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Members of Congress on Wednesday pelted the chief executive of Mylan, the company behind the EpiPen, the treatment for severe allergy attacks, with questions about steep price increases on the product and accused her of turning her back on families that could no longer afford the lifesaving treatment. The chief executive, Heather Bresch, was the latest in a string of drug company leaders to be interrogated by the House Committee on Oversight and Government Reform as public outrage has grown over the rising cost of drugs. (Thomas, 9/21)

The House Committee on Oversight and Government Reform called Bresch to testify in the wake of public outrage over EpiPen, whose list price has risen to $600 for a pair of the devices compared with $100 in 2007. Lawmakers in turn described the actions as "sickening," "disgusting" and showing "blatant disrespect" for American families who can no longer afford the life-saving device for children susceptible to severe allergic reactions. (Humer, 9/21)

Mylan CEO Heather Bresch infuriated lawmakers as she tried — and mostly failed — to explain steep cost increases of her company's life-saving EpiPens. ... In almost four hours of questioning, the soft-spoken CEO at times seemed unsure, or declined to answer directly, when asked questions about the company's finances and profits, angering lawmakers. (Jalonick, 9/22)

Bresch’s compensation was an issue for lawmakers as well, as it often is when CEOs appear before lawmakers. When asked about her pay, Bresch briefly stuttered before saying, “It’s in the middle” compared to others in the industry. Bresch was awarded $19.4 million in pay last year, which made her the 25th-best paid executive in the health-care industry, according to data compiled by Bloomberg. Her response generated more outrage from lawmakers. (Edney and Langreth, 9/21)

Proposed solutions included finding ways for the Food and Drug Administration to ease the drug-approval process so competition can help bring down prices and calls for greater transparency in pharmaceutical pricing. But Heather Bresch, Mylan's chief executive, stayed firm in her message that the list price of EpiPen had increased because of the inherent complexity of the pharmaceutical marketplace and that few patients were paying the list price. She has attempted to shift blame away from her company to a network of middlemen that sits between drug companies and patients and take a cut of the price. Bresch said that Mylan's efforts to cut down the price patients pay - including its plan to release a half-price generic version of EpiPen - would solve the problem. (Johnson, 9/21)

“We believe it was a fair price, and we now just lowered it by half,” Ms. Bresch said. Her remarks triggered criticism from Oversight and Government Reform Committee members from both parties. Several accused Mylan during the first hours of the hearing of profiting excessively from a relatively inexpensive drug that patients’ lives depend on. “I am a very conservative and pro-business Republican, but I am sickened by what I’ve heard,” Rep. John Duncan (R., Tenn.) said. (Rockoff, Radnofsky and Hernandez, 9/22)

“The greed is astounding; it’s sickening and disgusting,” said Rep. John Duncan, R-Tenn. Rep. Elijah Cumming of Maryland, the ranking Democrat on the committee, said Mylan “jacked up” the price of the life-saving product “to get filthy rich at the expense of our constituents.” He accused the company of using a “simple but corrupt business model” to enrich themselves in the same manner as Martin Shkreli of Turing and executives at Valeant Pharmaceuticals, who drew public criticism for huge price increases for drugs their companies made. (Radelat, 9/21)

She said most patients at risk of an allergic reaction now have access to the drug, and that 85% of patients pay less than $100 for a two-unit package. “Looking back, I wish we had better anticipated the magnitude and acceleration of the rising financial issues for a growing minority of patients who may have ended up paying the full … price or more,” she said. “We never intended this.” Bresch said the company was making far less on the drug than the public believed. She said after rebates and fees Mylan received just $274 of the device’s $608 wholesale price. (Petersen, 9/21)

While the company apparently is looking to use the analysis to downplay its profits, analysts say the margin is still quite high. Ronny Gal, a pharmaceutical industry analyst at the investment firm Sanford Bernstein, says Bresch's numbers mean Mylan makes a 40 percent profit margin on the device. (Kodjak, 9/21)

In a particularly tense exchange, Rep. Tammy Duckworth (D-Ill.) questioned Bresch about a report by USA Today this week that said her mother had misused her clout on a school board to help boost EpiPen sales. “Your own mother is lobbying to make sure they’re in your schools,” Duckworth, who is running for Senate this fall, shouted, holding up a copy of the newspaper. Bresch interrupted: “I’m sorry, Congressman. That is completely inaccurate.” Earlier in the hearing, Bresch had strongly denied the report detailing a concerted effort by Gayle Manchin — Bresch's mother, the Democratic senator’s wife and the then-president of the National Association of State Boards of Education — to push state lawmakers to support legislation mandating school systems to buy anti-allergy devices, such as EpiPens, back in 2012. (Ferris, 9/21)

