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It’s back-to-school time — as well as campaign season — and lawmakers are becoming increasingly focused on the growing cost of pens: EpiPens, that is. Members of Congress are expressing rising alarm about the increasing costs of the lifesaving injection device for people with severe allergies, and they are hearing from anxious parents. (Hulse, 8/23)

Responding to the high cost of the EpiPen auto-injector for reversing life-threatening allergic reactions, Senator Chuck Grassley (R-Iowa), who chairs the Senate Judiciary Committee, on Monday wrote Mylan Laboratories asking for pricing data on the device. At the same time, Senator Amy Klobuchar (D-Minn.) asked the US Federal Trade Commission and the Senate Judiciary Committee to investigate price hikes taken by Mylan. Klobuchar happens to be the ranking member of Senate Judiciary Antitrust Subcommittee. And Senator Richard Blumenthal (D-Conn.) also wrote the company for data about assistance programs to patients and first responders. And he also demanded that Mylan lower its price. (Silverman, 8/22)

In a call for the Federal Trade Commission to investigate the increased price of EpiPen packs, Sen. Amy Klobuchar (D-Minn.) compared the rising cost of the device to companies such as Turing and Valeant hiking up the prices of rare pharmaceuticals. Mylan, the company that acquired EpiPens in 2007, has increased the cost of the allergic reaction reversal treatment from $100 per pack in 2008 to $500 currently, Klobuchar wrote in a letter sent Monday to the FTC. According to Klobuchar, the increases don’t seem to be justified because the company doesn’t need to recover the cost of developing the treatment, and the higher price is forcing some patients to maintain expired EpiPens because they can’t afford to update theirs annually. (McIntire, 8/22)

Two senior lawmakers on the U.S. Senate's Judiciary Committee on Monday pushed for information regarding sharp price increases for EpiPens, drug-filled injectable devices used by people to counter potentially deadly allergic reactions. (8/22)

The chairman of the Senate Judiciary Committee is seeking information on Mylan’s decision to increase the price of EpiPens since acquiring the treatment in 2007. Sen. Chuck Grassley (R-Iowa) asked Mylan’s CEO to explain the price increases that have occurred over the past few years, which have come under scrutiny. The price of the drug has increased by 400 percent and has put financial pressure on families and schools, he says. (McIntire, 8/22)

Senate Judiciary Committee Chairman Chuck Grassley (R-Iowa) is asking the maker of EpiPens to explain sharp increases in the device's price. Grassley wrote a letter to Mylan, the company that makes EpiPens, asking for an explanation of a 400 percent increase in the price since 2007. (Sullivan, 8/22)

A major health-services company is revamping the employee wellness and care-management programs supplied to its clients after a yearslong study of who actually benefits from calls offering health advice. (Wilde Mathews, 8/22)

By now, most hospitals know they should be on social media, but they still struggle to understand where the value lies for them. Consider this: More than 40% of consumers say that information found via social media affects the way they deal with their health. Social media offers hospitals the opportunity to impact health outcomes on a large scale. (Simon, 8/22)

Democratic presidential nominee Hillary Clinton is proposing a package of ideas aimed at helping small businesses, including a new standard deduction that could simplify tax filing and improvements to a little-used tax credit for companies that offer workers health insurance. (Meckler, 8/23)

Republicans in Congress have insisted the only way to fix Obamacare is to repeal it. But with Barack Obama about to leave the White House, several Republicans sound willing to tweak it rather than kill it. These Republicans suggest that a Hillary Clinton presidency could shift the debate over the Affordable Care Act just enough to work on improvements with someone who isn’t the law’s namesake.  (Wayne and House, 8/23)

