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The White House will shift about $500 million designated for fighting Ebola to combating the Zika virus, saying the step is necessary because Congress hasn’t acted on the administration’s request for emergency funding to tackle the mosquito-borne disease. The $510 million in existing Ebola funding, plus almost $80 million from other sources, will be redirected to allow for an immediate Zika response, Shaun Donovan, director of the Office of Management and Budget, said Wednesday. (Armour, 4/6)

In an effort to break the two-month deadlock over funding to fight the encroaching Zika virus, Obama administration officials announced on Wednesday that, as congressional Republicans had demanded, they would transfer $510 million originally intended to protect against Ebola to the Zika battle. Officials from the Office of Management and Budget, the Department of Health and Human Services, and the State Department said they would move a total of $589 million to efforts to contain Zika. In addition to funds moved from the Ebola budget, an additional $79 million would come from several other accounts, including money previously allotted to the national strategic stockpile of vaccines and other emergency supplies for epidemics, said Sylvia Mathews Burwell, the secretary of the Department of Health and Human Services. (McNeil, 4/6)

The redirected funds will go to mosquito control and surveillance; education about how to prevent transmission; supporting states and territories in their own Zika virus responses; and developing vaccines and better diagnostic tests. (Bichell, 4/6)

While the administration has acknowledged that substantial Ebola funding is left over, it has already committed much of it to helping at least 30 other countries prevent, detect and respond to future outbreaks and epidemics. It also wants to preserve money to keep fighting Ebola should it flare up again. (4/6)

The White House announced Wednesday it will shift $589 million in government spending to combat the Zika virus, and warned Congress that it would regret ignoring the Obama administration’s request for $1.9 billion to increase research and defenses against the disease. (Sink, 4/6)

Top Zika investigators now believe that the birth defect microcephaly and the paralyzing Guillain-Barre syndrome may be just the most obvious maladies caused by the mosquito-borne virus. Fueling that suspicion are recent discoveries of serious brain and spinal cord infections - including encephalitis, meningitis and myelitis - in people exposed to Zika. (Steenhuysen, 4/6)

Allergan Chief Executive Brent Saunders criticized as “un-American” and “capricious” the new Treasury Department rules that scuttled the drug company’s $150 billion tie-up with Pfizer Inc. “The rules are focused on the wrong thing: Our government should be focused on making America competitive on a global stage, not building a wall locking companies into an uncompetitive tax situation,” Mr. Saunders said in an interview. (Rockoff, 4/6)

Allergan CEO Brent Saunders said Wednesday that the Treasury Department actions that led his pharmaceutical company and Pfizer to terminate their proposed merger are “a bit un-American.” “We built this deal around the law, regulations, all the notices that were put out by the Treasury, and it was a highly legal construct. We followed the rules that Congress had set for companies looking to move to a foreign domicile,” Saunders said in an interview on CNBC. (Jagoda, 4/6)

A day after the Obama administration limited the ability of U.S. companies to do international deals to lighten their tax burdens, Pfizer Inc. and Allergan PLC terminated their planned $150 billion merger and other companies around the globe raced to assess the impact of the new rules. The new Treasury Department rules—the third such attempt to rein in a spate of so-called tax-inversion deals—drew swift condemnation from Allergan Chief Executive Brent Saunders, who criticized them as “un-American” and “capricious.” (Rubin and Rockoff, 4/6)

U.S. tax rules are more difficult to sue over than other regulations that emanate from Washington, presenting a challenge to anyone considering a lawsuit over an Obama administration plan to discourage deals known as inversions, tax lawyers say. Business trade groups have frequently gone to court since President Barack Obama took office in 2009 to try to block rules about the environment, health or labor unions, but taxes are different because of a law that generally bars suits until a tax is assessed, the lawyers said in interviews this week. (Ingram, 4/6)

President Barack Obama scored a victory this week when Pfizer scrapped a $160 billion overseas deal that would have kept a chunk of the drugmaker's profits beyond the U.S. tax man's reach. But recent, aggressive federal actions that discouraged Pfizer Inc.'s combination with another drugmaker, Allergan PLC, won't stop all so-called inversions, or deals that end with a company relocating to another country — at least on paper — and trimming its U.S. tax bill in the process. Tax and legal experts say these deals, which have come under growing criticism from politicians, will remain attractive to some companies until the U.S. pursues a massive tax law overhaul. ... Inversions have become particularly popular in health care. (4/6)

