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House members spent a lot of time last week congratulating themselves for passing a permanent "doc fix" -- that is, an end to the yearly ritual of readjusting the rates Medicare pays to health care providers in order to avoid drastic cuts that could cause them to stop treating elderly patients. One problem: The "doc fix" isn't actually fixed. While the House overwhelmingly passed the bipartisan deal that permanently changed the formula ahead of the April 1 deadline while also reauthorizing key health programs supported by Democrats, the Senate did not act on the House bill after completing budget votes in the wee hours Friday morning -- postponing action until senators return from recess on April 13. (DeBonis, 4/2)

Doctors across the country will face a 21 percent cut in government payments for treating Medicare patients if Congress does not act to prevent it before April 15, an official with the Centers for Medicare and Medicaid Services warned Wednesday. (Miller, 4/2)

Just about everyone agrees the Sustainable Growth Rate formula is flawed, but once upon a time it was seen as a great new way for Medicare to pay doctors. Few are predicting that its likely successor will be a comparable disaster — but there are still plenty of things that could go wrong with the Merit-Based Incentive Payment System, which has already been dubbed MIPS. (Pradhan, 4/2)

The House-passed package to replace Medicare's physician payment formula doesn't include a permanent repeal of caps on how much the program spends on rehabilitation therapy, but proponents say the issue could resurface as an amendment and throw a new wrinkle into the debate when the Senate takes up the measure after recess. Maryland Democrat Benjamin L. Cardin, who has introduced introduced legislation to scrap the caps with Maine Republican Susan Collins, is hoping for an opportunity to offer a repeal amendment, according to spokeswoman Sue Walitsky. (Attias, 4/2)

A few small lines of a new bill meant to permanently fix the way Medicare pays doctors are grabbing attention among those who work on medical malpractice issues. They're not likely to change much about malpractice suits against doctors, but they do touch on a larger debate over how it should be decided in such cases if doctors acted appropriately, some legal experts caution. (Schencker, 4/2)

President Obama’s chief economist on Thursday delivered a fierce rebuttal to what he called “nonsensical” claims from conservatives that the Affordable Care Act would be the end of the U.S. economy. “To put it mildly, these doomsday prophecies have not come to pass,” Jason Furman, the chief of the President’s Council of Economic Advisers, said Thursday at a panel hosted by the Center for American Progress. (Ferris, 4/2)

Obamacare is a boon to the U.S. economy, President Barack Obama’s top economic adviser said in a speech aimed at changing the tone of debate over the Affordable Care Act’s effects, though he offered little direct evidence. (Wayne, 4/2)

More voters say their family is worse off than better off under ObamaCare. In addition, most of those who had to change their insurance coverage because of the health care law say it cost them money. (Blaton, 4/3)

Delta Air Lines became the first major carrier Thursday to make same-sex domestic partners whole for additional income taxes they owe for health care plans. Atlanta-based Delta will pay those taxes for employees retroactive to Jan. 1. The tax is only a problem for employees living in states that do not recognize their marriages; Georgia is one of them. Delta executives, pilots, flight attendants and other employees living there have to pay extra tax based on the value of the insurance. (Mayerowitz, 4/3)

The majority of seniors in [Multipurpose Senior Services Program] reside in one of the seven counties participating in the state's duals demonstration project, or Cal MediConnect, which is part of the state's larger Coordinated Care Initiative. Roughly two-thirds of all duals (those dually eligible for Medicare and Medi-Cal) live in the seven-county demonstration area. Medi-Cal is California's Medicaid program. For MSSP participants in the duals demonstration project counties -- Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo and Santa Clara counties -- MSSP care is being moved into a Medi-Cal managed care plan. The program would remain the same in MSSP sites outside of the seven-county demonstration project. (Gorn, 4/2)

Emory Healthcare and Aetna are teaming up in a collaboration known as an “accountable care organization’’ (ACO), which aims to enhance patient care and reduce costs. ACOs are networks of hospitals and doctors — and sometimes insurers — that arose as a central feature of the 2010 Affordable Care Act. (MIller, 4/2)

