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Health care advocates are eager to see Medicaid expansion get off the ground in 2016, sometime after Gov. elect John Bel Edwards' Jan. 11 inauguration. The new governor has said Medicaid expansion -- which would provide health insurance for more than 250,000 uninsured working poor -- is "among the highest priorities" of his new administration. But there also are several challenges Edwards' new administration could face as the expanded program takes off. (Litten, 12/23)

In a prelude to what the group says will be an all-out effort in the upcoming state legislative session, members of the local activist organization Athens For Everyone showed up for a recent pre-legislative meeting of Athens-Clarke County’s mayor and commission and the five members of the state legislative delegation to press for Medicaid expansion in Georgia. While they didn’t have a place on the agenda for last week’s pre-legislative meeting — an annual session in which Athens-Clarke officials ask for state legislative assistance on a broad range of issues — the handful of Athens For Everyone representatives who came to the City Hall meeting held up cards reading “600 Georgians will die in 2016 without Medicaid expansion,” and “7,998+ Athenians in Medicaid gap” as Commissioner Jared Bailey made a case for the expansion. (Thompson, 12/23)

A showdown between two companies fighting over a drug for a rare neuromuscular disease powerfully illustrates the growing tension in the United States over the rising prices of drugs. The issue has drawn increased scrutiny from policy makers and prompted rising public outrage, much of it directed at Martin Shkreli, who has become a symbol for pharmaceutical price gouging. Turing Pharmaceuticals, the company he formerly headed, and others have been harshly criticized for abruptly raising the prices of medicines after acquiring them — without having taken the risks involved in research and development. (Tavernise, 12/22)

The price of drugs is making headlines this year. But aggressive pricing tactics are not new — and those affected most are the poorest in developing countries, says Judit Rius Sanjuan, an international law specialist and U.S. manager and legal policy adviser for Doctors Without Borders' Access Campaign. (Shaikh-Lesko, 12/23)

Signatures have been submitted in an effort aimed at keeping Ohio agencies and publicly-funded entities from buying prescription drugs at prices higher than what the U.S. Department of Veterans Affairs pays. Ohioans for Fair Drug Prices and AIDS Healthcare Foundation group say more than 171,000 signatures were turned in Tuesday in their campaign to force a vote on the Ohio Drug Price Relief Act. (12/23)

One of the biotech companies run by Martin Shkreli, the reviled drug price-gouger charged with securities fraud last week, was informed Wednesday that its stock will be delisted by Nasdaq because of Shkreli's arrest and other issues. Meanwhile, KaloBios Pharmaceuticals Inc. also is dealing with the abrupt resignation of its accounting firm and a void left by its firing of Shkreli. (12/23)

Tampa's Moffitt Cancer Center is suspending a clinical trial sponsored by KaloBios Pharmaceuticals, a California biotechnology company that was run by entrepreneur Martin Shkreli until his arrest last week on fraud charges. The trial, which sought to develop a new treatment for leukemia, hadn't started yet, Moffitt spokesman Steven Blanchard said Tuesday. (McGrory, 12/23)

A major insurer said recently it would offer life insurance to HIV-positive people because of their rising life expectancies, prompting cheers from AIDS activists. But on the very same day, the nation’s top disease control official described an America falling far short in its fight against AIDS. It might seem a jarring disconnect — but it reflects very different realities dividing the estimated 1.2 million Americans living with HIV/AIDS. (Feder Ostrov, 12/24)

The Peace Corps says its top priorities are the health, safety and the security of its volunteers. But a new internal report acknowledges that some volunteers who come home sick or injured have been waiting years — even decades — for adequate medical care and have fallen deeply through the cracks of a federal insurance bureaucracy. The report, by a task force set up by the agency in March, is a particularly candid assessment by top Peace Corps officials of government failure to provide top-notch health-care access to thousands of young people who serve in far-flung developing countries. (Rein, 12/23)

Forty years ago, the U.S. outlawed the sale of small turtles as pets because they harbor salmonella, a bacterium that causes a highly unpleasant and occasionally deadly illness in humans. Now salmonella infections tied to the tiny critters are back, public health officials reported Wednesday in the journal Pediatrics. From May 2011 through September 2013, turtle-associated salmonella was linked to eight outbreaks across 41 states, Washington, D.C. and Puerto Rico, covering 473 illnesses. Some 28 percent of those sickened had to be hospitalized. (Hobson, 12/23)