Even as the cost of EpiPens dramatically rose, so too did the number of prescriptions written for patients in Medicare, sending spending by the program skyrocketing nearly 1,100 percent from 2007 to 2014, a new report shows. During the same period, the total number of Medicare beneficiaries using EpiPens climbed 164 percent, from nearly 80,000 users in 2007 to more than 211,000 in 2014, according to the analysis by the Kaiser Family Foundation. While the report does not delve into what’s behind the increase, factors could include increased awareness among people with allergies, marketing efforts and access to insurance coverage. (Appleby and Carey, 9/21)

Medicare’s prescription drug program increased spending on EpiPens from $7 million in 2007 to $87.9 million in 2014, an increase of 1,151 percent, according to a new Kaiser Family Foundation brief. Average spending per EpiPen prescription increased from $71 in 2007 to $344 in 2014. EpiPens come in a pack of two and must be replaced every 12 to 18 months. While the number of Medicare Part D enrollees using EpiPens also increased during the seven-year period that Kaiser examined, that increase (164 percent) was significantly lower than the increase in total spending on EpiPens. (Owens, 9/20)

Mylan is just the most recent pharmaceutical company to spark a nationwide uproar over excessive drug pricing. These companies have either jacked up the retail list price of drugs that have long been on the market after acquiring their patents, which is what Mylan did with EpiPen, or have imposed sky-high prices on newly developed, highly-effective drugs such as Gilead Sciences’ hepatitis-C drugs Sovaldi and Harvoni, which retail for roughly $1,000 per pill, or $84,000 for a course of treatment. Expensive drugs have greatly added to the overall annual cost of U.S. health care and are posing serious economic consequences for consumers, health insurers and federal government agencies and programs. (Pianin, 9/21)

The EpiPen, the potentially life-saving device that delivers a dose of medicine to people having a severe allergic reaction, has been all over the news for its outrageous price spike. Going up 500 percent in just under a decade is upsetting. But even as the company and regulators are dealing with its price, going unaddressed is the product’s significant design flaw. (Groeger, 9/21)

A Republican-run House committee voted along party lines Wednesday to hold a company that provides researchers with fetal tissue in contempt of Congress. Republicans say StemExpress has not produced all the documents they want. Democrats say the GOP is harassing the California-based company and trying to discourage fetal research. Democrats walked out of the meeting before the 8-0 vote. They say the committee lacks the authority to take such action. (9/21)

A House panel investigating fetal tissue research Wednesday voted to begin contempt proceedings against a California company — an effort that Republicans contend is a rescue mission for the unborn and that Democrats call a witch hunt. Representative Marsha Blackburn of Tennessee, the chairman of the House Select Investigative Panel on Infant Lives, has been pursuing StemExpress, which collects fetal tissue from abortion providers and sells it to medical researchers, for nearly a year. (Kaplan, 9/21)

The House committee set up to investigate Planned Parenthood on Wednesday voted to recommend holding a fetal tissue procurement company in contempt after Democrats walked out of the session in protest. The panel voted to advance a resolution holding Stem Express in contempt for failing to provide all of the documents it was required to turn over under a congressional subpoena. Republicans said they were looking for accounting records from the company to make sure that it is not involved in the sale of fetal tissue for profit, which is illegal. (Sullivan, 9/21)

House Democrats on Wednesday walked out of a meeting of a congressional investigative panel launched in the aftermath of the controversy over Planned Parenthood's abortion practices, charging the proceedings amounted to a "witch hunt." The meeting of the Select Investigative Panel on Infant Lives was to consider a report recommending that the biotech company StemExpress LLC and its founder Catherine Spears Dyer be held in contempt for refusing to comply to subpoenas seeking accounting records relating to research of fetal tissue. (Rahman, 9/21)

The House Energy and Commerce Committee advanced a half-dozen public health-related bills Wednesday. The six bills were approved unanimously by the committee on voice votes, and covered a range of topics from mental health first aid to classifying some synthetic drugs. In the Senate, similar bills are working their way through the committee process. (McIntire, 9/21)

Democrats believe they have finally found the leverage they need to force Republicans to approve funding to address the water crisis in Flint, Mich.: historic flooding in Louisiana. Democrats are pushing for a Senate-passed aid package for Flint to be linked to flood relief funds in a stop-gap spending bill that would prevent a government shutdown at the end of the month. Republicans say they want to give the House more time to consider passing funding for Flint, but Democrats have refused to sign off on the spending bill until the issue is resolved. (Snell, 9/21)

