Modern Healthcare: Medicare Advantage Prior Authorizations Tightened Under CMS Proposal
Medicare Advantage insurers face new regulations governing marketing, prior authorizations and supplemental benefits under a proposed rule the Centers for Medicare and Medicaid Services issued Monday. The draft regulation also would raise network adequacy standards and promote the use of biosimilar medications, and is another step in a campaign by President Joe Biden's administration to rein in the health insurance companies participating in Medicare Advantage. (Tepper, 11/6)

Stat: Government Looks To Tinker With New Caps On Medicare Advantage Broker Payments
The federal government is proposing to rein in health insurance companies that entice brokers with lavish bonuses to sell their Medicare Advantage plans by placing a firmer cap on broker compensation. (Herman, 11/6)

The Washington Post: Biden Administration Seeks To Crack Down On Private Medicare Health Plans 
Under a draft rule issued Monday by the federal Centers for Medicare and Medicaid Services, Medicare Advantage plans would be required to work harder to encourage customers to make use of extra benefits available to them, rather than the companies merely invoking them as a selling point. The proposal also would help Americans with Medicare drug benefits gain access to biosimilars, less expensive versions of biologic drugs made from living cells or other organisms. (Goldstein, 11/6)

USA Today: Biden Tackles Medicare Advantage Plans: These Are The Proposed Changes
“We want to ensure that taxpayer dollars actually provide meaningful benefits to enrollees,” said Health and Human Services Secretary Xavier Becerra. If finalized, the proposed rules rolled out Monday could also give seniors faster access to some lower-cost drugs. Administration officials said the changes, which are subject to a 60-day comment period, build on recent steps taken to address what they called confusing or misleading advertisements for Medicare Advantage plans. (Groppe, 11/6)

More Medicare developments —

Reuters: Exclusive: Cigna Explores Shedding Medicare Advantage Business -Sources
U.S. health insurer Cigna Group (CI.N) is exploring the sale of its Medicare Advantage business, which manages government health insurance for people aged 65 and older, a move that would mark a reversal of its expansion in the sector, according to people familiar with the matter. Cigna, which got into the Medicare Advantage business with its $3.8 billion acquisition of HealthSpring in 2011, would be backing away at a time the U.S. government is tightening its purse strings in reimbursing health insurers for their services, should it go through with the move. (Carnevali, 11/6)

Mother Jones: Donald Trump Freed A Convicted Medicare Fraudster. The Justice Department Wants Him Back. 
On a Thursday in September 2019, Philip Esformes arrived for his sentencing at the federal courthouse in downtown Miami looking pale and gaunt. The previous April, after an eight-week trial, Esformes, heir to a large, successful chain of nursing homes, had been convicted of fraud, kickback and money laundering crimes, and obstruction of justice. Citing more than $1 billion in false reimbursement claims, prosecutors described him as the linchpin of the “largest single criminal health care fraud case ever brought against individuals by the Department of Justice.” Esformes, then 50, had been in jail since his arrest more than three years earlier. The deep tan he ordinarily cultivated had faded. He’d developed skin rashes and shed some 50 pounds. (Pomorski, 11/1)

In related news about prescription drug costs —

Stat: On Drug Prices, HHS Secretaries Becerra And Azar Duke It Out
Two very different health secretaries took the stage Monday to defend their presidents’ plans — failed and not — to bring down high drug costs. President Biden’s Health and Human Services Secretary Xavier Becerra praised Medicare’s new powers to negotiate drug prices, fighting back against the now-common refrain that it would delay drug launches and curb innovation, this time lodged by Trump HHS Secretary Alex Azar. (Owermohle, 11/6)

Modern Healthcare: CMS, HHS Understate 340B 'Clawback's' Financial Impact, Lawyers Say
Providers participating in the 340B drug discount program will receive $9 billion by early next year under a regulation finalized Thursday designed to compensate hospitals for 340B payment cuts in previous years. Industry pushback could set the stage for another protracted legal battle surrounding the 340B program, which offers estimated 25%-50% discounts on outpatient prescription medicines to safety-net hospitals and other providers that treat low-income and uninsured patients. (Kacik, 11/6)

The Washington Post: Will Ohio Issue 1 Voters Back Abortion Rights? Other Red And Swing States Have. 
Leesa Howard thinks abortion should be rare and not used for “birth control.” She’ll readily vote next year for Donald Trump, backing the man who remade the Supreme Court to end Roe v. Wade. But Howard, 53, also knows a woman who got pregnant in high school and said an abortion kept her life on track. She plans to vote “yes” this week on an Ohio ballot measure that would enshrine access to the procedure in the state constitution. “I don’t think the government should be able to tell us what we should do with our own bodies,” Howard said. (Knowles and Blanco, 11/6)

