouan, 4/26)

The New York Times: De Blasio To Propose $2 Billion For New York City’s Hospital System
New York City’s public hospital system “is on the edge of a financial cliff,” Mayor Bill de Blasio’s administration is warning in a report to be released on Tuesday as part of his budget, which proposes a restructuring and an infusion of $2 billion in subsidies. Along with a push for new revenue and new savings for the system, Health & Hospitals, the city subsidy — a $700 million increase over the 2016 fiscal year — is intended to shrink a gap that is projected to balloon to $1.8 billion by 2020, up from a current $600 million shortfall. (Bernstein, 4/25)

The Wall Street Journal: New York City Will Seek Hospital-System Overhaul
Mayor Bill de Blasio’s administration will propose an overhaul of the cash-strapped public-hospital system in the city’s budget presentation on Tuesday, people familiar with the matter said. The overhaul is expected to turn inpatient centers—which are more expensive but often prized by communities—into outpatient centers and focus less on emergency rooms, one of these people said. It will include retraining some employees, adding billions to the system’s budget as changes are made, and attempting to revise the formula on how health care is funded. (Dawsey, 4/25)

Modern Healthcare: Merger Indigestion
Hospital operator mergers have created big—sometimes behemoth—health systems that will provide the scale necessary to achieve operating efficiencies and compete for more cost-conscious consumers. So they say. But some of the biggest mergers in recent years have so far failed to deliver on that promise. ... their stumbles are renewing concern that mergers and acquisitions are not the best path for achieving those efficiency and competitiveness goals. (Evans, 4/23)

Georgia Health News: State’s Hospital Safety Ranking Goes Down
About one-fourth of Georgia hospitals received an “A” grade on patient safety in newly published ratings. That percentage, determined by the Leapfrog Group, is down from this past autumn, when one-third of Georgia hospitals got an “A” in the organization’s rating (Miller, 4/25)

The Kansas Health Institute News Service: Hospitals Wary Of KDHE Budget Cut Option
One of the governor’s options to patch a hole in the state budget includes a $35 million cut from the Kansas Department of Health and Environment, a move a hospital group says could harm its members. Gov. Sam Brownback laid out three proposals to patch the budget hole last week after revenue projections for this budget year and the next were lowered by $350 million. One of the options includes the $35 million KDHE cut. (Hart, 4/25)

Bloomberg: Record Municipal Junk Bond For Hospital Set As Market Draws Cash
The need to protect against earthquakes is about to jolt the municipal junk-bond market from its slumber. California’s Loma Linda University Medical Center on Wednesday is planning the biggest speculative grade, tax-exempt health-care deal since at least 1990, according to data compiled by Bloomberg. The $883 million sale will finance an expansion and overhaul to comply with the state’s seismic safety requirements, a project that will double the center’s debt and triggered a fall from investment grade last year. (Varghese, 4/26)

The Associated Press: Oklahoma Bill Tying Abortions To Doctor Licenses Criticized
Of the pieces of anti-abortion legislation that Oklahoma lawmakers have considered this session, one that would strip doctors of their license to practice has abortion rights activists and the state's medical association balking. The bill would prohibit any physician who performs abortions, deemed "unprofessional conduct" in the measure, from obtaining a license to practice medicine. That would be the first such law in the nation — and an unconstitutional attempt to ban abortions, according to Center for Reproductive Rights, a New-York based abortion rights organization. (4/25)

The Des Moines Register: Branstad Backs Move To Defund Planned Parenthood
Gov. Terry Branstad said Monday he believes the Iowa House has adopted a "reasonable proposal" that would continue statewide family planning services while barring funds for Planned Parenthood and other abortion providers. (Petroski, 4/25)

The Hill: Americorps Workers Helped Young Women Get Abortions
Six members of the national service program AmeriCorps recently escorted young pregnant women to abortion clinics in a “direct violation” of federal funding rules, a government watchdog will report Tuesday. The volunteers served as clinic escorts, also known as “abortion doulas,” in parts of New York City, according to a source familiar with the report from a federal inspector general’s office. A summary of the report will be published online Tuesday. (Ferris, 4/25)

The Boston Globe: Overwhelmed By Overdoses, Clinic Offers A Room For Highs
Alarm over the rocketing fatality rate, and the need to better manage staffing disruptions from all those overdoses, has led Boston Health Care for the Homeless to adopt an unorthodox and controversial plan: On Tuesday, it will open a room where drug users can ride out their highs under medical supervision, with the aim of preventing deaths. (Pfeiffer, 4/26)

