Politico Pro: Congress Reaches Final Deal To Address Opioid Crisis
House and Senate negotiators late Tuesday reached a final agreement on a bill addressing the opioid crisis following weeks of talks and a failed bid to include $4 billion worth of unrelated policy changes favorable to the pharmaceutical industry. The bipartisan bill, H.R. 6 (115), attempts to address nearly every aspect of the public health epidemic, from expanding access to addiction treatment and prevention programs to beefing up law enforcement efforts to curtail the trafficking of illegal drugs. (Ehley, Karlin-Smith and Tahir, 9/25)

The Hill: Lawmakers Unveil Massive Bipartisan Bill Aimed At Fighting Opioid Crisis
Aside from opioid policy, drug companies also failed in an intense lobbying push to attach a provision to the bill easing their costs in Medicare. The change would have rolled back a provision from February’s budget deal that raised drugmakers costs in Medicare’s coverage gap, known as the donut hole. Drug pricing groups and some Democrats came out strongly against including the provision in the opioids bill, saying it was a “handout” to Pharma. (Sullivan, 9/25)

CQ: Senate, House Conferees Release Text Of Opioid Agreement
“Once signed into law, this legislation sends help to our communities fighting on the front lines of the crisis and to the millions of families affected by opioid use disorders,” a bipartisan, bicameral committee of nine lawmakers involved in leading the negotiations said in a statement Tuesday night. The conferees included Alexander and House Energy and Commerce Chairman Greg Walden, R-Ore. They said the bill took months of bipartisan work by eight House committees and five Senate committees. The House originally passed its own package (HR 6) in late June. The agreement includes measures to develop new nonaddictive painkillers and to overhaul prescription drug monitoring programs. It would also reauthorize the Office of National Drug Control Policy. (Raman, 9/25)

MPR: Drug Treatment Programs And Jails Work Together To Help Inmates
Amidst an opioid overdose epidemic that now claims almost 50,000 lives each year in the United States and rising rates of meth use, county jails and treatment programs have started to work more closely together. Teen Challenge is just one organization working directly with inmates in Minnesota's 87 counties to try to help get inmates access to treatment, and to avoid the danger of overdose faced by people leaving jail. (Collins, 9/25)

The Washington Post: Bowser Backs Bill Penalizing Dealers Of Synthetic Drugs As Overdoses Spike In D.C.
D.C. Mayor Muriel E. Bowser (D) is proposing emergency legislation to crack down on drug dealers amid a spike in synthetic marijuana overdoses while a permanent version of the bill makes its way through the D.C. Council. D.C. fire department medics treated or transported more than 1,600 people for symptoms consistent with synthetic drug overdoses between July 14 and Sunday, according to city officials. (Nirappil, 9/25)

Bloomberg: New Jersey Opioid Deaths Surge Even After Prescriptions Decline
Opioid overdose deaths rose 24 percent in New Jersey last year, even after doctors wrote fewer prescriptions, according to the state medical examiner’s office. In all, 2,750 painkiller-related deaths were reported in 2017, or about eight a day. Just over half were attributed to fentanyl and its analogues, or drugs engineered to mimic its extreme potency in tiny doses. Heroin-related fatalities dropped to 41 percent of the total, from 61 percent in 2016. (Young, 9/25)

The New York Times: Trump Unleashes On Kavanaugh Accuser As Key Republican Wavers
President Trump assailed the latest woman to accuse Judge Brett M. Kavanaugh of sexual misconduct, saying on Tuesday that she “has nothing” because she was “messed up” at the time, even as a key Republican senator urged colleagues to take the accusations seriously. With pressure rising in advance of a make-or-break hearing on Thursday, Mr. Trump lashed out in a more vociferous way than he has since his nominee came under fire for allegations of sexual assault, blaming Democrats for orchestrating a “con game” and targeting one of Judge Kavanaugh’s accusers in scathing, personal terms. (Baker and Fandos, 9/25)

The Washington Post: ‘Back In The Foxhole Together’: Conservatives Rally Around Kavanaugh Amid Accusations
The powerful and well-funded conservative movement has launched into overdrive to rescue the Supreme Court nomination of Brett M. Kavanaugh, decrying the sexual assault allegations against him as unfounded and warning Republicans that buckling to Democratic pressure would undermine voter enthusiasm weeks before the midterm elections. (Costa, 9/25)

Politico: Democrats In The Dark On Eve Of Historic Kavanaugh Hearing
Tens of millions of people will be watching Christine Blasey Ford when she appears before the Senate Judiciary Committee for a potentially history-shaping hearing on Thursday. Yet Ford has had no apparent contact with the people who could help her most through the ordeal: Senate Democrats. (Schor and Bade, 9/26)

Politico: Red-State Democrats Refuse To Come Out Against Kavanaugh
Democrats have all the cover they need to vote in lockstep against Brett Kavanaugh. But a half-dozen of them have refused to go there, even after the pair of sexual assault allegations against the Supreme Court nominee. Democratic insiders are feeling more bullish than ever that the party’s 49 caucus members ultimately will oppose Kavanaugh. Yet the undeclared bloc of Democratic senators could be a problem for Democratic leaders, who want to put the weight of the nomination entirely on a handful of holdout Republicans. (Everett and Schor, 9/25)

The New York Times: They Say Sexual Assault, Kavanaugh Says It Never Happened: Sifting Truth From Memory
When Judge Brett M. Kavanaugh and Christine Blasey Ford present their vastly different recollections to the Senate on Thursday, the quality and reliability of memory itself will be on trial. Judge Kavanaugh has emphatically denied allegations from Dr. Blasey that he tried to rape her when they were teenagers or ever committed sexual assault against anyone. Dr. Blasey and another accuser, Deborah Ramirez, have recounted their alleged incidents with both precise detail and gaping holes. (Carey and Hoffman, 9/25)

Los Angeles Times: Kavanaugh Vs. Kavanaugh: Supreme Court Nominee Has Offered Conflicting Accounts Of His Teenage Drinking
The toughest challenge facing Judge Brett Kavanaugh when he appears at a Senate hearing Thursday about allegations of a decades-old sexual assault may be reconciling the two starkly different depictions circulating about his high school and college years. Unfortunately for Kavanaugh, both versions — one of a hard-partying, heavy-drinking frat boy and the other of a church-going athlete known from age 14 for respecting women’s dignity — come from Kavanaugh’s own words. (Savage, 9/25)

