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Summaries Of The News:


Mylan To Bring Generic EpiPen To Market; Critics Say Move Is A Smokescreen

The generic version will cost $300, about half the price of the EpiPen-branded medication. But the company could actually end up making more in the end.

The New York Times: Mylan Tries Again To Quell Pricing Outrage By Offering Generic EpiPen
In its latest move to quell outrage over its price increases, the maker of the EpiPen has resorted to an unusual tactic — introducing a generic version of its own product. The company, Mylan, said on Monday that the generic EpiPen would be identical to the existing product, which is used to treat severe allergic reactions. But it will have a wholesale list price of $300 for a pack of two, half the price of the brand-name EpiPen. (Pollack, 8/29)

The Washington Post: Mylan To Introduce A Half-Price Generic Version Of EpiPen
Joshua Sharfstein, a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health, called it a face-saving move by the company. The generic offers a way of dropping the price of one version of the drug, while also bringing the company some benefits. It will allow Mylan to segment the market, because some people will continue to buy the brand-name product. (Johnson, 8/29)

The Wall Street Journal: Mylan To Launch Cheaper Generic EpiPen Alternative
The EpiPen price increases exploded over social media and on Capitol Hill, in part, because many children depend on the drug-injection device to reverse severe allergic reactions. Most consumers pay less than $100 out-of-pocket for EpiPen, according to Mylan. But a sizable minority are covered by high-deductible health-plans that require buyers to pay a much larger share of the drug’s full list price. (Walker, Winslow and Steele, 8/29)

NPR: Maker Of EpiPen To Sell Generic Version For Half The Price
Mylan CEO Heather Bresch has spent the past week trying to shift blame for the increased cost of the product away from Mylan and onto insurance companies. The company argued that more people have high-deductible health plans and high copayments on medications now, so they are feeling the pain of price hikes more than they would have in the past. She repeated that Monday in a statement posted on the company's website. (Kodjak, 8/29)

CNN Money: Generic EpiPen At $300 Coming Soon, As Mylan Responds To Outrage
The company didn't say why consumers would buy the more expensive branded version, but responded with a statement. "Mylan will continue to offer both -- generic and brand -- options for patients so that they can work with their healthcare provider to determine the best option for them," the company said. (Egan, 8/29)

Dallas Morning News: Drugmaker Mylan To Offer Cheaper Generic For EpiPens, But Texas Families Remain Concerned 
Families around Texas that rely on the epinephrine auto-injectors to treat life-threatening allergic reactions responded to the introduction of a new generic with muted approval. Many parents continue to hold a cynical view of Mylan’s changes, grateful for some relief but disappointed that it took a national media firestorm to cause it. “They’re doing that to help their company’s reputation, but it’s something that they should have done before,” said Maria Zhosar, a Dallas mother whose 8-year-old son Owen has severe peanut and tree nut allergies. (Lovegrove, 8/29)

St. Louis Post Dispatch: St. Louis Area Manufacturer Of EpiPens To Produce Mylan's New Generic Version 
Drugmaker Mylan NV will produce a generic version of the EpiPen after receiving unrelenting criticism over its high prices for the life-saving drug that stops allergic reactions. The company said Monday the generic version would result in cost savings of up to 50 percent, or a list price of $300 as opposed to the $600 price that caused a backlash from consumers, including parents who must buy the injectable drug for their school-age children. The money-saving generic version will be produced in the same St. Louis area facilities where the EpiPen is made. (Liss, 8/30)

PBS NewsHour: Did Outcry On Social Media Lead To Mylan’s Generic EpiPen? 
After news broke that the price of EpiPen injectors has skyrocketed, the allergy medicine’s maker, Mylan, announced its intention to offer a generic version of the product, to be sold at half the market price of the original. The New York Times’ Andrew Pollack and the University of Minnesota's Stephen Schondelmeyer talk with Gwen Ifill about the role public outcry played in the company's decision. (Pollack,Schondelmeyer and Ifill, 8/29)

Politico Pro: Mylan Generic Offer May Be A Drug Industry Trick, Critics Say
Mylan’s decision to market an authorized generic as a cheaper alternative to its branded EpiPen is yet another smokescreen to disguise the company’s drug pricing practices, which take advantage of inefficiencies and tricks built into the U.S. drug market, say critics. ... Today, the company said it would also produce an authorized generic version for sale at $300. That’s still three times the drug’s 2007 price, and some say the action will undercut efforts to get competing generics on the market. The drug in EpiPens, epinephrine, was first produced in 1904 and costs less than $1 per dose in most countries. (Karlin-Smith, 8/29)