Politico: Ohio Voters Weigh Weed Legalization
Ohio voters appear poised to back recreational marijuana legalization on Tuesday, nearly a decade after they rejected a similar ballot measure. Recent polls have found support for the question hovering around 60 percent, but in an off-year election where it’s uncertain who will show up at the polls the outcome is far from certain. (Shang, 11/6)

Detroit Free Press: Ohio Could Legalize Adult-Use Cannabis: What That Means For Michigan
 Michigan dispensary owners are some of the biggest opponents of the proposal, the spokesperson for the group behind the effort to legalize recreational marijuana in Ohio has said. That's because it's widely acknowledged that Ohio residents cross state lines to buy marijuana in Michigan and if it becomes available in Ohio, that could mean fewer customers for Michigan dispensaries, leading to an oversupply of marijuana that could drive prices even lower than what they've fallen to in the last few years. (Roberts, 11/7)

On races in Virginia, Kentucky, New Jersey, and Mississippi —

Reuters: Abortion Rights At Center Of Ohio And Virginia Elections
Virginia's Republican Governor Glenn Youngkin has said he will pursue a 15-week abortion limit if Republicans take control of the legislature, a move he has characterized as a reasonable compromise that could offer a blueprint for Republicans in 2024. (Ax, 11/7)

The Wall Street Journal: Voters Head To Polls Tuesday For Big Races In Virginia, Kentucky 
Voters in several states will give the country an early read on the electorate’s mood heading into the 2024 presidential campaign, with a Democratic incumbent in Kentucky testing the party’s strength in Trump Country and abortion front and center in Virginia’s legislative races. Tuesday’s gubernatorial race in Kentucky is expected to be competitive, while the Mississippi governor’s contest isn’t seen as close. Virginia and New Jersey have no statewide races, but all of the seats in each state’s legislatures are on the ballot. Control of Virginia’s legislature is on the line, with the results offering hints about the strength of both parties’ messages heading into 2024. (Calvert and Vielkind, 11/7)

The 19th: Virginia Elections Could Lead To Backslide In Protections For LGBTQ+ People
Even as Republican Gov. Glenn Youngkin has worked to restrict the rights of trans youth, Virginia remains the sole state in the South with more protections for LGBTQ+ people than discriminatory policies — a status that could change after this week’s elections. (Rummler and Barclay, 11/6)

The New York Times: In Mississippi, A Test Of Expanding Medicaid — And Scandal
The Deep South state now faces a pitched battle for governor, but the candidates have not made abortion the central issue, since the incumbent Republican governor, Tate Reeves, and his Democratic challenger, Brandon Presley, both oppose it. Instead, Mr. Presley’s surprisingly potent challenge has been fueled by a push to expand Medicaid under the Affordable Care Act and a public corruption scandal that saw the misspending of $94 million in federal funds intended for Mississippi’s poor on projects like a college volleyball facility pushed by the retired superstar quarterback Brett Favre. (Weisman, 11/7)

In related reproductive health news —

Reuters: Biden Admin Urges Court To Allow Confidential Contraceptive Access For Teens 
The Biden administration on Monday urged a federal appeals court to allow minors in Texas to access birth control through clinics funded by a federal program without having their parents notified. The administration is asking a three-judge panel of the 5th U.S. Circuit Court of Appeals to overturn a ruling by U.S. District Judge Matthew Kacsmaryk, who last December ruled in favor of Alexander Deanda, a man who claimed that the so-called Title X family planning clinic program removed his right to direct his daughters' upbringing. (Pierson, 11/6)

Fox News: Missouri Attorney General Sues Biden Admin For Approving The Shipment Of Chemical Abortion Pills In The Mail
The Missouri attorney general announced on Monday that his office is suing the Food and Drug Administration (FDA) and the Department of Health and Senior Services after they unlawfully approved the shipping of chemical abortion pills in the mail. Attorney General Andrew Bailey’s suit, which was joined by the states of Idaho and Kansas, comes on the heels of his efforts earlier this year, warning CVS and Walgreens that their plan to use the mail to distribute abortion pills would violate state and federal laws. (Wehner, 11/6)

KFF Health News: Iowa’s Governor Opposes Abortion — And Has Final Say On Whether Medicaid Pays For It 
Any Iowa hospital or clinic seeking Medicaid payment for providing an abortion would need approval from the state’s most prominent abortion opponent: Gov. Kim Reynolds. No one bothers to try. Iowa’s Medicaid regulations include an unusual policy requiring signoff from the governor’s office before the public health insurance program could pay for any abortion services, even if they meet the state’s strict criteria. (Leys, 11/7)

