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Morning Briefing

Summaries of health policy coverage from major news organizations

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Tuesday, Mar 22 2016

麻豆女优 Health News Original Stories 2

  • Debate Arises Over HHS Plans For Privacy Rules On Addiction Treatment
  • More Sickle Cell Patients Survive, But Care Is Hard To Find For Adults

Health Law 1

  • As Increasing Numbers Gain Coverage Under Obamacare, GOP Faces Dilemma

Supreme Court 1

  • Swing-Vote Kennedy's Past Approval Of Contraception Workaround May Signal Outcome Of Wednesday's Case

Marketplace 1

  • Anthem Files Lawsuit Against Express Scripts Over Prescription Drug Prices

Administration News 1

  • FDA Proposes Ban On Powdered Surgical Gloves

Campaign 2016 1

  • Health Care Industry Braces For Its Enemy No. 1: The Republican Front-Runners

Public Health 4

  • One City's Plan To Fight Its Heroin Crisis: Supervised Injection Centers
  • Sickle Cell Adults Find Health Care System Not Ready For Them
  • Houston Health Officials' Message: Zika Virus Is Coming, We'd Better Get Ready
  • Even With Universal Lead Testing Some Baltimore Children Fall Through The Cracks

State Watch 3

  • Ala. Governor Threatens Budget Veto Over Medicaid Appropriation
  • Mass. Community Hospitals Struggle With Low Payments
  • State Highlights: FamilyCare Signals Willingness To Settle Months Long Dispute With Oregon Health Authority; Kansas Lawmakers Move To Protect Tobacco Settlement Funds

Editorials And Opinions 1

  • Viewpoints: Drug Cost Control Plans Based On Misunderstanding; Valeant In The Headlines Again

From 麻豆女优 Health News - Latest Stories:

麻豆女优 Health News Original Stories

Debate Arises Over HHS Plans For Privacy Rules On Addiction Treatment

The current guidelines, last updated in 1987, require patients to specify exactly who gets information about their care. But advocates of change say the new rule will fit in better in the era of sharing patient data through electronic medical records. ( Michelle Andrews , 3/22 )

More Sickle Cell Patients Survive, But Care Is Hard To Find For Adults

For many years, most people with sickle cell died in childhood or adolescence, and the condition remained in the province of pediatrics. During the past two decades, advances in routine care have allowed many people to live into middle age and beyond, but barriers to care remain. ( Erin N. Marcus , 3/22 )

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Summaries Of The News:

Health Law

As Increasing Numbers Gain Coverage Under Obamacare, GOP Faces Dilemma

The Associated Press looks at the difficult choice for Republicans who oppose the president's health program but haven't offered much to replace it for the millions of people who would be uninsured without it. Other health law news includes reports on broadening transgender rights, administration efforts to promote the law and possible changes to a program to help insurers deal with outsized risks.

There鈥檚 growing evidence that most of the dramatic gain in the number of Americans with health care coverage is due to President Barack Obama鈥檚 law, and not the gradual recovery of the nation鈥檚 economy. That could pose a political risk for Republicans running against 鈥淥bamacare鈥 in the GOP primaries as they shift to the general election later this year. While the health care law remains highly unpopular in the party, the prospect of taking away health care coverage from millions of people could trigger a backlash if the eventual GOP nominee鈥檚 plan to replace it is seen as coming up short. (Alonso-Zaldivar, 3/21)

Big companies are pushing back against proposed federal rules they say would require their medical plans to cover gender transition and other services under the nondiscrimination mandate of President Barack Obama's health care law. Civil rights advocates representing transgender people say the regulation, now being finalized by the Health and Human Services Department, would be a major step forward for a marginalized community beginning to gain acceptance as celebrities like Caitlyn Jenner tell their stories. (Alonso-Zaldivar, 3/22)

The Obama administration is trying once again to address a criticism that has dogged the president ever since his health care bill passed six years ago: they need to sell it better. And this time, they鈥檙e paying a lot more attention to the medical side 鈥 the parts that no one outside of a narrow circle of health care wonks really understands. (Scott, 3/22)

A controversial federal health program that helps insurers withstand the ebbs and flows of the new insurance exchanges will be put under the microscope this week with the hope of making it fairer in the long term. The CMS will host a public meeting Friday in which health insurers, state officials and others will offer their input on how to change the Affordable Care Act's risk-adjustment methodology for 2018 and beyond. Under the permanent risk-adjustment program, which is a zero-sum game, the federal government redistributes money from plans that have lower-cost, healthier members to companies that have higher-cost, sicker members. (Herman, 3/19)

Supreme Court

Swing-Vote Kennedy's Past Approval Of Contraception Workaround May Signal Outcome Of Wednesday's Case

The administration might have an advantage in front of the Supreme Court in its defense of the contraception mandate for not-for-profit groups, but it also faces questions about whether it has shown a compelling interest in making sure all women get contraception coverage.

