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Morning Briefing

Summaries of health policy coverage from major news organizations

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Wednesday, Mar 2 2016

麻豆女优 Health News Original Stories 4

  • Leading Scope Maker Olympus Agrees To Hefty Settlement In Kickback Cases
  • Medicine鈥檚 Power Couples: A Challenge In Recruiting Physicians To Rural Areas
  • UCLA Freshmen Learn About Growing Old
  • The Stethoscope: Timeless Tool Or Outdated Relic?

Supreme Court 2

  • Supreme Court To Hear Oral Arguments In Texas Abortion Case
  • High Court Rules, 6-2, Against Vermont's Health Data Law

Campaign 2016 1

  • Trump, Clinton Super Tuesday Victories Solidify Front-Runner Statuses, But Rivals Hold On

Marketplace 1

  • Scope Maker Olympus To Settle Federal Kickback Investigation For $646 Million

Health Law 1

  • Alaska Judge Rejects Suit Challenging Governor's Implementation Of Medicaid Expansion

Administration News 1

  • FDA Head Califf Lays Out Efforts To Battle Opioid Abuse

Public Health 2

  • Alzheimer's Association Ruptures Over 'Care vs. Cure' Friction, Extravagant Spending
  • Sexual Transmission Of Zika Virus, Thought To Have Been Rare, Raising Concerns As More Cases Emerge

State Watch 3

  • Gov. Brown Signs Law To Expand Tax On California's Managed Care Insurers
  • N.C. Officials Release Details Of Plan To Revamp Medicaid
  • State Highlights: Mass. General Struggles With Overcrowding; N.H. Officials Monitor Pediatric Cancer Cluster

Editorials And Opinions 1

  • Viewpoints: The Health Law's 'Awkward Place'; What The White House Told Hillary Clinton About Obamacare

From 麻豆女优 Health News - Latest Stories:

麻豆女优 Health News Original Stories

Leading Scope Maker Olympus Agrees To Hefty Settlement In Kickback Cases

The company will pay $646 million to end civil and criminal probes. Olympus鈥 leaders acknowledge responsibility for 鈥榩ast conduct鈥 they say was inconsistent with the firm鈥檚 values. ( Chad Terhune , 3/2 )

Medicine鈥檚 Power Couples: A Challenge In Recruiting Physicians To Rural Areas

A research letter published in JAMA suggests that physicians increasingly marry people who match them in terms of educational levels and career pursuits, making it more difficult to attract them to small-town practices. ( Shefali Luthra , 3/1 )

UCLA Freshmen Learn About Growing Old

A UCLA course on aging teaches students about the physical, emotional and financial realities of growing old. Professors hope they will consider careers that serve the elderly. ( Anna Gorman , 3/2 )

The Stethoscope: Timeless Tool Or Outdated Relic?

Why is a 200-year-old icon of the medical field still in wide use in the digital age? Some say modern tools are more informative and worth the extra cost, but the stethoscope has staunch defenders. ( Taunya English, WHYY , 3/2 )

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Summaries Of The News:

Supreme Court

Supreme Court To Hear Oral Arguments In Texas Abortion Case

Whole Woman鈥檚 Health v. Hellerstedt goes before the high court on Wednesday. It is the first major abortion case the court has heard in almost a decade.

The Supreme Court on Wednesday will hear its first major abortion case in almost a decade, one that has the potential to revise constitutional standards and to affect millions of women. Justice Antonin Scalia鈥檚 death last month may have muted the prospect of truly bold action, but even a 4-to-4 tie would have enormous consequences because it would leave in place an appeals court decision that could drive down the number of abortion clinics in Texas to about 10, from roughly 40. (Liptak, 3/2)

The clinics want the court to roll back regulations requiring doctors who perform abortions to have admitting privileges at nearby hospitals and forcing clinics to meet standards for outpatient or ambulatory surgical centers. Like other states, mainly in the South, Texas says it passed the measure to protect women's health. Justice Anthony Kennedy probably holds the deciding vote on the eight-justice court. He already joined with the court's four liberal members to block some restrictions from taking effect while the case is on appeal. (3/2)