For a long time, Gary Carmack of Waynesville watched his 25-year-old son James battle a heroin addiction. “He would look at me with these big, sad eyes, and he wanted so bad to get off of it,” Carmack said. “Everyone would be saying, ‘you just have to tell him to quit.’ And of course that’s virtually impossible without the right kind of help.” As a paramedic, Carmack had seen countless overdoses. The family tried desperately to get James into treatment. But in 2013, his son was one of 258 Missourians who died after using heroin that year. (Bouscaren, 12/23)

A string of cyberattacks sent shockwaves through the health care industry in 2015, exposing sensitive data of millions of Americans and serving up the chilling reminder that providers need to step up their security game. Hackers accessed more than 100 million health records in 2015, according to data from the Department of Health and Human Services. (12/23)

Advocate Health Care and NorthShore University Health System have put their merger on hold, after the Federal Trade Commission challenged the deal on antitrust grounds, court documents show. The FTC and the hospital chains agreed to a temporary restraining order to stop the merger, which a federal judge approved Tuesday. Without the restraining order, the hospital chains could have consummated their merger as early as Friday. (Sachdev, 12/23)

A Kansas mental hospital that lost federal funding failed to supervise care, perform safety checks and protect suicidal patients, inspectors said. The Centers for Medicare and Medicaid Services report cited a rape at the Osawatomie State Hospital in October as an example of the problems that prompted the federal government to cut off funding Monday. Kansas now has to pay for care at the facility, which is one of only two of its kind in the state. (12/23)

A New Jersey judge ruled Tuesday that a law that allowed Cooper University Hospital to take over emergency medical services in Camden from rival Virtua Health was unconstitutional. Superior Court Judge Douglas H. Hurd, ruling orally from the bench in Trenton, ordered the Christie administration not to implement the law. Hurd did not issue a written decision. (Seidman, 12/23)

Privately insured hospital patients in Grand Junction face the ninth-highest average inpatient prices in the country, according to a new study. The results are surprising because President Barack Obama held up the Western Slope city as a model health care market in 2009 because of its low Medicare costs. But those familiar with Grand Junction's health care environment have known for years that costs for the privately insured — as opposed to those in the federally funded program for seniors — are high. (Olinger, 12/22)

California health care providers will soon be using a faster and more secure database aimed at combating drug abuse. State Atty. Gen. Kamala Harris and the California Department of Consumer Affairs announced Tuesday that providers who log in with secure Web browsers starting Jan. 8 will be using the new version of the Controlled Substance Utilization Review and Evaluation System, known as CURES 2.0. The system is designed to prevent overdoses and illegal sales of prescription drugs. (Goldenstein, 12/23)

The maker of OxyContin will pay Kentucky $24 million over the next eight years as part of the settlement of a long-running lawsuit that accused the company of misleading the public about the addictiveness of the powerful prescription drug. The state first filed the lawsuit against Purdue Pharma in 2007. The Connecticut-based company has had FDA approval since 1995 to market OxyContin, a type of opioid that can relieve pain and has similar qualities to the illegal drug heroin. (Beam, 12/23)

Serious errors were made by an appointee of Gov. Terry Branstad in terminating a multimillion dollar contract to privatize Medicaid, a company has alleged in newly filed court documents. As a result, WellCare says the state should be required to reinstate its contract that was terminated last week. The appeal filed Wednesday in Polk County District Court launches what a legal expert said is likely the beginning of a long and costly battle over Gov. Terry Branstad’s already controversial plan. (Clayworth, 12/23)

Mercy Medical Center of North Iowa is announcing they will be signing on with two private Medicare companies as part of the new managed care. Mercy officials say they’ve signed contracts with AmeriHealth Caritas and Wellcare Health. Gov. Terry Branstad’s highly controversial change to privately-managed care is set to take effect January 1, 2016 in an effort to make the program more efficient. (Ismail, 12/23)

Cab companies can't force elderly and disabled people to share taxis with others whose rides are paid for by Medicaid, state regulators have ordered. The move by the Nebraska Public Service Commission is intended to stop the controversial practice of "multiloading" riders without their permission. ... Many of those riders had complained about multiloading, saying their medical conditions required them to spend as little time as possible in a cab. And Omaha-based Happy Cab, which does not multiload its taxis without passengers' permission, filed a complaint against Lincoln-based Servant Cab, which did. (Pluhacek, 12/23)

Kay Ghahremani will take over as CEO of the Texas Association of Community Based Health Plans in January. The former director of Medicaid programs for the Texas Health and Human Services Commission sat down with the Chronicle to talk about the role that Medicaid health plans play in managing the health of 1.3 million Texans. (Hawryluk, 12/23)