Experts say the White House may have some advantages going into a U.S. Supreme Court case centering on questions of religious freedom and the Affordable Care Act's requirement that employers provide birth control coverage to employees. But the government will also face questions about whether it truly has shown a compelling interest in making sure all women get contraception coverage. The justices are taking up the issue on Wednesday. (Schencker, 3/21)

President Obama鈥檚 signature health care law once again is coming before the Supreme Court, this time in a case involving nuns who say the law鈥檚 contraception mandate violates their religious freedom rights. (Mears, 3/22)

Marketplace

Anthem Files Lawsuit Against Express Scripts Over Prescription Drug Prices

Anthem's suit said it determined that it was paying 鈥渕assively excessive prices鈥 to Express Scripts, generating 鈥渁n obscene profit windfall鈥 for the pharmacy-benefit manager. Express Scripts President Tim Wentworth, who will take over as CEO in May, said he doesn't intend to lose Anthem as a customer.

Health insurer Anthem Inc. sued Express Scripts Holding Co. for about $15 billion in damages, alleging that the pharmacy-benefit manager violated their contract through excessive charges and failures in its operations. The lawsuit, filed on Monday in the U.S. District Court for the Southern District of New York, seeks damages tied to what Anthem said was Express Scripts鈥 unduly high pricing for drugs. Anthem also asked for a judgment that it could terminate its deal with Express Scripts, which stretches to 2019, but the insurer said it hasn鈥檛 determined if it would actually end the contract. (Wilde Mathews, 3/21)

The battle over drug prices escalated Monday when health insurance giant Anthem Inc. sued Express Scripts, a manager of drug benefits, to get a bigger share of savings on prescription medicines. Anthem is looking for a change in its contract with Express Scripts, which handles drug benefits for 80 million people. The insurer says it's overpaying for pharmaceuticals and not benefiting from rebates the pharmacy benefit manager has negotiated with drugmakers. (Kodjak, 3/21)

Insurers contract with middleman companies like Express Scripts, which negotiate rebates and discounts on prescription drugs on behalf of the people they insure and pocket some of the savings for themselves. Anthem entered into a ten-year agreement with Express Scripts in 2009 that included a provision for a periodic review of pricing, to ensure that the prices Anthem received were competitive with others in the marketplace. According to the lawsuit, Express Scripts' current pricing for the contract now exceeds competitive pricing by $13 billion, plus an additional $1.8 billion through a transition period after the contract is terminated. (Johnson, 3/21)

Anthem said in a statement that Express Scripts was obligated to negotiate in good faith to make sure Anthem received competitive pricing, but that it had refused to do so. A spokesman for Express Scripts said that Anthem鈥檚 lawsuit had no merit, and that it had 鈥渃onsistently acted in good faith and in accordance with the terms鈥 of its deal with Anthem. (3/21)

Express Scripts Holding Co.鈥檚 incoming chief executive officer is trying to keep its biggest customer, after health insurer Anthem Inc. sued to recoup billions of dollars in what it called excess payments for drugs and threatened to end their relationship. 鈥淲e don鈥檛 intend to lose Anthem. We鈥檒l get through this,鈥 Express Scripts President Tim Wentworth, who will take over as CEO in May, said in an interview. 鈥淲e think we have done a great job for Anthem.鈥 (Tracer and Langreth, 3/21)

Will the deal prompt other insurers to look closely at their contracts with聽pharmacy benefits managers? Modern Healthcare examines that and other possible reactions to the suit聽鈥

Anthem's legal strike against Express Scripts Holding Co. may spur other health insurance companies to re-evaluate their contracts with pharmacy benefits managers to see if they are getting shortchanged on drug savings. It could also allow Anthem and others to consider integrating drug benefits under their own corporate umbrellas. At a minimum, observers expect more calls for transparency throughout the drug pricing process, which often is shrouded in secrecy in the name of 鈥渢rade secrets鈥 and has become one of the most divisive issues in healthcare. (Herman, 3/21)

Administration News

FDA Proposes Ban On Powdered Surgical Gloves

The Food and Drug Administration said the powder added to some latex gloves can cause breathing problems, wound inflammation and scar tissue on internal organs when used during surgery. It would only be the second time the agency banned a device on the market.