Pfizer needs a Plan C. Two years ago, the pharmaceutical giant tried — and failed — to take over the British rival AstraZeneca in a bid to become the world’s largest drug company and lower its tax bill in the process. On Wednesday, Pfizer said another big overseas merger had failed, this time a $152 billion merger with Allergan, after the Obama administration introduced rules that would make the deal much less attractive. Now, Pfizer finds itself at yet another crossroads. (Thomas and Bray, 4/6)

Three Pfizer Inc. executives will each receive $1 million cash awards tied to the drugmaker’s combination with Allergan Plc even after that $160 billion deal was terminated. (Ritcey and Melby, 4/6)

The end of the health-care industry’s biggest ever merger may also be the beginning of another round of deal-making for Allergan Plc. (Gokhale and Hallam, 4/6)

The collapse of one pharmaceutical mega-merger could beget many smaller deals - at least that is the hope of biotech investors. Shares of the beaten-up biotech sector rallied on Wednesday as U.S. drugmaker Pfizer Inc and Ireland-based Allergan Plc called off their $160 billion merger after new U.S. Treasury rules aimed at curbing tax-cutting inversion deals. (Krauskopf, 4/6)

Gov. John Kasich’s administration projects more than 650,000 poor Ohioans will lose Medicaid coverage while taxpayers save nearly $1 billion under a plan to charge new fees for the government health coverage and impose penalties on those who miss payments. The proposal would require those being treated for breast and cervical cancer, teens coming out of foster care and other working-age, nondisabled adults on Medicaid to make monthly payments into a health-savings account to help cover their expenses beginning Jan. 1, 2018. (Candisky, 4/7)

In his 2015 budget proposal, Kasich, who is running for the Republican presidential nomination, suggested assessing premiums for adults above 100% of poverty. GOP state lawmakers last summer passed a bill to have it apply to all program beneficiaries. Pundits aren't sure that will help Kasich win votes among those in his party who did not approve of the Ohio governor's decision to expand Medicaid in 2013. On Monday, his administration posted a summary of a waiver the state plans to submit to the CMS for approval. (DIckson, 4/6)

House Speaker Taylor Barras has filed legislation that will allow hospitals across the state to be charged a first-of-its-kind fee that will help the state pay for the cost of Medicaid expansion. The bill is the result of several years of legislative work that began under former Gov. Bobby Jindal, a vocal opponent of Medicaid expansion. Despite Jindal's opposition, legislators were able to find workarounds for financing Medicaid expansion that allowed them to avoid Jindal's veto while constructing a mechanism that would allow the state to raise money to pay for expansion from health care providers. (Litten, 4/6)

A coalition working to expand Medicaid in South Dakota is racing to complete its work before a new president moves into the White House. The state has negotiated for years with the Obama administration to reach agreement on re-interpret federal policy on funding Medicaid-eligible American Indians. And in February, the governor's office learned that the federal government would accept the terms of a compromise if the state would expand Medicaid. But that progress could face a serious setback come November if a new administration clears out and replaces current staff at the federal health agencies that have worked with the state or moves to abolish the federal healthcare program for needy people. (Ferguson, 4/6)

Gov. Asa Hutchinson called the debate over Arkansas' hybrid Medicaid expansion a "watershed" moment on Wednesday, as lawmakers advanced his plan to keep and rework the program that provides subsidized health coverage to more than 250,000 people. The House and Senate are set to take up legislation Thursday outlining the Republican's proposal to keep the hybrid expansion after the plan easily cleared two committees at the start of a special session. (DeMillo, 4/6)

A Florida woman confronted Gov. Rick Scott about some of his controversial policies as he ordered coffee at a Gainesville Starbucks on Tuesday in a video that has gone viral, according to WFTS. Cara Jennings, the woman in the video, told the TV station that she couldn't pass up the opportunity to speak her mind on the governor's decision to strip state funding from any clinic that performs abortions, even if that means restricting access to other services such as cancer screenings and reproductive health care, and for refusing to expand Medicaid. (Cutway, 4/6)

A woman was caught on camera exploding at Florida Gov. Rick Scott while the Republican politician stopped for coffee at a Gainesville Starbucks Tuesday, calling Scott a derogatory name and blaming him for the state's failing economy. "You cut Medicaid, so I couldn't get Obamacare," the woman yelled at Scott as he attempted to place an order. ... "You don't care about working people." (Flores, 4/6)