Politico: Senate Panel Schedules Kavanaugh Vote For Friday
The Senate Judiciary Committee will vote on Brett Kavanaugh's nomination to the Supreme Court on Friday morning, less than 24 hours after Kavanaugh and Christine Blasey Ford appear before the panel to discuss Ford's allegation that Kavanaugh sexually assaulted her more than 30 years ago. (Schor, Bresnahan and Everett, 9/25)

The Washington Post: Trump Administration Launches Review Of Government-Funded Fetal Tissue Research
The Trump administration has launched a review of all federally funded research that uses fetal tissue and has canceled one contract for such material, stepping into a decades-old controversy that has been a sidelight to the ideological war over abortion. Federal health officials dispatched a letter Monday ending a contract with a California-based nonprofit group targeted by social conservatives in Congress and a coalition of antiabortion and faith-based groups. In July, the Food and Drug Administration had agreed to pay the organization, Advanced Bioscience Resources, nearly $16,000 for fetal tissue that was to be implanted into mice for research into immune responses to drugs. (Goldstein, Cha and McGinley, 9/25)

Stat: Trump Administration Launches Review Of Scientific Research Involving Fetal Tissue
The announcement follows the release of a letter sent earlier this month by 45 anti-abortion leaders to HHS Secretary Alex Azar, expressing outrage about the Food and Drug Administration’s contract and urging him to end government funding for fetal tissue research. In 2017, the National Institutes of Health spent roughly $98 million on the research. “The use of fetal tissue is important or even necessary for some kinds of work,” said Alta Charo, a bioethics professor from the University of Wisconsin who has defended fetal tissue research before Congress. Charo noted that research using fetal tissue led to the development of key vaccines and is now crucial to research on understanding how exposure to Zika virus during pregnancy causes birth defects. (Thielking, 9/25)

The Wall Street Journal: Trump Administration Cancels Research Contract For Fetal Tissue
The action rekindles a longstanding and emotional debate over the use of fetal tissue in research. Conservative evangelical voters, who are among the GOP’s strongest supporters, strongly oppose the use of such tissue when it comes from abortions. Research groups, however, say the use of fetal tissue is vital to medical advances because it has qualities that adult tissue doesn’t have.The debate over abortion, they add, should be kept separate from the question of whether such tissue should be used. (Armour and Burton, 9/25)

The Hill: Trump Administration Terminates Contract With Fetal Tissue Firm After Opposition From Anti-Abortion Groups 
The Food and Drug Administration, which is under HHS, contracted with Advanced Bioscience Resources in July to acquire fetal tissue to implant into mice for research purposes. Republicans on Capitol Hill criticized the decision in a letter to FDA Commissioner Scott Gottlieb, writing that "unborn children are not commodities to be bought and sold." "The practice of conducting research using the body parts of children whose lives have been violently ended by abortion is abhorrent," reads the Sept. 17 letter, signed by 85 House members. (Hellmann, 9/24)

In other news from the administration —

The New York Times: E.P.A. Places The Head Of Its Office Of Children’s Health On Leave
The Environmental Protection Agency on Tuesday placed the head of its Office of Children’s Health Protection on administrative leave, in an unusual move that several observers said appeared to reflect an effort to minimize the role of the office. Dr. Ruth Etzel, a pediatrician and epidemiologist who has been a leader in children’s environmental health for 30 years, joined the E.P.A. in 2015, after having served as a senior officer for environmental health research at the World Health Organization. (Davenport and Rabin, 9/26)

NPR: FAA Budget Bill Could Bring Changes To Air Ambulance Business
Air ambulance rides can be lifesavers. But how much should they cost? In the ongoing, crowdsourced "Bill of the Month" investigation, NPR and Kaiser Health News have received more than a dozen bills from people around the country on the hook for medevac helicopter rides that ranged from $28,000 to $97,000.What gives? Why should a lifesaving flight come with a life-altering bill? (Fortier, 9/26)

Kaiser Health News: Bill Of The Month: Emergency Air Ambulance Ride Leaves Injured Doctor With $56,603 Bill
It was the first — and only — time Dr. Naveed Khan, a 35-year-old radiologist, ever rode in an all-terrain vehicle. Khan took the wheel from his friend and drove circles in the sand, on a trail along the Red River in Texas. “As soon as I turned to the side where my body weight was, this two-seater vehicle … just tilted toward the side and toppled,” Khan recalled. It landed on his left arm. (Kodjak, 9/26)

In other news on health care costs —

Modern Healthcare: UnitedHealth, Envision Dispute Over Surprise ER Bills Heats Up
The dispute between UnitedHealth Group and staffing firm Envision Healthcare is heating up again. UnitedHealth sent a letter to more than 700 hospitals stating Envision will likely be out of network starting next year because of its emergency department billing practices, the insurer said Tuesday. UnitedHealth blamed Nashville-based Envision for an impasse in contract negotiations, claiming the staffing firm demands to be paid much more than Medicare pays for the same services. Envision's practices, UnitedHealth argued, are a major reason for the high cost of ED visits. (Livingston, 9/25)

Denver Post: Rep. Ed Perlmutter Backs Bill To Defer Student Loan Payments For Cancer Patients
A Colorado congressman is backing a bill that, if approved, would pause student loan payments for patients while they receive cancer treatments. The bill, supported by U.S. Rep. Ed Perlmutter, D-Arvada, is part of an appropriations package the House of Representatives is scheduled to vote on — and approve — Wednesday. The bill has already passed the Senate. (Seaman, 9/25)

Kaiser Health News: Putting Oversized Health Care Costs Upfront — On T-Shirts 
If only patients knew how expensive medical procedures are and how wildly prices vary by hospital, they could be smart shoppers and lower the cost of health care for everybody. At least that’s what policy experts and health insurers keep saying as they promote “consumer-directed” health care and cost-comparison websites.None of it has had much effect. Now, exasperated Maryland officials are presenting hospital cost information in a way they believe Americans might understand: on a T-shirt. (Hancock, 9/26)

The Hill: GOP Ad Uses Shark To Hit Dem On 'Government Takeover' Of Health Care 
Across the country, Republicans have been attacking Democrats for supporting "Medicare for All," arguing it is too costly and disruptive. Republicans have been trying to counter an onslaught of Democratic attacks over ObamaCare repeal and undermining protections for pre-existing conditions. (Sullivan, 9/25)

