The New York Times: Trump Signs Order To Require Recipients Of Federal Aid Programs To Work
President Trump quietly signed a long-anticipated executive order on Tuesday intended to force low-income recipients of food assistance, Medicaid and low-income housing subsidies to join the work force or face the loss of their benefits. The order, in the works since last year, has an ambitious title — “Reducing Poverty in America” — and is directed at “any program that provides means-tested assistance or other assistance that provides benefits to people, households or families that have low incomes,” according to the order’s text. (Thrush, 4/10)

The Associated Press: Trump Signs Executive Order Pushing Work For Welfare
"Part of President Trump's effort to create a booming American economy includes moving Americans from welfare to work and supporting and encouraging others to support common-sense reforms that restore American prosperity and help them reclaim their independence," he said. The order focuses on looking for ways to strengthen existing work requirements and exploring new requirements for benefits such as food stamps, cash and housing assistance programs. (Colvin, 4/10)

The Washington Post: Trump Executive Order Strengthens Work Requirements For Neediest Americans
The executive order is the strongest statement Trump has made about the country’s social safety net program since his February budget proposal to slash billions of dollars in food stamps, health insurance and federal housing subsidies. Trump indicated at the time that he would push legislation to institute broad work requirements for families receiving housing vouchers, expanding on moves by some states to require recipients of Medicaid and food stamps to work. (Jan, 4/10)

The Wall Street Journal: Trump Signs Executive Order For Revamp Of Federal Aid Programs
Democratic and liberal critics of the policies have countered that many programs help low-income families that are already working, and additional requirements would increase bureaucracy for them and for local and state governments. “The evidence shows that such requirements have few long-term positive effects on employment and often result in families losing help they need to afford the basics,” said Sharon Parrott, a senior fellow at the left-leaning Center on Budget and Policy Priorities. (Radnofsky, 4/10)

Politico: Trump Orders Top-To-Bottom Review Of Welfare Programs
Under Trump, HHS has already sought to enshrine work requirements in Medicaid, a first in the history of the health coverage program for the poor. Kentucky, Indiana and Arkansas got the green light this year to require certain able-bodied adults to work as a condition of keeping their health benefits. Advocates for the poor contend that employment rules for Medicaid are not legal and have already sued to stop the Kentucky requirements from taking effect. Conservatives used the executive order to push federal health officials to approve pending Medicaid work requirement requests in several other Republican-led states, including Utah, Maine, Wisconsin, Arizona and Alabama. (Woellert, 4/10)

Meanwhile, in the states —

Minnesota Public Radio: Should Medical Assistance Come With A Work Requirement?
There are bills in the Minnesota House and Senate that would require people receiving Medical Assistance to work or volunteer. The bills specify that those who are "able-bodied" should be able to work or volunteer while receiving Medical Assistance, Minnesota's version of Medicaid. (Miller and Shockman, 4/10)

Milwaukee Journal Sentinel: Wisconsin Gov. Scott Walker Signs Limits On Welfare Programs Into Law
Wisconsin Gov. Scott Walker on Tuesday signed new limits on welfare programs into law, committing state and federal taxpayers to nearly $80 million in spending to draw more people into the labor force. (Stein, 4/10)

Health News Florida: Medicaid Patients With HIV May Lose Coverage In Miami
Medicaid patients living with HIV in South Florida might need to find new health insurance. The Agency for Health Care Administration will decide whether to drop its contract with AIDS Health Care Foundation by the end of this month. (Prieur, 4/10)

The Washington Post: Trump Says Veterans Wait Too Long For Health Care. VA’s 33,000 Vacancies Might Have Something To Do With That.
The Department of Veterans Affairs, facing intense scrutiny amid reports of widespread dysfunction and a push by the Trump administration to outsource more medical care, has tens of thousands of full- and part-time vacancies nationwide, according to data compiled by veterans advocates, lawmakers and federal unions. Most urgently, the agency’s health-care network needs thousands of primary care physicians, mental-health providers, physical therapists, social workers — even janitorial staff, Sen. Jon Tester (Mont.), ranking Democrat of the Senate Veterans’ Affairs Committee, told The Washington Post in an interview. Of equal concern, he said, VA lacks enough human resources personnel to vet candidates and make the hires. (Wax-Thibodeaux, 4/10)

In other news —

The Hill: VA Privatization Fight Could Erupt In Confirmation Hearing 
Long-simmering tensions about privatizing the Department of Veterans Affairs could erupt into a confirmation battle over President Trump's pick to lead the department. Trump’s decision to oust former VA Secretary David Shulkin late last month and replace him with White House physician Ronny Jackson stoked speculation that the White House wants to allow veterans more access to private-sector health care providers. (Weixel, 4/11)

Modern Healthcare: 5 Takeaways From CMS' Final 2019 ACA Marketplace Rule 
The CMS issued a 523-page final rule late Monday that agency officials said is meant to give states more power to regulate their individual and small-group health insurance markets. The rule also furthers the Trump administration's agenda of chipping away at Affordable Care Act rules in lieu of a full repeal, which congressional Republicans haven't been able to pull off. (Livingston, 4/10)

Politico Pro: CMS Overhaul Of Obamacare Program Could Help Small Insurers
The Trump administration is moving forward with a major change to one of Obamacare’s insurance stabilization programs meant to attract more competitors to the struggling marketplaces. The change to the law’s risk adjustment program, which is supposed to help insurers with disproportionately sicker customers, comes after years of complaints that it hurt smaller companies and drove them away from the exchanges. (Demko, 4/10)

Meanwhile, in the states —

Chicago Tribune: Some Illinois Consumers Won’t Have To Pay Obamacare Penalty This Year 
Consumers who chose to pay a penalty rather than sign up for health insurance are getting a break, depending where they live. Most consumers have been required under the Affordable Care Act to have health insurance or pay a federal penalty of $695 per adult or 2.5 percent of household income for last year, whichever was greater. (Schencker, 4/10)

