The Wall Street Journal: Health Law Enrollment Periods To Be Tightened
The Obama administration will tighten the rules for people who enroll in insurance through HealthCare.gov outside of official enrollment periods, hoping to hold down costs that insurers blamed on late sign-ups. A top federal health official said Monday that the administration will eliminate some criteria for late sign-ups and make other criteria language clearer. Insurers say that the rules are so broad that people can wait until they get ill to buy insurance. That raises health-care spending and overall premiums because people who are sicker generally cost more to cover. (Armour and Radnofsky, 1/12)

Politico: Gaming Obamacare
Obamacare customers are gaming the system, buying coverage only after they find out they’re ill and need expensive care — a trend insurers warn is destabilizing the fledgling health law marketplaces and spiking premiums for everyone. Insurers blame the problem on lax rules that allow more than 900,000 people to sign up for coverage outside the standard enrollment season — for instance, when they change jobs or move — without sufficient proof they are eligible. (Demko, 1/12)

The Associated Press: Kentucky Moves Ahead With Plans To Dismantle Health Exchange
Kentucky’s new Republican administration is moving forward with plans to shut down the state’s health insurance exchange, becoming the first state to cut ties with one of the key pieces of President Barack Obama’s signature health care law because of a political promise. Gov. Matt Bevin notified federal officials in a letter dated Dec. 30 that the state exchange will cease operations “as soon as is practicable.” That will be at least a year from now, according to federal law. It will not affect health plans sold for 2016. (Beam, 1/11)

The Washington Post: Kentucky Governor Moves To Shut Down State’s ACA Insurance Exchange
In a statement Monday, Bevin’s office said he had taken steps to eliminate the “redundancy” of Kynect. He previously had pledged to shut down the exchange because “it adds no value” given the existence of HealthCare.gov. The former Democratic governor, Steve Beshear, had urged Bevin to maintain the exchange, noting that it is financed through a surcharge on insurance plans. Shutting Kynect would cost at least $23 million in state money, Beshear said. (Sun, 1/11)

Louisville (Ky.) Courier-Journal: Bevin Notifies Feds He'll Dismantle Kynect
The decision drew immediate fire from health care advocates, including Bill Wagner, executive director of the Family Health Centers, a network of public health clinics in Louisville. "It's a great disappointment," Wagner said. "It's an unwelcome setback in our efforts to reach the number of uninsured people and improve access to health care in Kentucky." (Yetter, 1/11)

New Hampshire Public Radio: GOP Lawmakers Asking Health Providers To Help Foot The Bill For Medicaid Expansion
Republican leaders in the New Hampshire House and Senate say they’re willing to consider reauthorizing the state’s Medicaid expansion after its sunset date at the end of 2016 — as long as they can find someone to help foot the costs. On Monday’s edition of The Exchange, House Speaker Shawn Jasper said it doesn’t seem politically feasible to expect him to pass a plan that requires more public spending. (McDermott, 1/11)

Reuters: Louisiana Governor Pledges To Expand Medicaid In Inaugural Address
Louisiana Governor John Bel Edwards laid out his agenda during his inaugural address on Monday, pledging to expand Medicaid, enact education reforms, and find long-term solutions to the state's large budget deficit. Edwards, the first Democrat to hold the office of governor in Louisiana since 2008, said he planned to begin accepting federal funding on Tuesday to expand healthcare to residents through the Affordable Care Act, also known as Obamacare. (Carroll, 1/11)

New Orleans Times-Picayune: John Bel Edwards Emphasizes Unity As He Becomes Louisiana's 56th Governor
Gov. John Bel Edwards reprised a message about political unity and putting "Louisiana first" shortly after being sworn in as Louisiana's 56th governor Monday (Jan. 11). ... Edwards emphasized many of the same issues he brought up during his campaign. Almost immediately, he reiterated his plans to to kick off Medicaid expansion in Louisiana on Tuesday, less than 24 hours after he takes office. (O'Donoghue, 1/11)