Powdered medical gloves 鈥 the kind used in surgery or to examine patients 鈥 would be ordered off the market under a new proposal by the Food and Drug Administration. That would put the gloves in an exclusive club 鈥 only one other device has been banned by the agency: prosthetic hair fibers in 1983. When an already approved device turns out to pose higher-than-expected risks, the agency usually tries to correct the problem by adding a warning to the label or changing how the device is used. But in the case of the gloves 鈥 and the hair fibers 鈥 the FDA concluded that no labeling fixes would do the trick. (McGinley, 3/21)

Federal health officials are moving to ban most surgical gloves made with powder, a feature designed to make them easier to wear, but which actually poses health risks to patients and health professionals. The Food and Drug Administration said Monday that the powder added to some latex gloves can cause breathing problems, wound inflammation, and scar tissue on internal organs when used during surgery. The agency proposed the ban Monday in a federal filing. (Perrone, 3/21)

The Food and Drug Administration proposed banning powdered surgical gloves Monday, saying the powder can carry dangerous allergens into the air. The FDA has been warning about the gloves for nearly 20 years. Powder makes the gloves easier to take on and off and absorbs sweat 鈥 but it can get into the air and even into surgical openings. (Fox, 3/21)

In other FDA news聽鈥

Abbott's recent recall of its new $30,000 heart valve repair device called the MitraClip led to an intensive educational campaign to retrain surgeons in proper implantation techniques. The speedy action will likely prevent thousands of injuries. But the voluntary action has also renewed concerns by patient safety advocates that some new devices are being thrown on the market without sufficient clinical testing or adequate training.The rapid response by Abbott and the Food and Drug Administration comes at a time when quality and safety researchers are increasingly concerned about the cascade of new medical devices and equipment being introduced into day-to-day practice. (Rubenfire and Rice, 3/21)

Federal health officials have approved a new injectable drug to treat patients who have been exposed to the deadly toxin anthrax. The Food and Drug Administration said it approved Anthim on Friday to treat inhalation anthrax, which can cause serious injury and death. The condition occurs when anthrax bacterial spores are inhaled. (3/21)

Before joining the Food and Drug Administration as a deputy commissioner in February 2015, Robert Califf, a cardiologist by training, spent most of his career running a clinical trial institute at Duke University. His expertise in clinical research was considered good preparation to lead an agency where those trials are ultimately analyzed as evidence in drug and device approvals. But with his elevation to FDA commissioner last month, he added a few new areas to his portfolio, including the agency鈥檚 $1 billion food safety mission. And while that area is outside of Califf鈥檚 traditional expertise, in a March 16 interview with CQ he described the many parallels he sees between food safety and the regulation of medical products. (Siddons, 3/21)

Campaign 2016

Health Care Industry Braces For Its Enemy No. 1: The Republican Front-Runners

With both Donald Trump and Ted Cruz promising to repeal the health law, hospitals, insurers, consulting firms and others whose businesses have boomed see headaches ahead. In other news, Hillary Clinton talks about how she would expand health care of undocumented immigrants.

The health care establishment that鈥檚 benefited from Obamacare is grappling with a disturbing truth. Either of the two leading candidates for the GOP presidential nomination could be the industry鈥檚 Enemy No. 1 鈥 for totally different reasons. (Pradhan and Demko, 3/21)

Hillary Clinton on Monday night explained the way she would at least partially expand access to Obamacare to undocumented immigrants. "There are two steps here," the Democratic presidential front-runner said in a televised town hall on CNN. "If someone can afford to pay for an insurance policy off the exchanges that were set up under the Affordable Care Act, I support that." (Condon, 3/21)

Public Health

One City's Plan To Fight Its Heroin Crisis: Supervised Injection Centers

The mayor knew the idea would spark backlash, but he also knew he had to do something drastic to battle the crisis that held his city in its grip. Meanwhile, STAT offers an interactive graph that shows how the epidemic has spiked in the past 15 years.