The Associated Press: Hogan Signs Bills On Health Care, School Safety
Gov. Larry Hogan signed legislation on Tuesday that takes a unique approach to stabilize health insurance rates in the state health care exchange’s troubled individual market. The bill taps about $380 million that health insurance companies no longer have to pay in federal taxes due to changes in the federal tax code to help prevent rising premiums for about 150,000 people. A separate bill the governor already has signed creates a long-term plan to preserve the exchange through a reinsurance program. (Witte, 4/10)

The Hill: Doctors Bristle At Push For Opioid Prescription Limits 
An increasing number of states and entities in the health industry are putting curbs on the amount of opioids that doctors can prescribe, a controversial move aimed at combating the opioid crisis. These limits have garnered support from various stakeholders and are now being considered in Congress, with a bipartisan group of senators proposing to set a cap on first-time prescriptions for acute pain. (Roubein, 4/11)

New Hampshire Public Radio: Rep. Kuster Meets With Leaders On The Frontlines Of N.H.'s Opioid Epidemic
Congresswoman Annie Kuster met in Concord Monday with more than a dozen state and local leaders to discuss how to best use funding aimed at the opioid epidemic. Kuster led a listening session where doctors, law enforcement and mental health experts offered expertise on how to battle addiction in the state. (Garrova, 4/10)

The Philadelphia Inquirer: Opioid Addiction Treatment With Medicine Works Best. Why Don't More Young People Get It?
Overall, opioid use disorder in this age group, especially those age 18 to 24, has skyrocketed. Yet for a variety of reasons, MAT is not reaching many of the young people who might benefit from it. (Giordano, 4/11)

Kaiser Health News: KHN On C-SPAN: Current Capitol Hill Thinking On Combating The Opioid Crisis
Kaiser Health News correspondent Shefali Luthra was interviewed as part of C-SPAN’s in-depth examination of recent developments regarding the nation’s opioid crisis. Luthra talked about ideas circulating around Capitol Hill — in hearings, in legislation and in budget measures — to combat the problem, as well as how states have been responding, among other things. The program first aired April 5. (4/11)

Stat: A New York Attorney Becomes The Face Of A Crucial Abortion Rights Case
Brigitte Amiri, an attorney with the American Civil Liberties Union, was spending the weekend on Long Island with her family in late September when she got the call about Jane Doe. She wasn’t Jane Doe just yet. She was a pregnant 17-year-old immigrant from Central America being held in federal custody after entering the U.S. illegally. She’d obtained a judge’s permission to get an abortion. But the Office of Refugee Resettlement — a branch of the Trump administration responsible for unaccompanied immigrant minors — wouldn’t allow it. (Thielking, 4/11)

In other women's health and abortion news —

The Hill: Trump Appointee At Center Of Fight Over Religious Freedom 
Roger Severino is implementing strict rules at the Department of Health and Human Services (HHS) meant to protect religious rights — in part because of discrimination he says he has experienced firsthand. The son of South American immigrants, Severino, the director of the HHS Office for Civil Rights (OCR), grew up in Los Angeles, where he says “people attempted to close doors in front of me, and I’ve had to fight to pry them open.” (Hellmann, 4/10)

The Hill: Planned Parenthood Targets Judicial Nominee Over Abortion Comments 
Wendy Vitter, President Trump's judicial nominee for the eastern Louisiana U.S. District Court, is being targeted by Planned Parenthood as an anti-abortion extremist who should not be confirmed. In a five-figure digital ad campaign running nationally on Facebook and Twitter, Planned Parenthood is urging supporters to tell their senators to vote against her confirmation. (Hellmann, 4/10)

Politico Pro: Abortion Foes Press For Tighter Curbs, Anticipating More Trump Supreme Court Picks
Abortion foes emboldened by the odds of President Donald Trump shaping the Supreme Court are pushing some of the strictest restrictions ever, including a federal ban as early as six weeks of pregnancy and total bans on the procedure in Ohio and South Carolina. (Haberkorn, 4/10)

And in Arizona —

Arizona Republic: Arizona House Passes Bill To Make Abortion Doctors Ask More Questions
Women who receive an abortion in Arizona could soon face a more detailed line of questioning about why they want to end their pregnancy. The Arizona House of Representatives voted Monday to amend a controversial abortion bill that would require doctors to ask their patients for a specific reason for having the procedure. (Gardiner, 4/10)

Modern Healthcare: Calif. Hospitals Blast New Rate-Setting Proposal For Providers 
California hospitals are on edge over a bill dropped late Monday that would mandate regulated rate-setting for providers. The measure would use Medicare rates as the benchmark to calculate commercial insurer payments, and would cost state hospitals $18 billion in the first year alone, according to preliminary projections. The California effort is being pushed by patient advocates and labor unions who say the rising cost of healthcare is cutting into wage growth. It is the first signal from the country's most populous state that legislators are wading into the minefield of addressing healthcare prices as consumers grow increasingly unhappy. (Luthi, 4/10)

Politico: Texas Health Group Cashes In On State’s Rural Hospital Crisis
The Hashmi group’s hospitals don’t accept commercial insurance, charge unusually high rates and have run afoul of state inspectors. But the rural community of Bowie, Texas, felt like it got a lifeline when the Dallas for-profit offered to buy its shuttered hospital. The North Texas town of 5,000 — which was hit hard by a drop-off in oil and gas production and rejected a property tax increase to keep the former Bowie Memorial Hospital afloat — had few options. Without a hospital, residents would have to drive nearly 30 miles for emergencies and the town would lose high-paying medical jobs. (Rayasam, 4/10)