See KHN's past coverage of the clinic's plan: Boston’s Heroin Users Will Soon Get A Safer Place To Be High

And in other news —

STAT: Chinese Labs Modify Deadly Fetanyl To Circumvent Ban On Sales In U.S.
Chinese laboratories are producing and openly selling a new form of deadly fentanyl to get around China’s recent export ban on the synthetic drug causing thousands of overdose deaths across the United States. The slightly tweaked version of fentanyl — called furanyl fentanyl — is so new that it is not on the US government’s list of controlled substances. That means the altered fentanyl, which was blamed for the March overdose of an Illinois man, is technically legal for drug dealers to sell. (Armstrong, 4/26)

The Connecticut Mirror: House Passes ‘Comprehensive’ Opioid Bill
After a floor debate laced with stories of the toll drug addiction has taken across Connecticut, the House on Monday unanimously passed what legislators described as a comprehensive measure aimed at curbing the epidemic of opioid and heroin abuse. (Levin Becker, 4/25)

The New York Times: A Brother’s Mental Illness Influenced John Kasich’s Views
Gov. John Kasich often speaks about mental health in his campaign for president. He has defended his decision to expand Medicaid in Ohio by highlighting its benefits for mentally ill residents. He is probably the only Republican candidate this year to ask a crowd, “Do you know what it’s like for somebody to live with depression?” The question, posed at a rally in upstate New York recently, threw a hush over a room of 1,000 people. Mr. Kasich went on: “There are people here who know exactly what I’m talking about.” (Gabriel, 4/25)

Media outlets also offer coverage of mental health issues out of the Iowa, New Mexico and North Carolina —

The Associated Press: Mental Health Providers Say Iowa Needs More Prescribers
A bill pending in the Iowa House would allow specially trained psychologists to prescribe medication to mentally ill people in hopes of alleviating a shortage of treatment options, but the proposal has run into opposition from some of the state’s psychiatrists. (Vujicic, 4/25)

The Associated Press: More People Accessing Mental Health Services In New Mexico
The number of New Mexicans accessing behavioral health services through government-funded programs has increased nearly 5 percent within a year's time, adding to a surge that began with the expansion of the state's Medicaid program. (Bryan, 4/25)

North Carolina Health News: NC Mental Health Agencies Announce Workforce Development Collaborative
Three of North Carolina’s Medicaid mental health organizations announced last week that they’ll be jointly launching a workforce-development initiative to offer training resources to frontline professionals who provide services to people with disabilities. (Sisk, 4/26)

Roll Call: Senators Seek To Settle Zika Bill's Cost
Senate appropriators are aiming to wrap up this week their negotiations on how they'll pass an emergency spending package to address the Zika virus as well as its cost, sources familiar with the negotiations told Roll Call Monday. (McCrimmon, 4/25)

The Dallas Morning News: Dallas County Getting Head Start On Fight Against Mosquito Season
Officials are warning Dallas County residents of the dangers of mosquito-transmitted diseases – even though mosquito season hasn’t started yet. Zac Thompson, the county’s director of the Health and Human Services Department, wants people to focus on preventing the spread of the Zika and West Nile viruses before mosquito season starts the first week of May. (Siron, 4/25)

The Hill: CDC: E-Cig Ads Led To Increased Youth Smoking Rates
A new government study sheds light on the popularity of electronic cigarettes among youth. The Centers for Disease Control and Prevention (CDC) found that teenagers who are exposed to e-cigarette advertisements are more likely to vape. “Kids should not use any type of tobacco product, including e-cigarettes,” CDC Director Tom Frieden said in a statement. “Exposure to e-cigarette advertising is associated with youth e-cigarette use." (Devaney, 4/25)

The Baltimore Sun: As Authorities Debate The Rules, Vapers Form A Colorful Culture
Look through the window of the gathering place on York Road some night, and you'll think it's a tavern from another time. Men and women shoot pool. People cluster, chat and flirt. A haze hangs thick in the air. But it isn't smoke — and if you make the mistake of using the S-word here, the habitues of Towson Vaporium will likely look at you as though you've come from another planet. (Pitts and Waseem, 4/25)

