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A Montana judge on Monday found that the Treasure State is violating its residents’ right to a clean environment — delivering a major victory to the 16 kids, teens and young adults behind the first U.S. youth-led climate trial. Judge Kathy Seeley of the 1st District Court in Montana ruled that state lawmakers flouted Montana’s constitutional right to a “clean and healthful environment” when they passed a law barring agencies from considering the climate effects of fossil fuel projects. (Clark, 8/14)

The Montana case will face an appeal to the state Supreme Court, Emily Flower, a spokesperson for Montana Attorney General Austin Knudsen (R), confirmed Monday. She decried the ruling as “absurd” and said Montanans cannot be blamed for changing the climate. ... Despite the track record of dismissals for youth-led climate cases in the United States, experts said the Montana youths had an advantage in the state’s constitution, which guarantees a right to a “clean and healthful environment.” Montana, a major coal producer, is home to the largest recoverable coal reserves in the country. The plaintiff’s attorneys say the state has never denied a permit for a fossil fuel project. (Selig, 8/14)

Nearly 188,000 dementia cases in the U.S. each year may have been caused by air pollution, researchers estimate, with bad air quality from wildfires and agriculture showing the strongest links to a person's risk of Alzheimer's disease and other kinds of dementia later in life. Published Monday in the journal JAMA Network Open, the new estimates are the latest to underscore the range of health risks scientists have long warned are being driven by air pollution. (Tin, 8/14)

The Inflation Reduction Act of 2022 provides billions of dollars in direct funding and tax incentive opportunities that health systems can use to finance climate resiliency and renewable energy infrastructure projects. The funding is still becoming available, with several tax and grant opportunities rolling out this year. Significantly, the Inflation Reduction Act enables tax-exempt entities, such as nonprofit organizations and local governments, to receive direct payments for qualified investments. The window to take advantage of certain cost-sharing arrangements will close at the end of 2024. (Hartnett, 8/14)

Less than a year after an oilfield waste disposal site opened near Tara Jones’ home in 2019, she and her family noticed a foul odor. They lived a half-mile away, amid the mesquite trees and pastures west of Corpus Christi. But the sour smell from the Blackhorn Environmental Services site was potent. Jones would later learn her neighbors had been complaining for months about Blackhorn’s waste pits near the town of Orange Grove, population 1,300. Neighbors later said they sneezed, coughed, got itchy eyes and, on the worst days, felt nauseated. (Buch, 8/15)

In the five-state public health region that includes Texas, the rate of heat-related emergency room visits surpassed 1,000 during the first week of August, according to the Centers for Disease Control and Prevention. That’s more than double the rate during a similar time frame in 2022 and more than triple the rate from 2019, data shows. (Gill, 8/14)

With this dangerous heat wave forecasted to keep smothering the southern U.S. and Florida the next several weeks, it is important to know the key differences between heat-related illnesses. The combination of heat and humidity will result in dangerously high “feels like” temperatures to continue hitting the triple digits. These conditions could prompt significant health risks if precautions are not taken. (Hazel, 8/14)

The Department of Justice (DOJ) lambasted the Chamber of Commerce’s request for an injunction to block the Medicare drug price negotiation program, arguing in court filings that the organization had no standing to file the lawsuit and that pausing the program would harm the public. The rebuttal comes weeks before the federal government is expected to name the first 10 drugs chosen for price negotiation. (Choi, 8/14)

The pharmaceutical industry has taken most of the heat in Congress and the public's mind for high drug prices. But increasingly, scrutiny is shifting to a different part of the supply chain: pharmacy benefit managers. PBMs may not resonate with the average person the way big drugmakers like Pfizer do, but they play an important role in determining how much people wind up paying for medicines. (Sullivan, 8/14)

Hospitals are scrambling to halt a nearly $1 billion cut the Biden administration made to their Medicare payments for treating low-income and uninsured patients. Why it matters: The reduction to fiscal year 2024 payments announced earlier this month was far larger than what Medicare had originally proposed, catching hospitals by surprise. And though Medicare already finalized the cuts, hospitals say the agency must reconsider its decision to avoid jeopardizing care for disadvantaged patients. (Goldman, 8/15)

The Centers for Medicare and Medicaid Services debuted a slate of changes to ACO REACH on Monday that are designed to boost participation in the value-based care program. The agency's Center for Medicare and Medicaid Innovation elevated financial reserve requirements and reduced enrollment minimums under the Accountable Care Organization Realizing Equity, Accountability and Community Health, or ACO REACH, program, the office announced via its website. (Tepper, 8/14)