KCUR: Would-Be Savior Of Missouri, Kansas Hospitals Accused Of Wider ‘Fraudulent Scheme' 
The same lab billing arrangement put in place at a small, rural hospital in Unionville, Missouri, is the subject of a federal lawsuit in Georgia that calls it a fraudulent scheme designed to enrich its architects. The lawsuit, filed by Blue Cross and Blue Shield of Georgia, alleges that since August 2016, a 49-bed hospital in rural north Georgia has billed it more than $174 million for lab tests Blue Cross did not agree to pay for. The arrangement at Chestatee Regional Hospital in Dahlonega, Georgia, is strikingly similar to the one at tiny Putnam County Memorial Hospital in Unionville, which is now seeking to oust its owner. (Margolies, 4/10)

Boston Globe: Carney Hospital President Takes New Job
The president of Carney Hospital in Dorchester is leaving to take a new job. Walter J. Ramos, who became president of Carney in 2015, will become chief executive of the Boston-based human services company Rogerson Communities in July. (Dayal McCluskey, 4/10)

Boston Globe: Tufts Hospital CEO Criticizes Planned Beth Israel-Lahey Merger
The chief executive of Tufts Medical Center on Tuesday criticized the proposed merger of Beth Israel Deaconess Medical Center and Lahey Health, arguing that the deal would increase costs and widen health care disparities. Tufts, a teaching hospital in Boston’s Chinatown neighborhood, competes with Beth Israel Deaconess and Lahey, but it serves a much higher share of patients on Medicaid, the government health program for poor and low-income individuals. (Dayal McCluskey, 4/10)

The Associated Press: Number, Severity Of Brain Injuries Raises Dementia Risk
A large study offers more evidence of a link between traumatic brain injuries and dementia later in life, with repeated injuries and severe ones posing the greatest danger. Researchers analyzed 36 years of health records of 2.8 million people in Denmark, where a national health system makes it possible to explore connections in a far-reaching way. Overall, the risk was small. About 95 percent of people who suffered a brain injury never developed dementia. (Johnson, 4/10)

The New York Times: Traumatic Brain Injuries Are Tied To Dementia
T.B.I. has a wide range of severity. It extends from a mild sports concussion — an elbow to the head in a basketball game, for example — that results in very brief or no unconsciousness and no structural harm to the brain, to the most severe brain injuries that can cause extended unconsciousness, coma or even prove fatal. The study, in Lancet Psychiatry, used Danish health databases that included all residents as of Jan. 1, 1995, who were at least 50 years old at some time during the 36-year follow-up, from 1977 to 2013. Among 2,794,852 people, they found 258,827 who had had at least one T.B.I. (Bakalar, 4/10)

Los Angeles Times: What Ails America? The Answer Varies From State To State
The state of the union's health is improving. But it is doing so very unequally, and recent signs of progress are in danger of being reversed by diseases of excess and despair, including obesity, depression, suicide and substance abuse. Those are the broad conclusions of a new roundup of Americans' vital signs published Tuesday in the Journal of the American Medical Assn. (Healy, 4/10)

The Wall Street Journal: How Death Strikes Around The U.S.
A grim tally of “years of life lost” shows that substance abuse, suicides and diabetes drove a rise in premature deaths in nearly half the country, according to researchers who mapped variations in death rates among people 20 to 55 years old. The research offers a detailed look at the trends pulling down life expectancy among young and middle-aged Americans in recent years. So-called “deaths of despair,” including drug overdoses, have been on the rise, especially among white Americans, according to recent studies. (McKay and Rigdon, 4/10)

Minnesota Public Radio: Minnesota's Premature Death Rate Lowest In The Nation
A University of Washington national analysis of premature death, found Minnesota has the lowest rate of what are called "years of life lost," based on data from 1990 to 2016. University global health professor, Ali Mokdad said living circumstances and lifestyle choices determine premature death rates. (Zdechlik, 4/10)

Health News Florida: Life Expectancy Study Provides Insight Into What's Killing Floridians
A national study released Tuesday provides a state-by-state look at life expectancy and the factors that are killing Floridians, and as one might expect, opioid abuse is near the top of the list. The years of life lost due to opioid use in the state jumped more than 750 percent over the past 26 years, according to The State of U.S. Heath study published in the Journal of the American Medical Association. (Ochoa, 4/10)

The Associated Press: 5 Years On, Marathon Bomb Survivors Inspire Medical Advances
In the five years since the Boston Marathon bombing, medical science has made promising advances in amputations and artificial limbs, in part because of lessons learned from the victims and research dollars made available as a result of the attack. Some of the 17 people who lost limbs in the April 15, 2013, bombing could, like many other amputees, benefit from these developments, since many are coming to a crossroads in their treatment. A number still struggle with pain, and others may be looking to replace their prostheses, which are approaching the end of their useful life. (Marcelo, 4/11)

CNN: Does Talcum Powder Cause Cancer? A Legal And Scientific Battle Rages
Visitors who walk into Deborah Giannecchini's ranch house in Modesto, California, will notice a well-tended garden, four small dogs who greet every visitor with enthusiasm and a sign that hangs prominently displayed in her living room that reads "It's never too late to live happily ever after." She got it when she was 62 years old, after she married her husband, Leland, but it could also represent her current mission: to help other women avoid the pain she's experienced and allow them to have their own happy endings. (Christensen, 4/11)

NPR: Medicine That Can Prevent HIV Infection Is Still Widely Unknown
A big part of Washington D.C.'s plan to get its HIV rate down is to get more uninfected people on PrEP, a two-medicine combination pill that's also sold under the brand name Truvada. When taken daily by people who are at high risk for contracting HIV via sex or shared needles with someone who is infected, this pre-exposure prophylaxis can cut the risk of HIV infection by 92 percent, studies show. (Simmons-Duffin, 4/10)

Cleveland Plain Dealer: Are Frozen Embryos Human Life? Fertility Treatments Present Ethical Dilemmas
The incident March 3-4, in which rising temperatures in a cryogenic freezer rendered 4,000 frozen eggs and embryos nonviable, has raised many questions about life, death and technology. But the mere fact that a human egg can be fertilized and then frozen poses important ethical questions, according to Cristie Cole Horsburgh, a board member of the Bioethics Network of Ohio and a bioethicist at the Cleveland Clinic. (Washington, 4/11)