Sioux Falls (S.D.) Argus Leader: Could Timing Doom Medicaid, Teacher Pay Debates?
In politics, timing is everything, they say. Could the adage doom Gov. Dennis Daugaard's top priorities for the 2016 legislative session? The Republican governor is expected to pitch Medicaid expansion and higher teacher pay Tuesday during his State of the State address. Either proposal on its own would be a tough sell to conservative legislators in his own party. Convincing them to bend on both is doubly ambitious. "One could have greater success if the other were not in play," House Speaker Brian Gosch, R-Rapid City, said Monday. (Ferguson, 1/11)

Also, some guidance for consumers who may qualify for Medicaid coverage -

Kaiser Health News: Slipping Between Medicaid And Marketplace Coverage Can Leave Consumers Confused
For people whose income changes shift them above or below the Medicaid threshold during the year, navigating their health insurance coverage can be confusing. Ditto for lower income people who live in states that may expand Medicaid this year. Under the health law, states can expand Medicaid coverage to adults with incomes up to 138 percent of the federal poverty level (about $16,000 for an individual). Thirty states and the District of Columbia have done so. This week I answered three questions from readers about how Medicaid interacts with plans on the health insurance marketplaces. (Andrews, 1/12)

Reuters: HCA Says Insurance Exchange Enrollment Encouraging So Far
The chief executive of HCA Holdings Inc on Monday said he expects the Affordable Care Act to drive more growth for the U.S. hospital operator in 2016 as Americans sign up for insurance coverage through exchanges created under the law. About 11.3 million Americans have signed up so far for individual health insurance in 2016 through HealthCare.gov and the state-based exchanges, the U.S. government said last week. Enrollment for these plans, which were created under the health reform law known as Obamacare, closes on Jan. 31. (Kelly, 1/11)

New Hampshire Public Radio: More N.H. Residents Have Insurance, But They're Paying For It
More people have health insurance in New Hampshire, but they're also paying more for it. That's according to the Insurance Department's annual report on costs. From 2013 to 2014, the uninsured rate dropped from 11 to 9 percent - at least 20,000 more people got coverage. But they're also paying more for less. Patients often have access to fewer providers. The average premium went up nearly 4 percent, but it was higher in the individual market, which has seen the most growth because of the Affordable Care Act, says Tyler Brannen with the Insurance Department. (Rodolico, 1/11)

New Hampshire Union Leader: Officials: Obamacare Customers In NH Got Nearly $200 Each In Refunds
New Hampshire health insurers had to refund nearly $200 each to individual-market customers in 2014, under a provision of the Obamacare law that forces insurance companies to spend at least 80 cents of every premium dollar on claims, state insurance officials reported Monday. The rebate provision mostly affected Anthem Blue Cross and its health maintenance organization, Matthew Thornton. Together, the two refunded $5 million, according to a November consultant report about the New Hampshire insurance market in 2014, the first year of the individual mandate under the Affordable Care Act/Obamacare law. (Hayward, 1/11)

The New York Times: Hillary Clinton Confronts Bernie Sanders As Polls Show Her Lead In Iowa Narrowing
Facing new pressure from Senator Bernie Sanders in Iowa, Hillary Clinton confronted him in direct terms on Monday, warning Iowans that if elected president, he would put their health insurance in the hands of Republican governors and raise taxes on the middle class. ... On health care, Mrs. Clinton said that she wanted to build upon the Affordable Care Act, while Mr. Sanders wanted to scrap it in favor of a universal health plan that would empower the states — and potentially Republican governors, who she has said cannot be trusted. (Rappeport, 1/11)