CNBC: Generic EpiPen Drug Could Actually Make More Money For Mylan
Mylan's unusual decision to introduce an identical, generic EpiPen competitor follows a week of pressure to lower the price of its lifesaving allergy drug — but some are now questioning whether the move, designed to appear as a price-lowering measure, may in fact net Mylan more revenue than the original version. The generic version of EpiPen will have a list price of $300 for a two-pack, about half that of the branded EpiPen, Mylan said Monday. ... Out of the $608 list price, it said it nets just $274 per EpiPen 2-Pak, after rebates to pharmacy benefits managers and cuts taken by others in the chain, such as distributors and pharmacies. So if the generic has a list price of $300, and Mylan doesn't need pay out as much to the rest of the supply chain, what will the net price be of generic EpiPen? (Tirrell, 8/29)

The Wall Street Journal: Mylan’s New Generic Causes Stock Market Ripple
Mylan isn’t the only company riding the EpiPen roller coaster of late. The pharmaceutical company announced Monday that it plans to sell a generic version of EpiPen, its best-selling product. This news came after a national uproar over the drug’s high price. Generic EpiPen will cost $300 for a pack of two, a more than 50% cut to the sticker price of the branded version, and will be available in the next several weeks. That news, however, caused a sharp selloff in the shares of Adamis Pharmaceuticals, a small drug company aiming to develop its own generic version of EpiPen. (Grant, 8/29)

Meanwhile, a House committee is launching an investigation of the company —

Morning Consult: House Oversight Committee Is Investigating Mylan
The House Committee on Oversight and Government Reform is investigating Mylan, the pharmaceutical company under fire after raising the price of EpiPens more than 400 percent since 2007. Committee Chairman Jason Chaffetz (R-Utah) and ranking member Rep. Elijah Cummings (D-Md.) wrote to Mylan CEO Heather Bresch on Monday, asking for a several documents and a briefing by the end of next Tuesday to help the committee “better understand the increasing cost of EpiPen.” (McIntire, 8/29)

Reuters: House Committee Requests EpiPen Documents From Mylan
U.S. representatives Jason Chaffetz and Elijah Cummings of the House Committee on Oversight and Government Reform sent a letter to Mylan NV Chief Executive Heather Bresch on Monday asking for documents and communications related to the fast-increasing price of allergy auto-injector EpiPens. (Bengaluru, 8/29)

Scientists See Promising Results By Repurposing Existing Drugs To Fight Zika

Rather than starting from scratch, researchers test already-developed drugs -- and initial results are described as dramatic. Meanwhile, a new study finds that a female mosquito can transmit the virus to her eggs.

The Washington Post: Scientists Find Drugs For Cancer, Hepatitis C Can Kill Zika In Petri Dish. But Will They Work In Humans?
Scientists have discovered three existing drugs — used for cancer, hepatitis C and for parasitic infections — that they say appear promising against the Zika virus. The experiments were conducted only in lab-grown human cells in petri dishes, but the results were dramatic. Zika is so devastating that the damage it does has been thought to be irreversible. But the researchers said some of the compounds that the group tested not only allowed cells to live longer in the face of infection — but also in some cases fully recover from them. (Cha, 8/29)

The Wall Street Journal: Potential Zika Virus Therapies Identified By Researchers
Scientists have identified several potential therapies for the Zika virus from among 6,000 drugs already commercially available or undergoing clinical trials, according to a new study. The research, published Monday in the journal Nature Medicine, could help quicken discovery of medications for Zika and help prevent the neurological disorders associated with it, including microcephaly, a condition in which babies are born with abnormally small heads associated with improper brain development. (Hernandez, 8/29)

NBC News: Drugs Used To Fight Hepatitis, Worm Infections Might Stop Zika
A drug already on the market to treat worm infections and another being tested against liver diseases may also help treat Zika virus infections, researchers reported Monday. The findings are a rare bit of good news about Zika, which has caused epidemics across Latin America and the Caribbean, and smaller outbreaks in Florida, the Pacific and southeast Asia. (Fox, 8/29)