In other election news —

The 19th: Disability Victory Is Working To Get More Disabled Candidates Elected
While politicians with disabilities like Sen. John Fetterman have become increasingly visible in national politics, disabled people are still significantly underrepresented. A new organization, Disability Victory, aims to change that. (Luterman, 11/6)

NBC News: Kids Who Survive Gun Injuries Suffer Increases In Pain, Psychiatric Disorders: Study
Through one year after a firearm injury, children and teens experienced a 117% increase in pain disorders, a 68% increase in psychiatric disorders, including PTSD, anxiety, depression and psychosis, and a 144% increase in substance use disorders relative to the controls. “Our results suggest that the struggles of the survivors on a daily basis to recover, to heal, to get by and make it to the next day is a challenging road,” said Dr. Zirui Song, one of the paper’s authors and a primary care physician and associate professor of health care policy and medicine at Harvard Medical School. (Mantel, 11/6)

KFF Health News: Children Who Survive Shootings Endure Huge Health Obstacles And Costs 
Oronde McClain was struck by a stray bullet on a Philadelphia street corner when he was 10. The bullet shattered the back of his skull, splintering it into 36 pieces. McClain’s heart stopped, and he was technically dead for two minutes and 17 seconds. Although a hospital team shocked him back to life, McClain never fully recovered. Doctors removed half his skull, replacing it with a gel plate, but shrapnel remains. (Szabo, 11/6)

The New York Times: When A Child Is Shot, Trauma Ripples Through Families, Study Finds 
With each mass shooting, Americans look to one grim indicator — the number of dead — as a measure of the destructive impact. But damage left behind by gunshot wounds reverberates among survivors and families, sending mental health disorders soaring and shifting huge burdens onto the health care system, a new analysis of private health insurance claims shows. ... “What comes after the gunshot is so often not talked about,” said Dr. Chana Sacks, co-director of the Gun Violence Prevention Center at Massachusetts General Hospital and an author of the new study, published on Monday in the journal Health Affairs. The study, which analyzed thousands of insurance claims, maps out lasting damage to families and communities. (Barry, 11/6)

The Washington Post: Childhood Trauma May Be Predictor Of Adult Headaches, Researchers Find
People who experienced trauma as a child or adolescent were found to be 48 percent more likely to have serious and recurrent headaches as an adult than were those who had not experienced trauma in their early years, according to research published in the journal Neurology. The finding stemmed from the analysis of data from 28 studies, involving 154,739 people. The researchers categorized traumatic events as either threat-based (such as physical, sexual or emotional abuse, witnessing or being threatened by violence, and serious family conflicts) or deprivation-based (including neglect, financial adversity, parents’ separation, divorce or death, and living in a household with mental illness, alcohol or substance abuse). (Searing, 11/6)

The Supreme Court weighs gun rights and domestic violence —

Politico: Gun Rights And Domestic Violence Collide At Supreme Court — But Justices Will Be Looking To The Past 
The justices will reach for their historian hats again Tuesday as the Supreme Court confronts the latest test of gun rights in modern America: whether people accused of domestic violence have a right to carry firearms. A 29-year-old federal law says no. It bars people under domestic violence protective orders from possessing guns. But when the court hears arguments on the constitutionality of that law, the justices likely will focus on whether the law meets a “text, history, and tradition” test the court laid out just last year for gun-rights cases. (Gerstein, 11/7)

The Wall Street Journal: Texas Man With History Of Wantonly Firing AR-15 Could Gut Gun Laws Nationwide
Zackey Rahimi pulled a gun on his ex-girlfriend in a parking lot and shot at a witness who saw them arguing, prompting a Texas family court to issue a protective order in 2020 temporarily forbidding him from possessing firearms. Rahimi ignored the order, authorities say, going on to threaten another woman with a gun, fire an AR-15 into the house of one of his narcotics customers, and shoot into the air at a Whataburger drive-through after his friend’s credit card was declined. That led to his conviction under a 1994 federal law prohibiting people under domestic-violence orders from possessing guns—and set up the latest chapter in the modern history of the Second Amendment.  (Bravin, 11/6)

The New York Times: Texas Man At Center Of Supreme Court Case Says He No Longer Wants Guns
In a handwritten letter from jail, the man at the center of a major Supreme Court gun rights case to be heard on Tuesday apologized for going down “a wrong path” and wrote that he would no longer carry a gun. “I will make sure for sure this time that when I finish my time being incarcerated to stay the faithful, righteous person I am this day,” the man, Zackey Rahimi, wrote. He added that he wanted “to stay away from all firearms and weapons, and to never be away from my family again.” Despite Mr. Rahimi’s vows in the July 25 letter addressed to a local judge and prosecutor, gun rights advocates acknowledge that he is not an ideal poster boy for the Second Amendment. (VanSickle, 11/6)