Texas says the clinic requirements are designed to protect the health of women, while other provisions in the law, such as barring abortions after 20 weeks of gestation, are intended to limit abortions, said state Rep. Jeff Leach, a Plano Republican and one of the legislation鈥檚 co-sponsors. 鈥淲e in Texas are always looking for ways to be vigilant about protecting women鈥檚 health and protecting innocent life,鈥 Mr. Leach said. 鈥淚t鈥檚 a win-win for Texas.鈥 Amy Hagstrom Miller, owner of Whole Woman鈥檚 Health LLC, a chain of abortion clinics that is the lead plaintiff in Wednesday鈥檚 case, disagrees with the women鈥檚-health claims. 鈥淭he standards are just based on politics. They have nothing to do with health and safety,鈥 she said. 鈥淎bortion takes anywhere from five to 10 minutes, there鈥檚 no incision, there鈥檚 no anesthesia,鈥 she said, adding that she thinks there are no procedures to justify the state鈥檚 outpatient surgery center standards. (Bravin, 3/2)

Lawyers for the state of Texas are making an unusual argument in a closely watched abortion case set to go before the U.S. Supreme Court on Wednesday: A law that placed new restrictions on clinics providing abortions didn't have much of an impact. Abortion providers dubbed the measure "the Texas clinic shutdown law." In arguments challenging it, they point out that 22 of 41 clinics in Texas have closed since it was passed in 2013. But Texas Solicitor General Scott Keller takes issue with those numbers, saying the abortion providers have failed to show that the law was the only cause of all the closures. (Hurley, 3/1)

So why did this case go to the Supreme Court? Abortion rights groups do not consider the Supreme Court a friendly environment. But the law鈥檚 full implementation would have such an impact in the nation鈥檚 second-largest state that they felt they had no choice but to ask the Supreme Court for a ruling. And Nancy Northup, president of the Center for Reproductive Rights, said a decision from the high court was inevitable. 鈥淭he cases just keep coming,鈥 she said. (Barnes, 3/2)

The current legal challenge to the Texas abortion law, which was passed by the Republican-led Legislature in 2013, has been in court for almost two years. In April 2014, abortion providers filed the lawsuit challenging HB 2鈥檚 ambulatory surgical requirement and requesting an exemption from the admitting privileges provision for Whole Woman鈥檚 Health in McAllen and Reproductive Services in El Paso. The case went to trial that summer, and U.S. District Judge Lee Yeakel of Austin struck down the ASC requirement two days before it was set to go into effect. He also put enforcement of the admitting privileges provision on hold. The U.S. Supreme Court first intervened in the case in October 2014 to delay implementation of the ASC requirement and exempt the border clinics from the admitting privileges requirement. (Ura, 3/2)

Scalia's death dramatically limited the possible outcomes. Given the current makeup of the court, if Texas wins, it most likely would be a muted victory on a 4-4 vote. That would apply only to Texas and two other southern states. And it would leave unanswered questions about abortion regulations 鈥 which in some places, like Texas, led to clinic closures 鈥 in the rest of the nation. "Beforehand, there was never much of a thought about a tie leaving us without a decision that governs the country," said Jennifer Dalven, director of the American Civil Liberties Union's Reproductive Freedom Project. "That's a possibility now." (Haberkorn, 3/2)

The young woman lay on the exam table, waiting for her abortion. She expected pain. Tears. The grip of regret. But the dimly lit room smelled of lavender, and the nurse was asking about the butterfly tattoo on her right wrist. 鈥淚t鈥檚 for my daughter,鈥 the woman replied. 鈥淢y butterfly.鈥 She was 28, a single mother of three, her youngest 10 months old. She lived with her parents and was studying to become a medical assistant. She could not afford this procedure; her Catholic grandmother had slipped her the $440. She didn鈥檛 want to bring another child into poverty just as she was climbing out. That was how she wound up at Whole Woman鈥檚 Health of McAllen. The debate over abortion often involves sweeping abstractions. But what happens inside this clinic 鈥 and just beyond its walls 鈥 illustrates how abortion is lived in America, 43 years after Roe v. Wade. (Paquette and Somashekhar, 3/1)

Meanwhile, a special House committee聽holds its first hearing on the investigation into fetal tissue donation聽鈥

Republicans leading the special House panel investigating fetal tissue procurement and research practices are set to aggressively question the morality and necessity of that research when the panel convenes its first hearing Wednesday. The Select Investigative Panel, created by Republican leaders last year following the release of undercover videos produced by anti-abortion activists, will gavel to order in an underground Capitol hearing room while, just across the street, the Supreme Court begins hearing arguments in the most closely watched abortion case in 24 years. (DeBonis, 3/2)

High Court Rules, 6-2, Against Vermont's Health Data Law

Justice Anthony Kennedy, writing for the court in one of the first cases since Antonin Scalia's death, says that the law, which requires insurance companies to provide state officials with health care data, could impose a major financial burden on health care providers.