Starting February 1, some Medicaid reimbursements will be dropping by nearly 50 percent. The rate adjustment is the result of a U.S. Supreme Court ruling this year. The ruling upheld the state's ability to set reimbursement rates for Medicaid services. In 2011, a group of health care providers filed the suit against the state of Idaho. The group asking for the state to increase their Medicaid reimbursements. (Johnson, 12/23)

Pregnant women using New York’s health exchange no longer have to wait for certain open enrollment periods to qualify for health insurance. Governor Andrew Cuomo signed the bill into law Tuesday making New York the first state in the country to allow pregnancy to act as a “qualifying event” for health care on the state health exchange. The legislation passed one vote shy of unanimous in both houses. (Pasquantonio, 12/23)

California insurers have been awarded $9.3 million in tax credits for making more than $46.6 million in capital investments for underserved communities, the California Department of Insurance announced. The program, the California Organized Investment Network (COIN) Community Development Financial Institution (CDFI) tax credit, aims to create jobs, build affordable housing and fund other community development projects. (Vesely, 12/23)

Federal health officials say nearly 376,000 Virginians have signed up for 2016 coverage under the Affordable Care Act. The U.S. Department of Health and Human Services says 375,891 Virginia residents signed up or renewed coverage on the federal marketplace from Nov. 1 through Dec. 19. Nationally, more than 8.2 million people enrolled in Virginia and the 37 other states that are using the HealthCare.gov website and call center. (12/24)

Small businesses in New Hampshire are facing a lot of questions as the federal health insurance marketplace and its evolving rollout enters its fourth year, but it still offers opportunities for cost savings, which is why their participation through the federal online marketplace has increased 15-fold. (Brooks, 12/23)

Nearly half the rape kits in evidence at the Grand Rapids Police Department, dating back 15 years, were not submitted to the state police for DNA testing, according to documents obtained by 24 Hour News 8. But police say that doesn’t mean rapists are walking free. This fall, at the request of the state Attorney General’s Office, Grand Rapids police sorted through the 403 rape kits still in evidence and found that 199 had gone untested, documents show. (Kolker, 12/23)

Lawyers representing 11,000 mentally ill inmates in Illinois prisons have reached a settlement with the state in a long-running class-action lawsuit that alleged inadequate treatment amounted to "cruel and unusual punishment," a deal both sides heralded on Wednesday. Among a long list of provisions, the agreement calls for the Illinois Department of Corrections to build four new treatment units, including at Logan, Pontiac, and Dixon prisons, at a cost of $40 million. Hiring new staff members is expected to reach another $40 million a year. (Tarm, 12/23)

The first grader was shuffling through his school papers when he stumbled across it: the test he had been taking last month when he got so angry that he had punched another student in the face. (Rosenthal, 12/23)

For two straight years, Christie Padilla tried unsuccessfully to get healthcare for her daughter. In each instance, she said, coverage was denied. “It was an absolute feeling of helplessness,” explained Padilla, “We weren’t seen because information had been entered incorrectly.” Padilla, president of the Kent Education Association teachers union, said she is one of 238 teachers who encountered the same issue this school year. (Langler, 12/23)

For the first time in its 45-year history, the University of Illinois College of Medicine at Peoria will begin admitting first-year medical students in 2017, growth projected to pump $6 million into the local economy over the next two years. UICOMP Regional Dean Dr. Sara Rusch said the shift from a three-year to a four-year medical school would “revolutionize” Peoria’s medical community, adding that it’s “possibly the single most important expansion” since the medical school opened. (Adams, 12/22)

A Pasadena man whose critical, life-threatening illness led to a lawsuit challenging a 1999 Texas law that grants hospital ethics committees power to withdraw life-sustaining treatment in hopeless cases died Wednesday at Houston Methodist Hospital. Chris Dunn, 46, was admitted to the Texas Medical Center hospital in early October after a diagnostic scan at a Pasadena hospital revealed a mass on his pancreas. In mid-November, Dunn's family was apprised that the hospital had done all it could do and that, unless another facility could be found to treat him, life-sustaining care would be discontinued. A legal challenge to the Texas Health and Safety Code led to continuation of such care, which Dunn was receiving at the time of his death. (Turner, 12/23)