The Washington Post: Anti-Vaccine Reviewers Target Children’s Books On Amazon
“Judah Maccabee Goes to the Doctor: A Story for Hanukkah” does not read like the product of an outraged mind. The story describes a young boy named Judah who must brave a pediatrician's needle — for his health and, he comes to realize, his little sister's. The book, published in August, is so zippy and crisp that you can hardly tell author Ann D. Koffsky wrote it from a place of anger. Koffsky is an Orthodox Jew and describes herself as religious. She said she became furious at reports of Jewish families that claimed religious exemptions from vaccinations and sent their non-vaccinated children to private schools. (Guarino, 4/9)

Kaiser Health News: Is There Such A Thing As Normal Aging?
For 93-year-old Joseph Brown, the clearest sign of aging was his inability the other day to remember he had to have his pants unzipped to pull them on. For 95-year-old Caroline Mayer, it was deciding at age 80 to put away her skis, after two hip replacements.And for 56-year-old Dr. Thomas Gill, a geriatric professor at Yale University, it’s accepting that his daily 5½-mile jog now takes him upward of 50 minutes — never mind that he long prided himself on running the distance in well under that time. (Horovitz, 4/11)

Los Angeles Times: How Single-Payer Healthcare Has Divided Democrats In California's Race For Governor
When Gavin Newsom campaigns on his support for a California single-payer healthcare system, he's talking about more than the virtues of universal care. He's trying to sell himself as a bold visionary. When Antonio Villariagosa warns of the financial calamity that awaits if the state adopts single payer, he's trying to send a different message — that he's a fiscally responsible realist who won't make promises he can't keep. (Willon, 4/11)

The Washington Post: A Year After D.C. Passed Its Controversial Assisted Suicide Law, Not A Single Patient Has Used It
Nearly a year after the District enacted a law allowing terminally ill patients to end their lives — over the objections of congressional Republicans, religious groups and advocates for those with disabilities — not a single patient has used it. And just two of the approximately 11,000 physicians licensed to practice in the District have registered to help patients exercise their rights under the law. Only one hospital has cleared doctors to participate. (Nirappil, 4/10)

Arizona Republic: Why Parents Are Losing Custody Of Trans And Gender Non-Conforming Kids
A recent Arizona Appeals Court review of the case highlights the challenges of mediating custody battles between parents who differ on how to handle kids who may be transgender — a matter LGBT experts say most U.S. family courts are poorly equipped to handle. (Polletta, 4/10)

The Associated Press: Free-Range Parenting Laws Letting Kids Roam Could Catch On
After Utah passed the country's first law legalizing so-called free-range parenting, groups in states from New York to Texas are pushing for similar steps to bolster the idea that supporters say is an antidote for anxiety-plagued parents and overscheduled kids. Free-range parenting is the concept that giving kids the freedom to do things alone — like explore a playground or ride a bike to school — makes them healthier, happier and more resilient. (4/10)

The Star Tribune: Rare Partnership To Make Cancer Research, Treatment Accessible In Rural Minnesota 
Cancer patients in isolated corners of Minnesota will gain easier access to experimental medications, treatment protocols and prevention programs through a new state-funded cancer consortium launched Monday. Led by the University of Minnesota and the Mayo Clinic, the consortium is a rare, high-profile partnership between two competing medical research giants. Supported by $8 million approved by the state Legislature last year, the consortium will circulate clinical trial opportunities through 18 sites across the state. (Olson, 4/10)

The Wall Street Journal: Theranos Lays Off Most Of Its Remaining Workforce
Blood-testing firm Theranos Inc. laid off most of its remaining workforce in a last-ditch effort to preserve cash and avert bankruptcy for a few more months, according to people familiar with the matter. Tuesday’s layoffs take the company’s head count from about 125 employees to two dozen or fewer, according to the people familiar with the matter. As recently as late 2015, Theranos had about 800 employees. (Carreyrou, 4/10)

The Associated Press: State Appeals Abortion Ruling For Minors In Alabama
Attorneys for the state of Alabama and one of its few abortion clinics faced off before federal judges Tuesday, debating the state’s effort to reinstate a law that let judges put minors seeking abortions through a trial-like process. The state’s legislators in 2014 changed the process for minors to get abortions through a court order instead of parental consent. The new law let judges appoint a lawyer for the fetus and required minors to notify district attorneys, who could call witnesses to decide whether the minor was mature enough to have an abortion. Parents could attend the hearing if they already knew about it. (Moench, 4/10)

Modern Healthcare: Rhode Island Looks To Curb Balance Billing
Rhode Island may join states trying to shield insured patients from surprise medical bills if they have to visit a physician or hospital out of their carrier's network—also known as "balance billing." The Rhode Island Senate's health committee is considering legislation this week that would limit a patient's out-of-pocket costs for an emergency department visit or other needed treatment to a co-pay or deductible. The provider would have to bill the carrier using a reimbursement rate calculated by the state's insurance commissioner. The bill also includes arbitration measures to resolve disputes between providers and insurers. (Luthi, 4/10)

The Associated Press: Virginia Jail Opens Unit For Those With Mental Health Issues
A Virginia jail has opened a new unit that aims to provide more attention and resources to men with mental health issues. The Roanoke Times reports four inmates at the Roanoke City Jail will move into the unit on Tuesday. The jail repurposed two general population inmate areas into the unit as part of its ongoing efforts to better identify and help those with mental health issues. (4/10)

New Orleans Times-Picayune: Louisiana Changed A Law To Release More Sick, Old Prisoners. Part Of It Could Be Reversed.
Last year, Louisiana passed legislation aimed at making it easier to let sick, old and dying people out of prison as part of its larger criminal justice overhaul. Now, it looks like some of those efforts may last only a few months. The Louisiana Senate voted 28-7 Tuesday (April 10) for legislation that would undo a portion of the program it approved in 2017 to handle sick and old inmates more cost effectively. The House, which was more skeptical of the criminal justice overhaul in the first place, will now take up the bill for consideration. (O'Donoghue, 4/10)