The New York Times: Zika Can Be Transmitted By Female Mosquito To Her Eggs, Study Says
The Zika virus can be transmitted by a female mosquito to her eggs, eventually infecting her adult daughters, researchers reported on Monday. But mother-daughter transmission happens so rarely among mosquitoes that it is probably not an important factor in the global Zika epidemic, according to the lead author of the study, published in The American Journal of Tropical Medicine and Hygiene. (McNeil, 8/29)

Stat: Mosquitoes Carrying Zika Can Hand Down Virus To Offspring
Like a physical trait or a family heirloom, the Zika virus can be handed down by an infected female mosquito to some of her offspring, a new study shows. The study, by scientists at the University of Texas Medical Branch in Galveston, confirms that so-called vertical transmission of the virus occurs in Aedes aegypti mosquitoes, the main species responsible for the spread of Zika. But vertical transmission doesn’t always happen. In fact, the research suggests it only occurs at a rate of 1 in every 300 mosquitoes. (Branswell, 8/29)

NBC News: Mosquitoes Can Infect Their Eggs With Zika
Here's another reason it will be hard to get rid of Zika: Mosquitoes can pass the virus to their offspring in their eggs. It's not a surprising finding. Mosquitoes infect their larvae with other viruses, too, including Zika's close relative the dengue virus. But it's another obstacle for people trying to get rid of Zika and the mosquitoes that spread it. (Fox, 8/29)

And in other Zika news —

The New York Times: In Reaction To Zika Outbreak, Echoes Of Polio
Now that the Zika virus has landed in the continental United States, and now that polio has re-emerged in Africa after two years without a case, it may be instructive to look back at New York’s early epidemic. It featured many of the problems that have bedeviled our response to the Zika epidemic: false rumors, ethnic prejudice and ineffective measures. (McNeil, 8/29)

Orlando Sentinel: Poll: Half Of Floridians Concerned About Getting Zika 
About half of Floridians are concerned that they or their family members might get the Zika virus, and they're not happy with how state officials have been handling matters related to Zika, according to a new poll. ... The non-partisan group conducted a telephone poll of 625 registered Florida voters Aug. 22-24, with two questions: how concerned people were about getting the Zika virus and how they rated Florida state officials' performance in dealing with the Zika virus. (Miller, 8/29)

Tampa Bay Times: The Location Of Pinellas County's First Local Zika Case Is A Secret. Good Idea Or Bad? 
Maps issued by the Florida Department of Health pinpoint right down to street level where mosquitoes are spreading the Zika virus in South Florida. But in Pinellas County, officials refuse to get any more specific than saying a single infection was found somewhere in the county's 280 square miles. Surgeon General Celeste Philip said it makes no sense to divulge where the infected resident lives or works until officials can confirm the virus is being spread in those locations. (O'Donnell, 8/29)

Health Law Issues And Implementation

Administration Proposes New Rules For Health Marketplaces To Help Insurers In 2018

The draft regulation would revamp the risk adjustment program for insurance companies and comes as several high-profile insurers have opted to cut back on participation in the exchanges. Meanwhile, Senate Majority Leader Mitch McConnell tells a business group that the law likely will be revamped next year, and some other Republican lawmakers are concerned that the administration tried to pressure Aetna.

The Associated Press: Last Chance? Obama Administration Proposes Health Law Fixes
In one of its last chances to tinker with the president's signature health care law, the Obama administration Monday proposed a series of fixes and adjustments for 2018, when the White House will have a new occupant. The changes are detailed in a highly technical draft regulation, nearly 300 pages long. Insurers and consumer advocates were trying to decipher its implications Monday evening. The proposal would update the health insurance marketplace's premium stabilization system to reflect concerns that insurers have raised. It also proposes changes to a current five-year ban on companies returning to the health law's markets after they have left. Some big name carriers have dramatically scaled back for 2017. (Alonso-Zaldivar, 8/29)

Modern Healthcare: CMS Proposals Would Alter ACA Marketplaces, Risk Adjustment In 2018 
The CMS proposed rules Monday afternoon that would make several changes to the Affordable Care Act marketplaces and refine the law's risk adjustment, heeding calls from the health insurance industry. The proposed rules, which normally are released in November, come after weeks of intense scrutiny and uncertainty about the viability of the new ACA insurance exchanges. Aetna, Humana and UnitedHealth Group, which have bigger footprints in the employer and Medicare Advantage markets, all have announced major retrenchments for the 2017 season, which begins Nov. 1. (Herman, 8/29)