Hillary Clinton poked fun at the Donald Trump’s repeated claims that her health is failing Monday night, jokingly asking ABC’s Jimmy Kimmel to take her pulse while they spoke on his late-night TV show. The Democratic nominee’s physical well-being has been a topic of discussion on the campaign trail ever since Trump claimed she "lacks the mental and physical stamina to take on ISIS" last Monday. The allegation, a staple of right-wing media critiques of Clinton, was quickly denounced by her campaign, which pointed to a doctor’s letter released last year that pronounced her health “excellent.” (Lima, 8/23)

For years, most Americans have opposed abortions late in pregnancy. Zika could change that, potentially undermining support for a national ban on abortion after 20 weeks of pregnancy as more women infected with the virus find themselves in the crosshairs of the abortion wars if they choose to end their pregnancies. (Haberkorn, 8/22)

The Zika threat has led to economic opportunities for some businesses in Maryland and elsewhere as the state and federal governments have launched efforts to prevent spread of the virus. Millions have already been spent or committed in Maryland, and that's just a fraction of the billions Zika is expected to cost the United States, as well as Central and South America, where there have been far more cases. (Cohn, 8/22)

Gov. Rick Scott said Monday the state is sending $5 million to Miami-Dade County to help in the ongoing effort to stem an outbreak of the Zika virus. As part of $26.2 million in emergency state funding authorized by Scott, the governor said Miami-Dade would receive the money for additional mosquito-control staff, mosquito spraying and community outreach. (8/23)

More than 7,000 students in Miami-Dade County started the new school year Monday in a Zika zone. The reopening of school came with more than the usual first-day jitters. With mosquito-spread Zika infections in the area up to 37 now, parents worried about the kids they sent out the door and off to class. The science of the mosquito-borne virus was part of the first day’s lesson plan at a middle school in Wynwood, CBS News correspondent David Begnaud reported. (8/22)

A consumer’s advocacy group is calling out Gov. Rick Scott for telling pregnant women concerned about Zika to contact their doctors, because that won’t work for 300,000 women who don’t have doctors due to Florida not expanding Medicaid coverage. The Florida Health Alliance, with more than 100 organizations in various medical fields, began asking members Monday to send letters to Scott and Florida lawmakers demanding they expand Medicaid in light of the growing Zika threat. (Freeman, 8/22)

New York City’s public hospitals are in critical condition with rising costs and plummeting revenue. There’s no dispute about that diagnosis. The problem is with Mayor Bill de Blasio’s proposed cure, according to health policy makers, hospital administrators and budget watchdogs. As NYC Health + Hospitals President Ram Raju describes it, the largest U.S. municipal-healthcare provider is an ailing system of 11 hospitals that’s losing revenue because of increased competition from non-profit hospitals for Medicaid patients and drastic cuts in federal and state aid for indigents.  (Goldman and Braun, 8/22)

For the second time this month a Houston-area Kindred hospital has announced it will close. The Kindred Hospital at 2130 W. Holcombe Blvd., near the Texas Medical Center, will shutter in October, and all 204 positions will be eliminated, according to a letter sent to the Texas Workforce Commission last week. The health care company confirmed the news Monday. Earlier this month, the Kindred Hospital in Baytown also announced its closing and the elimination of 33 jobs, the Workforce Commission reported. (Deam, 8/22)

A judge will hear arguments later this month from lawyers representing two medical staffing agencies who say their clients should be excluded from contributing toward legal settlements paid to 188 patients who tested negative during a hepatitis C outbreak. Exeter Hospital filed a lawsuit in January 2014 against a half dozen staffing agencies, saying the agencies are responsible for allowing former technician David Kwiatkowski to remain working in the medical field while knowing about his drug habit. (Kimble, 8/22)

The Executive Council on Wednesday is expected to approve a $36.5 million contract for Dartmouth-Hitchcock to provide psychiatric services at New Hampshire Hospital and other state institutions, despite continued concerns over changes in staffing. Those concerns were heightened after a recently discharged New Hampshire Hospital patient committed suicide in Nashua. Republican gubernatorial candidate and Manchester Mayor Ted Gatsas has asked the council to hold off on the vote. (Solomon, 8/22)