The Hill: GOP Senate Candidate Says He Supports Pre-Existing Conditions While Backing Lawsuit To End Them
Missouri GOP Senate candidate Josh Hawley says in a new ad that he supports forcing insurance companies to cover pre-existing conditions, even as he takes part in a lawsuit that would overturn those protections in ObamaCare. Hawley, Missouri's attorney general, who is running against vulnerable incumbent Sen. Claire McCaskill (D), said in the ad released Monday that his oldest son has a rare chronic disease — a pre-existing condition, he notes. (Hellmann, 9/25)

The Hill: Romney Opposes Utah's Medicaid Expansion Ballot Measure 
Utah Senate candidate Mitt Romney (R) said he supports the state’s efforts to partially expand Medicaid, but does not think a full expansion will be viable. In an interview with the Salt Lake Tribune, Romney praised the state’s partial approach, which would use federal money to expand coverage to people earning up to 100 percent of the poverty level. It would also institute a work requirement. (Weixel, 9/25)

And other news on the elections comes out of Massachusetts and California —

Boston Globe: Citing Two Candidates With ‘100 Percent’ Scores, Abortion Rights Group Stays Out Of Race For Governor
The Planned Parenthood League of Massachusetts’s political arm is taking a noteworthy side in the gubernatorial race — neither. Four years after backing Martha Coakley in her race against now-Governor Charlie Baker, the Planned Parenthood Advocacy Fund said Tuesday it is remaining neutral in the contest between the Republican and Democrat Jay Gonzalez. (Stout, 9/25)

The New York Times: For Gavin Newsom, A Stealth Run For California Governor
He may seem hesitant to say it, but Gavin Newsom wants your vote for governor of California. Really. Mr. Newsom took the stage to cheers in the hot afternoon sun in Orange County the other day. For 20 minutes, he talked about the Democratic candidates for Congress and the California Legislature. He talked about President Trump. He talked about poverty, homelessness, immigration and global warming. (Nagourney and Arango, 9/26)

The New York Times/ProPublica: Cancer Center Switches Focus On Fund-Raising As Problems Mount
Memorial Sloan Kettering Cancer Center has abruptly changed the focus of an annual fund-raising campaign amid a widening crisis that has already led to the resignation of its chief medical officer and a sweeping re-examination of its policies. The campaign, initially titled “Harnessing Big Data,” was to have focused on the cancer center’s research into the use of artificial intelligence in cancer treatment, according to a brochure on Memorial Sloan Kettering’s website. (Thomas and Ornstein, 9/25)

ProPublica/WMFE: Orlando Paramedics Didn’t Go In To Save Victims Of The Pulse Shooting. Here’s Why.
Like many fire departments at the time, Orlando had long relied on a traditional protocol for mass shootings, in which paramedics stayed at a distance until an all-clear was given. The department had tasked Anibal Saez Jr., an assistant chief, with developing a new approach being adopted across the country: Specialized teams of medics, guarded by police officers and wearing specially designed bulletproof vests, would pull out victims before a shooter is caught or killed. ... None of that equipment was used at Pulse. (Aboraya, 9/26)

In more news on gun violence and safety —

Reuters: Investors At Smith & Wesson Parent Support Call For Gun Safety Report
Investors at American Outdoor Brands Corp approved a call for the gun maker to produce a safety report, officials said during its annual meeting on Tuesday, marking a second win for religious activist shareholders focused on firearms makers after a series of mass shootings in the United States. The resolution, approved over the company's objections, asks its board to report by February on its efforts to monitor gun violence, to research and produce safer guns, and for an assessment of reputational and financial risks. (Kerber, 9/25)

The Associated Press: Maryland Official Criticizes Gun Laws In Warehouse Shooting
A Maryland law enforcement official is criticizing gun laws in the wake of a shooting at a warehouse last week in which four people were killed and three people wounded. The Baltimore Sun reports Harford County Sheriff's Maj. William Davis told Aberdeen's mayor and city council members Monday 26-year-old Snochia Moseley had been diagnosed with acute schizophrenia, but answered "no" to whether she had been diagnosed with a mental illness when filling out paperwork to purchase a handgun. (9/25)

Stat: Congenital Syphilis Cases Surge To 20-Year High As Officials Re-Up Calls For Testing
Cases of congenital syphilis reached a 20-year high last year after they more than doubled from 362 in 2013 to 918 in 2017, leading health authorities to emphasize the importance of testing all pregnant women. Congenital syphilis cases occur when a mother passes the bacteria to her baby during pregnancy or delivery and can cause a host of complications, including stillbirth, premature birth, and the death of the newborn. Babies who are born with syphilis can have neurological problems and may go blind or deaf within the first few years of their lives. (Joseph, 9/25)

The Associated Press: Newborn Syphilis Cases In US Reach Highest Level In 20 Years
The last time the number was that high or higher was in the 1990s. In adults, cases of syphilis and other sexually transmitted diseases also are rising. Health officials say possible reasons include a wave of illegal drug use. They say women should be tested during pregnancy so they can be treated with antibiotics. (Sotbbe, 9/25)

Houston Chronicle: Texas Babies Born With Syphilis More Than Doubled Last Year, Part Of Nationwide Trend 
The number of Texas babies born with syphilis more than doubled in 2017 and the state rate is now the nation’s fourth highest, according to a new report highlighting the increase nationally. The report, issued Tuesday by the Centers for Disease Control and Prevention, showed 176 of the nation’s 918 cases of congenital syphilis last year occurred in Texas, up from its 2016 total of 71. Only Louisiana, Nevada and California reported a higher rate of cases than Texas. (Ackerman, 9/25)

San Antonio Press-Express: Texas Babies Born With Syphilis More Than Doubled Last Year, Part Of Nationwide Trend
"We are alarmed by the numbers, but at the same time they weren’t totally unexpected,” said Tammy Foskey, the sexually transmitted disease manager for the Texas Department of State Health Services. “There was a 20 percent increase in all female syphilis cases in 2017 and there are significant access issues in many minority and underserved populations. In addition, the state last year began digging more into the issue, uncovering cases we might have missed in past years.” (Ackerman, 9/25)

Miami Herald: Syphilis Cases Spike Among Newborns In Florida, U.S.
The number of babies born with syphilis in Miami-Dade and Broward counties has skyrocketed in recent years, contributing to a statewide and national trend that has raised concern among public health officials. ...Florida reported 93 cases of congenital syphilis, or about 41.3 per 100,000 births, in 2017, among the highest in the nation, the CDC said.(Chang, 9/25)