A mix of business groups and labor unions are pushing to tee up the next big Obamacare fight: killing its so-called Cadillac tax. It is, they say, the type of Obamacare “fix” that Republicans and Democrats can agree on — notwithstanding the problem of filling an $87 billion budget hole that nixing the levy would produce. (Faler, 4/2)

The Florida House overwhelmingly approved a $76.2 billion budget Thursday that was more than $4 billion less than the Florida Senate plan passed a day earlier, a discrepancy largely due to the House's staunch refusal to expand Medicaid. House leaders are adamant they aren't about to back off, even if it means that the two chambers, both controlled by Republicans, won't come to an agreement by the scheduled end of the legislative session in May. ... Senate President Andy Gardiner, R-Orlando, responded that he wasn't going to "rant and rave" about the issue of expanding federal Medicaid assistance to the poor. "This is a serious matter," he said. "This is a $2.2 billion hole, 800,000 people not covered." (Van Sickler and McGrory, 4/2)

In the most adamant remarks yet from House leaders, Rep. Richard Corcoran, R-Land O’Lakes, said Thursday the chamber “won’t dance” with the Senate on Medicaid expansion. ... His remarks were part of staunch defense of the House position to refuse a Senate plan to offer Medicaid eligibility to 800,000 Floridians making up to 138 percent of the federal poverty level, or about $33,000 a year for a family of four. (Rohrer, 4/2)

Rep. Richard Corcoran, the House budget chief who is the ideological force behind the House's resistance to Medicaid expansion, declared rhetorical war on the Senate Thursday in his closing arguments in support of the House's $76.2 billon budget. In a fiesty speech after nearly three hours of debate over the budget, Corcoran said the federal government's threat to cancel the cost-sharing program for hospitals known as the "Low Income Pool" is holding the state hostage and blasted his Senate colleagues for using the force of their budget to provoke a renewed debate over Medicaid expansion. (Klas, 4/2)

Federal health officials said Thursday that they are still negotiating with the state over the potential loss of more than $1 billion for Florida hospitals, despite assertions that talks were being halted. Officials at the Centers for Medicare and Medicaid Services have "not stopped conversations with the state of Florida," spokesman Aaron Albright said. "CMS remains in contact with state officials and continues to share information. Senior officials from CMS will continue conversations with state officials." (Kennedy, 4/3)

The sole surviving bill to expand Medicaid in Montana has its first hearing in a House committee next Tuesday -- and Democrats already are angling to move it to the floor and bypass the committee. ... SB405, sponsored by Sen. Ed Buttrey, R-Great Falls, would expand Medicaid in Montana to provide health coverage for tens of thousands of low-income Montanans and accept federal money to pay for the expansion. The bill passed the Senate this week, but SB405 is expected to have a more difficult time in the House, where GOP leadership has vowed to defeat it. (Dennison, 4/3)

A selling point for expanding Medicaid in Montana is that it should reduce health care prices and insurance rates for everyone -- but its biggest backers say those reductions aren’t a sure thing. If the Legislature agrees to expand Medicaid, an estimated 26,000 to 33,000 low-income Montanans without health insurance would be covered the next two years. Hospitals and others supporting the expansion say they will start getting paid for services they now provide as charity -- and that payment will reduce cost-shifting to customers who are insured. Yet an executive with the MHA, the lobby for Montana’s hospitals, says reducing cost-shifting doesn’t necessarily mean a direct cut in health care prices. (Dennison, 4/3)

For his Medicaid expansion plan to be successful, membership will decrease, Sen. Ed Buttrey said Thursday at a roundtable on his HELP Act at Benefis Health System. The Great Falls Republican's bill, whose full name is Montana Health and Economic Livelihood Partnership, would accept federal funds to expand Medicaid coverage to people whose income is below 138 percent of poverty level. The bill also has a job-training component, with people who enroll asked to participate in a Department of Labor and Industry workforce assessment survey for the creation of a job placement plan. (Wipf, 4/2)