The Supreme Court says state officials can't force certain health insurers to turn over reams of data revealing how much they pay for medical claims. The justices ruled 6-2 that efforts by Vermont and at least 17 other states to gather and analyze the data conflict with federal law covering reporting requirements for employer health plans. The case involves Liberty Mutual Insurance Co., which operates a self-insured health plan for its workers and refused to turn its data over to Vermont. (3/1)

The Supreme Court on Tuesday quashed state efforts to gather health-care data from insurance plans, ruling that such reporting requirements run afoul of federal laws regulating employee benefits. The case came from Vermont, where a 2005 law mandates that larger health insurance plans report 鈥渋nformation relating to heath care costs, prices, quality, utilization or resources required鈥 to a state database. (Bravin, 3/1)

In a ruling that could have reverberations for a Connecticut health reform effort, the U.S. Supreme Court ruled Tuesday that certain health plans could not be required by a state to disclose data for use in a health care claims database. The court ruled 6-2 in the case, Gobeille v. Liberty Mutual Insurance Company, which centered on whether health plans that are not governed by state law can nonetheless be required by a state to report data to a so-called all-payer claims database. The case centered on Vermont's law and database. (Levin Becker, 3/1)

The Supreme Court split, 6-2, on Tuesday in the first cases decided since the death last month of Justice Antonin Scalia. In both cases, the court's four conservative justices voted together and picked up the votes of two of the Democratic-appointed justices, while the other two Democratic appointees dissented. In the second case, the court ruled that federal law overrules a Vermont statute that requires insurance companies to report health-claims data to the state. Justice Anthony Kennedy wrote the majority opinion, which Justice Clarence Thomas joined with some reservations. Sotomayor and Kagan dissented. (Gerstein, 3/1)

Campaign 2016

Trump, Clinton Super Tuesday Victories Solidify Front-Runner Statuses, But Rivals Hold On

Both Hillary Clinton and Donald Trump nabbed at least 7 states, with Sen. Bernie Sanders holding on to 4, including his home state of Vermont, and Sens. Ted Cruz and Marco Rubio taking 3 and 1, respectively. The vast majority of voters did not rank health care as the most important issue.

Super Tuesday was a win for the front-runners in both parties on a pivotal night in which healthcare policy seemed to play a minor role. ... The percentage of Democrats ranking healthcare as the most important issue for them Tuesday ranged from 16% in Massachusetts to 26% in Tennessee. Those voters strongly went with Clinton in the states where she came out on top, according to exit polls. More than two-third's of Clinton's voters on Tuesday, according to exit polls, said in general they'd rather stick with President Barack Obama's policies than move in a more liberal direction. (Muchmore, 3/1)

Donald J. Trump won sweeping victories across the South and in New England on Tuesday, a show of strength in the Republican primary campaign that underscored the breadth of his appeal and helped him begin to amass a wide delegate advantage despite growing resistance to his candidacy among party leaders. Mr. Trump鈥檚 political coalition 鈥 with his lopsided victories in Alabama, Georgia, Massachusetts and Tennessee, and narrower ones in Arkansas, Vermont and Virginia 鈥 appears to have transcended the regional and ideological divisions that have shaped the Republican Party in recent years. (Burns and Martin, 3/1)

Hillary Clinton took full command of the Democratic presidential race on Tuesday as she rolled to major victories over Bernie Sanders in Texas, Virginia and across the South and proved for the first time that she could build a national coalition of racially diverse voters that would be crucial in the November election. Based on results from Democratic primaries and caucuses in 11 states, Mrs. Clinton succeeded in containing Mr. Sanders to states he was expected to win, like Vermont and Oklahoma, and overpowering him in predominantly black and Hispanic areas that were rich in delegates needed for the Democratic nomination. (Healy and Chozick, 3/1)