Also —

The Washington Post: Father Of Highland Park Shooter Pleads Guilty For Son’s Access To Guns 
The father of the man accused of killing seven people and wounding 31 at the 2022 Fourth of July parade in Highland Park, Ill., pleaded guilty Monday to seven counts of misdemeanor reckless conduct for his role in allowing his son to obtain firearms. Robert Crimo Jr. had been charged for “recklessly” sponsoring his son’s gun ownership application and allowing him access to firearms and ammunition, even though he was aware that Robert Crimo III had threatened violence and expressed suicidal thoughts. The young man was indicted last year in connection with the mass killing in the suburban Chicago town. (Berger, 11/6)

The Texas Tribune: Mom Of Uvalde School Shooting Victim Runs For Mayor
Nearly 18 months after the deadliest school shooting in Texas, Uvalde residents will elect a new mayor in a special election. Among the three candidates vying to lead the majority-Latino town is Kimberly Mata-Rubio, whose daughter Lexi was killed at Robb Elementary School last May. (Salhotra, 11/7)

Reuters: US CDC To Expand Surveillance Of Traveler Samples For Respiratory Viruses 
The U.S. Centers for Disease Control and Prevention (CDC) said on Monday it was expanding testing of samples collected from international air travelers beyond COVID-19, to include flu and respiratory synctial virus (RSV) beginning November. The agency's traveler-based genomic surveillance program, or TGS, began in 2021 to help with early detection of new SARS-CoV-2 variants. CDC conducts voluntary nasal swabbing and airport wastewater sampling as part of it. (11/6)

More on the spread of covid —

The New York Times: Some Covid Vaccines Are Still Hard To Find
Scott Lee, an entrepreneur who lives in North Bergen, N.J, said that when he tried to find a Novavax shot through the C.D.C.’s vaccine finder, it sometimes showed the shots as available when they actually were not, and some independent pharmacies that may have the shot weren’t listed. When he tried to book an appointment online at CVS, he had to fill out a lengthy scheduling form — only to realize at the end that he needed to speak with a pharmacist by phone first to get a Novavax shot. “It’s been a bit of a disaster,” Mr. Lee said. CVS has since updated its website to say that the Novavax vaccine is carried at all locations and that appointments are not required. (Sheikh, 11/6)

Medical Xpress: Researchers Develop A Nasal Vaccine That Prevents COVID-19 In Preclinical Studies
A team of University of Maryland researchers developed a nasal spray vaccine that delivers the SARS-CoV-2 spike protein into cells of the airway in mice and hamsters, triggering an immune response that significantly reduced infection and spread of COVID-19. The technology can be adapted to induce immunity to other respiratory illnesses, such as influenza and respiratory syncytial virus (RSV) infections. (Cutlip, 11/6)

CIDRAP: Childhood Abuse Linked To Higher Risk Of Adult COVID-19 Death
A new study from researchers at the University of Pittsburgh shows adults who suffered childhood abuse or neglect were more likely to be hospitalized for COVID-19 or die from the virus in adulthood. The study was published last week in the Journal of Epidemiology and Community Health. (Soucheray, 11/6)

CIDRAP: Partial Recall: Personal Beliefs May Skew Pandemic Memories, Deepen Polarization
Personal motivations color people's memories of the COVID-19 pandemic, biasing their assessment of past political actions and complicating emergency-preparedness planning, suggests an analysis of four empirical studies. For the review, published last week in Nature, a team led by researchers from the University of Bamberg in Germany and the University of Chicago evaluated the results of surveys of 10,776 vaccinated and unvaccinated German and Austrian adults about pandemic-related risk perceptions, protective behaviors, and trust in government and science. (Van Beusekom, 11/6)

Also —

Stat: Pulse Oximeter Inaccuracies Called Out In Attorneys General Letter 
More than two dozen attorneys general are urging Food and Drug Administration officials to take urgent action to address disparities in how well pulse oximeters, the fingertip devices used to monitor a person’s oxygen levels, work on people with darker skin. (McFarling, 11/7)

KFF Health News' 'Epidemic' Podcast: The Scars Of Smallpox 
In 1975, smallpox eradication workers in the capital of Bangladesh, Dhaka, rushed to Kuralia, a village in the country’s south. They were abuzz and the journey was urgent because they thought they just might get to document the very last case of variola major, a deadly strain of the virus.  When they arrived, they met a toddler, Rahima Banu. (11/7)

CBS News: Coalition Of Politicians, Health Organizations Demand White House Finalize FDA Ban On Menthol Cigarettes
Menthols, which are known for their minty taste, are easier to smoke and harder to quit. According to the Centers for Disease Control and Prevention, they are the choice of 81% of Black smokers, compared to 34% of white smokers. The White House Office of Management and Budget is currently reviewing an FDA proposal to prohibit menthol cigarettes and on Monday, local leaders called on the Biden administration to finalize those rules quickly. (Fan, 11/6)