Stat: The End Of HIV Transmission In The U.S.: A Once-Thinkable Goal Is Up For Discussion
A mere decade ago, 45,000 Americans a year were contracting HIV. Since the Centers for Disease Control and Prevention started collecting data on HIV-related deaths just over 30 years ago, more than half a million of those people have died from AIDS. And yet, today, the struggle against HIV may be undergoing a sea change.U.S. health officials and HIV experts are beginning to talk about a future in which transmission in the United States could be halted. And that future, they say, could come not within a generation, but in the span of just a few years. (Branswell, 9/26)

US News & World Report: The Burden Of Race On Community Health In America
A decade and a half ago, a landmark study explored how racial and ethnic minorities face disparities in health care quality, even after accounting for socioeconomic differences. Such trends have persisted for decades, with deadly effects: Another study using 2002 data found there were 229 excess deaths daily that could be avoided by closing the mortality gap between blacks and whites. That's like a Boeing 767 with all black passengers crashing every day, as David Williams of the Harvard T.H. Chan School of Public Health points out. (McPhillips, 9/25)

ProPublica: The Child Abuse Contrarian
In the past seven years, [Michael] Holick said, he has consulted or testified as an expert witness in more than 300 child-abuse cases throughout the U.S. as well as the United Kingdom, New Zealand, Australia, Germany and Canada. In almost every case, he has made the same finding: instead of blaming any injuries on abuse, he has diagnosed the child with a rare genetic disorder, Hypermobile Ehlers-Danlos syndrome, a condition that affects the connective tissues of the skin, bones and joints. (Armstrong, 9/26)

The New York Times: Appendicitis? Antibiotics May Be All You Need
Antibiotics may be a good option for many cases of appendicitis. Several randomized trials have shown that treating appendicitis with antibiotics rather than surgery may be safe and effective, but the long-term effects of avoiding an appendectomy have been unclear. (Bakalar, 9/25)

The New York Times: Shingles Vaccine Shortages Result From High Demand
Shingrix, the vaccine approved last year to prevent shingles, has proved so popular that its maker, GlaxoSmithKline, has not been able to produce it quickly enough to keep up with the demand. The vaccine is recommended for most people over 50. But many are having trouble getting it. The company says there are no manufacturing problems — it just didn’t expect so many consumers to want the vaccine. (Grady, 9/25)

WBUR: Tiny Boy Awaiting Delivery At South Shore Hospital Tests Project Aimed At Reducing C-Sections
Those avoidable C-sections are the focus of the Team Birth Project, designed by Shah with input from roughly 50 doctors, nurses, midwives, doulas, public health and consumer advocates who focus on childbirth. ...And this team has to perform at its best during an unpredictable event: labor. Shah says doctors and nurses generally agree about when a mom is in active labor, when a mom can have a vaginal delivery and when she needs a C-section. (Bebinger, 9/25)

The New York Times: Are We Wired To Sit?
Are we born to be physically lazy? A sophisticated if disconcerting new neurological study suggests that we probably are. It finds that even when people know that exercise is desirable and plan to work out, certain electrical signals within their brains may be nudging them toward being sedentary. The study’s authors hope, though, that learning how our minds may undermine our exercise intentions could give us renewed motivation to move. (Reynolds, 9/26)

The Associated Press: Governments To Discuss Tackling Tuberculosis At UN Summit
Governments from around the world will gather Wednesday to discuss the persistent scourge of tuberculosis, which last year claimed more lives than any other communicable disease. About 1.3 million people worldwide died of TB in 2017. A further 300,000 people with both HIV and TB died in last year, according to World Health Organization figures released this month. (Jordans, 9/25)

MPR: Health Officials Working To Make Flu Shot More Effective
With influenza season right around the corner, public health officials and manufacturers continue working to improve the effectiveness of the flu shot. Last year's shot was only 36 percent effective according to the Center for Disease Control and Prevention. (Hallberg, 9/25)

The Associated Press: What's Yogurt? Industry Wants Greater Liberty To Use Term
If low-fat yogurt is blended with fatty ingredients like coconut or chocolate, is it still low-fat? Is it even yogurt? The U.S. government has rules about what can be called "yogurt," and the dairy industry says it's not clear what the answers are. Now it's hopeful it will finally get to use the term with greater liberty, with the Trump administration in the process of updating the yogurt definition. (Choi, 9/25)

Concord (N.H.) Monitor: VA Urgent Care Facility Will Stay Open 24/7 For At Least The Time Being
Many things are in flux at the Veterans Administration Medical Center in Manchester, but overnight hours at the urgent care facility aren’t among them – at least, not yet. ... The idea that the VA is looking at a number of possible changes, among them whether to close the urgent care facility in Manchester during some late-night hours, came up at a recent regular meeting between VA staff and staffers of U.S. Rep Annie Kuster, who serve on the House Veterans Affairs Subcommittee. That and news of meetings by senior staff at the Medical Center has led to rumors that the urgent care facility might end its long-standing policy of never being closed. (Brooks, 9/25)

Boston Globe: Warren Backs Nurse-Staffing Ballot Question
The labor union promoting a ballot question to increase nurse staffing at Massachusetts hospitals now has the endorsement of US Senator Elizabeth Warren. ...The Massachusetts Nurses Association is promoting ballot Question 1, which would set limits on the number of patients assigned to hospital nurses at one time. (Dayal McCluskey, 9/25)

The Associated Press: Board Tasked With Developing Cancer Research Center To Meet
A Virginia state board tasked with developing plans for a cancer research and treatment center is set to convene for the first time. The Henrietta Lacks Commission is named for Henrietta Lacks, a Virginia woman whose cells were taken without her consent and widely used in groundbreaking research. It will meet Wednesday in South Boston. (9/26)

KQED: State Fines Psychiatric Hospital In Attack On Nurse Amid Renewed Staffing Concerns
Now, dozens of Service Employees International Union Local 1021 members plan to hold an informational picket in Oakland on Tuesday afternoon to draw attention to staffing issues there and two other Alameda County medical facilities. (Goldberg, 9/25)