The Hill: Administration Issues New Rules Aimed At Strengthening ObamaCare
The Obama administration on Monday announced new regulations intended to strengthen the health of the ObamaCare marketplaces and improve the experience for insurers. The range of technical tweaks announced by the Centers for Medicare and Medicaid Services (CMS) on Monday is the latest step in a range of actions the administration has taken this year to address some complaints by insurers. (Sullivan, 8/29)

Morning Consult: CMS Adds Prescription Drug Data To 2018 Risk Adjustment
The Centers for Medicare and Medicaid Services on Monday issued a proposed rule to govern how Obamacare exchanges will operate in 2018. The proposal would change Obamacare’s risk adjustment program to account for prescription drug data. Currently, the government determines which plans have sicker enrollees, and thus should receive assistance, based on claims data. (Owens, 8/29)

The Associated Press: McConnell: Obamacare 'Crashing;' Next President Must Fix It
U.S. Senate Majority Leader Mitch McConnell predicted Monday that the federal health care overhaul championed by President Barack Obama is likely to undergo changes next year, regardless of who wins the White House and which party has the upper hand in Congress. The Kentucky Republican, who has long advocated repealing the Affordable Care Act, told a business audience in his hometown that the law "can't possibly go on like it is." He predicted the overhaul "will be revisited by the next president, whoever that is." (Schreiner, 8/29)

The Hill: GOP Senators Argue DOJ Pressured Aetna On ObamaCare 
Two Republican senators are accusing the Department of Justice (DOJ) of trying to pressure Aetna to participate in ObamaCare marketplaces through its review of the company’s proposed merger.  Sens. Tom Cotton (R-Ark.) and Ben Sasse (R-Neb.), both strong opponents of the health law, point to questions that the DOJ sent to Aetna on June 30 as part of the department’s anti-trust review of Aetna’s proposed merger with Humana. (Sullivan, 8/29)

And in state news —

Des Moines Register: Insurance Rate Hikes Approved For Thousands Of Iowans
More than 75,000 Iowans will see their insurance premiums rise next year. Iowa Insurance Commissioner Nick Gerhart has approved rate increases sought by four companies who provide health insurance in the state, Gerhart's agency announced Monday. The increases include plans covered by Wellmark Blue Cross & Blue Shield, the state's dominant health insurer. The rate increases vary from about 19 percent to 43 percent, depending on the carrier. (Patane, 8/29)

Chicago Tribune: Illinois Emergency Room Visits Increased After Obamacare, Study Says
Hospital emergency department visits increased in Illinois after the Affordable Care Act took effect — the opposite of what many hoped would happen under the landmark health care law, according to a new study. ... Emergency visits in Illinois increased 5.7 percent, or by more than 14,000 visits a month on average, in 2014 and 2015 compared with 2011 through 2013, according to the study, published online in Annals of Emergency Medicine, a peer-reviewed journal. (Schencker, 8/29)

Gov. Christie Says 'Naysayers' Have Been 'Proven Wrong' About N.J. Medicaid Expansion

The Republican governor, who bucked many in his party to support the health law's Medicaid expansion, says more than half a million state residents have gained coverage under the plan. In other news, Kentucky's only Democratic member of Congress criticizes the governor's plan to change the Medicaid expansion there, Idaho officials remain divided over efforts to expand the program, Oklahoma's Medicaid director resigns after some turbulent years and Tennessee enrolls more children in its Medicaid dental coverage. Christie Boasts N.J. Medicaid Expansion Success Under Obamacare
Gov. Chris Christie on Monday boasted the success of expanding the Medicaid program in the state, arguing the "naysayers" have been "proven wrong" and that 566,000 additional New Jerseyans have insurance coverage. It's been three years since Christie announced he planned to buck his party and embrace President Obama's Medicaid expansion under the Affordable Care Act. He was one of only a handful of GOP governors to embrace the changes. (Arco and Livio, 8/29)