In town on April 5, 2016, to tour the recently opened factory and headquarters for biopharmaceutical company Nanotherapeutics, [Gov. Rick] Scott stopped in to the coffee chain for a cup. Cara Jennings, a former Lake Worth city commissioner, saw Scott and ripped into him from her seat. Among other grievances, she accused him of denying her health care coverage with his policies. "In fact, you cut Medicaid so I couldn’t get Obamacare," Jennings shouted on April 5, 2016. ... we can look at whether Scott cut Medicaid, the joint state and federal program to provide health insurance for the very poor, in a way that could have denied people health coverage under the Affordable Care Act. It’s not so much that he cut anything, but more that he hasn’t consistently supported expanding the program. That has indeed left hundreds of thousands of Floridians without coverage. (Gillin, 4/6)

Thomas Maino knew he was going to die. Suffering from serious ailments, the 93-year-old veteran had rejected invasive treatments and asked only that he be made comfortable after he was admitted to a Syracuse nursing home in November 2008. But on a snowy Saturday morning the following January, his moans could be heard down the hallway. (Porat, Adams and Huseman, 4/7)

Nurses and other medical staff are leaving their positions in Texas’ nursing homes because of low pay, advocates say, setting up the possibility for a nursing shortage in long-term care facilities as the state’s 65-and-over population booms in the next few years. The state’s low Medicaid reimbursement rate contributes to the low pay, a dynamic that’s driving nurses out of nursing homes or out of the health industry entirely, said Julie Sulik, vice president of Clinical Services for Southwest Long Term Management. (Blanchard, 4/6)

Gov. Pete Ricketts has approved new whistleblower protections for nurses in Nebraska. The governor signed a bill Wednesday that would ban retaliation against nurses who file complaints with the state. It also would guarantee confidentiality for nurses even if their allegations later become a public record. (4/6)

A Chicago teaching hospital urged a federal appeals court on Tuesday to overturn a National Labor Relations Board ruling that allows unions to organize in healthcare facilities by adding so-called micro units of workers into existing bargaining units. (Iafolla, 4/6)

Another new health insurance startup is hitting the marketplace. Bright Health has raised $80 million from a handful of venture capital firms and has its sights set on the Affordable Care Act exchanges and, eventually, Medicare Advantage. Bob Sheehy, the former CEO of UnitedHealthcare, is one of Bright Health's co-founders and serves as CEO. (Herman, 4/6)

Premiums in the long-term care insurance program for federal employees and retirees are expected to increase later this year for most enrollees, the government has said, but exactly when and by how much is yet to be determined. The Office of Personnel Management on Tuesday awarded a new seven-year contract to the John Hancock Life and Health Insurance Company to administer the Federal Long Term Care Insurance Program. The program provides in-home, assisted living and nursing home benefits for those unable to fully care for themselves due to physical or mental conditions. (Yoder, 4/6)

The New England Journal of Medicine is arguably the best-known and most venerated medical journal in the world. Studies featured in its pages are cited more often, on average, than those of any of its peers. And the careers of young researchers can take off if their work is deemed worthy of appearing in it. But following a series of well-publicized feuds with prominent medical researchers and former editors of the journal, some are questioning whether the publication is slipping in relevancy and reputation. The journal and its top editor, critics say, have resisted correcting errors and lag behind others in an industrywide push for more openness in research. And dissent has been dismissed with a paternalistic arrogance, they say. (Ornstein, 4/5)

MedStar Health Inc. said Wednesday that hackers who seriously disrupted its operations and held some data hostage did not exploit software vulnerabilities that were the subjects of warnings in 2007 and 2010 to break into its corporate network. The hospital chain released a new statement after The Associated Press reported Tuesday that hackers broke into a corporate computer server exploiting flaws that had persisted for years on the network. The AP's report was attributed to a person familiar with the investigation who was not authorized to discuss the findings publicly. MedStar said the new information came from Symantec Corp., which it hired to investigate. (Abdollah, 4/6)

MedStar Health is disputing a report that the hospital company should have known as early as 2007 about weaknesses in its system that contributed to a massive cyberattack that encrypted its files. (McDaniels, 4/6)

Medical errors are estimated to be the third-highest cause of death in the country. Experts and patient safety advocates are trying to change that. But at least one of the tools that’s been considered a fix isn’t yet working as well as it should, suggests a report released Thursday. That’s according to the Leapfrog Group, a nonprofit organization known for rating hospitals on patient safety. Leapfrog conducted a voluntary survey of almost 1,800 hospitals to determine how many use computerized-physician-order-entry systems to make sure patients are prescribed and receive the correct drugs, and that medications won’t cause harm. The takeaway? While a vast majority of hospitals surveyed had some kind of computer-based medication system in place, the systems still fall short in catching possible problems. (Luthra, 4/7)