A federal plan to expand physician training in rural areas is geared toward primary care, but that training has not yet expanded according to Medicare plans. Congress approved money and a mandate for the U.S. Centers for Medicare and Medicaid Services (CMS) to create 1,000 new residency slots for physician training in rural and underserved areas. That happens in hopes of physicians staying to practice where they learn, said the research letter in JAMA. (Payerchin, 8/14)

Big Medicaid-managed care plans that serve the majority of the program's beneficiaries are seeing membership slip as more states redetermine program eligibility — a trend that could eat into some of the insurers' bottom lines, according to Georgetown University's Center for Children and Families. If the remaining Medicaid enrollees as a group are sicker overall, plans may have to eat some of the higher cost of care unless states adjust their payment rates upward. (Bettelheim, 8/14)

Acrocyanosis, venous pooling of blood in the legs that causes them to turn blue, may be yet another symptom of long COVID, according to a case report published in The Lancet. The case report features a 33-year-old man who for 6 months experienced blue legs after 10 minutes of standing, accompanied by a heavy, itching sensation. The legs returned to a normal color after 2 minutes of lying down. (Soucheray, 8/14)

The World Health Organization is monitoring a new strain of Covid-19 called EG.5, or “Eris,” that accounts for a growing share of cases in countries including China and the United States. The WHO has designated it a “variant of interest,” meaning it will be monitored for mutations that could make it more severe. Based on current evidence, the WHO says it presents a low public health risk at a global level, in-line with other variants currently in circulation. (Reid, 8/15)

In September 2020, the height of the COVID-19 pandemic, public health officials and researchers started hunting for signs of the virus' spread in an unexpected place: our poop. Samples of municipal wastewater provided a wealth of information that ― combined with diagnostic lab testing, hospitalization rates, and other disease surveillance data ― could warn officials of a rise in cases, help them track evolving forms of the virus and inform public health policy. (Shastri, 8/14)

A three-year chase for a Utah man accused of posing as a medical doctor to sell hoax cures for a variety of diseases, including COVID-19, has come to an end. Gordon Hunter Pedersen sold a "structural alkaline silver" product online as a preventative cure for COVID-19 early in the pandemic, the U.S. Attorney's Office for the District of Utah said in a statement. He also claimed in YouTube videos to be a board-certified “Anti-Aging Medical Doctor” with a Ph.D. in immunology and naturopathic medicine, according to the release, while donning a white lab coat and stethoscope in his online presence. (Arshad, 8/14)

�鶹Ů�� Health News: Epidemic: Zero Pox! 

In 1973, Bhakti Dastane arrived in Bihar, India, to join the smallpox eradication campaign. She was a year out of medical school and had never cared for anyone with the virus. She believed she was offering something miraculous, saving people from a deadly disease. But some locals did not see it that way.  (8/15)

Such fees have become routine in American health care in recent years, according to an investigation by ProPublica published on Monday, and some medical clinics say they'll seek to pass those costs on to patients. Almost 60% of medical practices said they were compelled to pay fees for electronic payment at least some of the time, according to a 2021 survey. With more than $2 trillion a year of medical claims paid electronically, these fees likely add up to billions of dollars that could be spent on care but instead are going to insurers and middlemen. (Podkul, 8/15)

Mayo Clinic will start charging patients for some online messaging exchanges with their doctors, closing an increasingly popular backdoor route to free medical advice. Patients will be warned, starting Friday, that their messages could result in charges of up to $50 if Mayo doctors respond with diagnostic information. The Rochester-based health care system announced the switch Monday in response to a recent 132% increase in patient messages, which sometimes averted the need for billable clinic visits. (Olson, 8/14)

The best-paid doctors in America work in the Dakotas, where they averaged $524,000 (South) and $468,000 (North) in 2017 in their prime earning years, including business income and capital gains. That’s well above the already astonishing $405,000 the average U.S. doctor made in the prime earning years, defined here as 40 to 55. (Van Dam, 8/11)

CommonSpirit Health, the massive not-for-profit health system formed through a 2019 merger, paid its former CEO $35.5 million in 2021, the latest year for which data is available. The size of Lloyd Dean’s pay package is likely to reignite questions about health system CEO pay, especially at tax-exempt organizations. (Bannow, 8/14)

The University of Texas at Austin and one of the most well-known cancer treatment centers in the world are partnering to build a new $2.5 billion medical hub geared toward serving Central Texas. The University of Texas System Board of Regents Chair Kevin Eltife announced Monday plans to create the new facility in partnership with the MD Anderson Cancer Center, the nation’s No. 1 cancer hospital. MD Anderson is part of the university system and has several locations in the Houston area. (Simpson, 8/14)