Federal prosecutors should investigate whether a former Veterans Affairs Department executive committed perjury when he testified about the cost of a new Denver-area VA hospital, which is more than $1 billion over budget, members of Congress said. Florida Rep. Jeff Miller, chairman of the House Veterans Affairs Committee, and Rep. Mike Coffman, R-Colo., said Wednesday the Justice Department should investigate Glenn Haggstrom’s statements to Congress in 2013 and 2014. (Elliott, 9/22)

A U.S. congressional committee has launched an examination of the Food and Drug Administration's criminal office, raising questions about the unit’s management and handling of cases involving food, drugs and devices. The House Energy and Commerce Committee told FDA Commissioner Robert Califf it is "examining management concerns" and "possible morale concerns with the field offices" of the Office of Criminal Investigations. (Greene, 9/21)

A liberal attempt to revive the so-called public option — a government-run insurance plan to shore up gaps in the Affordable Care Act — is opening old wounds between the Democratic Party’s liberal and moderate wings. Thirty-three mostly liberal Democrats, including all the Senate leadership, have signed onto a nonbinding Senate resolution introduced last Friday to add the public option to Obamacare, arguing that it is needed to fix problems with the president’s signature health care law. (Haberkorn, 9/22)

With insurers dropping out and premium rates going up, Obamacare has hit its roughest patch in years. Even some Democrats are acknowledging the law needs fixes. But according to Anne Filipic, the doom-and-gloom predictions aren't just misplaced — they're making her job harder. "We have real challenges in reaching the remaining uninsured and helping them understand that there are affordable options," the president of Enroll America told POLITICO's "Pulse Check" podcast. "This broader narrative isn’t helpful to them." (Diamond, 22)

MNsure is getting conflicting advice about whether its funding mechanism should be changed. Currently, the state-run health insurance exchange is funded in part by a 3.5 percent tax applied to premiums of insurance plans bought on MNsure. MNsure has about 70,000 enrollees, with hopes to sign up more at this fall’s open enrollment, and the 3.5 percent tax on these plans is projected to bring in about $13 million next year. At the beginning of the year, a Health Care Financing Task Force convened by Gov. Mark Dayton recommended a change: Lower the 3.5 percent tax significantly, but apply the tax not just to the 70,000 current MNsure plans, but also the 180,000 plans purchased on the individual market without involving MNsure. (Montgomery, 9/21)

Anthem Inc. and Cigna Corp. have accused one another of violating the terms of their merger agreement, according to a legal filing by the Justice Department, which is suing to block the health-insurance deal on antitrust grounds. In the filing, Justice attorneys say that in a telephone conference on Aug. 16, Cigna’s lawyers disclosed “further deterioration” in the relationship between the two companies, which have for months been engaged in behind-the-scenes sniping amid efforts to pull together their $48 billion deal. (Wilde Mathews and Kendall, 9/21)

A lawyer for Cigna said during a teleconference last month that in-house attorneys for the companies had exchanged letters alleging each violated the deal’s terms, the government said in the filing Wednesday in Washington. The Justice Department raised the issue as part of a dispute over evidence in its lawsuit against the insurers seeking to stop their merger. (McLaughlin, 9/21)

The federal government, which sued to block the deal in July on antitrust grounds, submitted its latest filing with the hope of receiving all relevant documents between Anthem and Cigna. DOJ attorneys believe the “adversarial communications” contradict Anthem's argument that the transaction will create efficiencies and instead will lead to a messy integration. (Herman, 9/21)

The American Medical Association, strongly opposed to the merger of Anthem and Cigna, said in a report Wednesday that the deal would greatly limit competition for private health insurance in Connecticut and nine other states, leading to premium increases and fewer choices of doctors and hospitals for the state’s patients. In another four states, Ohio, New York, California and Wisconsin, the impact of the proposed merger, which has been opposed by the Justice Department, would have a lesser impact but still “poses significant competitiveness concerns,” the AMA said. (Radelat, 9/21)

A merger between insurance giants Aetna and Humana could threaten the quality and affordability of health care in Illinois and 14 other states, according to an American Medical Association analysis released Wednesday. Aetna and Humana say they want to combine to offer better access to higher quality affordable care. But the Chicago-based AMA has been a vocal opponent of the deal, arguing it will lead to less competition among insurers and, in turn, fewer choices for consumers, at higher costs. (Schencker, 9/21)