St. Louis Public Radio: Mizzou Researchers Find Potential Link Between Insulin, Plastic Additive BPA
Bisphenol A — or BPA — is a plastic additive found in bottles, the resin lining of food cans and thermal receipt paper. An experiment by Mizzou researchers exposed a small group of people to the chemical. After the exposure, the researchers measured subjects’ insulin levels, and found people exposed to the BPA had produced more insulin. (Fentem, 9/25)

New Orleans Times-Picayune: 4 New Orleans Doctors, 2 Others Ordered To Pay Millions In Restitution In Medicare Fraud Case
Four New Orleans area doctors, a biller and an office manager were sentenced to prison time and a collective $30 million in restitution payments this week for their roles in a Medicare fraud scheme that involved more than 20 people and netted millions in fraudulent Medicare reimbursements, according to U.S. Attorney Peter G. Strasser's office. The six people sentenced this week by U.S. District Judge Susie Morgan were convicted in May following a month-long federal trial. (McKnight, 9/25)

MPR: Minneapolis Community Funds Focus On Lead Poisoning, Asthma
Those two health concerns — asthma and lead poisoning — are at the heart of a city plan to spend more than a half-million dollars to raise awareness and connect at-risk families with resources to help. Trice is helping facilitate a discussion Thursday inviting community members to offer suggestions on how the $600,000 should be allocated over the next three years. (Yuen, 9/25)

Tampa Bay Times: A Doctor Was Sued For Malpractice. He Tried To Fight It. It Cost Him Nearly Everything.
Even now, his mind flashes to the legal papers, to the accusation that he was responsible for a woman’s death. [Scott] Plantz’s insurer encouraged him to settle the suit for $50,000, which it would have paid, and move on. ...Convinced he had done nothing wrong, Plantz refused on principle. The decision would lead him on a decade-long odyssey that bloomed into an obsession. (Solomon, 9/25)

Detroit Free Press: Family Wins $130M In Beaumont Hospital Malpractice Case
An Oakland County jury awarded a family more than $130 million in damages in a medical malpractice lawsuit filed against Beaumont Hospital after a child sustained severe brain damage, resulting in cerebral palsy, while receiving care at its Royal Oak facility. The jury award Monday came after a three-week civil trial in Oakland County Circuit Court, and is believed to be the one of the largest jury settlements in Michigan history, according to the law firm that filed the lawsuit. (Hall, 9/25)

Houston Chronicle: Humana Pledges $15 Million To UH New Medical School 
As the health care ground continues to shift, sometimes surprising alliances emerge.In Houston, one such pairing has formed with the announcement Tuesday of a collaboration between the planned University of Houston’s College of Medicine and insurance giant Humana, which has pledged a $15 million gift over 10 years to help defray startup and operational costs. It is the first major gift by a large corporation to the future medical school’s campaign to raise $1 billion, said Dr. Steve Spann, founding dean of the UH College of Medicine. (Deam, 9/25)

Atlanta Journal-Constitution: Atlanta Court Allows Woman's Racial Harassment Suit To Proceed
The federal appeals court in Atlanta has refused to dismiss a lawsuit filed by an African-American woman who says she endured racist comments from her coworkers on an almost daily basis, including one who allegedly called her “a dumb black (racial slur).” The ruling, issued Monday by the 11th U.S. Circuit Court of Appeals, allows Brenda Smelter’s lawsuit to go to trial against Southern Home Care Services, which sends caregivers to the homes of clients with medical needs. (Rankin, 9/24)

Richmond Times-Dispatch: Virginia Regulators Pick Five Companies To Open State's First Medical Cannabis Dispensaries
Virginia regulators gave initial approval Tuesday to five companies planning to open the state’s first medical cannabis dispensaries, selecting a mix of established industry players and Virginia-based entrepreneurs. After private discussions that lasted more than five hours, the Virginia Board of Pharmacy named the five winning applications out of a field of 51. (Moomaw, 9/24)

The Wall Street Journal: High Hopes For A Gene Therapy Come With Fears Over Cost
Just 4 years old, Caspian Soto uses a cane and headlamp to help him see when he walks. He can’t see in dark places like aquariums or movie theaters. He’s never seen the stars. Caspian was born with a rare, inherited eye disorder called Leber congenital amaurosis, which results in the progressive deterioration of the retina, the tissue at the back of the eye that detects light and color. He could lose all vision by the time he’s a teenager. (Reddy, 9/24)

The New York Times: Starring In That Drug Commercial? An Actual Patient
Several years ago, a casting director working on a commercial for the NovoLog FlexPen, a dial-a-dose insulin injector from Novo Nordisk, called a friend and urged her to try out. The friend, Vivicca Whitsett, a compliance administrator at a brokerage firm in Los Angeles and a stand-up comic, was game. Her audition went well, but Ms. Whitsett also filled an essential requirement: She has Type 2 diabetes. (Kaufman, 9/23)

Stat: Generic Drug Makers Face ‘A Silent Crisis,’ FDA Official Says 
One of the Food and Drug Administration’s top officials says that consolidation in the drug distributor market has made it less attractive for companies to sell generic drugs — and that raising prices of the drugs might actually invite more competition. ... As politicians rail against drug companies for setting high prices and decry pharmacy benefit managers for negotiating secret rebates, they have largely left the health of the generics marketplace out of focus. (Swetlitz, 9/21)

The New York Times: A G.O.P. Senate Candidate Highlights His Drug Industry Career. Should He?
When Bob Hugin joined Celgene in 1999 as its chief financial officer, the company was a struggling biotech that sold just one product — a leprosy drug — and faced a shaky future. By the time he stepped down as executive chairman in February to run for United States Senate, Celgene had become a pharmaceutical powerhouse with a market value of nearly $80 billion. And that onetime leprosy drug? It had been transformed into Revlimid, a best-selling cancer drug that, with annual sales of $8.2 billion, made up nearly two-thirds of Celgene’s net sales in 2017. (Thomas and Corasaniti, 9/24)

Stat: Insulin Prices Could Be Much Lower And Drug Makers Would Make Healthy Profits 
As prices for diabetes treatments continue to roil consumers, a new study suggests that manufacturers could make both human and analog insulins at low costs and still pocket a profit. After analyzing expenses for ingredients, production, and delivery, among other things, the researchers contend that the price for a year’s supply of human insulin could be $48 to $71 a person and between $78 and $133 for analog insulins, which are genetically altered forms that are known as rapid or long-acting treatments. Examples of analog insulins include Humalog, Lantus and Novolog. (Silverman, 9/25)