AdventHealth sued MultiPlan for allegedly colluding with other insurers to shortchange providers for care offered outside of an insurance company’s network, the latest example of the litigious relationship between health systems, physicians and insurers. ... AdventHealth alleged that nationally, MultiPlan underpays healthcare providers $19 billion a year. The system seeks damages for the alleged underpayments and lost revenue amounting to “hundreds of millions of dollars.” (Kacik, 8/14)

�鶹Ů�� Health News: Promising Better, Cheaper Care, Kaiser Permanente’s National Expansion Faces Wide Skepticism 

As regulators review Kaiser Permanente’s proposed acquisition of a respected health system based in Pennsylvania, health care experts are still puzzling over how the surprise deal, announced in April, could fulfill the managed care giant’s promise of improving care and reducing costs for patients, including in its home state of California. KP said it would acquire Danville, Pennsylvania-based Geisinger — which has 10 hospitals, 1,700 employed physicians, and a 600,000-member health plan in three states — as the first step in the creation of a new national health care organization called Risant Health. Oakland-based Kaiser Permanente said it expects to invest $5 billion in Risant over the next five years, and to add as many as six more nonprofit health systems during that period. (Meyer, 8/15)

When Dr. Lucy Lomas learned about the disturbing role of slavery in the origins of her medical specialty, gynecology, she said she felt “heaviness and heartache,” some of which she still carries with her. But she said she also feels a strong drive to create a better system of care for Black women, something that can’t be done without looking to the past. (Mohammed, 8/14)

Every year, doctors get better tools to fight cancer. Engineered cancer-killing cells, immunotherapies, targeted drugs, and more are helping clinicians cure more patients. Increasingly, though, oncologists are trying to use less radiation, long one of the main pillars of cancer therapy. In some cases, they are even keeping certain patients with low-risk tumors off radiation entirely. (Chen, 8/15)

The U.S. Food and Drug Administration on Monday granted accelerated approval to Pfizer's therapy for treating patients with a type of blood cancer that is difficult to treat, the company said. The health regulator's decision allows use of the therapy, branded as Elrexfio, in patients with multiple myeloma that is hard to treat or has come back after receiving four or more prior lines of certain classes of treatments. (Satija and Jain, 8/14)

Robert Nelsen is one of the most successful biotech VCs ever, having backed over three dozen companies that reached billion-dollar valuations. He's also a thyroid cancer survivor who credits early detection to a company in which his firm, Arch Venture Partners, never invested. There is a simmering medical debate over the value of full-body scans, like the one Nelsen received, and the growing cohort of venture-backed startups that provide them. (Primack, 8/14)

Ozempic and similar drugs are transforming the world’s understanding of obesity. It isn’t so much about willpower: It’s about biology. The success of the powerful new class of diabetes and weight-loss drugs shows how important chemistry is to determining a person’s weight. The brain is the body’s chief chemist, regulating appetite and making it difficult for many people to shed pounds and keep them off. The brain determines how much fat it wants people to carry, according to years of research bolstered by the new drugs. (McKay, 8/14)

As Bristol Myers Squibb works to build its treatment for a heart condition that can cause difficulty breathing into a blockbuster drug, it’s propped up an algorithm designed to help find more people who are affected. (Aguilar, 8/15)

The U.S. Food and Drug Administration (FDA) on Monday classified the recall of Philips' (PHG.AS) respiratory machines as its most serious type, as their use could cause serious injuries or death. The Dutch medical devices maker started the process on March 29 and has recalled 73,000 devices in the United Sates. The ventilators being recalled include Trilogy Evo, Evo O2 and EV300, among others. These devices help people with respiratory conditions to keep breathing at a regular rhythm. (8/14)

Patient advocates are warning that a recent proposal from the Food and Drug Administration meant to reduce consumers’ salt intake could inadvertently kill those with kidney disease, particularly Black Americans. (Florko, 8/15)

A surgical team from Washington University’s School of Medicine has successfully performed the first robot-assisted whole-liver transplant in the U.S. — and the patient was cleared to get back on the golf course just a month later. The surgery took place in May at Barnes-Jewish Hospital, and the patient — a man in his 60s with liver cancer and cirrhosis due to a hepatitis C infection — has recovered swiftly, according to his doctors. (Vargo, 8/14)