The Philadelphia Inquirer: More NJ Residents Insured Under Medicaid Expansion
Gov. Christie said Monday that more than a half-million New Jersey residents have gained health insurance as a result of his decision to expand Medicaid under the Affordable Care Act, even as he blasted President Obama's health-care law as an "incredible failure." ... Conservatives criticized Christie when he agreed to expand the program in 2013 and during his unsuccessful presidential campaign this election cycle, arguing that he had embraced Obamacare and that states wouldn't be able to shoulder the costs. (Seidman, 8/30)

The Hill: Christie: Critics Of Medicaid Expansion Have Been 'Proven Wrong'
Christie is one of several Republican governors to accept the expansion of Medicaid under ObamaCare, but is among the most prominent in that group as a former presidential candidate who is now an adviser to Republican presidential nominee Donald Trump. Trump’s running mate, Indiana Gov. Mike Pence (R), also accepted ObamaCare’s Medicaid expansion, though he put a conservative spin on it — by making beneficiaries pay premiums to pick up a share of the cost, for example. Christie and Pence, though, are both opposed to the healthcare law as a whole. (Sullivan, 8/29)

WDRB (Louisville, Ky.): Congressman Yarmuth Calls Gov. Bevin's Medicaid Proposal A 'Devious' Attempt To End Expansion
Congressman John Yarmuth is accusing Gov. Matt Bevin of plotting to end Medicaid expansion in Kentucky. Yarmuth is the only Democrat in Kentucky's congressional delegation, and a big supporter of the Affordable Care Act. He calls the governor's proposed Medicaid reforms "devious." ... He says Gov. Matt Bevin's plan to reform Medicaid will in fact cause more than 400,000 Kentuckians to lose the coverage they gained under Obamacare. (Smith, 8/29)

Idaho Statesman: Idaho Lawmakers’ Impasse On Medicaid Expansion Persists
Idaho lawmakers assessing health care alternatives for the state’s working poor demonstrated again the divisions that make it unlikely they will reach consensus on a bill for the Legislature. Half of a 10-member panel of legislators voiced outright opposition Monday to any version of Medicaid expansion to cover the estimated 78,000 Idaho adults who have no health coverage. That so-called gap group either earns too much to qualify for existing Medicaid or too little to be eligible for subsidized insurance on the state health care exchange created under the 2010 Affordable Care Act. Expanding Medicaid to cover such populations was part of the ACA, known popularly as Obamacare. (Dentzer, 8/29)

The Oklahoman: Oklahoma's Medicaid Director Announces Resignation
The state Medicaid director announced his resignation Monday in a letter to the agency's board, noting it was the "right time to explore options in the private sector." Oklahoma Health Care Authority CEO Nico Gomez, 44, told the board in his letter that he was stepping down after 20 years of public service .... Over the past two years, the agency has lost more than $868 million in state and federal dollars, as a result of state budget cuts and losing matching federal money as a result of those cuts. The agency's board has approved repeated rate cuts, paying medical professionals less and less for the services they provide to thousands of low-income Oklahomans. (Cosgrove and Green, 8/29)

The Tennessean: TennCare Dental Manager Ups Number Of Kids In Program
The company managing TennCare's dental benefits for Medicaid-eligible children increased the number of kids receiving care since winning the contract, federal data show. In the past year the number of children receiving care under the program increased 3 percentage points from TennCare's baseline 53 percent participation rate when DentaQuest won the contract in 2013, said Steven Brady, DentaQuest's Tennessee executive director. (Fletcher, 8/29)

Campaign 2016

Advocates Applaud Clinton's Mental Health Plan As Good Start, But Know Congress Controls Purse Strings

Presidential candidate Hillary Clinton's proposal focuses on the integration of mental and physical health care systems, training police officers and suicide prevention. But some worry that, the funding necessary to make them successful is unrealistic.