Abbott’s relationship with Purdue and its part in building the OxyContin brand are detailed in previously secret court filings unsealed by a Welch, W.Va., state court judge at the request of STAT. The records were part of a case brought by the state of West Virginia against Purdue and Abbott that alleged they inappropriately marketed the drug, causing users to become addicted to the opioid. The case was settled in 2004 when Purdue agreed to pay $10 million to the state. Neither company admitted any wrongdoing.The documents include internal Abbott and Purdue memos, as well as sales documents and marketing materials. They show that Abbott sales reps were instructed to downplay the threat of addiction with OxyContin and make other claims to doctors that had no scientific basis. The sales reps from the two companies closely coordinated their efforts, met regularly to strategize, and shared marketing materials. (Armstrong, 9/22)

New York Attorney General Eric Schneiderman is urging Gov. Andrew Cuomo to veto two bills that he says would roll back efforts to fight prescription opioid abuse. Schneiderman, a Democrat, expressed his concerns in a letter to Cuomo's legal counsel Tuesday. One of the bills would exempt nursing home doctors from rules requiring electronic filing of prescriptions. The other would alter existing rules governing controlled substance prescriptions to allow doctors, in certain cases, to not report the prescriptions directly to state health officials. (9/21)

Officials say Phase 1 of the city's first addiction recovery center is on track to be operational at the former Hoitt furniture building on Wilson Street by late October...Last fall, Anagnost, Andy Crews, president and CEO of AutoFair and Melissa Crews, chairman of the board of directors of HOPE for NH Recovery, announced plans to purchase the building at 267 Wilson St., with the goal of putting multiple services for recovering addicts under one roof. The first floor of the 37,000-square-foot building will become the new home of HOPE for NH Recovery, which will occupy 9,158 square feet, leaving an additional 2,624 square feet on the first floor for additional occupants. (Feely, 9/21)

Hill is one of nearly 1,800 contacts that Lucas County Sheriff John Tharp's Drug Abuse Response Team has made in the past 18 months with drug addicts — the majority of them in hospitals after they've suffered potentially fatal overdoses. In two-thirds of the cases, the addict subsequently got into a detox or long-term treatment program, or recovery housing. Lives were saved. No one knows exactly how many. Likewise, it's not clear how many of the 1,800 got clean and stayed that way. (Johnson, 9/22)

Mark Zuckerberg, Facebook’s chief executive, and his wife, Dr. Priscilla Chan, last year said they would give 99 percent of their Facebook shares to charitable causes. Now they are putting a large chunk of that money to work. The Chan Zuckerberg Initiative, the limited liability company into which Mr. Zuckerberg and Dr. Chan put their Facebook shares, on Wednesday said it would invest at least $3 billion over the next decade toward preventing, curing or managing all diseases by the end of the century. (Benner, 9/21)

The many components of the initiative include creating universal technology "tools" based on both traditional science and engineering on which all researchers can build, including a map of all cell types, a way to continuously monitor blood for early signs of illness, and a chip that can diagnose all diseases (or at least many of them). The money will also help fund what they referred to as 10 to 15 “virtual institutes” that will bring together investigators from around the world to focus on individual diseases or other goals — an idea that has the potential to upend biomedical science. (Cha, 9/21)

“This focus on building on tools suggests a road map for how we might go about curing, preventing and managing all diseases this century,” Mr. Zuckerberg said. “Because if we can develop the new tools that allow us to see these categories of disease in new ways, we could empower scientists all over the world to make much faster progress.” One such tool is a “cell atlas” or a map of all the different cell types in the human body and their different states. (Seetharaman, 9/22)

Neuroscientist and geneticist Cori Bargmann was named the Chan Zuckerberg Initiative’s president of science and will be in charge of bringing together scientists and engineers to develop medical breakthroughs. Chan also announced that the initiative will spend an additional $600 million to establish a “bio hub” in San Francisco to support researchers from Stanford University, UC Berkeley and UC San Francisco as they develop new tools to understand and treat diseases. (Lien, 9/21)

The couple said their new philanthropic organization, the Chan Zuckerberg Initiative, will attempt to bring scientists and engineers together, invent new technologies, and encourage the funding of basic science. “It doesn’t mean that no one will get sick,” Zuckerberg said. The goal, he said, would be to ensure that people get sick less often, or be able to better manage their diseases. (Love, 9/21)