The U.S. Attorney’s Office says an outpatient physical therapy practice has reached a $710,000 settlement to resolve claims that it billed Medicare for services performed without required supervision. Old Towne Physical Therapy LP, which owns three clinics in Delaware, reached the settlement with the U.S. to resolve allegations of health care fraud under the False Claims Act, according to a news release from the U.S. Attorney. (12/23)

When New Hampshire legalized medical marijuana in July 2013, no one expected the program to be up and running overnight. Two and a half years later, however, none of the dispensaries envisioned under the new law are open, and the only patient who has received medical marijuana had to file a lawsuit for the right to travel out of state to get it. So what’s taken so long? One reason is money. John Martin, licensing chief for the Department of Health and Human Services, says it was a challenge to launch a new program from scratch without additional resources. (McDermott, 12/23)

Hospital quality measures that do not account for patient do-not-resuscitate (DNR) status may penalize hospitals admitting a greater proportion of patients with limits on life-sustaining treatments. ... A retrospective, population-based cohort study was conducted among adults hospitalized with pneumonia in 303 California hospitals between January 1 and December 31, 2011. ... Without accounting for patient DNR status, higher hospital-level DNR rates were associated with increased patient mortality ..., corresponding to worse hospital mortality rankings. In contrast, after accounting for patient DNR status and between-hospital variation in the association between DNR status and mortality, hospitals with higher DNR rates had lower mortality ... with reversal of associations between hospital mortality rankings and DNR rates. (Walkey et al., 12/14)

Clinical home visit programs for Medicare beneficiaries are a promising approach to supporting aging in place and avoiding high-cost institutional care. ... We evaluated UnitedHealth Group’s HouseCalls program, which has been offered to Medicare Advantage plan members in Arkansas, Georgia, Missouri, South Carolina, and Texas since January 2008. We found that, compared to non-HouseCalls Medicare Advantage plan members and fee-for-service beneficiaries, HouseCalls participants had reductions in admissions to hospitals (1 percent and 14 percent, respectively) and lower risk of nursing home admission (0.67 percent and 1.3 percent, respectively). In addition, participants’ numbers of office visits—chiefly to specialists—increased 2–6 percent (depending on the comparison group). The program’s effects on emergency department use were mixed. (Mattke, Han, Wilks and Sloss, 12/7)

Using data from 49 states and Washington, D.C., we analyzed changes in cost-sharing under health plans offered to individuals and families through state and federal exchanges from 2014 to 2015. ... We found cost-sharing under marketplace plans remained essentially unchanged from 2014 to 2015. Stable premiums during that period do not reflect greater costs borne by enrollees. Further, 56 percent of enrollees in marketplace plans attained cost-sharing reductions in 2015. However, for people without cost-sharing reductions, average copayments, deductibles, and out-of-pocket limits under catastrophic, bronze, and silver plans are considerably higher than under employer-based plans on average, while cost-sharing under gold plans is similar employer-based plans on average. (Gabel et al., 12/22)

[W]e examine premiums and out-of-pocket costs, as well as total financial burdens for individuals with different characteristics enrolled in ACA-compliant nongroup coverage. ... individuals across the income distribution who are ineligible for Medicaid can still face very high expenditures. ... As medical care needs increase, however, financial burdens grow appreciably across the income distribution. Even with federal financial assistance, 10 percent of 2016 nongroup marketplace enrollees with incomes below 200 percent of FPL will pay at least 18.5 percent of their income toward premiums and out-of-pocket medical costs. Ten percent of marketplace enrollees with incomes between 200 and 500 percent of FPL will spend more than 21 percent of their income on health care costs. (Blumberg, Holahan and Buettgens, 12/21)

Employer spending on premiums is currently excluded from income and payroll taxes. Economists argue that this encourages overconsumption of health care, favors high-income workers, and reduces federal revenue. This issue brief suggests that the Cadillac tax is a “blunt instrument” for addressing these concerns because it will affect workers on a rolling timetable, does relatively little to address the regressive nature of the current exclusion, and may penalize firms and workers for cost variation that is outside their control. Replacing the current exclusion with tax credits for employer coverage that scale inversely with income might allow for regional adjustments in health care costs and eliminate aspects of the tax exclusion that favor high-income over low-income workers. (Nowak and Eibner, 12/18)

For uncomplicated respiratory infections, strategies that delay the patient’s pick-up or use of antibiotics can result in less antibiotic use with equal satisfaction, according to a new study. Patients who had to go pick up their prescriptions from the primary care office or who delayed taking the antibiotics experienced slightly greater symptoms for a slightly longer time during their illness than people who got antibiotics immediately, but all groups had similar satisfaction levels. (Doyle, 12/22)