In today's health care system, consumers are increasingly on their own when these complex -- and often costly -- medical problems arise. Primary care doctors once helped patients manage such situations, but many physicians now have 15 minutes or less for each appointment. It's in this high-pressure environment that a new industry of patient advocates -- sometimes called patient navigators -- has emerged, offering to help guide patients through knotty health situations. (Perrone, 4/2)

Even though consumers are digging deeper to cover rising out-of-pocket medical costs, they’re contributing less to health savings accounts that could help take the sting out of their expenses, according to a new study. Between 2011 and 2014, the percentage of people who said they contributed nothing to their health savings accounts (HSAs) more than doubled, to 23 percent, according to a survey by the Employee Benefit Research Institute. Meanwhile, the percentage who said they contributed $1,500 or more dropped to 30 percent from 44 percent. (Andrews, 4/3)

A growing number of U.S. health insurers are moving to restrict use of the laparoscopic power morcellator, further sidelining the once-popular medical device after federal regulators warned it shouldn’t be used on most women. (Kamp, 4/2)

A Vancouver man whose 53-year-old wife died in 2013 of a severe and unexpected infection is suing Virginia Mason Medical Center and the maker of allegedly defective medical scopes tied to “superbug” outbreaks in Seattle and across the nation. (Aleccia, 4/2)

A former prominent Las Vegas doctor already serving 18 years to life in state prison pleaded guilty Thursday to federal health care fraud and conspiracy charges in a hepatitis C outbreak that was called one of the largest ever in the U.S. The plea by Dipak Kantilal Desai, 65, avoided a federal trial for the former member of the Nevada State Board of Medical Examiners and one-time owner of busy endoscopy and colonoscopy clinics. (4/2)

New Jersey's top court says the state may legally deny Medicaid benefits to adult non-citizens who are in the United States legally but have been here less than five years. The state Supreme Court in a split decision released Monday affirmed a lower court ruling allowing the denial. The justices did not issue a new opinion in the case. (4/2)

A federal judge ordered Ohio officials on Thursday to reinstate Medicaid benefits for people in a lawsuit but denied a request to expand such relief to tens of thousands of others being terminated from the program. The decision comes in a case involving how the state's Medicaid agency "re-determines" the eligibility of recipients in the federal-state program. (Sanner, 4/2)

A federal court judge ordered Medicaid coverage continued or reinstated to several low-income Ohioans in a lawsuit against the state. U.S. District Judge Algenon L. Marbley’s temporary restraining order issued on Thursday applies only to those who filed suit. He declined a request to reinstate health benefits to thousands of other Medicaid beneficiaries who have been tossed from the rolls during the state’s annual redetermination process. (Candisky, 4/2)

The state’s Medicaid program is cutting payment rates for doctors who provide pregnancy care, perform deliveries and women’s preventive services, leading medical groups and advocates to worry that it could become harder for low-income pregnant women to find doctors to treat them. (Levin Becker, 4/2)

The University of Minnesota School of Nursing is launching the Gopher State's first nurse-led outpatient clinic, made possible by a recent change in state law. Family nurse practitioners will offer primary-care services and an on-site pharmacist in the downtown Minneapolis clinic, one of roughly 250 clinics in the country that operate without a physician's oversight. The clinic, which opens April 6, is expected to serve as a training facility for U-M nursing students, clinical pharmacists and other primary-care providers as well, the school said. (Rubenfire, 4/2)

They want their employers, airline contractors Prospect Airport Services and PrimeFlight Airline Services, to comply with a living wage law passed last year that requires pay of $10.88 or more per hour at city-owned facilities. They're also calling for affordable health benefits and sick days. (4/2)

An Iowa House committee has approved a bill that would keep two state mental health facilities open longer. The Appropriations Committee unanimously supported the bill Thursday. It would require the Department of Human Services to submit a transition plan to a new commission, which would have to give its approval before the facilities in Clarinda and Mount Pleasant could close. (4/2)