Georgia Health News: Blue Cross, Piedmont Claim Progress, But No Breakthrough
Blue Cross and Blue Shield of Georgia and Piedmont Healthcare each said Tuesday that they’re making progress in negotiations to reach a new contract. But major hurdles remain before the insurance giant and the expanding hospital system can reach an agreement. (Miller, 4/10)

The Associated Press: Fake Pot Likely Tainted With Rat Poison Kills 3, Sickens 100
Fake marijuana likely contaminated with rat poison has killed three people in Illinois and caused severe bleeding in more than 100 others, including a few in four other states. The federal Centers for Disease Control and Prevention has alerted doctors nationwide that patients with severe, unexplained bleeding may be additional cases. (4/10)

Kansas City Star: Poisoned Synthetic Marijuana In Missouri, Other States
More than 100 people in five states, including Missouri, have been treated in the past month for "serious unexplained bleeding" believed to be linked to inhaling fake marijuana laced with rat poison, according to the Centers for Disease Control and Prevention. Illinois alone has reported 107 cases, and three people have died, the state's Department of Public Health said Monday. (Schwers, 4/10)

Nashville Tennessean: Tennessee Health Care Leaders Charged In Medicare Scheme Totaling $4.6 Million
Two Tennessee health care executives were charged in an indictment unsealed on Monday for their alleged participation in a $4.6 million Medicare kickback scheme involving durable medical equipment. John Davis, 40, of Brentwood, Tennessee, and Brenda Montgomery, 69, of Camden, Tennessee, were each charged with one count of conspiracy to defraud the United States and to pay and receive health care kickbacks, and seven counts of paying and receiving health care kickbacks. (West, 4/10)

Orlando Sentinel: Humana Acquires Family Physicians Group In Orlando
Humana has acquired a large independent family practice in Orlando, even though there are speculations that the insurance giant itself may be in talks to be acquired by Walmart. The for-profit insurance company announced on Tuesday that it has acquired Family Physicians Group, one of the largest providers to Medicare and Medicaid beneficiaries in Central Florida, with 22 clinics in in Lake, Orange, Osceola and Seminole counties. (Miller, 4/10)

The Associated Press: Delaware Officials Warn Addicts Of Potentially Lethal Heroin
Delaware public health officials are advising drug users to be aware that the heroin they’re looking to obtain could be laced with fatal amounts of the synthetic painkiller fentanyl. The warning was issued Tuesday in the wake of 12 recent overdoses in Camden, New Jersey, on Friday, four of which were fatal. Officials note that Interstate 95 allows the flow of illicit drugs into Delaware from New Jersey and other neighboring states. (4/11)

San Francisco Chronicle: California Wildfires Linked To Heart Problems, Study Shows
One of the most comprehensive studies yet on the impacts of wildfire smoke in California, published Wednesday in the Journal of the American Heart Association, suggests that heart problems are as much a concern as respiratory problems, perhaps even more so. The finding of elevated cardiovascular risk, as much as 40 percent higher when dense smoke is present, provides not only one more reason to steer clear of ash-filled air but another thing for health care providers to consider when responding to wildfires. (Alexander, 4/10)

Chicago Sun Times: Experts Outline Successes And Flaws Of Illinois' Medical Cannabis Program 
A panel of experts met Monday night to discuss changing attitudes and approaches toward medical cannabis and the successes and shortcomings of Illinois’ pilot program at a Medical Cannabis 101 event in West Town. The state’s medical cannabis program was started just over two years ago. By the end of last year, 34,700 people had applied for the program, which covers patients who have been diagnosed with at least one of the 41 debilitating conditions the state has approved, according to the Illinois Department of Public Health. (Schuba, 4/11)

Tampa Bay Times: Could Tampa's Own Joe Redner Shake Up The Medical Marijuana Industry?
In an unprecedented lawsuit challenging the state’s interpretation of Amendment 2 and asserting what he says is his own constitutional right, [Joe] Redner is fighting to grow medical marijuana from his home in Tampa. After months of litigation against the health department, ending in a short trial last month, the judge is expected to rule any day. (Griffin, 4/11)

Los Angeles Times: Protesters Fight Against Homeless Moving To Irvine: 'We Will Decide Who Comes Into The City'
They wanted to make an impact by filling up the City Council chambers Tuesday to fight against the homeless moving to Irvine, but officials turned most of the crowd away at an unexpectedly short meeting. No matter, organizers had planned a protest in the plaza outside City Hall, and with about 100 people gathered, they kept chanting: "All our kids deserve better! All our kids deserve better!" (Do, 4/10)

San Francisco Chronicle: SF Mayor Farrell Blames Delay Of Homeless Psychiatric Beds On State Agency
The 54 psychiatric beds intended to help homeless people that Mayor Mark Farrell announced last month at St. Mary’s Medical Center still haven’t opened. On Tuesday, Farrell blamed a state agency for the delay. (Swan, 4/10)

The CT Mirror: Speaker: Gaming Issues, Pot Legalization Likely To Wait Until 2019
House Speaker Joe Aresimowicz was skeptical Tuesday that the legislature would resolve any major gaming issues or the legalization of marijuana this spring. And while the Berlin Democrat did not rule out action entirely on bills tied to casinos, sports betting or online lottery sales, he said Connecticut’s best approach probably is to develop a comprehensive plan for gambling — which will take more time. (Phaneuf, 4/10)

Sacramento Bee: Forget The Emerald Triangle. The Central Coast Is Becoming California's Weed Hotspot
The law contained protections for small farmers worried they would be crushed by big agricultural interests. But in an unexpected move, the California Department of Food and Agriculture scrapped a planned 1-acre cap on cannabis farms in November. No place has benefited more from that change than the Central Coast, which covers Santa Barbara, San Luis Obispo, Monterey and Santa Cruz counties. (Branan and Vaughn, 4/11)