Fox News: Ex-Law Enforcement Officials Warn Biden’s Menthol Cigarette Ban Could ‘Create A Vacuum’ For Mexican Cartels
Former law enforcement officials say Biden's proposed menthol cigarette ban will lead to a host of problems, including Mexican cartels saturating the U.S. black market. The Food and Drug Administration (FDA) proposed rules prohibiting menthol cigarettes and flavored cigars in April 2022. At the time, Health and Human Services Secretary Xavier Becerra said the action would protect children and benefit adult smokers. (Schoffstall, 11/6)

In other pharmaceutical news —

Reuters: Ozempic Side Effects 'Well-Known,' Novo Nordisk Argues
Novo Nordisk has refuted a Louisiana woman’s claim that her doctors weren’t properly warned of the side effects of the company’s blockbuster drug Ozempic, saying the vomiting and pain she alleged to have experienced are documented side effects included on the drug's label. The Danish drugmaker filed a motion to dismiss Jaclyn Bjorklund’s lawsuit against the company on Friday in Louisiana federal court. Bjorklund said that while taking the drug for Type 2 Diabetes she developed gastroparesis, a slowdown in the emptying of the stomach into the small intestine, that led to her vomiting and pain. (Jones, 11/6)

Stat: Astellas Shows Enough Data For Eye Drug To Support Expanded Use
Astellas on Saturday presented study results showing an increased treatment effect over time for its approved medicine for a common type of vision loss. The new data are probably enough to convince the Food and Drug Administration to remove restrictions on the drug’s use, but they still don’t measure up to a competing treatment from Apellis Pharmaceuticals. (Feuerstein, 11/6)

Reuters: Bristol Myers Buys Orum's Blood Cancer Therapy For Up To $180 Mln 
Bristol Myers Squibb has acquired Orum Therapeutics' experimental therapy to treat a type of blood cancer for a total value of up to $180 million, the privately held company said on Monday. The therapy, ORM-6151, which helps degrade a specific protein hard to treat previously, has received the U.S. Food and Drug Administration's (FDA) clearance for an early stage study. (11/6)

Reuters: Viatris US Court Win Reopens Path To Generic Of J&J Hypertension Drug 
A U.S. appeals court on Monday gave Viatris' Mylan Pharmaceuticals another chance to prove that its proposed generic of Johnson & Johnson unit Actelion's cardiovascular drug Veletri would not violate J&J's patent rights and should be allowed to go to market. The U.S. Court of Appeals for the Federal Circuit said that a West Virginia court interpreted a key part of the patents incorrectly and sent the case back for reconsideration. (Brittain, 11/6)

Reuters: Judge Trims US Lawsuit Accusing Cencora Of Fueling Opioid Epidemic 
A federal judge on Monday pared back a U.S. government lawsuit accusing drug distributor Cencora, formerly called AmerisourceBergen, of fueling the nation's deadly opioid epidemic by failing to report hundreds of thousands of suspicious orders of prescription painkillers. U.S. District Judge Jerry Pappert in Philadelphia federal court ruled that the government could only seek penalties for alleged failure to report suspicious orders after October 2018, when the federal Controlled Substances Act was amended to explicitly require such reports. The government's lawsuit, filed last December, claimed that the company failed to report suspicious orders going back to 2014. (Pierson, 11/6)

AP: US Orders Puerto Rico Drug Distribution Company To Pay $12 Million In Opioid Case
One of Puerto Rico’s biggest distributors of pharmaceutical drugs was ordered to pay $12 million after being accused of not reporting hundreds of suspicious orders for controlled substances, the U.S. Justice Department said Monday. Drogueria Betances, LLC is accused of not reporting at least 655 orders for fentanyl and at least 113 orders for oxycodone from 2016 through June 2019. The orders were considered suspicious given in part their frequency and size, the department said. (11/6)

In related news about the drug crisis —

WLRN 91.3 FM: All Miami-Dade Public Schools Now Stock Overdose Reversal Drugs
Every public school in Miami-Dade County now stocks the overdose reversal drug naloxone, which in nasal spray form is known as Narcan. School district officials announced the development Thursday as they launched a countywide awareness campaign around the deadly risks of the synthetic opioid fentanyl. (Payne, 11/6)

Axios: U.S. Health Outcomes Worse Than OECD Nations On Most Measures
The U.S. performs worse than the average developed nation on 77% of health status indicators like life expectancy, obesity and opioid mortality rate, according to an Organization for Economic Cooperation and Development report. U.S. health spending as a share of gross domestic product yet again far outpaces the other 37 OECD nations while the country continues to have poor outcomes, the OECD Health at a Glance 2023 report shows. (Reed, 11/7)