In 2013, same sex marriage became law in Maryland. Two years later, lawmakers are working on bringing equality to health benefits. Currently, straight couples are eligible for in vitro fertilization coverage under health insurance, after two years of unsuccessful attempts to have a baby. Now, lawmakers want to extend these benefits to lesbian couples facing similar challenges and it's getting widespread support in the house and senate. (Garriss, 4/2)

Minnesota officials say thousands of health care providers are violating the state's new rules requiring electronic patient health records — but there isn't much they can do about it. (Zdechlik, 4/3)

Missouri’s largest health insurer recently launched a new online patient-doctor interface, a move that reflects the growing importance of telehealth as the industry looks to curb costs and enhance patient access. More patients than ever are seeing their doctors through computer screens and smartphones. It’s a trend that shows no signs of subsiding as hospitals and insurance companies continue to roll out the latest technological advances. (Shapiro, 4/3)

More than 300 anti-abortion bills have been filed in state legislatures in the first quarter of 2015, a new study has found. Anti-abortion bills have been filed in a total of 43 states so far this year, according to research released Thursday by the reproductive health nonprofit Guttmacher Institute. (Ferris, 4/2)

A bill that would put more restrictions on abortion was introduced in the N.C. House Wednesday by a group of Republicans that includes a Charlotte lawmaker. The bill would increase the waiting time required to get an abortion, bar physicians other than obstetricians or gynecologists from performing abortions and prohibit medical schools at UNC Chapel Hill or East Carolina University from offering abortions. (Morrill, 4/2)

After months of review, New Mexico's top prosecutor is following through with a lawsuit against one of the nation's largest nursing home chains over claims of inadequate care. The state initially sued in December, alleging that the business' thin staffing made it impossible to provide good care. The suit targeted several nursing homes run by Preferred Care Partners Management Group, a privately held company with operations in at least 10 states: Nevada, Arizona, Colorado, Florida, Iowa, Kansas, Oklahoma, Louisiana, Mississippi and Texas. (Bryan, 4/2)

Among states, Massachusetts has the lowest rate of residents lacking health insurance. We know that. But beneath the topline state figure, there’s significant variation on a more local level. (Swasey, 4/2)

North Carolina's troubled system of mostly volunteer medical examiners would be transformed into a staff of trained, full-time death investigators under a new bill in the General Assembly. The architect of the legislation, Sen. Jeff Tarte, a Mecklenburg County Republican, says he would like to phase out the state's roughly 350 part-time medical examiners over a five-year period. The state's examiners – mostly doctors and nurses who look into deaths in their spare time – are supposed to determine the cause of suspicious and violent deaths, such as shootings, suicides and auto wrecks. Their findings are used to help solve crimes, identify public health threats and settle life insurance payouts. (Alexander, 4/2)

Nearly 250 Americans have been sickened by a drug-resistant stomach bug that is linked to overseas travel, federal health officials warned Thursday. The disease, which has been reported in 32 states since December 2014, comes as the government is already on high alert after outbreaks of potentially deadly antibiotic-resistant infections. (Ferris, 4/2)

[The study sought to] examine the proportions of patients admitted to the intensive care unit (ICU) with limitations on life-sustaining treatments and the proportions of such patients who receive aggressive care across individual ICUs. ... [It used a] database (from April 1, 2001, to December 31, 2008) including 141 ICUs in 105 hospitals in the United States and 277 693 ICU patient visits. ... Of the ICU admissions evaluated, 4.8% had previously established treatment limitations. ... Intensive care units vary dramatically in how they manage care for patients admitted with treatment limitations. Among patients who survive, escalations in the aggressiveness of care are more common during the ICU stay than are de-escalations in aggressiveness. (Hart et al., 3/30)