New York businessman Donald Trump won Republican primaries Tuesday from the Deep South to New England, but Texas Sen. Ted Cruz took his home state, Oklahoma and Alaska, ensuring that the race for the GOP nomination will stretch into the spring. Mr. Trump鈥檚 victories Tuesday are all the more impressive because, for the first time in the race, he faced concerted attacks from his chief Republican rivals. He continues to defy the laws of presidential politics, courting controversies that few other politicians could survive. ... In the race for the Democratic nominee, front-runner Mrs. Clinton swept the delegate-rich states of Massachusetts and Texas, as well as key Southern states. Her rival, Bernie Sanders, won in four states鈥擬innesota, Vermont, Oklahoma and Colorado鈥攚hich offered much less of a delegate haul. (O'Connor and Hook, 3/2)

Donald Trump on Tuesday night once again sought to strike a softer tone on Planned Parenthood, paying tribute to its "very good work for millions of women" while also keeping up a threat to cut off federal funding to the organization if it continues to offer abortion services. (Krieg, 3/2)

Marketplace

Scope Maker Olympus To Settle Federal Kickback Investigation For $646 Million

The company agreed to the payment to end civil and criminal probes of charges that it bribed doctors and hospitals to buy Olympus endoscopes and devices. A corporate whistleblower may collect $51 million from the settlement.

Medical device maker Olympus Corp., already under federal investigation for its role in superbug outbreaks, has agreed to pay $646 million to resolve criminal and civil probes into illegal kickbacks and bribes to doctors and hospitals. Federal prosecutors said Tuesday that the company鈥檚 settlement is the largest ever for violations of the U.S. Anti-Kickback Statute. A portion of the company鈥檚 payout, $22.8 million, will resolve similar bribery allegations in Latin America. (Terhune, 3/1)

The settlements resolve charges brought against the company by the U.S. attorney鈥檚 office for the District of New Jersey. The government alleged the U.S. bribes caused health-care providers to bill government health-care programs in violation of the False Claims Act. 鈥淭here was a relatively widespread pattern of the company using various forms of financial benefits鈥攃ash, trips, consulting agreements鈥攖o induce doctors, hospitals and other health-care providers to buy their stuff,鈥 Paul J. Fishman, the U.S. attorney for New Jersey, told The Wall Street Journal. (Walker, 3/1)

Olympus Corp., the nation鈥檚 largest distributor of endoscopes and related equipment, will pay $646 million to resolve separate criminal and civil investigations into kickbacks and foreign bribery, company and federal officials announced Tuesday. Olympus said its U.S. unit will pay $623.2 million plus interest to end the kickback case in New Jersey. The company also agreed to a corporate-integrity agreement and the appointment of a monitor. (3/1)

After Olympus Corp. paid to fly three doctors from a prominent California hospital to Japan for a weeklong vacation, one of the physicians thanked the company for providing them with 鈥渟o much extra entertainment that we did not expect.鈥 The expense-paid trip was just one of the dozens of illegal kickbacks that the Japanese maker of endoscopes paid to American doctors and hospitals for at least five years as it sought to increase sales in its most lucrative market, according to a criminal complaint federal prosecutors released Tuesday. (Peterson, 3/1)

A corporate whistleblower is set to collect $51 million 鈥 his share of a massive settlement with Olympus America to resolve charges it gave doctors and hospitals kickbacks to order its medical equipment. (Connor, 3/1)

Health Law

Alaska Judge Rejects Suit Challenging Governor's Implementation Of Medicaid Expansion

Republican legislators who brought the suit have not yet decided whether to appeal. News outlets also report on lawmakers in Idaho suggesting Medicaid expansion could still be on the agenda and efforts in New Hampshire to find funding for that state's expansion.

A Superior Court judge dismissed the Alaska Legislature鈥檚 lawsuit to halt Gov. Bill Walker鈥檚 Medicaid expansion Tuesday. In his decision and order, Superior Court Judge Frank Pfiffner concluded that the state acted within the bounds of the law when it expanded Medicaid. Legal arguments from both sides had focused on what was required under federal law, because state law says that Alaska must comply with federal requirements. Pfiffner sided with Walker. (Andrews, 3/1)

Superior Court Judge Frank Pfiffner dismissed a challenge to Walker's authority by the Legislative Council, which is comprised of state House and Senate lawmakers. That decision can be appealed. A spokeswoman for the Senate majority said the Republican-led majority is looking over the decision and will evaluate its options. The decision came as Republicans in Alaska were participating in the state's presidential preference poll. (Bohrer, 3/1)