Bloomberg: Are Drug Prices Too Low?
The mood at the annual generic drug industry confab in Orlando in February was especially somber. The discussion during one panel was all about plunging drug prices, consolidation among drug-buying groups, and the increasingly cutthroat nature of the business. A top executive at Israel-based Teva Pharmaceutical Industries Ltd., the No. 1 supplier of generics in the U.S., which is laying off 14,000 employees and shuttering about half its 80 manufacturing plants, tried to lighten the mood with gallows humor: “Teva certainly has no challenges,” said Brendan O’Grady, the executive vice president who heads its North American commercial business. The joke hit the mark, perhaps because it landed so close to home. (Koons, 4/11)

Stat: Drug Company Payments Appears To Influence Oncologists' Prescribing Habits
In the latest look at the financial ties between physicians and drug makers, a new analysis finds that oncologists who received payments for such activities as consulting or speaking were more likely to prescribe medicines sold by those companies. Specifically, doctors who received either research funding or general payments — which included meals and travel expenses — were nearly twice as likely to prescribe a kidney cancer drug sold by a company that marketed the medicine. And the odds were 29 percent higher that doctors would prescribe a chronic myeloid leukemia sold by a company that provided such payments. (Silverman, 4/10)

The Washington Post: CVS Pharmacists Will Have New Tools To Help Patients Save Money On Drugs
CVS Health is rolling out a new tool to alert its 30,000 pharmacists to cheaper drug options when they fill patients' prescriptions. For years, pharmacists have substituted generic drugs for identical brand-name versions. But CVS Pharmacy's Rx Savings Finder program will enable pharmacists and consumers to question doctors' prescription choices to save patients money. (Johnson, 4/11)

Stat: Mass. Governor Defends Vertex Pricing, Saying 'Innovation Is Expensive'
Despite heated rhetoric over the cost of prescription drugs, pricing of today’s medicines is “messy and complicated,” the governor of Massachusetts said Monday, allowing that pharmaceutical companies have the right to try to recoup their investments. Gov. Charlie Baker, asked whether drug companies are “getting away with murder” as President Trump has alleged, said “innovation is expensive,” particularly when “figuring out the human body.” (Thielking, 4/9)

Columbus Dispatch: Ohio Legislators Hear Support For Bill Seeking Transparency In Prescription Pricing
Calls intensified Tuesday for the General Assembly to force more transparency from pharmacy middlemen accused of billing Ohio’s Medicaid managed-care plans for much more than they reimburse pharmacists. Ten witnesses — cancer patients, representatives of national consumer groups and others — appeared before the House Government Accountability and Oversight Committee to testify in favor of House Bill 479, which would require that pharmacy customers be told about and receive the cash price for medicine whenever it’s cheaper than an insurance co-payment. (Schladen, 4/10)

Stat: More Lawmakers Question FDA Over Probe Into Floridians Importing Medicines 
For the second time in recent months, congressional lawmakers are asking if the Food and Drug Administration reversed a policy that allows Americans to import medicines under select circumstances. In a letter to the agency, the lawmakers referenced a series of raids last year in which FDA investigators visited Florida stores with search warrants to warn the owners that importing drugs from foreign countries is illegal. This was the same series of searches that prompted several senators last December to write the FDA about any changes in its policy toward importation. (Silverman, 4/10)

FiercePharma: Despite Reports From Merck And Johnson & Johnson, Pharma's Net Prices 'likely Not Coming Down': Analyst
Are drug prices coming down? Two leading drugmakers presented numbers suggesting the industry is facing increased pricing pressure, but Bernstein analyst Ronny Gal remains skeptical. Johnson & Johnson recently reported that net prices fell 4.6% in 2017 after the company paid out $15 billion in rebates and discounts. Merck said its net prices fell 1.9% last year. Of J&J's disclosure, Gal wrote on Monday that he believes the situation "does not represent 'real' pressure on the industry, but rather specific company circumstances." (Sagonowsky, 4/10)

The Wall Street Journal: Tishman Speyer Inks Deal With Pfizer And Wins $1.8 Billion Construction Loan
Developer Tishman Speyer has closed a large lease deal with pharmaceutical company Pfizer Inc. at its Hudson Yards tower and has secured financing to move ahead with the $3.7 billion project, Tishman said. Pfizer has signed a 20-year lease to take 15 floors at the Spiral, a 65-story skyscraper featuring cascading terraces. (Morris, 4/10)

Bloomberg: Novartis CEO Spurs Rare-Disease Shift With $8.7 Billion Deal
Novartis AG agreed to acquire AveXis Inc. for $8.7 billion to gain a promising drug to treat a rare disease that afflicts infants, hastening a shift toward gene therapy and precision medicines. Shareholders of the Bannockburn, Illinois-based company will receive $218 a share in cash in a tender offer, Novartis said in a statement Monday. The price is 88 percent above where AveXis closed Friday. (Kresge and Serafino, 4/9)

Stat: Biotech Vet David Hung Wipes Axovant From His Work History
Dr. David Hung has had a distinguished career in biotech, presiding over the development of a blockbuster cancer drug and flipping a company for $14 billion. But the last act, in which he led an Alzheimer’s disease startup through a catastrophic failure, is one from which he’d like to move on. Which is perhaps why Hung scrubbed it from his LinkedIn profile. (Garde, 4/10)

FierceHealthcare: State Solutions To Bring Down Drug Prices Face Steep Resistance From Drug Industry 
There are plenty of ways to tackle rising drug prices, experts say—if they aren't blocked by industry first. Even as states increasingly take legislative action on drug prices, they have been blocked by pharmaceutical companies in court, said Jane Horvath, senior policy fellow at the National Academy for State Health Policy, at a forum hosted in D.C. by Kaiser Permanente's Institute for Health Policy. "There's a whole constellation of problems or hurdles to be overcome, which is why state policy around drug prices is looking insane and just crazy," Horvath said. (Minemyer, 4/9)