AP: Mind-Altering Ketamine Becomes New Pain Treatment
As U.S. doctors scale back their use of opioid painkillers, a new option for hard-to-treat pain is taking root: ketamine, the decades-old surgical drug that is now a trendy psychedelic therapy. Prescriptions for ketamine have soared in recent years, driven by for-profit clinics and telehealth services offering the medication as a treatment for pain, depression, anxiety and other conditions. The generic drug can be purchased cheaply and prescribed by most physicians and some nurses, regardless of their training. (Perrone, 11/6)

NBC News: Why Are There No Treatments For Cocaine And Meth Addiction?
More people in the U.S. are overdosing from cocaine, methamphetamine and prescription stimulants and there's no approved medication to help them get off the drugs. ... Although the FDA has never ruled it out, in draft guidance released last month, the agency expressed openness for the first time to trials for new treatments that reduce the use of cravings for illegal stimulants, rather than solely looking at complete drug abstinence, a move welcomed by addiction specialists. (Lovelace Jr., 11/7)

Fox News: A Quarter Of US Medical Students Consider Quitting School And Most May Not Treat Patients: New Survey 
Among the next generation of doctors, many are considering quitting medical school even before donning their long white coats. A quarter of all medical students in the United States might quit school. That’s according to a new report from Elsevier Health, which surveyed students to get their perspectives on education, career plans and expectations for the future of health care. (Sudhakar, 11/6)

In other health industry news —

Military.com: VA Set Records For Number Of Appointments, Claims Processing, Compensation Over The Past Year
The Department of Veterans Affairs set records in multiple areas this past fiscal year -- a pace officials say they hope to continue in 2024 with targeted hiring for high-demand jobs, it announced Monday. The Veterans Health Administration, the VA's medical services arm, oversaw 116 million medical appointments in fiscal 2023, a 2.7% increase from the record set in fiscal 2022. And the Veterans Benefits Administration, which handles VA disability compensation and benefits, paid out $150 billion in compensation and benefits to 1.5 million veterans and survivors, a 39% increase, and processed nearly 2 million disability claims, up nearly 16%. (Kime, 11/6)

Modern Healthcare: Envision Healthcare Emerges From Chapter 11 Bankruptcy
Envision Healthcare has restructured its operations as part of the Chapter 11 bankruptcy process and reduced its debt by more than 70%, the physician staffing company said Friday. Envision filed for Chapter 11 bankruptcy protection in May, entering into a restructuring support agreement for about $7.7 billion in debt. The bankruptcy filing followed months of financial turmoil due to multiple payer lawsuits, rising labor costs and impacts from the No Surprises Act, which cut into much of Envision's profits from out-of-network bills. (Hudson, 11/6)

Crain's Chicago Business: Outcome Health Founder Rishi Shah Wants Sentencing Delayed | Modern Healthcare
Rishi Shah has rehired his original attorney, whom the Outcome Health founder says withdrew because he couldn’t afford him, as Shah is seeking to delay his sentencing until February. Shah, convicted alongside co-defendants Shradha Agarwal and Brad Purdy of a nearly $1 billion startup fraud in April, is scheduled to be sentenced Dec. 5. Each faces up to 30 years in prison. (Pletz, 11/6)

On the use of artificial intelligence —

Axios: IVF Doctors Could Use AI To Help Pick Embryos
AI could help people get pregnant. As doctors deal with overwhelming demand for fertility services, machine learning tools are offering ways to help streamline the IVF process. (Mallenbaum, 11/7)

Stat: Detecting Disease From Voice Signals With AI, And Data Concerns
Over the past few years, researchers have started using AI to capture signals from our voices in hopes of quickly diagnosing diseases. Academics and startup founders in the nascent field talked about the potential benefits, as well as the privacy implications, of this technology at the Milken Institute Future of Health Summit on Tuesday. (Lawrence, 11/7)

USA Today: Parkinson's Disease Patient Reports Progress From Spinal Cord Implant
Marc Gauthier had trouble getting up from a chair. His steps were small and shaky and he would fall five or six times a day. His Parkinson's disease had gotten so bad he couldn't be left alone. The former architect and small-town mayor had been "reborn" once, two decades earlier, when he received an implant that stimulated his brain and stabilized his trembling hands. He was ready for another rebirth. ... Now, he's the subject of a study, published Monday, reporting his success. (Weintraub, 11/6)

Reuters: Swiss-Designed Technology Helps Parkinson's Patient Walk Again
A long-term Parkinson's disease patient, Marc Gauthier had essentially been confined to his home until he became the first person to receive a new Swiss-designed implant that dramatically improved his ability to walk. Gauthier, 63, received a neuroprosthetic at Lausanne University Hospital (CHUV), comprising an electrode field placed against his spinal cord. Combined with an electrical impulse generator under the skin of his abdomen, the device stimulates his spinal cord to activate his leg muscles. (Mantovani and Tetrault-Farber, 11/6)