Following on a campaign in which women called Gov. Mike Pence's office to tell him about their periods, activists plan a more traditional protest this weekend of a new law banning abortions sought because of genetic abnormalities that makes Indiana one of the most restrictive states in the country. Women taking part in the phone blast have been offering information about their menstrual cycles, if they had cramps and other updates to the governor's flustered phone staff and posting the conversations to Twitter or a Facebook group. The "Periods for Pence" page has amassed thousands of "likes" in nearly a week. One caller asked if Pence could recommend a gynecologist. (4/6)

The Louisiana House voted Wednesday to triple the wait time for women seeking an abortion to 72 hours, an increase that would match Louisiana to five other states with the longest waiting periods in the country. The change to Louisiana's abortion restrictions is supported by Democratic Gov. John Bel Edwards and sailed through the House with an 89-5 vote. It moves next to the Senate for consideration. (4/6)

Opening statements are scheduled Thursday at the trial of an Arizona woman accused of faking a cancer diagnosis in a scheme to get the state to pay for her late-term abortion. Chalice Renee Zeitner is accused of presenting falsified medical records to support her claim that she had cancer and telling an obstetrician that her pregnancy put her life in danger. (4/7)

Attorney General Pam Bondi's office is urging the Florida Supreme Court to turn down an appeal in a legal battle over a 2015 law that requires women to wait 24 hours before having abortions. A three-judge panel of the 1st District Court of Appeal in February overturned a temporary injunction that had blocked the law from taking effect. (4/6)

A clinic in Oregon is set to become part of a national study geared at giving women easier access to the abortion pill. The program allows women to use telemedicine to talk to a physician over a computer instead of meeting in person. (Terry, 4/6)

Anti-abortion activists gathered in Washington on Wednesday had expected to hear from Donald Trump about his abortion positions. They left disappointed. Trump did not address the 115 Forum, a conference of abortion foes in Washington organized by Priests for Life. Three sources associated with the group said organizers had initially led attendees to believe that Trump would be speaking to them by phone. Yet later on Wednesday, organizers said the mogul would not be speaking. (Isenstadt, 4/6)

Billionaire hedge-fund investor Steven A. Cohen is committing $275 million to form a national network of free mental health clinics for military veterans and their families. (Gordon, 4/6)

New reports show the Manchester, N.H. and White River Junction, Vt. Veterans Administration Medical Centers manipulated records to make wait times for appointments appear shorter than they actually were. (Biello, 4/6)

Ascension Michigan will now provide care through the Veterans Choice Program, giving veterans the choice to receive care at Ascension Michigan locations throughout the state, including St. Mary’s of Michigan in Saginaw. As part of Ascension, the nation’s largest nonprofit healthcare system and the world’s largest Catholic health system, Ascension Michigan joins 23 other states and the District of Columbia in sustaining and improving the health of individuals and communities by serving as an official provider of veteran care outside the Department of Veterans Affairs. (4/7)

The nation's epidemic of addiction to painkillers and heroin is fueling runaway demand for a once-obscure form of housing known as "sober homes," where recovering addicts live together in a supervised, substance-free setting to ease their transition back to independence. The facilities are rarely run by credentialed professionals and are only lightly regulated — a situation that has prompted at least five states to pass or consider legislation to impose basic rules on how they operate. Some homes have been accused of tolerating drug use and participating in insurance fraud. (4/6)

On a recent morning, Henry McGhee checked in on the residents of one of the four sober homes he owns in Chicago. He’s been in business 15 years and estimates he’s provided housing for more than 8,000 people, many of them black men who completed prison terms for drug crimes. The Associated Press toured one of McGhee’s homes — a small apartment building in a tidy working-class neighborhood — to get a look at a growing segment of an industry responding to strong demand for addiction treatment. (Johnson, 4/6)

To stem its rising tide of drug overdose deaths, Seattle is among a growing number of cities considering public facilities where addicts can use hard drugs like heroin under medical supervision. The move is indicative of a shifting perception on how the problem of addiction should be managed. (Prall, 4/6)

The New Hampshire Board of Medicine moved closer to putting stronger opioid prescribing rules in place on Wednesday. The new rules, which come amid the state’s heroin and opioid epidemic, offer a stricter framework for doctors who prescribe opioids to patients with chronic and acute pain. (Nilsen, 4/6)

A street pill that looks like it came straight from the pharmacist is causing deaths in Orlando. State law enforcement officials discovered the so-called super pill recently, and they are warning residents to keep from buying pain killers on the black market. (Sago, 4/6)