Even Svante L. Myrick, the mayor of [Ithaca, New York], thought the proposal sounded a little crazy, despite the fact that it was put forth by a committee he appointed. The plan called for establishing a site where people could legally shoot heroin 鈥 something that exists nowhere else in the United States. 鈥淗eroin is bad, and injecting heroin is bad, so how could supervised heroin injection be a good thing?鈥 Mr. Myrick, a Democrat, said. But he also knew he had to do something drastic to confront the scourge of heroin in his city in central New York. (Foderado, 3/22)

Earlier KHN coverage:聽 (Bebinger, 3/3)

A new STAT-Harvard poll finds that 41 percent of Americans know someone who has abused prescription painkillers in the last five years 鈥 and 1 in 12 say they know someone who died from an overdose. (Bronshtein, 3/22)

Elsewhere,聽a measure before Connecticut lawmakers would limit prescriptions, and Kansas gets federal grants to help expand its opioid addiction聽treatment offerings聽鈥

New prescriptions for opioid medication to address non-chronic pain would be limited to a seven-day supply under a proposal state legislators from both parties are backing 鈥 one of several bills aimed at curbing a drug epidemic that killed, on average, more than one person per day in Connecticut last year. (Levin Becker, 3/21)

More than $1.4 million in federal grants will help four Kansas health centers enhance their treatment programs for opioid abuse. In announcing the grants earlier this month, the U.S. Department of Health and Human Services said abuse of and addiction to opioids, such as heroin and prescription painkillers, 鈥渋s a serious and increasing public health problem.鈥 (Hart, 3/21)

Meanwhile, KHN looks at the debate around聽the release of patient records for alcohol and drug abuse treatment聽鈥

What鈥檚 more harmful to patients being treated for drug or alcohol abuse: risking their health by keeping other medical providers in the dark about their substance abuse treatment? Or risking their jobs, homes and child custody arrangements by allowing potentially damaging treatment details to be electronically shared among an array of medical providers? Advocates have painted the possible patient outcomes in starkly different terms as they consider the federal government鈥檚 recently proposed update to guidelines that govern the release of patient records for alcohol and drug abuse treatment. (Andrews, 3/22)

Sickle Cell Adults Find Health Care System Not Ready For Them

Before advances in care, patients with sickle cell anemia died in childhood or adolescence. But now that they are living to make the switch from pediatric to adult care, they're finding an inadequate supply of physicians who have expertise with the condition and a dearth of infusion centers that could help reduce hospitalizations and the lengths of crises, among other struggles.

When Janoi Burgess was a child, he thought doctor appointments were fun. But when he turned 21, the South Florida resident could no longer go to his pediatric specialist. Instead, he 鈥渂ounced around鈥 to various adult primary care doctors, none of whom seemed well-versed in the details of his condition. When he had a painful sickle cell crisis two years later, his only choice was to go to a hospital emergency department, where, he says, he waited three hours for pain medication. Burgess鈥 experience is not unusual among many adults with sickle cell anemia, which affects up to 100,000 people in the United States, most of them African Americans. For many years, most people with sickle cell died in childhood or adolescence, and the condition remained in the province of pediatrics. During the past two decades, advances in routine care have allowed many people to live into middle age and beyond. (Marcus, 3/22)

In other public health news聽鈥

One winter week, my 7-year-old twins started with stuffed noses and sore throats. We did what parents typically do: We broke out the throat spray, the cough syrup, the decongestant. Instead of going away, the problem got worse. The pediatrician did a test for strep, which came back negative. After that, he just shrugged and told us it was a viral infection, probably stemming from an allergy to dust and pollen. (Cunha, 3/21)

A growing number of states are weighing whether to legalize marijuana to treat post-traumatic stress disorder. But for many veterans, the debate is already over. They're increasingly using cannabis even though it remains illegal in most states and is unapproved by the Department of Veterans Affairs because major studies have yet to show it is effective against PTSD. (3/22)

Houston Health Officials' Message: Zika Virus Is Coming, We'd Better Get Ready

Several elements -- its location as a "gateway city," the fact that it is home to the mosquitoes that carry Zika and its economic struggles -- combine to create a fertile ground for the virus. In other news, during President Barack Obama's historic visit with Cuban President Raul Castro, the two leaders discussed the countries' collaboration over Zika research, among other health care related topics.