Kaiser Health News: How A Drugmaker Turned The Abortion Pill Into A Rare-Disease Profit Machine
Even though the $550 yellow pills sold as Korlym have a controversial origin as the abortion pill, Leslie Edwin says they “gave me life.” The 40-year-old Georgia resident lives with Cushing’s syndrome, a potentially deadly condition that causes high levels of the hormone cortisol to wreak havoc on a body. When first diagnosed, she said, she gained about 100 pounds, her blood sugars were “out of control,” and she suffered acne, the inability to sleep and constant anxiety.“I wouldn’t leave the house,” Edwin said of her first bout with the condition. “I quit my job after a certain point. I just couldn’t keep being in front of people.” (Tribble, 4/10)

USA Today: Drug Companies Aren't Using Tax Windfalls To Cut Prescription Prices
Drug prices are a top pocketbook issue for Americans. President Trump understood that and campaigned on promises to bring down the cost of prescriptions. You’d think the massive tax cut he signed into law in December would be the perfect opportunity for drug companies to take some of their windfall and bring down those prices. But a new analysis shows that so far, you'd be wrong. Not being able to afford medication is unlike wrestling with any other expense. Our lives are governed by our chronic conditions, from diabetes and high blood pressure to depression and many forms of cancer. For most of us, the quality of our lives — and our longevity — depend on prescriptions to manage these conditions. (Andy Slavitt, 4/11)

Bloomberg: Massachusetts' Medicaid Proposal Could Be A Model For The U.S.
One big reason Americans pay too much for prescription drugs is that the government has been so reluctant to push prices down. Private health insurers pick and choose the medicines they cover and use that discretion to strike deals with drug companies. Medicaid -- which would have far greater negotiating power, if it were to use it -- is forbidden to do the same. Massachusetts Governor Charlie Baker would like to begin to change that. He's asked the federal government to let his state's Medicaid program create a selective drug formulary and negotiate prices for the products it chooses to cover. (4/9)

The Hill: Limiting Patient Choice Is The Wrong Way To Address High Drug Prices
In its recent budget request to Congress, the Trump administration outlined several actions the federal government should take to address rising drug prices. The goal is laudable – and action is long overdue. Some of the administration’s ideas could make significant positive impacts to patients’ ability to access treatments, including proposals to reduce Part D out-of-pocket costs, pass drug rebate payments along to patients, and reduce pharmacy benefit managers (PBMs) consolidation. However, as prescribing physicians, we are concerned that several of the administration’s most prominent proposals would not only fail to lower drug prices, but also severely limit our Medicare patients’ access to critical therapies. (David I. Daikh and Ralph L. Sacco, 4/10)

Bloomberg: Incyte Cancer Drug Flop Is Costly And Likely To Be Duplicated
A failed drug trial can derail a company or ruin a fund's year, but the flop on Friday of a heavily scrutinized trial of Incyte Corp.'s epacadostat and Merck & Co. Inc.'s blockbuster Keytruda in melanoma patients could have far broader implications. (Max Nisen, 4/9)

Orlando Sentinel: Promise Kept: Trump Tackles Drug Prices
President Trump campaigned on a pledge to tackle high drug costs. His administration is following through on that promise. Trump's Food and Drug Administration Commissioner, Scott Gottlieb, has been working to eliminate unnecessary delays in the drug-approval process. The reforms are paying dividends. Last year, the agency approved the most novel drugs since 1996. And the FDA set an all-time record for generic approvals. (Kenneth E. Thorpe, 4/10)

The Burlington Times-News: Allow States To Test Drug Costs
One big reason Americans pay too much for prescription drugs is that the government has been so reluctant to push prices down. Private health insurers pick and choose the medicines they cover and use that discretion to strike deals with drug companies. Medicaid — which would have far greater negotiating power, if it were to use it — is forbidden to do the same. Massachusetts Gov. Charlie Baker, R, would like to begin to change that. He’s asked the federal government to let his state’s Medicaid program create a selective drug formulary and negotiate prices for the products it chooses to cover. (Rich Jackson, 4/10)

Forbes: CVS To Compare Drug Prices At The Pharmacy Counter
CVS Health will introduce a new effort to help customers compare drug prices for more transparency at its pharmacy counters, ratcheting up pressure on the pharmaceutical industry and drug costs. Pharmacists have long advised patients on whether a drug is covered by insurance or whether a cheaper generic is available. But CVS admits a more robust effort is needed by its drugstores and pharmacy benefit business at a time an increasing number of patients are paying more out of their pockets for drugs as high deductible plans have proliferated. (Bruce Japsen, 4/11)

The Washington Post: VA Isn’t Broken. But It’s In Desperate Need Of Change.
Last month, President Trump nominated Navy Adm. Ronny L. Jackson to be the 10th secretary of veterans affairs. As the fourth VA secretary, I wish him well. The agency is not broken, as many outside commentators seem to think. The department provides world-class health care to more than 6 million patients every year and disability compensation to more than 4.6 million veterans. It administers nearly 3 million home loans annually, is helping nearly 950,000 veterans attend school and maintains 135 cemeteries as national shrines. (Anthony J. Principi, 4/10)

Chicago Tribune: Police Are Our Safety Net For The Mentally Ill In Crisis
Here’s the hard truth: What happened at the University of Chicago, where a campus police officer shot an allegedly threatening student, is exactly how our mental health system is designed to operate. For years the mental health community has argued that police should not be the safety net for mental health crises. Years. And the response from decision-makers and elected officials has not been to increase mental health funding. Or to build a comprehensive mental health crisis system to handle such situations. Or to pour funding into college campuses where 25 percent of people first experience the onset of mental health conditions. No, the response has been to pay for better police training. Until we put money and effort and thought into building a better mental health system, police officers will remain the safety net. (Alexa James, 4/10)