People may purchase subsidized health insurance through the ACA exchanges with premiums based on projected future income. However, if actual income is higher than estimated, they may be required to repay part or all of the subsidy when they file tax returns. This “reconciliation” process could raise taxes substantially for many ACA participants. However, analysis of income tax return data suggests that for most lower-income filers, the reconciliation will reduce the refund they receive rather than require them to remit additional tax because their refunds exceed the reconciliation amount. We conclude by making suggestions to improve the reconciliation process. (Burman, Mermin and Ramirez, 4/1)

The individual responsibility requirement, most often referred to as the individual mandate, included in the Affordable Care Act (ACA) has perhaps been the most controversial feature of the law since its passage. ... Although those opposing the ACA have decried the burdensome nature of such a mandate, a recent proposal (the Patient Choice, Affordability, Responsibility, and Empowerment Act, or PCARE) developed by [congressional Republicans] ... would impose strong penalties on the uninsured. ... Medicare Parts B and D also have provisions that penalize individuals for failing to promptly enroll in coverage .... With the PCARE proposal, there now seems to be at least some agreement across the political spectrum that insurance markets cannot effectively operate while simultaneously treating individuals equitably regardless of health status (e.g., covering pre-existing conditions, no medical underwriting) if the healthy can obtain coverage whenever they choose. (Blumberg and Holahan, 4/1)

[The researchers sought to] examine the impact of Massachusetts healthcare reform on changes in rates of admission to hospital for ambulatory care sensitive conditions (ACSCs), which are potentially preventable with good access to outpatient medical care, and racial and ethnic disparities in such rates, using complete inpatient discharge data (hospital episode statistics) from Massachusetts and three control states. ... we found no evidence of a change in the admission rate for overall composite ACSC or for subgroup composites of acute and chronic ACSCs. Nor did we find a change in disparities in admission rates between black and white people or white and Hispanic people for overall composite ACSC that existed in Massachusetts before reform. (McCormick et al., 4/1)

This interactive tool provides up-to-date information on U.S. health spending by federal and local governments, private companies, and individuals. It was developed by analysts at the Kaiser Family Foundation using data from the National Health Expenditure Account. (3/31)

This brief provides an overview of recent trends in Medicaid and CHIP enrollment .... In sum, the data show: As of January 2015, 70.0 million people were enrolled in Medicaid or CHIP. Nearly two-thirds of enrollees resided in states that have implemented the ACA Medicaid expansion. Between Summer 2013 and January 2015, there was a net increase of nearly 11.2 million people enrolled in Medicaid and CHIP among the 49 states reporting data for both periods. ... States that expanded Medicaid experienced significantly greater net Medicaid and CHIP enrollment growth between Summer 2013 and January 2015 than states that have not expanded. ... Children account for a greater share of total Medicaid and CHIP enrollment in nearly all states that have not expanded Medicaid compared to states that have expanded. (Artiga et al., 3/31)

Should the Court reject the Obama Administration’s regulatory interpretation of the provisions of the Affordable Care Act (ACA) at issue in the King case, the Treasury would be barred from paying premium subsidies to individuals who, while meeting all other eligibility criteria, live in any of the 34 states that have not established their own exchanges. Thus, the “insurance subsidies” would not be available to such individuals. However, that does not mean that those individuals would automatically lose their “insurance coverage.” (Haislmaier, 3/30)

[A] visual timeline of Medicare’s history, including the debate that led to its creation in 1965 and subsequent changes, such as: the passage and repeal of the Medicare Catastrophic Coverage Act in the late 1980s, the Medicare Modernization Act in 2003, and the Affordable Care Act in 2010. The video also highlights the program’s impact on the 55 million elderly and disabled Americans it covers today, as well as the fiscal challenges it faces in ensuring its long-term sustainability. (3/27)

The largest study to date of recent military and veteran suicides has identified two high-risk groups of former troops who are generally ineligible for the psychiatric care afforded to all others who served: those forced out of the military for misconduct and those who enlisted but were quickly discharged for other problems. In each of those groups, an average of 46 of every 100,000 former service members committed suicide each year — more than double the rate for veterans with honorable discharges. ... Traditionally, the military suicide rate has been about half that in the civilian world. But it surged and caught up over the course of the recent wars and has remained elevated. The explanation that once seemed obvious — the stress of combat — is no longer seen as a primary cause. (Zarembo, 4/1)