Gov. Terry Branstad signed a bill Wednesday that allows families, friends and first responders in Iowa to administer an emergency medication that counteracts the effects of an opiod overdose. (Boden, 4/6)

The number of overdoses linked to the potent painkiller fentanyl has grown by six over the past two days to 48, nearly two weeks after the first reports of such overdoses began popping up in the Sacramento region, the Sacramento County Department of Health and Human Services reported Wednesday. No additional deaths have been reported, leaving the region’s fentanyl-linked death toll at 10. (Buck, 4/6)

Trained pharmacists statewide soon will be able to dispense the overdose reversal drug naloxone without a prescription. Regulators announced Monday that a short web-based training program is available to pharmacists who want to help reduce deaths from heroin and painkillers. (Green, 4/6)

Ten years after the federal government approved the first vaccines to combat the cancer-causing human papillomavirus, nine years after those vaccines were recommended for all adolescent girls, and five years after they were recommended for all adolescent boys, less than half of girls and only a fifth of boys are getting immunized. (Ollove, 4/7)

Health officials said Wednesday that tests found no significant lead contamination in the blood of adults or schoolchildren in a former Nevada mining town where more than the federal safety limit for the heavy metal was found in water samples. (Ritter, 4/6)

Lead in drinking water at Delta Kelly Elementary in Rochester Schools doesn’t exceed federal limits, but the amount of copper does. That was the gist of a letter to parents from Superintendent Robert Shaner posted on the elementary school’s Facebook page March 24. ... Michigan, and Oakland County in particular, has had some water tests exceed federal limits for lead, but none recently. In Michigan, EPA data indicates 27 locations, most with private well systems, have tested higher than the federal lead limit of 15 parts per billion since 2013. ... But none of them exceeded federal limits when the water was retested. (Crumm, 4/6)

Water fountains at two Detroit Public Schools' buildings have been turned off after water samples found elevated levels of copper and lead. A drinking fountain at Burton International Academy had copper levels that are above suggested levels by the U.S. Environmental Protection Agency. And at Beard Elementary School, which closed in 2012 but is being leased by a private company for administrative space, a water fountain had higher than suggested levels of lead. (Higgins, 4/6)

Residents of Flint, Mich., may tell you lead is a serious menace, but for most of the last 5,000 years, people saw lead as a miracle metal at the forefront of technology. "You can think about lead as kind of the plastic of the ancient world," says Joseph Heppert, a professor of chemistry at the University of Kansas. He says it was because lead is easy to melt — a campfire alone can do it. Unlike iron, lead is malleable. "Once you form it into sheets you can do things that people had really never been able to do before with a metal," he says. "You can roll it into tubes, for example." ... Chris Warren, a professor of history at Brooklyn College, says Romans even sweetened their ­food with lead. (Morris, 4/6)

A lobbying group for California hospitals is giving $8.5 million to an initiative campaign to extend a temporary tax increase on the wealthy. The political arm of the California Association of Hospitals and Health Systems reported the March 23rd donation on Wednesday. (4/6)

Henry Ford Health System has finalized its deal to absorb smaller Allegiance Health of Jackson, marking the Detroit-based system's first significant expansion beyond southeast Michigan. Allegiance Health's 475-bed main hospital, formerly known as W. A. Foote Memorial Hospital, is now officially renamed Henry Ford Allegiance Health. The deal, which received all required regulatory approvals, also brings the more than 30 Allegiance Health outpatient centers into the Henry Ford fold. (Reindl, 4/5)

Antitrust scrutiny of hospital consolidation in the Chicago area isn't stopping Northwestern University's academic medical center from pursuing another merger. Chicago-based Northwestern Memorial is in talks with Centegra Health System, based in northwest suburban Crystal Lake, to explore a potential combination. There's no guarantee that the discussions will lead to a full-blown merger, but Northwestern has been more successful than not in closing deals. (Sachdev, 4/6)

Crystal Rivera’s son has the kind of health issues that would make any mother anxious: food allergies, asthma attacks, a skin condition. But 5-year-old Dacuarie Dillard was in good hands, seeing specialists at Boston Children’s Hospital, where he and Rivera had grown comfortable with his care. Things changed Jan. 1, when the family’s health insurer, Neighborhood Health Plan, began a new contract with Children’s that makes it more complicated for Dacuarie and thousands of poor children like him to see doctors at one of Massachusetts’ most prestigious hospitals, even as it becomes increasingly popular with wealthier patients from around the country and the globe. (Dayal McCluskey, 4/7)