(Will) Lautzenheiser, one of about 80 people worldwide with transplanted arms, can’t fathom what another American recipient told People Magazine last month — that he had considered getting his transplants removed. ... Patients go into their surgeries fully aware that the procedure is experimental and might not succeed, though 95 percent of the transplanted limbs have had good outcomes, said Dr. Vijay Gorantla, administrative medical director of the Reconstructive Transplant Program at the University of Pittsburgh. Fewer than 10 of the transplants have had to be removed. (Weintraub, 8/23)

Schools across Iowa are beginning classes this week amid concerns from public health officials about the drop in vaccination rates. At many schools, the percentage of students fully vaccinated is below 90 percent, and at a few around the state, it's below 50 percent. State Epidemiologist Dr. Patricia Quinlisk says more families are seeking exemptions from vaccinations for a variety of reasons.  (Moon, Kieffer and Dillard, 8/22)

A Georgia Tech researcher said Monday that hundreds of thousands of Georgia children have problems getting access to a dentist in the state. Nicoleta Serban, an industrial and systems engineering professor, told state lawmakers that there are more than 500,000 Georgia children who are not eligible for the public insurance programs Medicaid and PeachCare, but whose parents cannot afford dental care. (Miller, 8/22)

The state of Georgia could save millions of dollars a year and serve thousands of children from low-income families by increasing access to basic dental care, researchers told key lawmakers Monday. But one suggested solution appears to be stalled in the kind of fight between health care professionals that often eats up weeks of every General Assembly session. Dental hygienists say the dentist lobby — a big campaign contributor to lawmakers — held up legislation earlier this year that would have allowed hygienists to do basic cleaning and preventive care at so-called “safety-net settings,” qualified health centers and school-based health clinics, without a dentist present. (Salzer, 8/22)

The experience highlighted some of the hurdles facing a fledgling New York City health program to give low-income women free access to a resource that hospitals and insurers alike have long treated as a luxury for wealthy women seeking boutique births. Most doulas are present at delivery and later help the new mother care for her baby and give advice on breast-feeding. In 2015, the City Council and New York state started earmarking about $468,500 annually for the free program, called Healthy Women, Healthy Futures, as part of a broader initiative to address high rates of infant and maternal mortality among black New Yorkers as well as those women living in the city’s poorest neighborhoods. (Sharp, 8/22)

The survey also found that repeat crime victims are rarely able to access even basic services and support for recovery. Two out of three survivors reported anxiety, stress, difficulty sleeping and other symptoms resulting from the traumatic effects of their victimization, but few reported receiving treatment. Most were unaware of the full spectrum of victim services that are available, a finding that holds true nationally, too. (Dayton, 8/23)

Five years ago, when Lisa Conn became a mental health provider for juvenile justice in Santa Barbara County, she noticed a disturbing trend: A large number of the incarcerated girls were displaying symptoms of complex trauma and, in particular, sex trauma. ... “Their symptoms were beyond what we would typically see with sexual assault,” she said. Conn noticed the young women had an intense loyalty to the men she suspected were their abusers; they seemed almost brainwashed. “Not all of them would even say they were being raped, but they had the telltale signs of trauma.” (Bartos, 8/23)

Chauncey Liles Jr. was poisoned by lead paint by the time he was 2 years old. Now 18, he says he's struggled ever since...Now Liles, of West Baltimore, faces another challenge. The $1.3 million a jury awarded his family last week is in jeopardy because of a legal dispute between a London-based insurance company and Liles' former landlord. (Broadwater, 8/22)

Florida’s insurance regulators are considering two major rate increases.  The moves would raise rates for workers compensation insurance and property insurance with the state-backed company Citizens. Court rulings and water claims are driving the rate hikes insurers say, and across two days of public hearings they worked hard to make their case before the office of insurance regulation. The meetings mark the first major undertakings in the tenure of David Altmaier, the new head of OIR. (Evans, 8/22)