An apple a day doesn't necessarily keep the doctor away. That's according to proverb-busting research that found daily apple eaters had just as many doctor visits as those who ate fewer or no apples. The findings don't mean apples aren't good for you but they do underscore that it takes more than just one kind of food to make a healthy diet and avoid illness. (3/30)

Patient preference has shifted in terms of the way they want to hear skin biopsy results: most patients now say they would rather get the news faster by telephone than wait for a face-to-face clinic visit. In a study by Aditi Choudhry, MD, from the Dermatology Service, Veterans Affairs Medical Center in San Francisco, California, and colleagues, most (67.1%) of the 301 patients who responded to a survey preferred to speak directly with their physician by telephone to get results. (Frellick, 4/2)

A Roche blood test to screen fetuses for Down syndrome worked far better than standard prenatal screening tests in younger, low-risk women, U.S. researchers said on Wednesday, setting the stage for more widespread use. The new study, published in the New England Journal of Medicine, is the largest to show the tests are accurate in even low-risk women. But experts warned that women who test positive still need to confirm the result through more invasive diagnostic testing such as amniocentesis, especially if they would consider terminating a pregnancy. (Steenhuysen, 4/1)

Schools should not be using random drug tests to catch or deter drug abusers, the American Academy of Pediatrics advises in an updated policy statement. The Academy recommends against school-based “suspicionless” drug testing in the new issue of the journal Pediatrics. Identifying kids who use drugs and entering them into treatment programs should be a top priority, but there is little evidence that random drug testing helps accomplish this, said Dr. Sharon Levy, director of the adolescent substance abuse program at Boston Children’s Hospital and lead author of the new policy statement. (Doyle, 3/30)

Hospitals are discovering that it's nearly impossible to clean endoscopes blamed for spreading deadly bacteria that have sparked lawsuits from patients and sent device regulators scrambling for a fix. The Seattle hospital where a fatal drug-resistant superbug was spread by contaminated scopes is still finding germs on the instruments even after heightening its cleaning procedures, researchers reported in a journal article Monday. (Tozzi, 4/1)

Hospitals may want to devote more attention to the power of social media, according to a recent study looking at the correlation between hospitals' Facebook ratings and how well they performed on 30-day readmission rates. Hospitals with fewer patients readmitted to the hospital within 30 days—an outcome measure used to evaluate quality—also had higher ratings on the social media site's five-star rating scale, the report found. (Rice, 4/1)

Lawmakers are responding to recent concerns from researchers who collaborate with the Centers for Disease Control and Prevention that the agency's process for approving the release of scientific papers is “censoring, duplicative, and an impediment to timely dissemination of science.” Two researchers who have partnered with the CDC, University of Pennsylvania professors Michael Blank and John B. Jemmott III, argued in an editorial published last month in the American Journal of Public Health that the CDC has such a difficult and slow process for releasing scientific findings that “there are serious ethical questions regarding delays in dissemination of scientific information.” (Adams, 4/1)

A new report from consultancy Avalere says the exchanges are struggling to sign up the middle class. People with incomes close to the poverty line and who can buy exchange policies for just a few dollars a month are eagerly snapping up the product. More than three-quarters of the eligible folks making less than 150 percent of the federal poverty line have enrolled. But as you get north of 150 percent of the poverty line, the numbers start rapidly declining .... What does that tell us? People don't seem to want exchange policies unless there's a substantial subsidy. Which means that at higher income levels, there could be substantial adverse selection. However, I think it's a little early yet to worry. (Megan McArdle, 4/2)