When two employees at the University of Maryland St. Joseph Medical Center died just months apart in what the hospital described as domestic violence incidents, their co-workers were left wondering if they had missed signs at work about the problems at home and what they could have done to intervene. It was a tragedy no one at the hospital wants repeated. Two years later, the Towson hospital is beginning to teach employees how to recognize and prevent domestic violence among its 2,700-person workforce. Organizers hope the shift in attention normally reserved for patients not only helps workers remain safe but sets a standard that can be replicated at other hospitals. (Cohn, 4/6)

Standing beside nurses who recounted the surge in workplace injuries at the hands of violent patients at the state-run psychiatric hospitals, Gov. Mark Dayton urged legislators Wednesday to pay for critical upgrades and staffing increases. (Potter, 4/6)

Gov. Mark Dayton says urgent upgrades are needed at two state-run mental health facilities, and he's calling on lawmakers to come through this session with the necessary funding. Dayton wants $177 million to improve buildings and boost staffing levels at the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital in St. Peter. Employees from both facilities say the money is needed to make the places they work safe. (Pugmire, 4/6)

Conditions at the state’s psychiatric hospitals in Anoka and St. Peter are nightmarish and dangerous, employees said Wednesday. They’re pleading for millions of state dollars to improve security and hire more staff. (Montgomery, 4/6)

Patients who were potentially exposed to dangerous viruses while under the care of Baystate Noble Hospital are now suing. Between June 2012 and April 2013, new equipment was being used for colonoscopies at Noble Hospital. Following a recent Department of Public Health inspection, it was discovered that the disinfectant process of the new equipment was not adequate. (Goslee, 4/6)

The Yukon Kuskokwim Health Corporation is one step closer to expanding its hospital with the hope of improving health care in the region. Last week YKHC signed a joint venture construction agreement with Indian Health Services. “I’ve been waiting 14 years to sign that agreement on March 29. So it’s been a dream of the company’s,” YKHC President and CEO Dan Winkleman said. (MacArthur, 4/6)

Gov. Robert Bentley said today the Alabama Medicaid Agency would examine program cuts before he considers calling a special session over the state budget. Bentley and Medicaid Commissioner Stephanie Azar went over potential cuts one day after the Legislature overrode the governor's veto and enacted the General Fund budget. Lawmakers appropriated $700 million from the General Fund for Medicaid next year, $85 million short of the governor's request. ... [Bentley] said one option could be to eliminate prescription drug coverage for adults, which would save an estimated $50 million to $60 million in state dollars. "If we have to live within our means, then we have to make some very tough decisions," the governor said. (Cason, 4/6)

Gov. Robert Bentley and Medicaid Commissioner Stephanie Azar on Wednesday laid out a stark picture of the impact of the Medicaid budget approved by the Legislature, including the elimination of many services, cuts to physician reimbursements and elimination of drug coverage for adults. (Lyman, 4/6)

Many nursing homes across rural Oklahoma, including Fairview Fellowship Home, may have to stop serving Medicaid patients if the proposed cuts are approved. ... Fairview Fellowship Home is the only five star nursing home within a 50 mile radius in Major County. “We have 41 Medicaid residents here at our facility,” Dykes said. Dykes said that if the nursing home loses 25 percent percent of their Medicaid reimbursement rates, their facility would be out $550,000 a year. She said her facility may not have any other choice but to turn Medicaid patients away. (Price, 4/6)

Dwight Sublett has seen a lot of busts in his 33 years as a pediatrician in Stillwater, Oklahoma, but this year ranks among the worst. With oil hovering at $35 a barrel, the state is facing a $1.3 billion budget shortfall for the fiscal year starting on July 1. On March 29 the Oklahoma Health Care Authority warned it would have to cut 25 percent from reimbursements to physicians, hospitals, and other medical providers under the state’s Medicaid program, SoonerCare. The program covers a million poor Oklahomans each year, more than a quarter of the state’s population. “For the rural physicians, this is going to be a devastating blow,” Sublett says. (Tozzi, 4/7)

A New York health insurer's study shows 10 common conditions like sinus infections and sprains represented more than 2 million visits to hospital emergency rooms statewide and cost about $1.3 billion in 2013. The study says about 90 percent could have been treated elsewhere for less. Excellus BlueCross BlueShield examined 6.4 million emergency room visits in 2013, concluding many were avoidable with less expensive and faster treatment in doctors' offices, urgent care clinics or even through telemedicine. (4/6)