A modified expansion of Medicaid in Idaho still might emerge from this legislative session, but likely not without a super-majority of House Republicans signing on, House and Senate leaders told reporters Tuesday. Senate President Pro Tem Brent Hill, R-Rexburg, and House Speaker Scott Bedke, R-Oakley, took questions regarding health care discussions in the Statehouse, this year鈥檚 education funding, Senate prospects for a House-approved tax cut and the status of a seemingly stalled effort to extend state civil rights protections to the LGBT community. (Dentzer, 3/1)

House lawmakers continue to examine how New Hampshire would pay for Medicaid expansion for another two years. On Tuesday GOP leaders on the finance committee were again looking for a guarantee that if passed, private insurance rates will not increase. The Medicaid expansion proposal relies on federal dollars with the state鈥檚 insurance premium tax, with hospitals and insurance companies footing the rest of the bill. (Sutherland, 3/1)

Administration News

FDA Head Califf Lays Out Efforts To Battle Opioid Abuse

The newly confirmed Food and Drug Administration Commissioner Robert Califf says his agency can't alone solve the problem, but he pledges to support the development of harder-to-abuse painkillers, as well as encourage the safe disposal of such drugs. In other FDA news, the agency is asking the maker of Essure to conduct a new study on risks following reports of adverse effects from the sterilization device.

The Food and Drug Administration's new commissioner is pledging to fully back efforts to develop harder-to-abuse painkillers, part of a sweeping government effort to reduce deadly overdoses tied to prescription pain medications. Dr. Robert Califf told a panel of FDA advisers on Tuesday that his agency alone cannot solve the crisis of prescription drug abuse. But he pledged to do "everything possible under our authority to prevent abuse, save lives and treat dependence." (Perrone, 3/2)

In response to thousands of reports of adverse events related to Essure, an implantable sterilization device for women, the Food and Drug Administration on Monday announced that it asked the maker of the device to conduct a new clinical study on its risks. The FDA also issued new labeling guidance for the device, and released a checklist that doctors can use to discuss its risks with patients. (Siddons, 2/29)

Public Health

Alzheimer's Association Ruptures Over 'Care vs. Cure' Friction, Extravagant Spending

Prominent chapters have left the national organization over concerns including whether fundraising money should go to finding a cure or providing care for those living with the disease.

The Alzheimer鈥檚 Association, one of the country鈥檚 most powerful disease advocacy groups, is rupturing amid an escalating dispute over its priorities: raising money for a future cure versus supporting patients and families struggling with the disease right now. (Graham, 3/2)

In other public health news, classes encourage students to pursue careers working with the elderly, and new research聽looks at a prescription treatment for low libido in premenopausal women聽鈥

April Pearce is in the middle of her freshman year at UCLA, settling into life away from home for the first time. But instead of thinking about dorm food or exams, the 19-year-old is focused on something a little more abstract: old age. That鈥檚 because of a unique course Pearce is taking called Frontiers in Human Aging, designed to teach first-year college students what it means to get old 鈥 physically, emotionally and financially. In addition to teaching students about aging, the professors have another goal in mind: inspiring them to pursue careers working with the elderly. (Gorman, 3/2)

In the roughly six months since the Food & Drug Administration gave its blessing to the marketing of flibanserin, a prescription treatment for low libido in premenopausal women, the average patient taking the newly minted medication should have had three additional satisfying sexual events. She also would be four times likelier than a woman not taking the drug to suffer dizziness, four times likelier to report excessive sleepiness, and more than twice as likely to feel nauseated, says new research. (Healy, 3/2)

Sexual Transmission Of Zika Virus, Thought To Have Been Rare, Raising Concerns As More Cases Emerge

The Centers for Disease Control and Prevention is investigating more than a dozen cases where pregnant women whose only exposure to Zika was through unprotected sex have been infected.