World leaders agreed Wednesday on steps to curb the rapid rise of drug resistance, the first global effort to stop the spread of dangerous superbugs that are fast becoming immune to many of the most critical medicines. Infectious disease doctors have long warned that overuse of antibiotics in people and in animals puts human health at risk by reducing the power of the drugs, some of modern medicine’s most prized jewels. The problem is global, because the bugs are mobile. (Tavernise, 9/21)

World leaders approved a wide-ranging declaration Wednesday aimed at addressing the rising number of drug-resistant infections — something the World Health Organization says has the potential to kill millions and undermine the global economy, likening it to "a slow-motion tsunami." The declaration recognizes the size of the problem and encourages countries to develop plans to cut back on antibiotic use, make better use of vaccines and fund development of new drugs to combat antimicrobial resistance (AMR), which currently claims the lives of an estimated 700,000 people each year and is expected to rise sharply. (9/21)

Meeting under the umbrella of the United Nations General Assembly, international leaders on Wednesday launched new efforts to stem the rising tide of antimicrobial resistance, which has blunted the effectiveness of existing medications in treating infectious diseases.Heads of state and country delegates gathered at a U.N. meeting on the subject vowed to increase international coordination and funding aimed at monitoring the emergence of antimicrobial resistance and reducing the misuse of antimicrobial agents in human and veterinary health and agriculture. (Healy, 9/21)

U.S. health officials have identified a cluster of gonorrhea infections that show sharply increased resistance to the last effective treatment available for the country's second most commonly reported infectious disease. The findings from a cluster of Hawaii cases, presented Wednesday at a conference on prevention of sexually transmitted diseases, represent the first cluster of cases in the United States that have shown such decreased susceptibility to the double-antibiotic combination used when other drugs have failed. (Sun, 9/21)

Experts have been worried for a while that time is running out for the last working cures for gonorrhea infections. On Wednesday, some revealed there may be even less time left on the clock than had been previously thought. Scientists from the Centers for Disease Control and Prevention and Hawaii’s department of health reported a cluster of cases of gonorrhea in that state in which the Neisseria gonorrhoeae bacteria showed high-level resistance to one of the drugs, azithromycin, as well as reduced susceptibility to the second drug, ceftriaxone. (Branswell, 9/21)

The very first study reporting a link between the gut microbiome and obesity found that lab mice bred for obesity had half as many bacteria belonging to the Bacteroidetes phylum as lean mice did, and lots of bacteria in the Firmicutes phylum. It had the effect of a starter’s gun at a race: Scientists at labs around the world were off in pursuit of microbes causing obesity. The most intriguing support for that idea: transferring microbes from the guts of normal-weight mice into the guts of obese ones, and obese mice’s gut microbes into slim ones, seemed to cause the animals to switch to the body type consistent with their new bacteria, not their old selves, found a 2004 study. (Begley, 9/22)

Every study ranking nations by health or living standards invariably offers Scandinavian social democracies a chance to show their quiet dominance. A new analysis published this week—perhaps the most comprehensive ever—is no different. But what it does reveal are the broad shortcomings of sustainable development efforts, the new shorthand for not killing ourselves or the planet, as well as the specific afflictions of a certain North American country. Iceland and Sweden share the top slot with Singapore as world leaders when it comes to health goals set by the United Nations, according to a report published in the Lancet. (Roston, 9/22)

One of the biggest worldwide public health triumphs in recent years has been maternal mortality. Global death rates fell by more than a third from 2000 to 2015. The United States, however, is one of the few countries in the world that have gone against the grain, new data show. Its maternal mortality rate has risen despite improvements in health care and an overwhelming global trend in the other direction. (Tavernise, 9/21)

Before dinner on July 29, 3-year-old Carter Roberts of Chesterfield, Va., seemed perfectly healthy. That evening, he vomited. When he woke up the next morning with a slight fever of 99 degrees, his mother, Robin Roberts, figured that he was coming down with a cold. The next morning, she found him collapsed on his bedroom floor. “Mommy,” she recalls him saying. “Help me, help me.” (Hurley, 9/21)

The Centers for Disease Control and Prevention has more reasons to stop kissing your chickens -- and persuade you leave them outside. Last year, a salmonella outbreak infected more than 180 people, and the CDC sent out recommendations to leave poultry outside and to stop snuggling them. A recently released study by the centers found that between 1990 to 2014, 46 percent of salmonella patients said their household kept poultry inside and 13 percent reported kissing birds. (Bamforth, 9/21)

Nationwide, the number of Latinos living with Alzheimer’s is projected to increase from 379,000 in 2012 to 3.5 million by 2060 — a growth of 823 percent, says the report by the University of Southern California’s Institute on Aging and the LatinosAgainstAlzheimer’s network. The most dramatic jump will be among Latinos who are 85 or older, which will increase by more than 12 times, from 145,000 in 2012 to 1.7 million in 2060. (Pyle, 9/22)