The Washington Post: Clinton Confronts Rival Sanders As Iowa Polls Tighten
Hillary Clinton has spent much of her 2016 presidential campaign looking past Democratic rival Bernie Sanders, focusing instead on Republicans and the November general election. No longer. ... On Monday, she widened her health care critique to include Sanders, saying he would “rip up” the law and put power in the hands of states. Sanders said during a town hall meeting in Perry that large numbers of underinsured and sky-high deductibles demand a better health care system, which he would seek through his single-payer, Medicare-for-all system. Said Clinton: “I sure don’t want to turn over health care to Republican governors, for heaven’s sake. I think it’s a risky deal.” (Lerer and Thomas, 1/11)

The Washington Post's Fact Checker: Recidivism Watch: Rubio Again Wrongly Suggests He Damaged Obamacare
Sen. Marco Rubio (R-Fla.) is once again spreading the fiction that he was the lawmaker responsible for a provision in a spending bill that has wounded the Affordable Care Act, a.k.a. Obamacare. He previously earned Four Pinocchios for making this claim. (Kessler, 1/11)

NBC News: Panel Issues Final Mammogram Guidelines But They Won't Affect Much
There's a new set of final recommendations on when women should get mammograms, and it might add to confusion, but there's one basic bottom line: It's unlikely to change much for women. (Fox, 1/11)

The New York Times: Panel Reasserts Mammogram Advice That Triggered Breast Cancer Debate
In 2009, an influential panel of medical experts ignited a nationwide uproar by suggesting that women needed fewer mammograms than had long been recommended. Instead of starting at age 40 and being screened every year, women with average risk of breast cancer could safely begin at 50 and be tested every other year, the group said, citing extensive data to support its advice. It also said that after 74, there was not enough evidence to determine whether routine mammography was worthwhile. Outrage ensued, from advocates for screening who said the advice would lead to delayed diagnoses and deaths. On Monday, the same panel issued an update of its guidelines — and it is sticking to its guns. (Grady, 1/11)

The Associated Press: Task Force: Mammograms An Option At 40, Do More Good At 50
Mammograms do the most good later in life, a government task force has declared in recommending that women get one every other year starting at age 50. It said 40-somethings should make their own choice after weighing the pros and cons. The latest guidelines from the U.S. Preventive Services Task Force, made public Monday, stick with its advice that women should have one every two years between ages 50 and 74. But they also make clear that it's an option for younger women even though they're less likely to benefit. (1/12)

The Washington Post: New Breast Cancer Screening Guidelines At Odds With Congress
The task force's final recommendation is likely to be controversial because some other groups say the screening should start earlier. The American Congress of Obstetricians and Gynecologists, for example, recommends that regular screenings begin at age 40, while the American Cancer Society calls for women to start yearly screening at age 45 and then move to screening every two years starting at age 55. Congress has sided with proponents of earlier screening. Last month, in anticipation of Monday's release of the task force’s final recommendation, lawmakers took preemptive action: It directed insurers to ignore the task force's latest guidelines and, instead, to rely on its 2002 recommendation. (Sun, 1/11)

The San Francisco Gate: New Guidelines Recommend Mammograms Starting At Age 50
The U.S. task force’s guidelines are considered significant because they could influence how health insurers cover mammography in the future, but Congress made sure insurance coverage won’t be affected at least for the next two years. In December, President Obama signed a bill into law that ensures coverage for mammography will remain the same through 2017. The law guarantees that women 40 years and older enrolled in most health insurance plans will be covered for screening mammography, either annually or every other year, without copayments, coinsurance or deductibles. (Colliver, 1/11)

The Wall Street Journal: Final Recommendations On When To Start Getting A Mammogram
Medical groups decide on guidelines by weighing the potential benefits of breast-cancer screening, mainly lives saved through early cancer detection, against possible harms, including false positives that can lead to unnecessary tests and treatment. Weighing the various factors differently can change the conclusions. ... While regular mammograms for women in their 40s are effective in reducing deaths from breast cancer, the benefit is less than it is for older women and the potential harms are greater, the task force noted. (Reddy, 1/11)