More health and wellness news —

The Washington Post: Fruit Pouch Recall Expands After More Illnesses Linked To Lead
Three companies have issued recalls for applesauce pouches marketed for children because they may contain elevated levels of lead. At least seven illnesses in five states have been linked to tainted puree, regulators say. Schnuck Markets Inc. of St. Louis announced a recall of certain applesauce pouches because of “elevated levels of lead found in the cinnamon raw material” used by Austrofood SAS, which manufactures the pouches. WanaBana and the Weis supermarket chain took similar action. (Gregg, 11/6)

CBS News: Heavy Lead X-Ray Aprons At Dentist May Do More Harm Than Good, Experts Say
The protective aprons used during dental X-rays may be doing more harm than good. Experts, including at Tufts University School of Dental Medicine, say that's no longer necessary. Older-generation radiology equipment could scatter radiation beyond the teeth and jaw, but modern technology has reduced that risk significantly such that lead aprons don't provide any additional benefit.  (Marshall, 11/6)

CBS News: Adding Too Much Salt To Food Could Increase Risk Of Type 2 Diabetes, Study Says
Researchers at Tulane University studied more than 400,000 adults in the United Kingdom over 12 years and found that compared to people who "never or rarely" added salt to foods, those who "sometimes" added salt had a 13% higher risk of developing Type 2 diabetes. Those who "usually" added salt had a 20% higher risk; and those who "always" added salt had a 39% higher risk of becoming diabetic. (Marshall, 11/6)

Fox News: New Tech Has Spooky Ability To Detect Future Heart Attack: Study
A new study found that artificial intelligence could be used to help detect risk signs and possibly even prevent sudden cardiac death. The American Health Association found that AI was able to identify people who were at more than a 90% risk of sudden death, according to a report on the study in Medical Xpress. (Lee, 11/7)

CBS News: What Is Bone Smashing? The Dangerous TikTok Beauty Trend Surgeons Are Warning Against
The latest TikTok beauty trend encourages young people to strike themselves in the face with a blunt object to cause fractures in their face, in hope of achieving a perfect jawline or a more physically attractive face. Plastic and reconstructive surgeon Dr. Ben Schultz. from LifeBridge Health, said there is a false belief behind the increasingly controversial trend that when bones heal, they grow stronger. ...To anyone following this trend or thinking of trying it, Dr. Schultz has this to say. "The answer is don't. Don't do it." (Zizaza, 11/6)

Axios: DOJ Asks Supreme Court To Review Tennessee's Ban On Gender-Affirming Care
The Biden administration on Monday urged the Supreme Court to reverse Tennessee's ban on gender-affirming care for minors, saying any delay in review would endanger youths who are or will be denied critical medical care. The Justice Department petition comes after lower courts allowed bans in Tennessee and two other states to move forward this summer. (Bettelheim, 11/6)

In other health news from across the U.S. —

Fox News: What To Know About Legionnaires’ Disease, Lung Infection Confirmed At Arkansas Senior Center
A resident at the Methodist Village Senior Living facility in Fort Smith, Arkansas, has been diagnosed with Legionnaires' disease. "We have one resident with a confirmed case of Legionnaires'," Cat Hamilton, the director of member services for AHCA, told Fox affiliate KNWA. "We have implemented our water management plan and are working in collaboration with the Fort Smith Utility Department and the Arkansas Department of Health." (Rudy, 11/6)

Charlotte Ledger: Violence Against Doctors, Nurses Is Rising; A New Law Aims To Protect Them
Emergency physician Jennifer Casaletto has been cursed at, shoved, punched, spat on and bitten while trying to do her job. One patient threw a container full of urine at one of her medical residents. Another kicked her when she was pregnant. Violent incidents against health care workers have surged, Casaletto said, and she now tries to work mostly in large hospitals because they tend to have more security. (Crouch, 11/6)

New Hampshire Public Radio: Advocates Argue Telephone Hearings Deny Due Process Rights Of Psychiatric Patients
Civil liberties advocates say New Hampshire’s practice of affording patients who have been involuntarily committed due to mental health concerns an initial hearing over a telephone, instead of in-person, is a violation of their due process rights. The claims come more than five years into a legal battle over the state’s overburdened system for treating people in psychiatric distress, and the long-standing shortage of in-patient mental health beds. (Bookman, 11/6)