A dozen new Zika cases are raising worries that the virus may be more easily contracted through unprotected sex than originally believed. The Centers for Disease Control and Prevention reported Friday that they鈥檙e investigating 12 cases where the women鈥檚 only known exposure to the Zika virus was through sex with a male partner who had traveled to areas where Zika was active. (Ordonez, 3/1)

A New Hampshire woman recently became infected with the Zika virus through sexual contact with a male partner who had returned from an infected area, the first case of the emerging health problem to have been found in the state. The woman is not pregnant and has recovered from the illness, said Dr. Benjamin Chan, the state epidemiologist, during a conference call Tuesday afternoon. Her partner has also recovered from his illness. (Brooks, 3/1)

State officials have confirmed the first case of Zika virus in New Hampshire. A New Hampshire woman got Zika from having sex with a partner who had traveled to a country where the virus is being transmitted by mosquitos. The state says she's now in good health. Still, officials are reminding people of Zika's potential danger to pregnant women because the virus is feared to cause birth defects. (Rodolico, 3/1)

State Watch

Gov. Brown Signs Law To Expand Tax On California's Managed Care Insurers

The package is designed to help avoid losing more than $1 billion in federal matching funds for Medi-Cal, California's Medicaid program for low-income residents.

Gov. Jerry Brown signed legislation Tuesday to expand a tax on the health insurance industry so that the state doesn鈥檛 lose $1 billion in federal funding. Under the expansion, managed-care organizations 鈥 such as Blue Shield, Cigna and Aetna 鈥 will have to pay the state tax regardless of whether they serve Medi-Cal patients. Previously, only those serving Medi-Cal patients had to pay the tax and received federal matching funds to offset it. The newly added health plans will get a break on their corporate and insurance taxes so they don鈥檛 raise patients鈥 premiums. (Gutierrez, 3/1)

Gov. Jerry Brown signed major health plan tax legislation Tuesday, the day after lawmakers passed the package as part of a bipartisan deal with Brown to preserve a major funding source for low-income healthcare and other programs. (Miller, 3/1)

Passing the tax was a top priority for Gov. Jerry Brown and Democratic legislative leaders because it will help the state avoid a cutoff of more than $1 billion in federal matching funds for Medi-Cal, the state health insurance program for low-income Californians that now covers about one-third of the state's residents. The $1.27 billion tax cleared the state Senate on a 28-11 vote and then sailed through the Assembly 61-16 with support from almost a dozen GOP lawmakers, including Assembly Republican leader Chad Mayes. (Calefati, 3/1)

N.C. Officials Release Details Of Plan To Revamp Medicaid

The plan to move Medicaid into private managed care plans must still be approved by federal officials. Also in the news, a look at the woman leading the effort to change Alabama's Medicaid system, a dispute in Colorado over a Medicaid tax and the federal government stopping reimbursements at a hospital in South Dakota.

North Carolina Medicaid leaders revealed new details Tuesday about their plans to overhaul health systems that covers more than 1.9 million people. They'll rely on commercial insurers and medical provider networks to keep patients healthier and control costs 鈥 doing what legislators and Gov. Pat McCrory already agreed upon. Meeting their first deadline set in Medicaid overhaul legislation approved last September, top officials at the Department of Health and Human Services filed a status report on the project with a General Assembly oversight committee. (Robertson, 3/1)

The effort to privatize North Carolina's Medicaid program made its first substantive deadline Tuesday, but Department of Health and Human Services officials warned lawmakers that putting the plan in place will face at least one big obstacle: presidential politics. ... President Barack Obama is in his last year in office, and as the election approaches, [DHHS Secretary Rick] Brajer said he expects work to slow on the plan. Depending on who is elected next, he said, the federal government could do anything from accepting North Carolina's plan as is to demanding major changes or scrapping it entirely. (Binker, 3/1)

Legislators were given an overview of the plan to open the state鈥檚 $13 billion Medicaid business to insurance companies and 鈥減rovider-led entities鈥 鈥 hospitals, doctor groups or other health care providers who would offer health care plans to Medicaid patients.The federal government, which pays most of the state鈥檚 Medicaid costs, must approve the plan. The legislature required the state Department of Health and Human Services to submit a proposal to the federal government by June 1. (Bonner, 3/1)

[Stephanie] Azar has been part of Alabama Medicaid for 17 years, serving as general counsel before becoming acting commissioner in May 2012. ... Aside from the political and daily managerial tasks, Azar is working on an overhaul for how the program cares for patients. And other states are watching. On Feb. 9, the federal Centers for Medicare and Medicaid Services approved a waiver that allows Alabama to create 11 regional care organizations to help Medicaid beneficiaries with primary care, behavioral health and specialty care. (Evans, 3/1)