Reuters: State Attorneys General Joining Probe Of Health Insurer Mergers
About 15 state attorneys general have joined the Justice Department's probe of two big insurance mergers, according to people familiar with the matter, increasing the scrutiny on proposed deals that would reduce the number of nationwide health insurers to three from five. The formation of a large group to scrutinize Aetna Inc's plan to buy Humana Inc and Anthem Inc's bid for Cigna Corp complicate what is already expected to be a tough and lengthy review by federal antitrust enforcers. (Bartz, 1/11)

The Associated Press: Health Insurance Companies Agree To Pay $483K In Fines
The three health care insurers providing individual plan coverage to Delawareans under the Affordable Care Act have agreed to pay almost half a million dollars in fines for past violations of state insurance regulations. Insurance department officials say Highmark Blue Cross Blue Shield of Delaware will pay a fine of $383,000 under a recent consent order. Aetna Health Inc. and Aetna Life Insurance Co. have agreed to pay a combined total of $100,000 in fines. (1/12)

Reuters: Nestle Signs $120M Deal With Seres For 'Healthy Gut' Drugs
Nestle is investing in U.S.-based Seres Therapeutics for a third time in a year, this time injecting $120 million to develop and commercialize medicines aimed at restoring a healthy bacteriological balance in the human digestive system. The deal announced on Monday for so-called "healthy gut" products will give Nestle's Health Science division exclusive rights to sell Seres' experimental treatments for Clostridium difficile infection (CDI) and inflammatory bowel disease outside the United States and Canada. (1/11)

NPR: Popular Acid Reflux Drugs Are Linked To Kidney Disease Risk
People who take certain popular medicines for heartburn, indigestion and acid reflux may want to proceed more cautiously, researchers reported Monday. The drugs, known as proton-pump inhibitors (PPIs), appear to significantly elevate the chances of developing chronic kidney disease, according to a study involving more than 250,000 people. (Stein, 1/11)

Kaiser Health News: Hospitals Step Up To Help Seniors Avoid Falls
Falls are the leading cause of injuries for adults 65 and older, and 2.5 million of them end up in hospital emergency departments for treatment every year, according to the Centers for Disease Control and Prevention. The consequences can range from bruises, fractured hips and head injuries to irreversible calamities that can lead to death. And older adults who fall once are twice as likely as their peers to fall again. Despite these scary statistics, a dangerous fall does not have to be an inevitable part of aging. Risk-reduction programs are offered around the country. (Jaffe, 1/12)

The Concord Monitor: Lack Of Data Makes It Hard To Compare Success Of Concussion Programs
As New Hampshire tackles the issue of youth sports concussions, schools are trying different combinations of things, including no-contact practices, altered training protocols, differing rest periods and various new equipment. We would like to know which combinations are working best. But coaches, doctors, parents or educators making that decision face a big problem: Shortage of data. (Brooks, 1/12)

The Associated Press: Nurses Reunite, With Roles Switched, Decades Later
Lynn Bartos always had a good feeling about the soft-spoken nurse who would greet her warmly at the Milwaukee-area infusion clinic where she got treatments for rheumatoid arthritis pain. It turned out the two had a far deeper connection. That nurse, Nicole Krahn, was assigned to administer the IV this summer as Bartos settled in for one of the three-hour appointments at Froedtert & the Medical College of Wisconsin that come every five weeks. (Antlfinger, 1/12)

New Hampshire Public Radio: N.H. Medical Examiner: 385 Drug Deaths Counted In 2015, Final Total Could Be Higher
New Hampshire saw at least 385 drug deaths in 2015, according to the latest tally from the Office of the Chief Medical Examiner — but the actual total could be even higher, as some 45 cases are still pending toxicology. Toward the end of last year, state officials began warning that the state could end up surpassing 400 drug deaths total for 2015. Even if the current figure remains the same, however, that would still make 2015 the deadliest in recent years when it comes to drug overdose fatalities. (McDermott, 1/11)

