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The economic recession that blasted huge holes in state and local government budgets and rapidly rising health care costs are combining to create a long-term budget crisis for states that is so bad it would require massive tax hikes or spending cuts, according to a new government watchdog report. ... rising health-related costs borne by state and local governments, especially those incurred by government employees and retirees, are putting pressure on state budgets. State and local Medicaid expenditures and employee-related costs both grow faster than the gross domestic product, the GAO said. It estimated health-related costs will grow from about 3.9 percent of GDP this year to 7.4 percent by 2060. (Wilson, 12/22)

Andy Pasternak, a family doctor in Reno, Nev., has seen more than 100 new Medicaid patients this year after the state expanded the insurance program under the Affordable Care Act. But he won’t be taking any new ones after Dec. 31. That’s when the law’s two-year pay raise for primary care doctors like him who see Medicaid patients expires, resulting in fee reductions of 43 percent on average across the country, according to the nonpartisan Urban Institute. (Galewitz, 12/23)

The health department has been mired in controversy since 2012, when a drug analyst with the agency tampered with evidence and jeopardized tens of thousands of criminal convictions. That was quickly followed by a meningitis outbreak traced to a compounding pharmacy regulated by one of the department’s boards, and then the agency found itself in the cross hairs again because of the problem-plagued rollout of the state’s medical marijuana law. (Lazar, 12/23)

A medical services provider in Tempe charges less than $15 for a common blood test called a comprehensive metabolic panel. Just over 20 miles away, another medical-services provider in Mesa charges more than $1,630 for the exact same test, according to a study released by Hospital Pricing Specialists, a California-based firm that surveys prices for medical products and services. (Giblin, 12/23)

Texas Health and Human Services Commission chief Kyle Janek said Tuesday he was misled in briefings on a no-bid, $110 million deal handed to an Austin company for unproven software to detect Medicaid fraud. Janek said the Office of Inspector General, the commission’s audit arm, should have alerted him that its contract with 21 Century Technologies Inc., also known as 21CT, “proceeded outside the normal channels” for approval. (Langford and Smith, 12/23)

A University of Iowa scientist has been sanctioned for launching work on the deadly MERS virus without school approval and outside of the proper laboratory setting. The school also is being accused of improperly withholding forms that could help the public assess whether any of the deadly agent imported from a collaborator in Spain was stolen, lost or released. (Clayworth, 12/23)

In recent years, individuals who provide late-in-life care to a family member have been increasingly asked to take on complex nursing and medical tasks that were once performed only in hospitals and nursing homes by trained professionals — procedures such as cleaning wounds, operating feeding tubes and giving drug injections. Yet, despite the difficulty and importance of these tasks, family caregivers are frequently given little if any hands-on training about how to safely and effectively do them. In addition, many older caregivers — often the spouse of the person needing care — have their own health issues that make performing such tasks very problematic. (Perry, 12/23)

A Charleston pharmacy and its owner face federal health care charges. Trivillian's Pharmacy is charged in an information with health care fraud and misbranding drugs. Owner and operator Paula Butterfield is charged in an information with making a false statement in a health care matter. Trivillian's is accused of dispensing compounded drugs and generic drugs and billing Medicare and Medicaid for brand name drugs, which are more expensive. (12/23)

Sitting in a Junction City coffee shop with his laptop and a pile of textbooks splayed on a table, Will Stucker looks like any other college student, if a bit older than average. But Stucker, 38, has taken a different path to college than most of his classmates at Emporia State University. His path took him to South Korea and Kuwait, then to a tank rolling toward Baghdad, then to an armored Humvee on the streets of a small town in Iraq where insurgents repeatedly tried to kill him — and two of them almost succeeded. Then, finally, to a Department of Veterans Affairs hospital in Topeka, where counselors helped him work through the post-traumatic stress disorder (PTSD) he came home with. (Marso, 12/23)