Democratic Gov. John Hickenlooper's proposal to reclassify a Medicaid-related fee to balance the state budget and avoid taxpayer refunds is legal, Republican Attorney General Cynthia Coffman said in an opinion issued Monday. Debate over the arcane fee has dominated the legislature this year. Hickenlooper and Democrats who control the House want to remove about $750 million generated by the fee from constitutional spending limits that otherwise would require refunds. At stake, they say, is long-term investment in roads and schools in the fast-growing state. (Anderson, 3/1)

A government-run hospital on an Indian Reservation in South Dakota where federal health inspectors found serious deficiencies leading to people receiving substandard care 鈥 to the extent that the lives of emergency room patients were at risk 鈥 will no longer be able to bill the government for services provided to those eligible for Medicare and Medicaid. The Centers for Medicare and Medicaid Services notified the administration of the 35-bed hospital on the Rosebud Indian Reservation on Tuesday that the funding cutoff will take effect March 16. The move, which comes after the November findings and a follow-up inspection in February that found remaining problems, is a blow to an already-underfunded facility operated by the federal Indian Health Service. (Cano, 3/1)

State Highlights: Mass. General Struggles With Overcrowding; N.H. Officials Monitor Pediatric Cancer Cluster

News outlets report on health issues in Massachusetts, New Hampshire, Arizona, New Mexico, North Carolina, Virginia, Florida, Ohio, New York and California.

Massachusetts General Hospital is struggling with an overcrowded emergency department less than five years after it sought to fix the problem with a $500 million expansion. (Conti, 3/2)

A state health official says the state is monitoring after a study found a cluster of cases of a rare form of a pediatric cancer in southeastern New Hampshire. State Epidemiologist Dr. Benjamin Chan says they didn't find any behavioral or environmental risk factors deemed a contributor to the "small excess number of cases." (3/1)

A state Senate subcommittee considering bills that would revamp Virginia鈥檚 process for approving new medical facilities is working on a compromise bill, the panel鈥檚 chairman said Tuesday. (Smith, 3/1)

Late Monday, lawmakers released the additional payments some hospitals will receive in next year鈥檚 state budget. The plan, released at 9:30 p.m. Monday, is among the most anxiously-awaited parts of the state鈥檚 health care budget, as it included more than $1 billion in supplemental money for hospitals. Across the board, hospitals took hits owing to a $400 million reduction in the Low Income Pool, a pot of state and federal money that pays for uncompensated charity care. Among the hardest hit by the drop in LIP: the state鈥檚 safety net hospitals, which include public hospitals, specialty children鈥檚 hospitals and teaching hospitals. (Auslen, 2/29)

The former director of the Phoenix VA Health Care System 鈥 which had management problems that drew national outrage 鈥 has pleaded guilty to making false financial disclosures to the federal government about yearly gifts, prosecutors said Tuesday. Sharon Helman was accused of failing to list more than $50,000 in gifts she received from a lobbyist in 2012-14, according to authorities. (3/1)

A former behavioral health provider in Las Cruces filed a lawsuit this month against the main company that for years held the purse strings of state Medicaid dollars in New Mexico. La Frontera, in a 36-page lawsuit, alleges United Healthcare engineered a cover-up of its own failings by accusing 15 community providers across New Mexico of fraud in 2013. La Frontera is accusing United Healthcare 鈥 and its subsidiary, OptumHealth New Mexico 鈥 of fraud and misrepresentation that led to La Frontera losing millions of dollars while providing behavioral health-services in southern New Mexico, according to the lawsuit. (Soular, 2/29)

Mecklenburg County鈥檚 health director said Tuesday that a pilot program in Colorado that offered long-term contraception to teenagers and low-income women could provide benefits if started locally. Marcus Plescia, the heath director, told county commissioners that the Colorado program produced results usually not seen in health pilot programs. (Harrison, 3/1)

HealthSpan Partners will cease operations in January of 2017 following an agreement to sell its insurance business to Medical Mutual of Ohio. A HealthSpan spokesman said Tuesday afternoon that the company will wind down operations during the next year as it transitions its 105,000 individual and group customers to Medical Mutual. (Ross, 3/1)

Dr. John Armstrong's confirmation as state surgeon general was again postponed Tuesday after the Gov. Rick Scott appointee didn't have enough support in a Senate panel. But this may have been his last shot. There are no more scheduled meetings of the Ethics and Elections Committee during the legislative session. (Auslen and Bousquet, 3/1)