Stan Nicholas volunteered to become one of the first people in the world to try to regain his body’s function with the help of a little device planted in his brain and chest that the doctors hoped would stimulate them into action, even the parts of the brain that the stroke seemed to wipe out. (Christensen, 8/14)

Microgreens and mature vegetables may offer different nutrients, but they might both be effective in limiting weight gain, new research suggests. Microgreens - older than sprouts but younger than baby greens - have been touted by some as a superfood, and scientists are aiming to find out if they have earned this reputation, and how they compare with fully grown veg. (Massey, 8/15)

If women in the US got paid for their caregiving work, they would make an additional $627 billion per year, according to a new analysis. Women average about 52 minutes per day caring for children and other family members, including those outside the home, while men spend about 26 minutes a day on care, an analysis published Monday by the National Partnership for Women & Families, a working families research and advocacy group, shows. Assuming they’d earn the mean wage of $14.55 per hour for child-care workers or home health aides, women would each bring in an extra $4,600 annually if their caregiving work was compensated, while men would receive about $2,300. (Butler, 8/14)

The U.S. has seen a record increase in homeless people this year as the Covid-19 pandemic fades, according to a Wall Street Journal review of data from around the country. The data so far this year are up roughly 11% from 2022, a sharp jump that would represent by far the biggest recorded increase since the government started tracking comparable numbers in 2007. The next highest increase was a 2.7% jump in 2019, excluding an artificially high increase last year caused by pandemic counting interruptions. (Kamp and Najmabadi, 8/14)

For more than a decade, the state has been trying and failing to chase Planned Parenthood out of Texas. Texas restricted and then banned abortion. The state removed Planned Parenthood affiliates from state-funded health programs and turned down federal dollars rather than allow Planned Parenthood to receive them. Planned Parenthood has been cut out of funding for cancer screenings, contraception, HIV prevention and sex education. Despite this concerted effort from the highest levels of state government, Planned Parenthood’s clinic doors have remained open in Texas. (Klibanoff, 8/15)

A virtual web of reproductive health groups is openly helping Texans circumvent legal and logistical barriers set in place by strict anti-abortion laws, including those that ban shipping abortion medications by mail. With a few clicks of the mouse, Texans seeking abortion pills can view a list of vetted providers, visit virtually with a clinician in Massachusetts and arrange for medication to be sent directly — even though prescribing the pills is illegal in the nation’s second-largest state. (Wolf and Pacheco, 8/14)

An abortion provider that planned to open a clinic in Beverly Hills offering procedures beyond 24 weeks of pregnancy is alleging that the city “colluded and conspired” with antiabortion activists to force out the clinic. It gave formal notice Monday of damage claims against local officials. The dispute illustrates that even in the bluest parts of America, abortion rights face serious challenges — especially when it comes to the most controversial procedures. (Jarvie, 8/14)

Abortion access. Gun safety. The treatment of immigrants. The size of the safety net. Ease of voting. LGBTQ rights. On any number of policy issues, red states and blue states have drifted apart from each other over the past three decades, widening the gaps between what families in different parts of the country pay in taxes, receive in benefits, and experience when interacting with the government. At the same time, the cost of housing in these states has diverged, too. Blue states have throttled their housing supply, leading to dramatic price increases and spurring millions of families to relocate to red states in the Sunbelt. (Lowrey, 8/15)

Despite three decades of advances in medical science, it is roughly just as dangerous now for new mothers in Missouri as it was 30 years ago, said Traci Johnson, a doctor at University Health. It shouldn’t be that way, she said. New reports from state agencies in Kansas and Missouri found that maternal outcomes had been getting worse in both states as of 2020, when the analyzed data ends. The majority of deaths that were recorded in both states were found to be preventable. (Bernard and Bayless, 8/14)

After years of litigation to hold the pharmaceutical industry accountable for the deadly abuse of prescription painkillers, payments from what could amount to more than $50 billion in court settlements have started to flow to states and communities to address the nation’s continuing opioid crisis. But though the payments come with stacks of guidance outlining core strategies for drug prevention and addiction treatment, the first wave of awards is setting off heated debates over the best use of the money, including the role that law enforcement should play in grappling with a public health disaster. (Hoffman, 8/14)

States that declared themselves refuges for transgender people have essentially issued an invitation: Get your gender-affirming health care here without fearing prosecution at home. ... Already-long waiting lists are growing, yet there are only so many providers of gender-affirming care and only so many patients they can see in a day. For those refuge states — so far, California, Connecticut, Colorado, Illinois, Massachusetts, Maryland, Minnesota, New Jersey, New Mexico, Washington and Vermont, plus Washington, D.C. — the question is how to move beyond promises of legal protection and build a network to serve more patients. (McMillan and Schoenbaum, 8/15)