Stateline: Courts Force States To Provide Costly Hep C Treatment 
A series of recent court rulings and settlements, including one last week in Indiana, have found that states cannot withhold potentially life-saving but expensive medications from Medicaid beneficiaries and prison inmates who have chronic hepatitis C. Hepatitis C kills far more Americans than any other infectious disease. But when new antiviral drugs that for the first time promised a cure for hepatitis C hit the market in 2014, states blanched at their eye-popping prices and took steps to sharply limit the availability of those treatments for Medicaid beneficiaries and inmates. According to one recent survey, only 3 percent of inmates in state penitentiaries with hepatitis C receive the cure. (Ollove, 9/25)

CQ: Drug Prices Could Become A Divisive Issue For Democrats
Democrats are making the cost of prescription drugs a pillar of the party’s health care agenda in the midterm elections, but if they win a majority for the 116th Congress, the party will have to grapple with internal divisions over the issue that might be magnified next year. This campaign season has been notable for candidates pushing the party to reject corporate influence. For an emboldened progressive wing of Democrats, the party’s current plans might not be enough. Their views compete with those of new candidates from politically moderate areas with a big pharmaceutical industry presence that might be more inclined to join with longtime incumbents who sympathize more with the industry’s perspective. (Siddons, 9/24)

CQ: House Debates Drug Price, Health Preparedness Bills
The House cleared late Tuesday afternoon on a pair of bills related to drug price disclosures at pharmacies, after passing another measure designed to update health emergency preparedness programs. The bills, which were brought up under suspension of the rules, all received voice votes. If President Donald Trump signs the drug pricing bills into law as expected, they would be the first enacted legislation related to a proposal on the issue that the administration released earlier this year. (Siddons, 9/25)

Stat: Trials That Help Drug Makers Win FDA Approval Have Median Cost Of $19 Million
Although developing a new drug is generally considered to be a pricey proposition, the median cost of the pivotal trials needed to win regulatory approval is just $19 million, according to a new study. In other words, the key scientific evidence used to persuade the Food and Drug Administration to endorse a new medicine is a small fraction of the overall development costs regularly attributed to the efforts undertaken to bring a new medicine to market. (Silverman, 9/24)

Marketplace: Kickbacks Or A Helpful Service? Here's Why Pharma Is Under Fire
Pharmaceutical companies spend a lot of money to develop new blockbuster drugs — for research, and then getting the meds through clinical trials. ...But some major drug companies are offering other, more indirect benefits to doctors and patients to pump up prescriptions. This week, the California insurance commissioner sued AbbVie, the maker of Humira, a top-selling arthritis drug, over alleged kickbacks. (Hartman, 9/21)

The Wall Street Journal: U.S. Probes Drugmakers Over Free Services
Federal prosecutors are probing whether big drugmakers including Sanofi SA, Gilead Sciences Inc. and Biogen Inc. potentially violated laws by providing free services to doctors and patients, according to a Wall Street Journal review of securities filings. Drug companies say the services, such as nurses and reimbursement assistance, help doctors and patients. But the practices, which have become more prevalent as drugmakers have introduced more complex and expensive drugs, are drawing scrutiny over whether they serve an illegal commercial purpose: inducing sales. (Loftus, 9/21)

San Francisco Chronicle: Federal, State Officials Probe Gilead’s Drug Marketing Practices
California insurance regulators and Alameda County prosecutors have subpoenaed Gilead Sciences for information regarding the Foster City drugmaker’s marketing practices and other services. The subpoenas, issued in October by the California Department of Insurance and the Alameda County district attorney’s office, were disclosed in a filing with the U.S. Securities and Exchange Commission in February. (Ho, 9/21)

The Wall Street Journal: Some Good News From Rite Aid? It Is Possible
Rite Aid, weighed down by too much debt, has a clear opportunity to fix itself. In doing so, the drug chain can reshape the pharmacy-benefits-manager business. The past two years have been difficult for Rite Aid. The pharmacy company pulled out of a planned merger with grocery chain Albertson’s in August, after significant shareholder opposition to the deal’s terms. Regulators had already nixed a sale of the company to rival Walgreens Boots Alliance in 2017, though Rite Aid was able to sell a large share of its stores to Walgreens. (Grant, 9/26)

The Wall Street Journal: Novartis To Cut 2,000 Jobs Amid Revamp
Novartis AG plans to cut more than 2,000 jobs as part of a global restructuring, the latest move by its new chief executive to refocus the pharmaceutical giant on higher-value drugs. The Swiss company said Tuesday that most of the cuts would fall in its home market, where it plans to eliminate a net 1,000 production jobs—after taking into account the creation of 450 positions—and 700 positions in business services. (Mancini, 9/25)

Marketplace: Novartis Moves Away From Mass-Market Drugs
Drugmaker Novartis announced it's cutting more than 2,000 jobs — most of them in Europe — as part of a global restructuring. The company plans to focus on producing and selling more innovative drugs, but these specified medicines require lots of research and carry higher price tags. (Babin, 9/25)

Kansas City Star: Pharma CEO Responds To McCaskill On 400% Drug Price Hike
Nirmal Mulye, the CEO of a small Kansas City pharmaceutical company, got Twitter-famous — or infamous — last week after he was quoted saying he had a “moral requirement” to raise a drug price 400 percent. ...After the story broke, U.S. Sen. Claire McCaskill, a Missouri Democrat, and U.S. Sen. Susan Collins, a Maine Republican, sent Mulye a series of questions about the price increase on nitrofurantoin, an antibiotic for treating urinary tract infections. This week Mulye responded, but it appears that won’t be the final word. (Marso, 9/21)

The Wall Street Journal: We Can’t Afford The Drugs That Could Cure Cancer
When I was training as an oncologist nearly three decades ago, we dreamed of curing cancer. Today, advances in cellular immunotherapy make it no longer a dream: A cure for cancer has become possible, even probable. But tragically, the costs of these drug therapies are so high that the American health care system can’t afford them. A potential revolution in cancer care may be stymied by the high price of drugs, which suggests that we need to reconsider how we price them. (Ezekiel Emanuel, 9/20)