On March 10, Rep. Sheila Jackson Lee held a news conference at the Good Neighbor Healthcare Center in the part of Houston she represents. "What we're doing here today is having an intense briefing on the Zika virus with health professionals, working with the mayor and the city of Houston, the state and the country, to formulate the kind of partnership that can respond immediately," said Jackson Lee, a Democrat. Then she stepped aside, as the mayor, the assembled health officials and civic minded clergy all delivered a version of the same message: The Zika virus is coming to Houston, and we'd better get ready. (Palca, 3/21)

President Barack Obama and Cuban President Ra煤l Castro held a joint press conference Havana Monday, marking the first visit by a U.S. president to Cuba in nearly 90 years. Their remarks focused on U.S.-Cuban relationships, though Obama praised Cuban doctors for their work in West Africa fighting Ebola and touted the how Cuban and American physicians worked together both there and in Haiti to fight Cholera during his remarks. He also pointed to how researchers in both countries may work together against the spreading of viruses and diseases. (McIntire, 3/21)

Even With Universal Lead Testing Some Baltimore Children Fall Through The Cracks

Despite an 86 percent decrease in lead poisoning cases since 2002, hundreds of Baltimore children are still poisoned every year. The city is taking more steps, but some say its not enough. In other news, Michigan Gov. Rick Snyder releases goals to help Flint recover from its lead crisis.

When a doctor found that Kenicer Carty's 1-year-old daughter had a dangerously high level of lead last year, it triggered an alarm of sorts. Officials sent an inspector to Carty's 1930 row house in northeast Baltimore. It turned out that every single window had hazardous chipping lead paint. ... Baltimore banned lead paint in 1950, nearly 30 years before the rest of the country. Grassroots activism emerged early here, with a volunteer effort among parents in 1986. That became the national Coalition to End Childhood Lead Poisoning, which spawned the Green and Healthy Homes Initiative. Baltimore has seen a dramatic decline in cases of lead poisoning, down 86 percent since 2002. But despite these decades of effort, hundreds of Baltimore children are still poisoned every year. (Ludden, 3/21)

Michigan's government on Monday released goals to help the city of Flint recover from a health crisis caused by the lead contamination of its drinking water. The plan, involving several state agencies, is meant to address water infrastructure shortcomings and the health of children who have tested for high lead levels in their blood, expand support in Flint schools and boost economic development for the city, Governor Rick Snyder said. (3/22)

Gov. Rick Snyder said Monday he wants Flint and the entire state to have more stringent lead-level regulations than what federal rules require, following the city鈥檚 water contamination crisis. In the long term, Michigan will comply with a 鈥渕uch higher standard,鈥 according to a state document laying out the next steps in Flint in four areas 鈥 water supply and infrastructure, health and human services, education, and economic development. (Eggert, 3/21)

State Watch

Ala. Governor Threatens Budget Veto Over Medicaid Appropriation

Gov. Robert Bentley says the budget, which lawmakers are expected to approve this weekend, falls far short of the amount necessary for the program. Meanwhile, Bentley told health workers at a Monroe Country hospital that a lottery might be the most realistic option to raise adequate funding for the health insurance program for low-income people. And, in Mississippi, the Senate approved a bill calling for regular audits of the state's electronic records system and program beneficiaries.

Alabama Gov. Robert Bentley said Monday that he will veto a general fund budget lawmakers are expected to approve this week over what he called an "unacceptable" appropriation for Medicaid. The Alabama Senate on Tuesday is expected to give final approval to a budget that is $85 million short of the amount Bentley says is needed to adequately fund the state's Medicaid program. "Legislators just don't understand it, and I don't think they want to," Bentley said during a press conference in Monroeville to highlight problems with rural broadband and health care access. (3/21)

Gov. Robert Bentley told doctors and other employees at Monroe County Hospital today that a lottery is probably the only realistic option for raising more money for Medicaid. The governor said he thought voters would approve a lottery overwhelmingly if it made its way to the ballot, by "70 percent." ... The governor said the 94-bed hospital is an example of a strong and vital rural facility that could take a hit if Medicaid's funding request is not met. The Medicaid Agency has said it would have to cut payments to doctors and trim optional programs. Bentley said rural doctors would be affected. (Cason, 3/21)