Many patients with advanced cancer may still want to work, but symptoms from their disease or related treatment prevent them from doing so, a U.S. study suggests. The study focused on almost 700 adults aged 65 and under with metastatic cancer, meaning tumors had already spread to other parts of the body, and found that more than one-third of them continued to work after their diagnosis. But 58 percent of the patients in the study reported some change in employment due to illness, whether they scaled back hours or stopped working entirely. (Rapaport, 12/21)

Many medications can cause birth defects. That includes medicines that many teen girls take for conditions such as acne, seizures and migraines. Researchers at Children's Mercy Hospital wondered if girls 14 and older who are prescribed medicines that can cause birth defects get counseling from their health care providers about preventing pregnancy and get prescriptions for contraceptives. The researchers found that in many cases, they don't. At least there was no documentation of that. That means these teens could be at higher risk of pregnancy and having babies with birth defects. (McKean, 12/16)

After Bob Garraty's annual PSA blood test led to the diagnosis of a tiny, slow-growing prostate tumor, he opted to do something almost as stressful as getting treatment. He postponed it. Like a growing number of men, he chose "active surveillance" of his cancer. He had PSA blood tests plus physical exams every three months, and biopsies every year, in hopes that he would never need surgery or radiation -- and never risk treatment-related urinary and sexual problems. It didn't turn out quite that way. In October, after four years of surveillance, his biopsy revealed the cancer was turning more aggressive. To be safe, the 69-year-old workforce training consultant from the Harrisburg suburb of Hummelstown had prostate-removal surgery. (McCullough, 12/14)

One of the remarkable aspects of the politics of health reform is the way conservatives — even relatively mild, seemingly informed conservatives — have managed to keep believing that Obamacare is unraveling, despite the repeated failure of disaster predictions to come true. ... Anyway, it’s really helpful to have this new report from the Commonwealth Fund comparing actual performance with pre-implementation predictions. ... On enrollments: fewer people than expected signed up for the exchanges, but an important reason was that fewer employers than expected ended coverage and moved their employees into the individual market. (Paul Krugman, 12/23)

Martin Shkreli, the former hedge fund manager turned pharmaceutical CEO who was arrested last week, has been described as a sociopath and worse. In reality, he’s a brasher and larger version of what others in finance and in corporate suites do all the time. Federal prosecutors are charging him with conning wealthy investors. Lying to investors is illegal, of course, but it’s perfectly normal to use hype to lure rich investors into hedge funds. And the line between the two isn’t always distinct. (Robert Reich, 12/23)

Hillary Clinton this week promised to cure Alzheimer’s disease inside of a decade—even as she bemoans the tragedy of the Hepatitis C cures that are on the market today because she feels the prices are too high. That isn’t the only contradiction—or outright falsehood—dominating the political debate over pharmaceuticals. (12/23)

A growing number of medical students today are tacking on a business degree. Since 1993 the number of MD/MBA programs has ballooned from six to about 65, representing nearly half of all U.S. medical schools. The majority of MD/MBA students will complete a medical residency and use their business training to lead physicians and manage hospitals or other healthcare systems. Yet here at Stanford, where I am one of 18 such dual-degree candidates, some of my peers are considering joining digital health startups instead. We are surrounded by an explosion of such opportunities, propelled by more than $2 billion of venture capital funding in the first half of 2015. (Rich Joseph, 12/23)

In October, Centers for Medicare and Medicaid Services announced that doctors would be able to bill Medicare for end-of-life counseling starting in 2016. The decision encourages physicians to talk to their patients about advance directives, which helps individuals to express their preferences regarding end-of-life care and can ease the emotional toll on loved ones responsible for making difficult decisions on the patient's behalf. However, insurance providers and the medical community must also expand end-of-life care discussions to younger adults, who arguably have the most to lose. (Yoo Jung Kim, 12/23)

It’s impossible to know the depth of the drug addiction crisis that has affected the lives of so many people here in New Hampshire and across the country. Legal opioids – improperly used or illegally obtained – are just one side of this multifaceted issue in the current problem of prescription drug abuse. Working as a physician, every day I see patients with a diversity of pain issues. ... Health care providers now find themselves in the progressively precarious position of trying to provide safe and effective patient care, while feeling the pressure of perceived governmental oversight and scrutiny. In this environment and in the attempt to reach a balance, one question that deserves attention is: What is being done to increase access to medication specifically designed to treat pain and prevent abuse before it starts? (Dr. George Lantz, 12/23)