Figures from Nationwide Children’s Hospital Sports Medicine show that 56 percent of the 5,448 concussion-related hospital visits for those sports from 2010 to ’15 were from females. Nearly 62 percent of soccer-related head injuries happened to females — numbers that are consistent with national trends since 2005. Not only are females as susceptible as males to brain injuries, said Dr. Steven Cuff of Nationwide Children’s sports medicine clinic, but there also are studies indicating their symptoms are more intense and come in greater number. (Reed, 9/21)

Newly-hired veterans working for the Federal Aviation Administration could soon qualify for paid sick leave, if their disability rating exceeds 30 percent. The House voted Tuesday to approve a bill aimed at closing a loophole in the Wounded Warriors Federal Leave Act of 2015 that prevents those veterans from getting additional benefits. They would receive up to 104 hours of paid leave, under a bill sponsored by Democratic Rick Larsen of Washington state and Republican Rep. Frank LoBiondo of New Jersey. (Hotakainen, 9/21)

More than 250 patients of the U.S. Air Force Academy’s GI Clinic are being notified of potential health risks associated with recent procedures. Gastrointestinal endoscopy patients, treated between June and September, are being warned of a “very low” health risk after “discovery of a diversion from standard pre-cleaning protocols for a scope used in endoscopy procedures,” according to an Air Force Academy news release Wednesday. The precautionary notification is to service members, retirees, veterans and family members. (Nicholson, 9/21)

Marijuana pioneer Colorado is poised to add post-traumatic stress disorder to its medical marijuana program, joining 18 other states that consider PTSD a condition treatable by pot. A panel of state lawmakers voted 5-0 Wednesday to endorse the addition of PTSD to Colorado’s 2000 medical pot law. The vote doesn’t have legal effect; it’s just a recommendation to the full Legislature, which resumes work in January. But the vote indicates a dramatic shift for a state that has allowed medical pot for more than a decade but hasn’t endorsed its use for PTSD. (Wyatt, 9/21)

Planned Parenthood is asking a federal judge to quickly rule in its favor and overturn a Mississippi law that bans Medicaid spending with any health care provider that offers abortion. The women's health group points to a recent ruling by the 5th U.S. Circuit Court of Appeals that upheld an injunction against a similar law in Louisiana. (Wagster-Pettus, 9/21)

Arkansas' solicitor general told a panel of federal judges Wednesday that Arkansas was within its rights to cut off Medicaid funding for Planned Parenthood patients a little over a year ago, while an attorney for the provider said the state's action violated the federal Medicaid Act. Lee Rudofsky for the state and attorney Jennifer Sandman each spent 20 minutes arguing before the three-judge panel in St. Louis over whether an Oct. 2 preliminary injunction requiring the state to keep paying for the services for three women who filed suit should stand or be vacated. (Satter, 9/22)

The state has spent an additional $2.3 million on staffing to handle thousands of backlogged health insurance applications for people with low incomes or who are severely disabled, according to an audit. The audit looked into ongoing problems with the state’s Medicaid application backlog. Medicaid is the state and federal health insurance program. Kansas has a privatized Medicaid system called KanCare. The audit also discovered that as of mid-August, nearly 35,000 people have renewal applications pending and are waiting to find out if they will continue to receive services. (Dunn, 9/21)

Legislative auditors said Wednesday they can’t confirm that the Medicaid application backlog numbers state officials have reported are correct. Applications have been backlogged for about a year following the rocky rollout of a new computer system, an administrative decision that funneled all applications through a single state agency and a larger-than-expected influx of applications during the Affordable Care Act open enrollment period. The auditors said the Kansas Department of Health and Environment gets the backlog number from Accenture, the contractor that built the new software platform known as the Kansas Eligibility Enforcement System, or KEES. (Marso, 9/21)

The owner of a nursing home 80 miles northeast of Nashville claimed more than $2 million in Medicaid expenses that were instead spent for personal use, including purchases at discount stores, restaurants, furniture stores, nail salons, personal travel and, in one instance, to help pay for the wedding of the owner's daughter. Mabry Healthcare & Rehab Center reported hundreds of thousands of dollars in expenses to care for patients on Medicaid, including $176,000 in gift cards, $134,000 in personal travel expenses and $81,000 in personal legal fees over a five year period, according to the audit. Owner Kathleen Graves also claimed for reimbursement of $322,500 paid to a business run by her husband, $33,162 spent on her daughter's college tuition and $1,184 for her daughter's wedding. (Wadhwani, 9/21)