The Mississippi Senate passed a narrower version of a bill Monday that would require an electronic records system for Medicaid and a regular audit of Medicaid recipients. House Bill 1116 would hire an outside company to build a computerized record of Medicaid recipients鈥 information. The Senate version, approved Monday by a committee, requires that Medicaid officials periodically verify recipients鈥 financial information and residency to determine if they鈥檙e still eligible for aid. Any recipient found to have left Mississippi would stop getting aid within three months after they left. (Benchaabane, 3/21)

Mass. Community Hospitals Struggle With Low Payments

In other Massachusetts hospital news, a heated debate is taking place in the statehouse regarding how hospitals can press insurers to cover virtual visits. Elsewhere, Marketplace reports that hospital mergers within state borders may drive up treatment prices and the CEO of Chicago's Presence has diagnosed the hospital chain's financial ills. In Dallas, Parkland Hospital is experimenting with how patients with complex conditions can care for themselves at home.

Massachusetts community hospitals are losing business to larger urban teaching hospitals, a trend that threatens to undermine the state鈥檚 campaign to curb health care spending. In its first report on the issue, the state鈥檚 Health Policy Commission said Monday that community hospitals are being squeezed by lower payments from insurers and the choice of many patients to be treated at big Boston hospitals, even for routine medical care. (Dayal McCluksey, 3/21)

When is a video chat with a doctor equivalent to an office visit? State legislators across the US have been grappling with that question as hospitals press for insurance companies to fully cover virtual appointments 鈥 and insurers balk at those demands. But the political wrangling, including a heated debate now at the Massachusetts statehouse, hasn鈥檛 stopped the growth of telemedicine. (Bailey, 3/22)

There鈥檚 a growing 鈥 and troubling 鈥 body of evidence that hospital mergers lead to higher prices. In other words, insurers, employers 鈥 we all tend to pay more for C-sections, heart surgery and hip replacements as hospitals get bigger and more powerful. (Gorenstein, 3/21)

Michael Englehart, president and CEO of Presence Health, is not a doctor. But he's caring for a sick patient 鈥 his hospital chain. In an unusually frank discussion Wednesday, Englehart said he's surprised at what he has uncovered since starting Oct. 1. His diagnosis is ugly. Billing and collection failures. Weak internal accounting controls. Outdated technology. (Sachdev, 3/18)

The Holy Grail in health care is finding a way to cut costs and improve outcomes. Researchers at Parkland Hospital in Dallas say they鈥檝e uncovered a way to do both 鈥 so that patients who typically have to stay in the hospital for more than a month can go home and care for themselves. (Silverman, 3/21)

State Highlights: FamilyCare Signals Willingness To Settle Months Long Dispute With Oregon Health Authority; Kansas Lawmakers Move To Protect Tobacco Settlement Funds

News outlets report on health issues in Oregon, Kansas, California, Wisconsin, Colorado and Puerto Rico.

A coordinated care organization embroiled in a months-long dispute with the Oregon Health Authority issued a news release on Monday saying it is ready to settle. The statement by FamilyCare followed dueling news releases on Friday, stemming from a public threat by the state to terminate its relationship with the organization. (Terry, 3/21)

The Kansas Legislature moved Monday toward ratifying agreements with American Indian tribes meant to ensure the state continues to receive money from a legal settlement with major tobacco companies. The 1998 multistate settlement on tobacco-related Medicaid costs provides roughly $60 million a year that Kansas uses to fund children鈥檚 programs. One of the stipulations of the settlement is that Kansas enforce taxes and regulations on small-scale tobacco manufacturers who did not join the settlement so they aren鈥檛 able to grab significant market share from the large manufacturers who did. (Marso, 3/21)

They know California's landmark right-to-die law, set to kick in June 9, is for the terminally ill. And they support that effort. But what most of the dozen people at a town hall meeting on Monday in Morgan Hill wanted to know is why their friends and relatives suffering from Alzheimer's or dementia cannot take advantage of the law. (Seipel, 3/21)

Your health insurance company denied your treatment. Or it won鈥檛 provide the prescription drug you need. Or you鈥檝e got a billing dispute. Or your longtime doctor was dropped from your health plan. When you鈥檝e got a complaint about health care, where are you gonna go? The MyPatientRights.org site is one starting point. (Buck, 3/21)