The “doc fix” bill that passed the House last week on a 392-37 vote is a piece of cheese that could smell really, really bad by the time the Senate comes back from its spring break to consider the measure. ... The bill could become a powerful enabler to drastically change, if not end, the traditional fee-for-service model of Medicare. That’s because the law would create—get ready for two more healthcare acronyms—MIPS and APM. MIPS stands for the Merit-Based Incentive Payment System, which would reward or penalize doctors based on patient health outcomes compared with performance thresholds. APM is short for Alternative Payment Model programs, which provide different rates and incentives for doctor payments. These programs could trigger big changes in how Medicare works and in how doctors perform medicine. (Philip Moeller, 4/1)

Mark Cuban is a billionaire entrepreneur. He’s a star of the “Shark Tank” reality TV show. He’s the savvy owner of an NBA basketball team, the Dallas Mavericks. He’s even invested in four health care companies. But Mark Cuban doesn’t understand health care. That’s the obvious conclusion after Cuban issued a string of lunkheaded tweets on Wednesday — encouraging his 2.8 million Twitter followers to get their blood tested every quarter — that only got worse when Charles Ornstein, a ProPublica reporter, gently challenged him. (Dan Diamond, 4/2)

The most damning portion of the indictment chronicles Mr. Menendez’s advocacy on behalf of Dr. Melgen when federal officials, in 2009, found that he had overbilled Medicare by nearly $9 million. “We have a bit of a situation with Senator Menendez, who is advocating on behalf of a physician friend of his in Florida,” an official at the Department of Health and Human Services warned a colleague who was designated to take the senator’s call. Senate staff members routinely work on behalf of constituents, but there appears to be no reasonable explanation for the hours of work they put into a billing dispute on behalf of a doctor from another state. Mr. Menendez took the matter up directly with the secretary of health and human services during a meeting in August 2012. Two months later, Dr. Melgen donated $300,000 to a political action committee that was working to get Mr. Menendez re-elected. (4/2)

Menendez's interventions on behalf of Dr. Saloman Melgen with both the Department of Health and Human Services over Medicaid reimbursements and with the State Department with regard to a port security firm in the Dominican Republic owned by Melgen, might not have piqued the curiosity of the Justice Department had the doctor been a resident of the state of New Jersey. The gifts Menendez received in the form of vacations and contributions to his legal defense fund and political causes, could get him into trouble if it turns out that they constituted a quid pro quo arrangement. If the Justice Department can establish that fact, Menendez is a goner and might face expulsion from the Senate and worse. (Ross K. Baker, 4/2)

Among the sophisticates it’s fashionable to despair over American progress against cancer, but the reality is that every year medicine makes steady and durable gains. On Monday the National Cancer Institute and other researchers published new findings on cancer’s incidence and death rate in the U.S. over the last decade that show better outcomes and longer lives. (4/2)

[T]there is a potential vehicle for a new Supreme Court examination of informed consent: a recent decision by the U.S. Court of Appeals for the Fourth Circuit that conflicts with other appellate court decisions. The Fourth Circuit struck down a North Carolina statute, called the Display of Real-Time View Requirement, that required physicians to “perform an obstetric real-time view of the unborn child” that the patient could see; to simultaneously explain the display ... and to offer the patient “the opportunity to hear the fetal heart tone.” ... Laws prescribing exactly what physicians must say, regardless of patients' needs or preferences, make a mockery of informed consent and patient autonomy. Laws that compel physicians to speak for the state devalue physicians' professional judgment and responsibility to act in patients' best interests. (Wendy K. Mariner and George J. Annas, 4/2)

Health care consumers won a significant victory when Massachusetts Suffolk County Superior Court Judge Janet Sanders blocked a settlement that would have allowed Partners HealthCare, the system that dominates the Boston area, to acquire three additional health care providers in eastern Massachusetts. Sanders concluded that the acquisitions “would cement Partners' already strong position in the health care market and give it the ability, because of this market muscle, to exact higher prices from insurers for the services its providers render.” ... But there is an even bigger reason for New Englanders to celebrate the judge's ruling. The danger lay not only in Partners' expanded dominance but also in the degree to which the settlement would have shut out other innovative competitors. (Regina E. Herzlinger, Barak D. Richman and Kevin A. Schulman, 4/2)