Amber Bohlman tried almost everything to get pregnant. For five years, she took hormones that gave her headaches. Bohlman underwent three rounds of intrauterine insemination (IUI), in which her partner’s sperm was directly implanted into her uterus. Though Bohlman, who did two tours in Iraq in her 20s, grew increasingly worried that she would run out of chances to get pregnant. Still, there was one method she still hadn’t tried: in vitro fertilization (IVF), which is generally considered to be the most effective form of assisted reproductive technology. (Luthra, 8/14)

New research finds a large number of LGBTQ people say they’ve experienced discrimination and medical gaslighting from healthcare providers. (Mastroianni, 8/13)

A privately run clean-needle program in Santa Cruz County, aimed at limiting the spread of HIV and other drug-borne diseases, was illegally authorized in 2020 by state health officials who failed to consult with local law enforcement agencies, the program’s chief opponents, a state appeals court ruled Monday. (Egelko, 8/14)

A new law in Illinois restricts the way gun dealers and manufacturers can market and sell their products and subjects them to civil penalties for violations. Gov. JB Pritzker on Saturday signed House Bill 218 into law. Labeled the Firearm Industry Responsibility Act, it took effect immediately. “We hold opioid manufacturers accountable. Vaping companies accountable. Predatory lenders accountable. Gun manufacturers shouldn’t get to hide from the law – and now, they won’t be able to. Here’s to an Illinois where everyone feels safe in every corner of our great state,” Pritzker said in a statement. (Hancock, 8/15)

All those extra pounds come at a cost — a $9.3 billion hit to the state’s economy in 2022,or about 2% of the gross domestic product, according to a new report supported by Eli Lilly and Co. London-based GlobalData report finds that in Indiana, where 36.3% of adults self-report as obese and 33.3% overweight, obesity accounts for 69,400 fewer adults in the workforce because of obesity-related unemployment and early deaths. Medical conditions and complications that stem from obesity added up to an extra $1.2 billion in medical spending for employers, the report found. (Rudavsky, 8/15)

Hypertension is considered to be the No. 1 risk factor for death globally. So it’s no wonder convenient, relatively low-cost blood pressure machines with single-size, standard cuffs can be found in both clinics and homes across the U.S. The “Get It, Slip It, Cuff It, Check It” campaign makes it sound incredibly simple. However, these popular machines and simple-sounding advice may lead to wildly inaccurate results for the sizable portion of the U.S. population with wider or longer arms. (Devabhaktuni Srikrishna, 8/15)

As a primary care physician, I continue to work daily to restore patients' trust in medicine. When the government repeatedly stated as fact their latest recommendations, only to later change those "facts," it undermined patient confidence in the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration. (Mary Paquette, 8/14)

Robert F. Kennedy, Jr., has floated a conspiracy theory that COVID “ethnically targeted” white and Black people and spared Ashkenazi Jewish and Chinese people. While this racist and antisemitic claim was, and is, easily debunked by global data on COVID cases and deaths, it was presented by Kennedy as a scientific theory and was widely circulated. (Eleanor J. Murray and Monica H. Green, 8/14)

Last week �鶹Ů�� estimated that, based on the most current data from 44 states and the District of Columbia, at least 4.5 million people in the United States have fallen off the Medicaid rolls since April 1. These rates of disenrollment range from 72 percent in Texas to 8 percent in Wyoming. While data are still being tabulated for Massachusetts, close to 69,000 residents have been disenrolled from Medicaid as of June. The devastating consequences of Medicaid’s unwinding of continuous coverage deserves immediate attention. (Katherine Gergen Barnett, 8/15)

There is no way to regulate and control pregnancy without regulating and controlling people. States that have enacted abortion bans in the wake of the Supreme Court’s ruling last year in Dobbs v. Jackson Women’s Health have also considered the establishment of new regimes for the surveillance and criminalization of anyone who dares to circumvent the state’s dictates for the acceptable use of one’s body. (Jamelle Bouie, 8/15)

As STAT reported recently, the Senate Committee on Health, Education, Labor, and Pensions (HELP) has indicated that it will not consider the nomination of Monica Bertagnolli as director of the National Institutes of Health unless she pledges to take specific steps to reduce drug prices. However, the HELP Committee may want to focus on reducing drug spending, the product of price and units prescribed, rather than simply pricing. (Mark J. Ratain, 8/15)