Be on alert: A spike in overdoses in Hamilton County emergency rooms coupled with a lack of effectiveness of the antidote naloxone is leading health officials to believe that deadly opioids are getting to heroin users. The Hamilton County Heroin Coalition issued the warning Monday after Hamilton County Public Health noted a surge in hospital overdose cases. The emergency department-visit surveillance system detected the increase over the weekend, beginning on Friday, health officials said. (DeMio, 8/22)

New York's attorney general has reached a settlement requiring a Buffalo-based insurer to pay thousands of improperly denied claims for outpatient psychotherapy and nutritional counseling for eating disorders. (8/22)

Perhaps one of the unintended consequences of the U.K.'s "Brexit" vote earlier this summer is an influx of foreign investments in a local market: high-tech biomedical laboratory space. According to reporting today by The Boston Globe's Robert Weisman, roughly half of last year's $46 billion in commercial real estate sales were made by foreign investors. And with area lab space in short supply, what does this mean for the biomedical industry in the Boston area? (Bologna and Becker, 8/22)

A company named in a federal lawsuit in the 2014 death of a Macomb County jail inmate could be in line to take over medical services at Wayne County's jails and juvenile detention facility...But many staffers say that privatizing medical care is not the solution for Wayne County's jails. Several nurses and social workers who attended a commission meeting Thursday predicted that many current staffers would leave, exacerbating the county's staff-retention problems, although the administration said the goal is to improve care and retention. (Lawrence, 8/22)

Advanced Dermatology is now one of the largest dermatology practices in the United States, with 155 offices in 13 states, including 30 offices in Central Florida. "In our model, we purchase [physicians'] practices, and they can practice as long they want," said Leavitt, CEO and chief medical officer of the group. "We make it easier by giving them resources, so they can enjoy being doctors again."  (Miller, 8/22)

Aetna’s withdrawal from Affordable Care Act markets has sparked the latest round of dire predictions about the law’s survival. Yet time and time again the ACA has proved durable, insuring 20 million Americans with improvements each year. This time will be no different. (Ezekiel Emanuel and Topher Spiro, 8/22)

All but the most hardened partisans understand that the Affordable Care Act’s insurance exchanges are in serious trouble. In 2010, the Congressional Budget Office predicted that 21 million people would have exchange-based coverage in 2016; the real number was about 12 million. As insurers head for the exits, the gap between initial hype and final reality will widen. (Avik Roy, 8/22)

Last week Aetna, one of the country’s largest insurance companies, announced that it was cutting back its participation in the health care exchanges created by the Affordable Care Act (ACA). With several other major insurers also cutting back their participation, there will be very limited competition in many markets. This prospect has supporters of the ACA worried and opponents gleefully looking forward to the day when millions may lose their insurance. (Dean Baker, 8/22)

[The ACA] is based on the free market, for-profit healthcare system of both insurance companies and healthcare providers. Indeed, it has empowered them both, swelling enrollment by millions and sending their profits soaring. Even as Aetna pledged last week to drop out of the healthcare exchanges in eleven of fifteen states, citing anticipated losses, their Q2 earnings topped $780 million. There is nothing anti-capitalist about the ACA. It works in conjunction with the free-market healthcare system which has existed here since the beginning. It is also the very last chance that system has to prove it can work. (Patrick Tomlinson, 8/22)

Here’s another cruel irony for Obamacare.Two new health care models that aim for better outcomes at a lower price are taking hold in North Texas, but they won’t be offered on HealthCare.gov next year. That’s because the insurers participating in the efforts, Aetna and Scott & White Health Plan, said last week that they would exit the exchange business in the state. (Mitchell Schnurman, 8/22)

Aetna announced last week that it was reducing participation in health insurance exchanges created by the Affordable Care Act. It will sell plans in only four states next year, including Iowa, down from 15 this year. This follows similar market exits from UnitedHealth Group and Humana. This is yet another reminder of why government should not rely on private companies to deliver health insurance to Americans. History has repeatedly shown this is a costly, dangerous and unsustainable idea. Yet politicians refuse to listen to history. (8/22)