The University of Missouri nursing school announced today it has received nearly $20 million in federal funding to expand its research that has been successful in reducing hospitalizations among nursing home residents in the St. Louis area. The grant is the largest the MU Sinclair School of Nursing has ever received and the second largest in the university's history. The goal of the research, which will involve 32 area nursing homes, is to create a model for others to implement. (Munz, 4/6)

An appeals court Monday sided with the Florida Department of Children and Families in a dispute about expenses for a woman who went into a Tallahassee nursing home after suffering a spinal-cord injury in an accident. (4/6)

The nursing school at the University of Missouri has received nearly $20 million in federal funds to expand research that has already reduced hospitalizations among nursing home residents in the St. Louis region. (4/6)

Sutter Health, long accused of abusing its market power in California, is squaring off against major U.S. employers in a closely watched legal fight over health care competition and high prices. The latest fight has erupted over Sutter’s demand that employers sign an arbitration agreement to resolve disputes. Without it, Sutter says employers must pay sharply higher rates — 95 percent of its full charges — for out-of-network care at its hospitals, surgery centers and clinics. (Terhune, 4/7)

Dr. Nathan Ravi, now 64, was living on the East Coast, working as a chemical engineer; he was a father, husband and in excellent physical condition as a hobby runner — 5Ks, hours of gym time and the like. So why at 28 did he develop type 1 diabetes? He sums up the answer in one word: bisphenol, more commonly known as BPA, for bisphenol-a. It’s the best known and possibly the most harmful culprit in a family of chemicals known to, or suspected of harming people. (Jackson, 4/6)

A St. Louis director of a nonprofit that helps families care for Alzheimer’s sufferers told Congress Wednesday that there was a “national crisis” because of “15 million unpaid dementia caregivers who need help today.” Lisa Baron founded Memory Care Home Solutions 16 years ago after her experiences helping to care for a mother-in-law who suffered from Alzheimer’s. (Raasch, 4/6)

Health-tech startup HealthJoy, whose artificial intelligence platform helps consumers navigate health care-related decisions, has raised $3 million in seed funding from GoHealth and angel investors. The River North-based company — founded in 2014 by CEO Justin Holland and president Doug Morse-Schindler — sells a platform called “Joy” that acts as a virtual health care assistant for those trying to cut costs and navigate their insurance plan. (Graham, 4/6)

Pennsylvania is competing with 23 other states for a federal grant that will push health care into the future. A midstate group - Berks Counseling Center - is part of the state's application. It's one of 16 that's been selected to work with the state on the final submission to the federal government. (Allen, 4/6)

Every year, the Massachusetts Medical Society picks an important public health topic of the day and tries to figure out how to make a difference. This year, it’s guns. (Bebinger, 4/6)

Rutgers has created a new health care provider organization. University officials say Rutgers Health will become one of the first academic health care provider organizations in the nation to integrate a full range of health-related specialties with more traditional fields. (4/6)

For the first television ad in his 8th Congressional District Democratic primary campaign, Del. Kumar P. Barve recounts the story behind the passage of a 1997 law requiring HMOs to pay for blood work. Barve (D-Montgomery) sponsored the measure after he learned about the crisis confronting Osama Farrag, a Gaithersburg constituent, who faced bankruptcy because his infant son required daily transfusions not covered by his health maintenance organization. (Turque, 4/6)

Pfizer never tried to hide the fact that its proposed $152 billion merger with Allergan, based in Ireland, would cut its tax bill in the United States. But even as it rushed to complete the biggest tax-avoidance deal in the history of corporate America, it continued to promote the strategic and economic benefits of the merger. (4/6)

The U.S. government's latest moves to prevent the $160 billion Pfizer-Allergan tax inversion deal, and future ones like it, can make the U.S. market unattractive to legitimate foreign investors. The administration uses the U.S. market's enormous size to browbeat companies into submission. Size alone, however, can only motivate investors to a degree. (Leonid Bershidsky, 4/6)

In the pharmaceutical industry we develop medicines and therapies to address world-wide health challenges. The work is complex and deeply gratifying. At Pfizer we employ more than 30,000 highly skilled people in the United States alone and invest almost $8 billion annually in R&D, much of it in the U.S. (Ian Read, 4/6)

Congrats big pharma! You ruined a favored and often lucrative tax tactic for the entire corporate world. With hubris and attempted mega-deals, the industry called forth the wrath of the U.S. Treasury Department against inversions and similar deals designed to net U.S. firms lower tax rates. (Max Nisen, 4/6)