New Hampshire Public Radio: As Dirty Needles Pile Up, One N.H. Lawmaker Seeks To Legalize Needle Exchange
In Manchester this past year, more than 540 dirty syringes have been found. But as heroin use increases across the state, used needles are also showing up in cities like Nashua, Dover and Laconia. As part of our series, Dangerous Ends, we look at one bill seeking to legalize needle exchange programs in New Hampshire – a proposal that has been controversial in the state. Walk around Manchester with the city’s public health director and you spend a lot of time with your eyes fixed on the ground. (Sutherland, 1/11)

New Hampshire Public Radio: Citing Heroin Concerns, Berlin Allows Overdose Drug Narcan In Schools
Citing concern about illegal drug use, the Berlin school board will be making the anti-overdose drug Narcan available in its schools. Almost six percent of Berlin high school students admitted trying heroin at least once, according to a 2013 student survey prepared by the Centers for Disease Control and Prevention, says Corinne Cascadden, the superintendent of the Berlin schools. (Jensen, 1/11)

Elsewhere, a look at why medication isn't reaching the addicts who need it —

Stateline: In Drug Epidemic, Resistance To Medication Costs Lives
Dr. Marvin Seppala wrote a book on conquering drug addiction with counseling and group therapy. The spiritual, abstinence-based strategy pioneered by Alcoholics Anonymous helped him overcome his own alcohol and cocaine addiction when he was 19. As medical director of Minnesota’s fabled Hazelden clinic, he watched it work for patients. He believed in it — and then he changed his mind. (Vestal, 1/11)

Winston-Salem (N.C.) Journal: Legislators To Get Update On Medicaid Reform, Fed Settlement
Legislators and the health-care industry will today get their first update on the roll out of the state’s controversial Medicaid reform initiative. ... The reform plan coordinates Medicaid physical, behavioral, dental, pharmacy and long-term-health services. Under the plan, three insurers would contract to run statewide managed care organizations (MCOs), and up to 10 provider-led entities, or groups of doctors and hospitals, would enroll patients in regional networks. (Craver, 1/11)

The Chicago Sun-Times: Chicago Woman Gets Six Years For Medicaid Fraud
A Chicago woman was sentenced to six years in prison last week for stealing more than $250,000 in Medicaid funds over three years. Debra Gaines, 55, was convicted of theft of state property and vendor fraud in July for a scheme to collect Medicaid funds for mental health services that were not provided by a doctor, according to the state’s attorney general’s office. Gaines billed Medicaid for $276,000 between 2007 and 2010 for services provided by Dr. Ernest Mensah under her business called Heavenly Interventions, the attorney general’s office said. (1/11)

Los Angeles Times: Former California Health Regulator Agrees To A Fine For Helping Kaiser
A former top regulator for the state who was involved in an audit of Kaiser Permanente before going to work for the HMO has admitted she acted improperly and has agreed to pay a fine, according to documents released Monday. Marcella Faye Gallagher was supervising attorney for the state’s Department of Managed Health Care while it audited Kaiser to make sure the HMO’s mental health plan complied with state law by providing timely access to services. (McGreevy, 1/11)

The Associated Press: Pendleton Prisoners Sue Indiana Over Cases Of Tuberculosis
Dozens of inmates at Pendleton Correctional Facility in central Indiana are suing the state after cases of tuberculosis at the prison. An inmate at the facility was moved into isolation at another prison in June 2014 after testing positive for active tuberculosis, and state officials said that he received a standard four-drug treatment. State Department of Health spokesman Ken Severson said an outbreak believed to have started with the inmate resulted in three active tuberculosis cases and 75 latent infections among Pendleton inmates. (1/11)

The Associated Press: Pittsburgh Hospital, Data Company To Work On Pricing System
A Pittsburgh hospital is partnering with a Utah data analytics company to help hospitals save money by better calculating the cost of health care services. Salt Lake City-based Health Catalyst plans to build a commercial version of cost management technology and analytics that were developed at UPMC. (1/12)