The Columbus Dispatch: Opponents Urge Rejection Of New Medicaid Fees
Opponents of a state plan to charge new fees to Medicaid beneficiaries are urging federal regulators to reject the proposal. At a Statehouse press conference today, U.S. Sen. Sherrod Brown, D-Ohio, said the Republican-backed plan aims "to gut" the recent expansion of Medicaid through Obamacare, which has extended tax-funded health coverage to more than 600,000 poor Ohioans. (Candisky, 4/25)

Toledo Blade: Brown Rips Ohio GOP For Medicaid Proposal
A proposal to require working poor Ohio adults to pay more toward their government-funded health care is a Republican effort to undermine the Affordable Care Act, U.S. Sen. Sherrod Brown said Monday. ... Mr. Brown also urged the federal government to reject the request to waive rules so the state may charge premiums from as many as 1.4 million nondisabled, nonelderly people on the rolls. (Provance, 4/26)

Modern Healthcare: Breaking The System: State Budget Battles Gut Healthcare For The Most Vulnerable
Even as the White House touts the Affordable Care Act's successful coverage of nearly 20 million people, residents across the country are struggling to access and afford healthcare and social service programs. State legislatures are seeing shrinking revenue because of tax cuts and low energy prices. North Dakota and Texas, which rely on oil tax revenue, are facing huge budget shortfalls. ... Now, after years of threatening to do so, health and social service programs are cutting services or folding outright. Medicaid programs are seeing monthslong delays in approving beneficiaries. (Munchmore, 4/23)

The Associated Press: Cash-Strapped West Virginia May Delay Medicaid Provider Pay
West Virginia officials warn that payments to Medicaid providers may be delayed amid state budget woes. The Department of Health and Human Resources told providers in a letter Monday. (4/25)

Charleston (W.Va.) Gazette-Mail: Medicaid Payments May Falter If Budget Not Reached
Health care providers around the state are being put on notice that the state may have trouble paying for Medicaid services if the budget impasse is not resolved. About 24,000 Medicaid providers are receiving letters sent Monday by the state Bureau of Medical Services warning that there could be delays receiving payments for services provided, resulting from potential cash flow issues caused by ongoing budget shortfalls. (Kabler, 4/25)

West Virginia Public Broadcasting: W.Va. Medicaid Doctors Put On Alert As State's Cash Flows Dwindle
The funding problems for the 2016 fiscal year have been known to both executive and legislative leaders. In early April, Department of Revenue officials told the Charleston Gazette-Mail the state was some $146 million short of what it would need to keep the government open through June 30. (Marra, 4/25)

The Connecticut Mirror: GOP Budget Plan: Slash Agency Budgets, Cut Bonding Drastically
The Republican proposal does call for reductions to mental health funding compared to what was originally budgeted, but they are far smaller than [Gov. Dannell] Malloy’s proposed cut and would not affect grants paid to providers for mental health and substance abuse treatment. (Phaneuf, Rabe Thomas and Levin Becker, 4/25)

Minnesota Public Radio: Minnesota Releases Treasure Trove Of Health Care Data
A treasure trove of information on health conditions, medical services and costs in Minnesota is now available to researchers, providers and insurers. The Minnesota Department of Health is publishing the first batch of data from its Minnesota All Payer Claims Database this week, and lawmakers hope researchers will mine the information to learn more about variations in health care services and patient outcomes. (Benson, 4/25)

Modern Healthcare: Southeast Michigan Health Systems Reverse Trends, Reap Profits
Southeast Michigan health systems last year battled double-digit increases in drug prices and historically low rate increases from commercial and government payers to post the highest profit margins in several years, according to top system executives. (Greene, 4/25)

The Oregonian: OHSU Recruits For National Autism Registry To Speed Research
Oregon Health & Science University is looking for people with autism for a national registry that aims to accelerate research. The registry is open to anyone diagnosed with autism spectrum disorder and their families. The idea is to gather genetic information from 50,000 people to give researchers a big pool of data to help them better understand the condition and find treatments. (Terry, 4/25)