Liz Dudek, secretary of the Agency for Health Care Administration, will retire Oct. 3 after more than 40 years in state government. Sam Verghese, head of the Department of Elder Affairs since 2014, is stepping down to be replaced by Scott's top pick for insurance commissioner, who was rejected for that job by the Cabinet this spring. Dudek and Verghese earned $141,000 a year. Dudek, 65, was one of the last remaining agency heads appointed in the early months of Scott's administration and oversaw a complete reform of Medicaid. (Auslen and Wallace, 9/21)

Liz Dudek, a longtime state health official who helped lead an overhaul of the Medicaid program, is retiring as secretary of the Florida Agency for Health Care Administration, Gov. Rick Scott announced Wednesday. Dudek, who has served as secretary since March 2011, shortly after Scott took office, will be replaced on an interim basis by Deputy Secretary Justin Senior. Dudek's retirement from the $141,000-a-year job is effective Oct. 3. (Saunders, 9/21)

If the open-ended nurses strike at Allina Health’s Twin Cities hospitals continues through Oct. 1, striking nurses will have to begin paying for the full cost of their health care coverage. No new negotiations have been announced as the Minnesota Nurses Association’s strike stretched into its third week. Allina, meanwhile, has said about 500 staff nurses have crossed picket lines, joining some 1,500 replacement nurses to staff the five area hospitals, which include United Hospital in St. Paul. Thousands of nurses walked off the job on Labor Day, striking largely over issues related to Allina’s plan to end their union-only health plan and transition the nurses to the corporate plan that covers other Allina employees. (Cooney, 9/21)

A federal judge in Fort Lauderdale has tossed out of court a lawsuit filed three years ago by the U.S. Justice Department that claimed Florida health administrators had acted with “deliberate indifference to the suffering” of disabled and medically complex children who were being warehoused in nursing homes for lack of more appropriate accommodations with family members or in the community. (Marbin Miller, 9/21)

Centers for Medicare and Medicaid Services lab inspectors moved to revoke Theranos' lab certificate effective Sept. 5 after finding multiple deficiencies at the company's Newark, Calif., lab. The certificate revocation also would force the shutdown of its Scottsdale lab. But more than two weeks after the Sept. 5 shutdown date passed, the company continues to draw blood from metro Phoenix customers and process those blood samples at its Scottsdale lab. (Alltucker, 9/21)

Tobacco giants Philip Morris and R.J. Reynolds have enlisted the help of a Long Beach public school teacher to persuade voters to reject a $2 cigarette tax increase on the November ballot, Proposition 56.The industry’s commercial, which began airing Sunday across the state, stars high school math and music teacher Davina Keiser. As she sets tests and pencils on empty desks in a classroom, Keiser says she was “astounded” to learn that Proposition 56 was written to undermine the state’s school funding guarantee. (Luna, 9/21)

Insurance Commissioner David Altmaier on Tuesday told Florida Gov. Rick Scott and Cabinet members that the Office of Insurance Regulation is “very close” to being finished with reviewing the proposal. The National Council on Compensation Insurance, which makes rate filings for workers’ compensation insurers, proposed the 19.6 percent hike primarily because of an April ruling by the Florida Supreme Court that said a limit on attorneys’ fees in workers’ compensation cases was unconstitutional. (9/22)

The hospital in Scott County that closed abruptly over the summer could reopen its doors under new ownership.The owner of the hospital, Pioneer Corp., has been trying to sell the facility, currently known as Pioneer Community Hospital of Scott in Oneida, Tenn., as part of a corporate bankruptcy proceeding and is getting close to reaching a deal, said Scott Phillips, founder of Healthcare Management Partners, which is advising Pioneer on its turnaround. (Fletcher, 9/21)

It’s not your typical prescription: “Take a selfie with a camel. Pet a porcupine. Ogle a galago. Repeat as needed. May be habit-forming, not that there’s anything wrong with that.” A few dozen patients at John Muir Medical Center in Walnut Creek heeded that advice Wednesday, availing themselves of exotic animals on site for Pet Therapy Day — part of National Rehabilitation Awareness Week. (Peterson, 9/21)

Of the many problems facing modern medicine, the deterioration of the patient-doctor relationship is one of the most pernicious. Today our health-care system is losing its humanity amid increasingly automated and computer-driven interactions between doctors and patients. (Caleb Gardner and John Levinson, 9/21)