The Senate on Monday advanced a bill that would forbid hospitals from withholding life-sustaining treatment from children without permission from a parent or guardian. Senate Bill 437 would prohibit a physician or health care facility from withholding life-sustaining treatment or placing a do-not-resuscitate order on someone younger than 18 without parental permission. If the parents disagreed, they could petition a district court to settle the case, with the presumption in favor of continuing treatment. (Hart, 3/21)

Frustrated with last week's failure of a bill to help children with chronic seizures, the head of the state Assembly said he's going to push the proposal as soon as possible next session. (Stein, 3/21)

A mentally ill prisoner who was found naked and dead in a Colorado jail cell two years ago was denied his psychiatric medication and physically abused by staff at the lock-up, lawyers for the inmate's family said Friday. John Patrick Walter died in the Fremont County jail in April 2014, according to a wrongful death lawsuit filed by his family in U.S. District Court in Denver on Thursday. (3/18)

A Puerto Rico doctor found guilty in a multimillion-dollar federal fraud case has been ordered to pay a U.S. insurance company more than $2 million in restitution. The U.S. Attorney鈥檚 Office said Monday that Dr. Anibal Pagan Romero also was sentenced to 10 years in prison as part of a case in which hundreds of other people were prosecuted. (3/21)

The campaign to qualify a November constitutional amendment requiring parental notification for abortions ended last week, the latest in a string of ballot failures for the effort鈥檚 sponsors. (Miller, 3/21)

Editorials And Opinions

Viewpoints: Drug Cost Control Plans Based On Misunderstanding; Valeant In The Headlines Again

A selection of opinions from around the country.

President Obama鈥檚 latest budget includes proposals鈥攅choed or one-upped on the presidential-campaign trail by Bernie Sanders and Hillary Clinton鈥攖hat would require pharmaceutical companies to release data on the cost of research and development (R&D) and the extent of discounts offered to insurers for each drug brought to market. Yet the key numbers already are disclosed freely鈥攁nd we know how to get better value from medicines and improve their affordability to patients. (John C. Lechleiter, 3/21)

Federal officials poked a medical hornet鈥檚 nest recently with an ambitious attempt to do what many American taxpayers 鈥 and patients 鈥 demand: tame rising prescription-drug costs in Medicare. Officials at the Centers for Medicare and Medicaid Services rolled out a proposal to test new ways of reimbursing doctors who administer drugs in their offices and in hospital outpatient departments. These drugs include cancer medications, antibiotics and certain eye care treatments 鈥 about $19 billion a year in Medicare spending. (3/22)

The future looks bright for Ohioans with disabilities. Thanks to the Ohio Achieving a Better Life Experience (ABLE) Act, individuals with disabilities have the ability to save money tax-free to pay for expenses related to their disability. (Sara Hart Weir and Chip Gerhardt, 3/21)

The call came right after lunchtime. 鈥淚鈥檝e fallen again.鈥 My great-aunt Emma sounded frustrated and frail. Her arm hurt too much to move, she said, let alone pick up the bag of groceries she鈥檇 just bought. It might be broken. Could I come pick her up and drive her to the emergency room? ... Unfortunately, our medical system caters to extremes, taking care of you most quickly if you are critically ill, covering you financially only if you鈥檙e destitute. Emma鈥檚 X-rays revealed a clean break in her upper arm 鈥 they put her in a sling and sent her home with ibuprofen 鈥 but what happened after showed me how difficult it is for the elderly and their families to navigate health care in this country. (A.K. Whitney, 3/22)

The crazy news out of Valeant continued this morning with a wild press release announcing, among other things, that Chief Executive Officer J. Michael Pearson is going to leave, but not yet, and that the board asked former Chief Financial Officer Howard Schiller to resign from the board, "but Mr. Schiller has not done so." (Matt Levine, 3/21)

It鈥檚 easy to find fault with ads for prescription drugs, as STAT recently did. Few people get to hear about the good that can come from these ads. For some people 鈥 including me 鈥 they provide the information and motivation to take life-saving action. (Deborah Clark Dushane, 3/21)