The Associated Press: Feds: South Carolina Should Stop Regulating Health Care Investments
The federal government has recommended South Carolina repeal requirements that health facilities get state permission for many kinds of construction and expansion, backing up something Gov. Nikki Haley has sought for years. In a letter and attached statement to Haley, who sought officials’ opinion in November, the Department of Justice and the Federal Trade Commission wrote that laws requiring something known as a certificate of need impede competition and make such projects more expensive. (Kinnard, 1/11)

The Star Tribune: For Hundreds Of Minnesotans, The Wait For Disability Services Is Over
The number of Minnesotans with disabilities who endure prolonged waits for crucial social services has fallen sharply in recent months, as the state removes long-standing barriers to families most in need of assistance. State officials are pressuring counties to spend more of the billions of dollars allocated annually — much of it unspent in recent years — for a coveted form of Medicaid assistance that helps people with disabilities build more independent lives in the community. (Serres, 1/11)

The Oregonian: A+ For Oregon On Birth Control, Sex Education, Reproductive Rights
Oregon received an A plus in reproductive heath and rights, according to The Population Institute's 2015 report card. Oregon was one of four states, including California, New Jersey and Washington, to get an A grade or higher, according to the report. The United States as a whole was graded a D plus, down from a C the year before. (Frazier, 1/11)

The Associated Press: Survey Gauges Ohio Nursing Home Emergency Prep
A survey of Ohio nursing homes has found they have plans for coping with natural disasters and other emergencies, yet many haven’t coordinated with key local agencies and facilities. Researchers at Miami University’s Scripps Gerontology Center added questions about emergency preparedness to their latest biennial survey for state authorities. Some nursing home residents in other states have been harshly affected by disasters such as Hurricanes Katrina and Sandy. (Sewell, 1/11)

The Associated Press: Kansas Panel Wants Study Of Family Structure In Foster Care
A foster family’s structure should be an important factor when Kansas places abused and neglected children in temporary homes, a legislative panel said Monday in a recommendation that one lawmaker said would encourage discrimination against gays and lesbians. The foster care study approved a recommendation that the Department for Children and Families use “evidence-based” factors in placing foster children. (Hanna, 1/12)

The Arizona Republic: Striking Phoenix Bus Drivers Lose Health-Care Coverage
Tensions between striking Phoenix bus drivers and Transdev, the contractor that operates many of the city's bus routes, escalated Monday as drivers blasted the company for suspending their medical insurance as they picket while waiting for a new contract. (Gardiner, 1/11)

Reuters: Has Obama Really Changed America?
Is Barack Obama a transformational president? ... Not surprisingly, as the president readies his final State of the Union Address, the issue is contested. ... What makes a president transformational? The first African-American president is inherently historic. Obama’s cheerleaders tick off his big accomplishments, as well: healthcare reform; the 2009 fiscal stimulus that helped save the economy; more than 14 million jobs created in a record stretch of 70 months of growth; progressive tax reforms; progress on climate change; the nuclear deal with Iran; the move to normalize relations with Cuba, and more. Skeptics note that his era may be called the “Long Depression” rather than the “Great Recession.” (Robert L. Borosage, 1/12)

The New York Times' Upshot: ‘I Am Drowning.’ The Voices of People With Medical Debt.
Our article on Americans’ struggles with medical debt generated thousands of reader comments. More than 1,200 readers wrote us to answer our question: “How have medical bills changed your life?” The article explored a large new survey of Americans who struggle with their medical bills. It found that while people with no health insurance are particularly vulnerable to financial distress, about 20 percent of Americans with health insurance were still experiencing difficulties paying for health care. Readers responded with their own experiences of medical debt. (Margot Sanger-Katz, 1/11