The New York Times: Britons Pay Hundreds For H.I.V. Drugs. Why Do Americans Pay Thousands?
Last week, the High Court of England and Wales announced a momentous decision: It invalidated the pharmaceutical company Gilead’s patent on Truvada, opening the way to generic competition. Truvada, a combination of two drugs, is one of the world’s most-used H.I.V. medicines. For treating H.I.V., it’s used along with a third drug. But many H.I.V.-negative people also take Truvada daily as a preventive. That’s called pre-exposure prophylaxis, or PrEP.In the United States, Truvada is available only as a brand-name drug. It costs $20,000 a year. (Tina Rosenberg, 9/25)

Bloomberg: Amarin Fish-Oil Heart Medicine Win Is Rarest Drug Success
When medical breakthroughs are announced, they often affect a surprisingly small number of people. Many new drugs these days are targeting rare diseases or niche patient groups, and their impact is further restricted by price. Monday’s results from Amarin Corp.’s test of purified fish oil Vascepa in people at risk for heart diseases are an exception — and one more likely than any recent drug outcome to affect the average person reading this column. (Max Nisen, 9/24)

Stat: Tuberculosis Is A Disease The World Could Control. But Will It?
The United Nations General Assembly might be best known for causing several days of traffic jams in midtown New York City. But this year, for the first time ever, one of the days will be devoted to tuberculosis. On September 26, heads of state and other leaders (Bill Gates is filling the U.S. speaker slot) will make comments, unveil a grand plan to fight TB, and share the funding commitments and other concrete steps that each country will take to fulfill an already-made pledge to beat back TB. The drugs to fight the disease are also improving. Bedaquiline and another new medicine, delamanid, are the first new TB drugs in over 40 years — yes, 40 years. Thanks largely to government incentives, they were developed, approved for use, and made widely available in 2015. (Paul Farmer and Lelio Marmora, 9/26)

The Hill: Disclosures Suggest Rebates And Insurers Responsible For Rising Out-Of-Pocket Drug Costs
With just six weeks to go until the midterm elections, candidates from both parties are looking for wedge issues to turn out support. Democrats hope that prescription drug prices are one of those issues. House Minority Leader Nancy Pelosi has instructed her colleagues to campaign on a three point plan of President Trump, the economy, and health care costs — specifically the cost of prescription drugs. Missouri Sen. Claire McCaskill, one of the most vulnerable Democratic Senators, has made prescription drug prices her signature issue. "I’m going after the pharmaceutical companies," she says. (Terry Wilcox, 9/24)

Forbes: The Morality Of Prescription Drug Pricing In America
While walking through the duty-free at Dulles International Airport in Washington, D.C., I happened upon the price tag of an imported French purse. Looking around, I wondered how many travelers could afford a $2,000 handbag. At the gate, I found a seat and logged on to the internet, where I happened upon a story about the CEO of Nostrum Laboratories, Nirmal Mulye. In an interview, Mr. Mulye explained why he raised the price of an antibiotic by more than 400%, from under $500 to over $2,000. (Pear, 9/24)

Bloomberg: Lilly Animal-Health IPO Elanco Makes Buyers Sit Up
Investors in Elanco Animal Health Inc. — the unit of Eli Lilly & Co., which went public on Thursday — are hoping for some of that Zoetis Inc. magic. And no wonder: Zoetis, too, is a former big pharma animal-health unit (of Pfizer Inc.), and has been a huge success since its own IPO in 2013, rising nearly 250 percent. But cosmetic similarity and IPO-day excitement may be causing an excess of optimism. (Max Nisen, 9/20)

The Washington Post: A TV Ad That Crystallizes The Biggest GOP Lie About Health Care
If there is a single campaign ad that is emblematic of the 2018 midterm election, it may be this one from Missouri Republican Senate candidate Josh Hawley, who is running to unseat Democratic Sen. Claire McCaskill. (Paul Waldman, 9/25)

USA Today: Medicaid Expansion Is Midterms Winner, Starting Point To Insure Everyone
Mitt Romney probably doesn’t want to be known as the “Godfather of Obamacare” any more than his niece, Republican National Committee Chair Ronna McDaniel, wants to be known as Ronna Romney McDaniel (which she was called until President Donald Trump reportedly asked her to stop using her maiden name.) But Romney, who signed what became the prototype of the Affordable Care Act when he was the governor of Massachusetts, is on the ballot Nov. 6 along with a key provision of Obamacare — and both are expected to win big. (Jason Sattler, 9/26)

Deseret News: Time To Tackle Government-Supplied Health Care Before It Gets Unmanageable
Census data now shows about 122 million Americans rely on government health insurance programs of one sort or another, a figure reported recently by the pollster scottrasmussen.com. Of this, 62.5 million are enrolled in Medicaid, the government program for low income people, 55.6 million are on Medicare, which primarily serves the elderly, and 15.5 million rely on military health care plans. The total represents an increase of about 14 million people enrolled in a government plan since 2013. Americans may not be aware of this gradual shift toward a government-dominated health care system. Regardless of how they feel about it, the shift ought not to take place without a robust public debate. (9/25)

The Washington Post: Needy Immigrants Need Not Apply
If the Trump administration has its way, hundreds of thousands of legal, law-abiding immigrants struggling to make their way in this country will have their hopes for a green card dashed if they accept government benefits for which they qualify. That means an immigrant family that falls on hard times and accepts noncash benefits such as housing vouchers or food stamps, even briefly, could be denied permanent legal residence in the United States. So much for welcoming the tired, poor and huddled masses. (9/25)

The New York Times: Trump’s Next Target: Legal Immigrants
When Kam Tam came to the United States at age 16 from China 50 years ago, he spoke little English, had a mouthful of rotten teeth and active tuberculosis, and weighed just 96 pounds. Through perseverance and a little help, he got his health back in order. The providers at his publicly funded community health center in San Francisco pulled four molars and cured his tuberculosis. It was the character instilled by his parents that got him through college and pharmacy school, Dr. Tam said. Today, he is a successful businessman and pharmacist who has repaid society for the support he and his family received. He continues to generously give back by donating his professional services and financial resources to vulnerable families in Oakland. (Tung Nguyen and Sherry Hirota, 9/25)

Miami Herald: We All Should Find Sexual Assault Abhorrent, But Not All Of Us Do
Gina Sosa is not impressed by attempted rape. “What boy hasn’t done this in high school?” she asks. “Please, I would like to know.” Since she asked so nicely, I went on Twitter, looking for men who managed to get out of school without committing attempted rape. Turned out to be pretty easy. I found lots of them. (Leonard Pitts, 9/25)