Minneapolis Star Tribune: Agencies Ask For Time To Comply With New Overtime Rules
Paula Hart and Dave Toeniskoetter sat outside the Cannon House Office Building last week after a day of back-to-back meetings with Minnesota’s congressional delegation had ended. ... Hart, the CEO of Volunteers of America Minnesota, and Toeniskoetter, CEO of the Mendota Heights-based independent living business Dungarvin, are trying to balance fair pay for workers with the cost of serving their intellectually and developmentally disabled clients. The pair ... want Minnesota’s federal politicians to press the U.S. Labor Department to extend the time they get to apply rules that will more than double the base salary of workers who can be declared exempt from overtime. (Spencer, 4/24)

Pittsburgh Post-Gazette: New Enrollees Rethinking Medicare Advantage Option
For years, Medicare Advantage plans have been big business for private insurers offering one-stop shopping, low premiums and extra benefits to an aging Western Pennsylvania population. But there are signs lately that the plans are losing some luster, as more retirees choose traditional plans with a Medigap supplement that sidestep concerns about access to providers and may represent better value in the long run. (Twedt, 4/26)

STAT: Billionaire Bankrolls New Brain Science Center At UC San Francisco
Former banker Sanford Weill transformed the Weill Cornell Medical College in New York with more than half-a-billion in donations in recent years. Now he is pivoting to the West Coast, pledging $185 million to create a neuroscience institute at the University of California, San Francisco. (Piller, 4/26)

The Associated Press: The Latest: Employee Placed On Leave Over School Lead Levels
Officials say a Tacoma School District manager has been put on paid administrative leave after it was discovered Friday that tests done nearly a year ago showed high lead levels in drinking water at two public elementary schools. District spokesman Dan Voelpel said Monday that the district's safety and environmental health manager was placed on leave. (4/25)

Wyoming Public Radio: Email Breach At Wyoming Medical Center
This February, the email accounts of two Wyoming Medical Center employees were compromised in a phishing scam. A phishing scam is an email that looks like it came from a credible source, and tricks the recipient into providing passwords and usernames in an attempt to access sensitive information. The scam won't work if the recipient ignores the email, and doesn't open any links. (Sanders, 4/25)

The Kansas Health Institute News Service: Clients Say Turnover Hinders Regional DCF Office For Disabled Employment
When Shannon Lindsey moved from Missouri to Kansas two years ago, she decided she wanted to go to Johnson County Community College to get a nursing degree that would make her more employable. Lindsey, now 49, has several disabilities, so she contacted Kansas’ vocational rehabilitation office for assistance. In Missouri she had the same vocational rehabilitation counselor for years — a state worker who understood her needs, what was available to help her and how to get it to her quickly. (Marso, 4/25)

The Seattle Times: New Twist On T-Cell Therapy Puts Leukemia Patients In Remission
Leukemia patients out of options and given just months to live have achieved sustained remissions thanks to a new twist on cancer immunotherapy, according to a highly anticipated study from scientists at Seattle’s Fred Hutchinson Cancer Research Center. (Aleccia, 4/25)

The Denver Post: Advisory Board To Help Sick Rocky Flats Workers To Meet For First Time This Week
A federal advisory board designed to help workers sickened while working at former nuclear weapons facilities in the United States, including Rocky Flats west of Denver, get compensation and medical benefits will meet for the first time this week. (Aguilar, 4/25)

NPR: Lesson Learned For Baltimore's Health Commissioner: 'I Like A Fight'
To wrap up [a] series on public health in Baltimore, Audie Cornish met up with Baltimore City Health Commissioner Leana Wen in Freddie Gray's neighborhood of Sandtown-Winchester. The health department recently opened a new outpost of its violence prevention program Safe Streets there, employing ex-offenders to mediate conflicts before they erupt in violence. Wen spoke about pushing a public health agenda in a city that has long struggled with poverty, violence and addiction. She also talked about what she, as an emergency physician, has learned in her first stint in government. (4/25)

AL.com: Doulas Help Pregnant Inmates Give Birth, Say Goodbye
Harley Ezelle gently rocked back and forth on a yoga ball in a meeting room at Tutwiler Prison as the woman next to her helped set her legs for maximum balance. It was the second meeting of the Alabama Prison Birth Project, which is bringing certified doulas to the women's prison to support pregnant inmates. (Yurkanin, 4/25)

Health Affairs Blog: About That Cadillac Tax
In December 2015, Congress delayed implementation of the so-called Cadillac tax, a 40 percent excise tax on high-cost employer health benefit plans. Now scheduled to be implemented in 2020, the Cadillac tax would effectively cap the current tax exclusion for employer health benefits. By excluding health benefits from taxable incomes, the current tax break creates incentives for employers to pay more of employees’ compensation via health benefits instead of taxable wages, possibly leading to overuse of health care services and driving up health costs. (Jeff Lemieux and Chad Moutray, 4/25)