Pfizer’s abandoned deal leaves all sides tainted. The United States Treasury looks bad for changing the rules on Monday to kill the $152 billion merger with Allergan. Lawmakers’ inaction encouraged such tax-driven transactions. But Pfizer and its chief executive, Ian C. Read, bear the most responsibility for wasting time and resources pushing an overpriced, risky deal. (Robert Cyran, 4/6)

“Moving from volume to value” is health care reform’s latest mantra. Policymakers hope to replace fee-for-service systems with value-based approaches that reward improved outcomes achieved at lower cost. Ground zero in these efforts is the Medicare Physician Fee Schedule (MPFS). What payment reformers often fail to recognize is that the specific MPFS payment rates have important implications for Medicare and its beneficiaries. The relative payment levels for the thousands of service codes and the absence of payment for other activities powerfully influence how physicians spend their time — and their tendency to perform unneeded tests and procedures. The mix of services that physicians provide under a particular fee schedule can affect value at least as much as any improvements derived from rewarding physicians on the basis of quality measures — the approach Congress took in the Medicare Access and CHIP Reauthorization Act of 2015. (Robert A. Berenson and John D. Goodman, 4/7)

While I’ve used an electronic medical record for several years, Epic, the system my hospital recently adopted, makes recording stories such as the one my patient shared especially difficult. Her grief and her fatigue, which are inseparable in reality, Epic treats as different problems. That she lives alone and there’s conflict in her extended family, which are also inextricable from her symptoms, must be filed under a tab marked “Social Documentation.” (Suzanne Koven, 4/6)

An impoverished 63-year-old woman is diagnosed with squamous-cell carcinoma of the lung with extensive metastases. There is no hope for cure, but radiation and chemotherapy, which could cost more than $100,000, may extend her life for a few months. If this patient unambiguously requests treatment, her doctors may struggle with the decision but will probably provide the treatment, ignoring the cost as a matter of principle. On the other hand, a health department — or a hospital — proposes an action that would prevent many cases of lung cancer by helping smokers quit. It could be offering free nicotine-replacement therapy to every smoker or running smoking counter-advertisements on television. The organization will immediately face resistance: Can we afford that? (Thomas A. Farley, 4/7)

Health care has faded into the background of the election campaign as Donald Trump himself has become the issue on the Republican side and the debate between Hillary Clinton and Bernie Sanders over health care has shifted to other topics. Health wasn’t even listed among the “most important issues” Republican voters could select from in the exit poll of Tuesday’s Wisconsin primary. But that doesn’t mean health is a total non-factor in the primaries; it is a more salient issue for some voting groups than others. And a broad constellation of health issues, not only the Affordable Care Act, are likely to have traction in the general election, particularly among women. (Drew Altman, 4/6)

We have let Walgreens down, America, and I for one am sick about it. Not sick enough, alas, to require pills, lozenges, expectorants and other over-the-counter medications, but I feel bad. Turns out reported incidents of the flu in the United States were down 16 percent from a year ago, as tracked by IMS Health. We're also winning the cold war. (Phil Rosenthal, 4/6)

Even though US consumers spend 3 times more for hospital care than for medication, they are much angrier with pharmaceutical companies than hospitals for driving up the cost of health care. Drug companies raise this apparent inconsistency in an effort to defend their pricing practices. In so doing, however, they fail to appreciate why they’ve been targeted for so much opprobrium. Ironically, the industry’s biggest public relations problems may arise from its most effective and widely applicable innovations. (Austin Frakt, 4/6)

One way of defining a "rogue" industry is to see which ones have declared war on their customers. By that measure, pharma stands at or near the top of combining the elements that go into making a rogue: contempt for the public and the unmitigated pursuit of greed. (Daniel Hoffman, 4/6)

The career of Rick Scott, Florida's Republican governor, has long been one of the outstanding mysteries out of the nation's statehouses. He won his first race for governor in 2010, even though the hospital company he ran until forced out in 1997, Columbia/HCA had been accused of defrauding federal healthcare programs and paid $1.7 billion in fines, damages, and penalties, then the largest healthcare fraud settlement in U.S. history. He won reelection in 2014, despite amassing a politically retrograde position on healthcare issues at odds with his supposed expertise in the field. (Michael Hiltzik, 4/6)

The winter my son Nat broke our playroom window with his head was an endlessly snowy one. He was home on school break and on sensory overload — rocking too wildly on a rocking chair, too close to the bay window. A nauseating shatter, like the crack of thin ice underfoot. Miraculously, he was not hurt. (Susan Senator, 4/6)