Boston Globe: This Is No Time For Betsy DeVos To Gut Sexual Assault Guidelines 
The White House’s unwavering defense of Supreme Court nominee Brett Kavanaugh has reinforced an unfortunate fact — the Trump administration is not disposed to believe women who accuse men of sexual misconduct. That’s exactly why there are legitimate concerns about what changes Education Secretary Betsy DeVos will ultimately make to the Obama-era campus sexual misconduct guidelines. Revisions are welcome; a wholesale gutting is not. (9/26)

Boston Globe: Nuns Secure A Victory For Gun Safety Advocates 
Curbing gun violence can seem such a daunting task, it’s hard to know where to begin. How about with a bunch of nuns?T he Sisters of the Holy Names of Jesus and Mary won a heartening victory Tuesday, when they got shareholders in American Outdoor Brands, formerly Smith & Wesson, to approve a proposal requiring the Springfield gunmaker to produce a report on gun safety. (Justin Sullivan, 9/25)

Los Angeles Times: Now 90, Songwriter Burt Bacharach Is Doing Everything He Can To Stop School Shootings
The man who wrote that song “I Say a Little Prayer” and hundreds more — songs that are part of the soundtrack of your life and the whole force of his own — that man, Burt Bacharach, is now asking for a little prayer and a little support from his fellow Americans for a cause that has moved him to tears, and to music. He and songwriter Rudy Perez composed “Live to See Another Day.” It’s a plea that the mass shootings of schoolchildren be stopped. It’s a video that’s just out, and it was crafted, compellingly, in the hallways and classrooms of an empty school. Its lyrics, like “Our lives mean something more than pain,” are performed by two teenage singers. At the video’s end, it asks people to donate to the Sandy Hook Promise Foundation, named for the school where 20 first-graders and six adults were murdered in 2012. (Patt Morrison, 9/26)

Stat: I Used Applied Psychoanalysis To Assess Trump. The Diagnosis Is Frightening
Much has been written by U.S. commentators, pundits, and even mental health professionals about Donald Trump’s mind and psyche during the 2016 campaign for the presidency and his first 20 months in office. Little of it was grounded in applied psychoanalysis, the practice of using psychoanalytical principles to understand the actions, motivations, and limitations of historical figures. (Justin A. Frank, 9/25)

Los Angeles Times: 'Screen Time' Is A Good Start To Curbing Our Smartphone Addiction, But Apple Needs To Do More
Screen Time, part of the operating system that iPhone owners began downloading last week, represents the biggest move yet by a technology company to encourage less use of a device, not more. That’s a good thing: According to data from a time-tracking app called Moment, Americans spend on average four hours a day — a quarter of our waking lives — staring at their smartphones.Screen Time, which is new with Apple’s iOS 12, automatically tracks how often you pick up your phone and how much time you spend on each app. It also allows you to set daily limits for time-sucks like social media, games, or streaming video. It’s a good start, but Apple could do more. A huge number of people need help creating better digital boundaries. (Catherine Price, 9/26)

The Hill: There's A New Drug Crisis Harming Americans
There is another drug crisis following the opioid crisis and that is the benzodiazepines with the brand names of Valium, Xanax, Klonopin and more. According to the journal Pharmacy, Xanax is among the top 25 drugs prescribed in this country.As a psychiatric nurse practitioner working in community clinics in Chicago, I have been pleaded with, cursed at, insulted and spat upon by patients who insist on getting a prescription for drugs that I consider dangerous. (Lois M. Platt, 9/25)

Stat: Urgent Action Is Needed To Stop The Epidemic Of Sexually Tranmitted Infections
The Centers for Disease Control and Prevention reported Tuesday unprecedented year-after-year rises in rates of sexually transmitted infections (STIs) in the United States. As physicians who care for patients with these infections and who oversee public health responses to STI outbreaks, we, like many of our colleagues, are frustrated and challenged by the anemic responses to this escalating public health epidemic. Our concerns are especially acute because the medical and public health communities know how to prevent these infections, yet as a country we have failed to implement basic public health practices that could reverse these trends. (Melanie Thompson and Matthew Zahn, 9/26)

Houston Chronicle: My Cancer Lost, But My Insurer Is Winning In Refusal To Pay For Treatment
When Blue Cross Blue Shield planted its flag in Texas, it was committed to providing quality health care. But over time, our state’s largest insurer lost its way. Last year I was diagnosed with oral cancer. That diagnosis set off a chain of events that left me stuck with a massive bill after BCBS refused to pay for my cancer treatment. So far, they have demanded that I pay back more than $60,000 and when all is said and done my final bill could reach over $100,000. I now find myself in a David versus Goliath battle with the company, fighting over the necessity of the treatment that left me cancer free and without horrible side effects. (Randy Montgomery, 9/26)

Los Angeles Times: Vote Yes On Prop. 4 For Children's Hospitals
California voters are being asked this November to authorize more than $16 billion in state bonds to fund a range of infrastructure projects, such as wastewater treatment and homeless housing. The smallest of these measures is Proposition 4, which would tee up $1.5 billion in new borrowing to add capacity, improve safety and upgrade equipment at nonprofit or public children’s hospitals around the state. Many of these hospitals serve a disproportionate share of low-income patients, leaving them dependent on the state’s help to meet their construction needs. Voters have approved two similar measures before, in 2004 and 2008, and they should pass this one as well. (9/25)

Sacramento Bee: Endorsement: Vote Yes On Prop. 4, Save A California Child’s Life
Faced with a choice of whether to provide children with access to top-notch hospitals or leave them and their families to fend for themselves, big-hearted Californians have shown time and again that they will gladly hand over their tax dollars — even in the midst of a recession. They should do so again this year by voting “yes” on Proposition 4 on the Nov. 6 ballot. (9/25)

San Jose Mercury News: Put Kidney Patient Care Above Corporate Profits
Dialysis patients have reported experiencing staffing levels so low that one technician was supposed to oversee treatment for 12 patients simultaneously, a situation that endangers patients. ...One source of the problem is that the industry is dominated by two big corporations—Fresenius and DaVita. (Megallan Handford, 9/25)

San Jose Mercury News: Initiative Would Endanger Dialysis Patients’ Lives
California physicians pay close attention to policies that negatively impact patients and decrease access to quality health care. Proposition 8 would be as bad for patients as anything we have seen in a long time. (Theodore Mazer, 9/25)