CBS News: Scholarship Brings Maternal Care To Colorado's Rural Areas
"Women who give birth in rural areas do have more complications of birth, and we're seeing that there really is an urban-rural disparity in outcomes," said Smith. "The intent is to grow the midwifery workforce to serve populations that are currently underserved by maternity care providers." A new scholarship will fund tuition, fees and living expenses for up to 14 nurses to complete a midwifery graduate program over the next four years. Nurses must commit to working in a rural area after graduation. (Mason, 11/6)

KFF Health News: New California Law Offers Fresh Protection From Steep Ambulance Bills
Last year, Jennifer Reisz’s college-age daughter, Megan, was kicked in the chest multiple times by the family’s horse. Megan fell to the ground, unable to move or speak. Though she was alone, her Apple Watch detected her distress and called 911. She was taken to a hospital in Clovis, a city in Fresno County, near where the Reisz family lives. But the severity of Megan’s injuries — four broken ribs and a partially collapsed lung — prompted doctors to transport her 12 miles by ambulance to the Level I trauma center at Community Regional Medical Center in Fresno. (Wolfson, 11/7)

The Washington Post: Librarians Join The Fight For Public Health 
As University of Pennsylvania health researcher Anna U. Morgan explains, libraries in America are an important part of the public health environment because they offer two foundational components of a successful health-care network — accessibility and trustworthiness. (John Herron, 11/6)

USA Today: Can You Text 911? Lewiston Shooting Shows Why We All Need The Option
A few years ago, during a medical emergency, my Deaf father was not able to call 911. This caused a delay in getting him the help he urgently needed. The terrifying experience led me to establish the nonprofit organization accesSOS, aimed at creating a text-to-911 solution. (Gabriella Wong, 11/7)

The Washington Post: AI Tools Are Keeping Hospital Patients Alive 
Artificial intelligence is already widely used in health care — to enhance cancer detection, reduce paperwork and tailor treatments. The question is, does it actually improve patient outcomes? (Leana S. Wen, 11/7)

New England Journal of Medicine: Modernizing Federal Oversight Of Laboratory-Developed Tests — Toward Safety, Validity, And Utility
Advances in precision medicine have fueled an evolution in the availability of laboratory-developed tests (LDTs). Defined as in vitro diagnostic tests that are “designed, manufactured, and used in a single laboratory,” LDTs were initially conceived as simple tests offered to limited, local groups of patients.1 But LDTs have grown in complexity, and some hospital and commercial laboratories now accept specimens from around the world. (Udit Singhal, M.D., Caroline Horrow, J.D., Aaron S. Kesselheim, M.D., J.D., M.P.H., and Todd M. Morgan, M.D., 11/4)

Stat: The PATCH Act’s Approach To Secure Medical Devices Is Limited
In August 2013, the FDA made news when it issued cybersecurity guidance for medical devices. But several years earlier, government officials recognized the risk: Soon after the FDA made its announcement, former Vice President Dick Cheney revealed in a “60 Minutes” interview that when his pacemaker was replaced in 2007, his doctors took precautions to make it hack-proof. (Paul Jones, 11/7)

Stat: Fertility Clinic Egg And Embryo Storage Is A Disaster
Kindbody, a fast-growing fertility chain, knowingly exposed countless eggs and embryos to unsafe conditions and suffered repeated embryo mix-ups, according to a months-long Bloomberg investigation published recently. Here we go again. Five years ago, a Pacific Fertility Center clinic in San Francisco suffered a massive storage tank failure that ended my dreams of ever becoming a mother. In all, 4,000 eggs and embryos from 400 people died that day in San Francisco. (Monica Coakley, 11/7)

USA Today: My Eating Disorder Consumed Me. We Deserve To Be Heard - And Our Illness Treated Like Any Other
About 30 million Americans suffer from an eating disorder. This includes binge eating, anorexia, avoidant restrictive food intake disorder, rumination disorder and bulimia nervosa. Eating disorders are life-consuming. People who suffer cannot just “get over it.” This disorder consumes your every thought. (Jami Schadler, 11/7)

The Atlantic: These Teens Got Therapy. Then They Got Worse
Researchers in Australia assigned more than 1,000 young teenagers to one of two classes: either a typical middle-school health class or one that taught a version of a mental-health treatment called dialectical behavior therapy, or DBT. After eight weeks, the researchers planned to measure whether the DBT teens’ mental health had improved. (Olga Khazan, 11/6)

Newsweek: Big Tech Is Exploiting Kids Online. Congress Has To Step In 
Social media platforms know the harm they do to children. Kids spend huge portions of their days in front of screens. About 40 percent of kids between the ages of 9 and 12 use Instagram daily, despite current law ostensibly restricting social media use for people younger than 13. Researchers, including Big Tech's own internal researchers, continue to confirm what American parents already know firsthand: social media use is a key driver of the current mental health crisis among children and teenagers, including growing rates of suicidal ideation and self-harm. (Chris Griswold, 11/6)