The best argument for a single-payer health plan is the recent decision by giant health insurer Aetna to bail out next year from 11 of the 15 states where it sells Obamacare plans. Aetna’s decision follows similar moves by UnitedHealth Group, the nation’s largest health insurer, and by Humana, another one of the giants. All claim they’re not making enough money because too many people with serious health problems are using the Obamacare exchanges, and not enough healthy people are signing up. (Robert Reich, 8/22)

The recent proposal for a large-scale test of payment reforms for Medicare Part B “physician-administered” drugs has generated broad opposition from many patient groups, physician specialty societies and pharmaceutical companies. While many consumer organizations that represent Medicare beneficiaries have expressed support, the future of the proposed reforms is unclear. (Peter Bach and Mark McClellan, 8/23)

Gov. Terry Branstad on Monday brushed off like an annoying mosquito questions about health-care providers going out of business or having to borrow money because the state’s Medicaid program isn’t paying them on time. ... we still have no real idea whether or how much the state is saving by moving to managed care. So the governor is discounting the reports from providers who say they are struggling to stay afloat amid managed care red tape in favor of expectations of savings that we still can’t actually document. (Kathie Obradovich, 8/22)

Patents are the lifeblood of biotechnology, the force that motivates companies to develop innovative medical treatments and bring them to market. The trouble is that these patents must be enforced in a court system that isn’t set up to adjudicate highly technical matters—resulting in rulings that seem arbitrary or even scientifically suspect. (Alex Berezow and Neal Mody, 8/22)

To date, nearly 2,000 Zika cases have been reported in the United States. In Miami alone, roughly 30 people have contracted Zika after being bitten by mosquitos, including a tourist who took the virus back with him to Texas. The Centers for Disease Control and Prevention (CDC) has taken the unprecedented action of issuing a travel warning for a community in the United States. Sadly, Congress has yet to act. (Dr. Thomas Gellhaus and Dr. Didi Saint Louis, 8/22)

There’s an exceedingly simple way to get better health care: Choose a better hospital. A recent study shows that many patients have already done so, driving up the market shares of higher-quality hospitals. A great deal of the decrease in deaths from heart attacks over the past two decades can be attributed to specific medical technologies like stents and drugs that break open arterial blood clots. But a study by health economists at Harvard, M.I.T., Columbia and the University of Chicago showed that heart attack survival gains from patients selecting better hospitals were significant, about half as large as those from breakthrough technologies. (Austin Frakt, 8/23)

New research suggests that nearly half of all clinical trials involving kids go unfinished or unpublished — either because the researchers lose interest in the work or take up more pressing projects, or, in some cases, because the companies that funded the studies don’t want the results to get out. That news won’t come as a surprise to anyone who has followed the fate of studies in general. But it should catch the notice of the FDA: The pharma industry currently gets a special bonus, in the form of extended exclusive marketing rights, for testing their drugs in kids — a rule that was implemented to accelerate research into childhood ailments. (Ivan Oransky and Adam Marcus, 8/19)

The massive yellow fever vaccination campaign that got underway this month in Angola and the Democratic Republic of Congo (DRC) will help save lives in those countries. It is also serving as a dress rehearsal for how all nations can best cope with vaccine shortages, something we could see a lot more of in the years ahead. (Seth Berkley, 8/22)

Last week, loud popping sounds triggered a frightening chain of events at J.F.K. Airport. ... Incidents of mass panic or hysteria depend on the mood of the crowd at the time an episode occurs. Over the past 30 years, I have studied many outbreaks of mass panic and hysteria. In all of them, the common denominator is a backdrop of anxiety and stress. Fear and anxiety can spread from person to person like a contagious disease. (Gary W. Small, 8/23)