As warning labels go, the small salt shaker emblems that began showing up on some New York City restaurant menus recently are fairly unobtrusive, but each is supposed to carry a powerful message. If the black and white logo appears next to a dish, it means it contains more salt, by itself, than doctors recommend that a person ingest in an entire day. Getting diners to pay attention to the logos, though, is another matter. (Dobnik, 3/1)

San Francisco supervisors voted unanimously Tuesday to boost the legal age to buy tobacco products from 18 to 21, despite arguments from opponents that cities and counties cannot trump California law. San Francisco becomes the second-largest city after New York City to raise the minimum age to buy cigarettes and other tobacco products, including e-cigarettes. Hawaii and Boston also require tobacco buyers to be 21. (Har, 3/1)

Editorials And Opinions

Viewpoints: The Health Law's 'Awkward Place'; What The White House Told Hillary Clinton About Obamacare

A selection of opinions from around the country.

In any other February, the Obamacare enrollment numbers released last month would have been big news. The Department of Health and Human Services announced that 12.7 million people had chosen health-care plans in the exchanges the law set up 鈥 far more than the 10 million HHS predicted would have exchange-based insurance in 2016. The number will likely go down, as some people fail to pay their premiums; the best case, according to the Kaiser Family Foundation鈥檚 Larry Levitt, is that about a million more people will be covered in 2016 relative to last year. These figures leave the Affordable Care Act in an awkward place. (3/1)

The State Department released the last batch of Hillary Clinton鈥檚 emails on Monday, and the exercise has been instructive about her recklessness with classified material. But as a side note, we ought to memorialize what President Obama鈥檚 aides were telling Mrs. Clinton about the Affordable Care Act, which was the opposite of what their boss was telling the public. Despite her duties as top diplomat, Mrs. Clinton found time to follow ObamaCare鈥檚 progress in Congress, and she received regular updates from Neera Tanden, then a White House health staffer. Ms. Tanden is now president of the liberal Center for American Progress, Mrs. Clinton鈥檚 economic policy shop. (3/1)

Insurance companies and employers want you to ration your health care. (Chris Tomlinson, 3/1)

The AARP reported on what a lot of older Americans know and detest: prescription drug costs are skyrocketing out of their reach. Drug manufacturer price spikes have put the average cost for a year鈥檚 supply of a prescription drug at more than $11,000. (Lewis Diuguid, 3/1)

Hospital CIOs meeting in Las Vegas got comps from a former gambling casino executive. But they weren't chips, free rooms or limousine rides. It was something potentially more valuable. They were told how to use data analytics to obtain and maintain the loyalty of healthcare customers who are increasingly choosing providers based on service and value. Gary Loveman is the recently appointed executive vice president of the Healthagen health services and consumer business unit at health insurance giant Aetna. Loveman's domain includes Aetna's population health, clinical care management and consumer insight functions. (Joseph Conn, 3/1)

The Supreme Court is about to hear what court watchers have called the most important abortion rights case in a generation. Yet, Whole Woman's Health v. Hellerstedt is not actually about abortion. Rather, the case asks whether politicians can strip constitutional rights by stealth, using laws that say one thing but do another. How the justices answer that question will echo far beyond reproductive rights. (Nancy Northup, 3/1)

Today in the United States, conservative social mores are putting women鈥檚 access to safe and affordable contraception at risk. Even in 2016, there is no assurance that birth control will be accessible to all U.S. women regardless of ability to pay. In its 2014 decision in Burwell v. Hobby Lobby Stores, the Supreme Court held that closely held corporations 鈥 those in which fewer than five people own more than half of company stock 鈥 may choose to exclude contraception coverage from their employees鈥 health insurance plans created under the Affordable Care Act if the use of contraceptives violates their religious beliefs. (Heather M. Prescott, 2/25)

First, it was Flint, Michigan. Now, Jackson, Mississippi, has raised the alarm that lead levels in its drinking water may exceed public health standards. These revelations have led to finger pointing, most notably in Flint, where health officials, regulators and politicians ignored warning signs of a looming crisis. Yet this disaster has far deeper roots. Although the potential dangers have been common knowledge for a century and half, lead pipes remained a popular choice in cities until quite recently, thanks to public ignorance, bureaucratic incompetence and, above all, industry pressure. (Stephen Mihm, 3/1)

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