Modern Healthcare: Healthcare Alone Won't Reverse Coming Longevity Decline
If Stephen Curry misses a free throw with the game on the line in the NBA finals, everyone will say he choked. If the two highest-paid teams in Major League Baseball this year (the Los Angeles Dodgers and New York Yankees) fail to make the playoffs, no one will congratulate them on a job well done. (Merrill Goozner, 4/23)

The Washington Post: Obamacare Disaster Will Be Obama’s Enduring Domestic Legacy
Historian David Maraniss notes, in Sunday’s Post, that President Obama came to office with the goal of changing “the trajectory of America” and leaving “a legacy as a president of consequence, the liberal counter to [Ronald] Reagan.” On the foreign-policy front, he is the anti-Reagan for certain. Reagan defeated Soviet communism and left us a safer world; Obama presided over the rise and metastasis of the Islamic State and left us a far more dangerous one. Domestically, Ronald Reagan told the American people: “The nine most terrifying words in the English language are ‘I’m from the government, and I’m here to help.’ ” Obama wanted to convince Americans that they were not terrifying. And the way he was going to do it was through the only great liberal legislative achievement of his presidency: Obamacare. (Marc A. Thiessen, 4/25)

The Wall Street Journal: Obamacare? Zika? Which Health Stories Americans Actually Follow
There has been a lot of health news over the past year, but which health stories really got through to the public? How about stories about Obamacare ranging from Republican efforts to repeal the law to stories about progress meeting enrollment targets? Or public health scares such as measles outbreaks or Zika? The scandals in VA health care? What about the stories about the political fight in Congress over Planned Parenthood funding? It turns out Obamacare, known formally as the Affordable Care Act, didn’t make the list of top health stories. The story that broke through the most? The fight over Planned Parenthood funding. Public health scares also broke through. And one health policy story with a consumer angle made the top group: rising drug prices. (Drew Altman, 4/25)

Modern Healthcare: Healthcare Providers Take Heat Over Debt Collection Lawsuits Against Patients
With surprise medical bills and high out-of-pocket costs getting increasing political attention, some hospitals and physician groups are drawing criticism for aggressive collection actions against patients. (Harris Meyer, 4/25)

The Cleveland Plain Dealer: Antibiotic Stewardship Programs Vital For Public Health: Cody Carroll
Antibiotic resistant bacteria, or "superbugs," are on the rise. The recent outbreak of an antibiotic resistant strain of the rare blood disease, Elizabethkingia, that has killed 18 people total in Wisconsin and Michigan serves as a reminder of the growing public health threat of resistant bacterial infections. (Cody Carroll, 4/24)

The Huffington Post: Want To Change The Conversation About Abortion? Listen To Women.
In Missouri, getting an abortion is a herculean task. Restrictive abortion legislation has caused all but one abortion provider in the state to shut down. If you do manage to get an appointment at that clinic, you are legally required to receive in-person “state-directed counseling that includes information designed to discourage [women] from having an abortion,” and then wait at least 72 hours after said counseling to get the procedure. This makes Missouri one of the most restrictive states in the U.S. when it comes to abortion, in a country where more than 230 abortion restrictions were enacted between January 2011 and January 2015. (Emma Gray, 4/25)

The New York Times: Oklahoma’s Unabashed Attack On Abortion
Give Oklahoma lawmakers points, at least, for honesty. They wanted to ban abortion, so they voted effectively to do just that — without offering any pretense of trying to protect women’s health, as supporters of other virulent anti-choice laws in states like Texas have done. Last Thursday, the Oklahoma House of Representatives voted overwhelmingly to bar doctors from performing abortions in all cases except to save the woman’s life. A doctor who violates the law would be committing a felony, punishable by up to three years in prison and the loss of his or her medical license. (4/25)

Modern Healthcare: We Can't Lose Focus On Quality In Pursuit Of Healthcare Value
It's widely recognized that the U.S. pays more for healthcare than other developed nations, yet achieves comparatively worse health outcomes, leading for calls to lower costs to improve value. But what if we increased quality at the same cost? (Catherine MacLean, 4/23)