After six years of pitched political battle, it has become conventional wisdom that Republicans are responsible for the Affordable Care Act’s unraveling. In part, this is true. Specifically, the refusal of red states to enter the Medicaid expansion and the defunding of the “risk corridors” have limited the law’s success. However, many of Obamacare’s deepest wounds have been self-inflicted. Out of desperation to ensure as many people as possible signed up for health insurance, the Obama administration has arbitrarily suspended onerous mandates, modified coverage requirements and extended enrollment periods. These illegal, ad hoc changes to the ACA — which I’ve referred to as “government by blog post” — have unintentionally, but foreseeably, weakened the exchanges during the pivotal first three years. (Josh Blackman, 9/21)

In Burwell v. Hobby Lobby Stores and Zubik v. Burwell, the Supreme Court has now twice opined on the Affordable Care Act’s contraceptive mandate and its accommodation. However, this term is a misnomer. Congress did not vote on a contraceptive mandate, nor did it create a series of exemptions and accommodations for religious employers. Hobby Lobby and Zubik were both premised on executive actions taken by the Obama administration in light of legislative silence. (Josh Blackman, 9/21)

A congressional hearing on Wednesday about the outlandish price increases of the EpiPen followed a pattern that has become all too familiar in recent years. A drug price soars for no reason; lawmakers call a hearing to scold a pharmaceutical executive; the executive pleads innocence and provides as little information as possible. The drama plays out with no effect on the price. (9/21)

Federally qualified health centers are entities that rely on federal money to provide care to low-income Americans, including the indigent. They cannot turn patients away for emergency care. It therefore made no sense that Texas could deny payment for such care in a case in Houston, doing so via a third-party, private managed care organization the state had delegated to reimburse the clinic. (9/21)

As we approach the election this fall, it seems like the news media report on little else. Unfortunately, too little news coverage addresses health care reform. This is ill-advised because there is still much to be done to improve the cost, quality, and access for patients within the US health care system. In this post, I will attempt to cover most of the major issues related to health care coverage that US consumers face. (Aaron, Carroll, 9/21)

A new rule decreed by the Baker administration essentially imposes a 40-hour per week limit on personal care attendants, or PCAs, who assist the elderly and people with disabilities. While there’s a transition period and some exemptions, the new policy means most workers — who currently earn $14.12 an hour — won’t be able to earn overtime. And that means the most frail and severely disabled people under their care must scramble to find multiple attendants to get through a 24-hour day. (Joan Vennochi, 9/21)

Promise me he won’t die here,” my patient’s daughter begged me. In her eyes was a fear born of familiarity: She’d seen too many of her family and neighbors die in a hospital. Just last year, her mother was admitted to the intensive care unit and never left. Now her 70-year-old father, whom I’ll call Ray, was in the same place, lying in a bed with his eyes unfocused and his speech confused. Ray would die here, and I could do nothing to stop that from happening. His life was never mine to save. It had been lost much earlier to the destructive grind of the impoverished, embattled neighborhood where he lived. Ray lived in East Harlem, N.Y., for a half-century. (Prabhjot Singh, 9/21)

The insecticide, Naled, which was sprayed over an area of Miami-Dade County twice last week and is due to be sprayed again this weekend in an effort to stop the spread of the Zika virus, is a potent neurotoxin that kills adult mosquitoes on contact. The protesters who disagree with the Centers for Disease Control and Prevention and local governments’ assurances that it is safe, are justified in their concerns — ask the European Union, which banned the use of this organophosphate in 2012; the beekeeper in South Carolina who recently lost more than 2 million bees after aerial spraying of Naled; or the governor of Puerto Rico who, despite an escalating outbreak of Zika, refused to use it and sent supplies back to the mainland. He was right to err on the side of caution. (Claudia Miller, 9/21)

For 21 straight days now, Dr. Eddie Phillips and I have faithfully refrained from using the word "should." That was our promise at the start of WBUR's 21-day exercise podcast, "The Magic Pill." We would never tell you that you "should" exercise. We would only share what you can do, and why you might want to do it. But a "should" is now exploding from my typing fingers, and it is this: If you're running to be the president of the United States, I'm sorry but you really should exercise, and you should be open and vocal about your commitment to being physically active. (Carol Goldberg, 9/21)

I have twice been diagnosed with Clostridium difficile, known as C. diff, a germ that can cause infectious diarrhea. It strikes a half-million Americans every year. Most people get the disease through taking antibiotics. That’s how I got it, and it was a miserable experience. (Andy Miller, 9/21)