Des Moines Register: Instead Of Getting Ahead On Medical Marijuana, Iowa Got Outpaced
It was a rather remarkable statement to hear from the head of a company investing more than $10 million to set up the first medical marijuana manufacturing plant in Iowa."I think the jury is out whether we can survive under the current law or not,” said owner Chris Nelson.Whoa. The MedPharm Iowa plant hasn’t even opened, and the man who won the exclusive right to grow and process marijuana for medicinal use is doubting its chance of success?  (Rekha Basu, 4/10)

Columbus Dispatch: Medical Marijuana Could Solve Opioid Epidemic
America’s opioid crisis has taken a staggering toll, killing more than 42,000 people in 2016 alone and more than 250,000 people over the past decade. On Thursday, underscoring the severity of the crisis, Surgeon General Jerome Adams urged “health care practitioners, family and friends of people who have an opioid use disorder and community members who come into contact with people at risk for opioid overdose (to learn) how to use naloxone and (keep) it within reach.” “Get naloxone,” he wrote. “Save a life. ”Naloxone is the highly effective anti-overdose drug now routinely carried by many first responders. Adams’ suggestion that so many Americans have it at hand is a stunning acknowledgment of the pervasiveness of opioids, which he said kill 115 people a day. ...Yet a new report in the Journal of the American Medical Association’s Internal Medicine magazine points to the promise of an inexpensive, far safer drug that could be used as a painkiller instead of opioids: marijuana. (4/10)

WBUR: What Is A Dignified Death? As Her Mother Slips Away, A Daughter Wonders
A Death with Dignity bill is once again under consideration in the state legislature. Its passage would enable a patient like my mother to not only state what medical measures she wanted to be withheld so as not to prolong her life, but the point at which she’d want a medical professional to end it. (Julie Wittes Schlack, 4/11)

Stat: Microhospitals And Healthplexes Offer A Peek At The Future Of Health Care
One initiative that holds particular promise is the microhospital, either standing alone or situated as part of a local “healthplex” replete with an exercise facility, laboratory testing, IV therapy, imaging, and pharmacy services. Microhospitals’ outpatient or short-stay facilities often hold fewer than 50 beds, and are able to tailor their offerings toward their communities’ specific health needs. ... These facilities offer a much-needed middle ground between costly, over-large hospitals and underequipped, freestanding EDs. (Rita E. Numerof, 4/10)

Des Moines Register: Inaction On Medicaid Leaves Iowans' Health Care At Risk
Iowans want to know that they have access to quality health care in their communities now and in the future. It’s more than a reasonable expectation; it’s a fundamental and basic duty we owe to each other. Unfortunately, the privatization of Medicaid by former Gov. Terry Branstad that has been continued by Gov. Kim Reynolds has undermined that fundamental duty of care. ...Now, a report from the state Ombudsman confirms what we already know from Medicaid patients, health care providers and Iowa taxpayers who contact us with their concerns every day: Privatized Medicaid is failing Iowans. (Nate Boulton, 4/10)

The Hill: Putting A Price Tag On Childhood Hunger
It’s hard to put a price tag on hunger, but a new report does just that: $2.4 billion. In 2016, that was the cost in Massachusetts alone for additional healthcare, special education, and lost work time related to food insecurity. This validates what I see regularly as a pediatrician. I’m a street doctor in Austin and Central Texas. I care for high-risk and homeless children living in shelters and alleyways, and I see firsthand hunger’s effects on their health and learning. Whether it is a chronic condition like diabetes or a developmental delay affecting success at school, food insecurity has devastating consequences for kids. (Michael K. Hole, 4/10)

St. Louis Post Dispatch: Early Head Start Supports The Potential Of Missouri’s Children
When Lilbourn, Mo., residents Faith Cole and Lorenzo Hill found out they were having a baby, they were determined to be the best parents they could be, so a few months into Faith’s pregnancy, they enrolled in Early Head Start. It’s the only federal program specifically designed to support healthy prenatal outcomes and improve the early education experiences of low-income babies and toddlers. Through Early Head Start, each week Faith and Lorenzo met with a home visitor who was trained in prenatal care and child development. They learned how to support the intellectual, social and emotional development of their new baby. When their son Lawson arrived, they felt well-prepared to take on this new chapter in their lives. (Michael Gaffrey and Matthew Melmed, 4/10)

Chicago Tribune: Who Would Be Punished For Abortion In A Post-Roe America?
The discovery of right-wing provocateur Kevin Williamson’s wistful 2014 musings — that abortion should be “treated like regular homicide under the criminal code” with punishments “up to and including hanging” for women who obtain them — got him fired Thursday from his new job at The Atlantic and again put abortion-rights opponents on the defensive. No, no, no, they said, reiterating the protestations they offered in March 2016 when then-candidate Donald Trump declared, “There has to be some form of punishment” for women who terminate their pregnancies. It’s doctors, they said, not patients, who will be treated as criminals should abortion be banned. (Eric Zorn, 4/10)

The Hill: Are Research And Medicine Catered To Only A Certain Type Of People?
Ideally, medical research should benefit everyone in society. Unfortunately this has not historically been the case. Populations such as children, women, and minorities have been consistently excluded from research, often due to unconscious or implicit bias or difficulty in adjusting research design to be more inclusive. (Angira Patel and Nana Matoba, 4/10)

Huffington Post: Medicine Has An Unhealthy Gender Pay Gap
Two of my female colleagues recently learned during water cooler conversation that a much junior male physician was making a larger salary than they were. Armed with this knowledge, the women successfully negotiated pay raises. These women are far from the only colleagues I know who have discovered that the gender pay gap extends to the medical field as a result of unexpected conversations. Most hospitals and clinics do not freely publish or advertise this inequity. (Roshini Pinto-Powell, 4/10)