The Huffington Post: More Evidence Of Medicaid Expansion's Positive Effects
Poor adults in states that have expanded Medicaid as part of health reform have greater access to health care services and fewer problems paying their medical bills, and hospitals there are admitting fewer uninsured patients, two new studies published in Health Affairs show. These findings provide more evidence that Medicaid expansion is improving the health of beneficiaries, as well as the budgets of many expansion states. It's a powerful lesson for the 20 states that haven't yet expanded. (Jesse Cross-Call, 1/11)

Forbes: Gov. Mead In Wyoming Pushes Obamacare Medicaid Expansion Again
Wyoming Gov. Matt Mead announced last month that he would spend the next few months advocating for Obamacare’s Medicaid expansion in next year’s budget. But so far, Wyoming legislators have taken a thoughtful approach, carefully reviewing all of the evidence and ultimately rejecting Obamacare expansion. And they haven’t just rejected it once. In 2014 alone, state lawmakers rejected Obamacare expansion a whopping six times. They rejected it again in 2015, even after the Governor put his support behind it. Instead of embracing Obamacare, the legislature specifically acted to prohibit Mead from pursuing any expansion without legislative approval. (Josh Archambault and Jonathan Ingram, 1/11)

USA Today: Even A GOP President Might Not Kill Obamacare
Republicans in Congress finally achieved their long cherished goal of sending President Obama a bill to repeal his signature health care law. It was a brief victory that lasted only until he vetoed it two days later. But it could be the high-water mark of the repeal drive that has been a pillar of conservative campaigns since 2010 — even if Republicans win the White House. The politics of the Affordable Care Act are changing, as even the newly elected Tea Party governor of Kentucky has acknowledged. Polling on the ACA, or Obamacare, reveals as much public division and ambivalence as ever toward the complicated health law. But it is beginning to reach a critical mass of users and people who know them — and that is the key to survival. (Jill Lawrence, 1/11)

The Wall Street Journal: Certifiably Needless Health-Care Meddling
An important but overlooked debate is unfolding in several states: When governments restrict market forces in health care, who benefits? Legislative majorities in 36 states believe that consumers benefit, because restrictions help control health-care costs. But new research confirms what should be common sense: Preventing qualified health-care providers from freely plying their trade results in less access to care. (Thomas Stratmann and Matthew Baker, 1/11)

Des Moines Register: Editorial: Wellmark Ruling Reveals Patient Struggles
Iowa’s largest health insurer searched for any way to justify not reimbursing an Iowa City pharmacist for drugs he dispensed to hemophilia patients. Wellmark Blue Cross and Blue Shield ultimately breached its contract with Michael Stein by not honoring 114 claims for drugs dispensed to 24 patients, according to a decision issued last month by the Iowa Court of Appeals. If the ruling stands, the insurer may owe an estimated $9 million. (1/11)

The San Francisco Chronicle: Pricey Hepatitis C Drugs Threaten Health Care System
When does Big Pharma profiting become profiteering? This issue was the subject last month of a Senate Finance Committee investigation of pricing practices of Gilead Sciences Inc., a leading provider of hepatitis C medications. After examining 20,000 pages of internal company documents, looking at Medicaid data and interviewing health care experts, the authors concluded that the Foster City drugmaker “pursued a calculated scheme for pricing and marketing its hepatitis C drug based on one goal: maximizing revenue regardless of the human consequences.” Community activists protested this kind of Big Pharma greed in front of the San Francisco hotel where the 34th annual J.P. Morgan Healthcare Conference opened Monday. ( Diana Sylvestre, 1/11)

Lexington (Ky.) Herald Leader: A Boost For Needle Exchanges
It’s sad that an epidemic of drug abuse and death is forcing a congressman from the hills of rural Kentucky to learn the science of opiate addiction. But we can all be grateful that U.S. Rep. Hal Rogers is rising to the challenge, and in the process, providing informed leadership to other Kentuckians in state and local government. (1/11)