Ulcerative colitis is a chronic, painful disease that affects 1.6 million people across the United States. In 2008, I became one of them. I鈥檒l be the first to admit that living with this illness has not been easy. Symptoms include nausea, headaches, intestinal cramps, vomiting, uncontrollable diarrhea, intestinal bleeding, joint pain and insomnia. Each day brings a new set of challenges. (Cheryl Portman, 3/21)

When I first answered God鈥檚 call to join the Little Sisters of the Poor and vow myself to Him and to the care of the elderly, I never dreamed of the happiness I would experience in serving, living with and caring for the aging poor until God calls them to Himself. I also never thought one day, I would be walking up the white marble steps of the Supreme Court to attend a legal proceeding in which the high court will decide whether the government can force my order to help offer health care services that violate my Catholic faith and that are already available through existing government exchanges. (Loraine Maguire, 3/22)

When California lawmakers voted this month to raise the legal age to buy cigarettes from 18 to 21, they joined Hawaii and more than 100 localities in seeking a new way to prevent vulnerable teenagers from getting hooked. Almost everyone who smokes started by age 18, research shows. (3/21)

Should you have to be 21 to buy beer and cigarettes, but 18 to smoke marijuana? If a measure that passed the California Legislature is signed into law, that鈥檚 exactly what will happen. The measure would raise the legal age to buy cigarettes to 21, the same as it is for alcohol. (Mike Gatto, 3/21)

Without guidance, we end up with a tragic cycle that just won鈥檛 go away: Thousands of men and women go in for routine treatments 鈥 treatments that don鈥檛 require more than a small dose of pain medication, for just a few days 鈥 and they leave with far more or far stronger medicine than they need. They become addicted, or they give the extra pills to a friend or family member who misuses the medication, or they leave them unguarded in a medicine cabinet for a child to take. (Kirsten Gillibrand and Shelly Moore Capito, 3/21)

The waiting room is full tonight. People fidget in their chairs. Some sleep. Most wear blank expressions. They've done this before. Some know the providers by name. "A true addict will wait as long as it takes to get a prescription," remarks a doctor. Some of tonight's patients will wait 14 hours to be seen by a provider. (Emily and Connor Narciso, 3/19)

President Obama recently proposed a $1.8 billion emergency funding package to assist federal agencies in managing the Zika outbreak abroad and preventing it from spreading domestically. Stopping or slowing this mosquito-borne disease, which has now been reported in more than 20 Latin American countries and 20 U.S. states, would seem to be a non-partisan priority 鈥 if not for humanitarian reasons, then for unadulterated self-interest. Mosquitoes don't respect international borders and when they seek out bloodmeals they don't discriminate on the basis of party affiliation. Nevertheless, the request for Zika funding inexplicably ran into trouble almost immediately. (May Berenbaum, 3/21)

The Ohio Department of Health will be able ease a lot of minds 鈥 and more importantly, better protect the health of others 鈥 by being able to test for the Zika virus at its Reynoldsburg lab, greatly cutting the time worried Ohioans must wait for results. Those who feared they had contracted the mosquito-borne virus previously waited an average of 19.5 days as blood specimens were sent to a federal lab. Now, results should be reported within 48 hours. (3/22)

The CDC says its policy is to identify the providers of contaminated food only when 鈥渨e perceive there are actions people can take to protect themselves.鈥 In this case, a spokeswoman said, the restaurant chain stopped using the product suspected to be the cause of the illnesses, curtailing the outbreak. There was nothing else consumers could do at that point to avoid illnesses, she said. The Iowa Department of Public Health, which was aware of the outbreak, took a similar stance. Even last week, Dr. Patricia Quinlisk, the department鈥檚 medical director, refused to discuss the business involved in the outbreak with a Register reporter. She said the department鈥檚 investigations remain confidential unless the department believes disclosure is necessary to protect the public health. (3/22)

At issue is a statistical test that researchers in a wide range of disciplines, from medicine to economics, use to draw conclusions from data. Let鈥檚 say you have a pill that鈥檚 supposed to make people rich. You give it to 30 people, and they wind up 1 percent richer than a similar group that took a placebo. Before you can attribute this difference to your magic pill, you need to test your results with a narrow and dangerously subtle question: How likely would you be to get this result if your pill had no effect whatsoever? If this probability, or so-called p-value, is less than a stated threshold -- often set at 5 percent -- the result is deemed "statistically significant." (3/21)

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