Politico: Clinton Unveils Mental Health Agenda
Hillary Clinton on Monday released a sweeping agenda to deal with the mental health problem in the United States, including a call to convene a White House conference on the issue during her first year in office. ... Clinton's plan encompasses the integration of mental and physical health care systems, including an expansion of reimbursement structures in Medicare and Medicaid, tasking the Center for Medicare and Medicaid Innovation to create and implement the new payment models. Suicide prevention is also a major focus of the plan, with Clinton's campaign saying she would assign all relevant federal agencies to create a cross-government initiative overseen by the surgeon general. Clinton previously announced her plan to increase funding for community health centers last month, an idea favored by primary rival Vermont Sen. Bernie Sanders. (Gass, 8/29)

The Washington Post: In Latest Policy Rollout, Clinton Puts Forward Agenda To Combat Mental Illness
Hillary Clinton put forward a package of initiatives Monday aimed at improving the plight of tens of millions of Americans coping with mental illness and pledged, if elected president, to hold a White House conference on the issue within her first year in office. The plan, the Democratic nominee said, seeks to fully integrate mental health services into the nation’s health-care system during her tenure as president. Measures include a national suicide prevention initiative, higher payments for providers in the Medicaid program, an emphasis on treatment over jail for low-level criminal offenders with mental health issues and the creation of new housing and job opportunities. (Wagner, 8/29)

USA Today: Clinton Rolls Out Plan To Improve Mental Health Care
Democratic presidential candidate Hillary Clinton called for putting mental health care on par with other types of health care Monday as part of a wide-ranging plan to address key problems in the treatment of people with mental illness. The proposal calls for expanding early intervention in mental illness; a national initiative to prevent suicide, which kills more than 40,000 Americans a year; increasing training for police who are called to the scene of a mental health crisis; providing mental health care for non-violent offenders to help them avoid going to jail for minor offenses; and investing in brain and behavioral research to develop better treatments. (Szabo, 8/29)

Modern Healthcare: Clinton Lays Out Mental Health Reform Plan, But Funding Still A Question 
While mental health advocates are pleased that a presidential candidate is discussing behavioral health reform and say that Hillary Clinton's recently released plan is a good foundation. But advocates say it still lacks implementation details and any solution to the issue that has stalled legislation in Congress: where to find the money. Clinton's plan highlights early diagnosis and prevention; integrating mental and physical healthcare and enforcing parity; access to housing and job opportunities; suicide prevention; prioritizing treatment over incarceration; and expanding brain and behavioral research. (Muchmore, 8/29)

Morning Consult: Clinton’s Mental Health Plan Echoes Debate In Congress
Hillary Clinton’s broad mental health plan, rolled out Monday, comes in the wake of a year of activity about mental health on Capitol Hill. Last month, President Obama signed into law the first major statute aimed at addressing overdoses and drug addiction. The House also passed its own wide-ranging mental health measure. ... Clinton’s plan overlaps with these legislative proposals, all bipartisan, in several ways. This is an area where some Republicans may be willing to work with Clinton should she win the White House in November. (McIntire, 8/29)

Meanwhile, the Department of Justice is increasingly targeting police departments for their treatment of those with a mental illness —

The Associated Press: Justice Dept. Focuses On Police Treatment Of Mentally Ill
Justice Department lawyers investigating police agencies for claims of racial discrimination and excessive force are increasingly turning up a different problem: officers' interactions with the mentally ill. The latest example came in Baltimore, where a critical report on that department's policies found that officers end up in unnecessarily violent confrontations with mentally disabled people who in many instances haven't even committed crimes. (Tucker, 8/29)


Walgreens And Prime Therapeutics To Combine Mail-Order Pharmacy, Specialty Drug Business

A partnership with the pharmacy benefits manager will gain the drugstore chain a greater share of the prescription drug market and position Walgreens to better compete with CVS.

The Wall Street Journal: Walgreens Forms Alliance With Prime Therapeutics
Walgreens Boots Alliance Inc. has struck a partnership with Prime Therapeutics to help it capture a greater share of the prescription-drug market and better compete with CVS Health Inc. On Monday, Walgreens announced it is partnering with Prime, a St. Paul, Minn.-based pharmacy benefit manager owned by 14 leading Blue Cross and Blue Shield health plans. The two companies will combine their specialty and mail-service businesses, and Walgreens will become the preferred pharmacy where Prime’s members could pay less to fill their prescriptions. (Ziobro and Stynes, 8/29)

The Star Tribune: Prime Therapeutics, Walgreens To Form Pharmacy Alliance 
Eagan-based Prime Therapeutics has formed a strategic alliance with drugstore giant Walgreens that would combine the companies' specialty and mail-order pharmacy businesses. In addition, health plan subscribers with pharmacy benefits managed by Prime Therapeutics would have preferred access to Walgreens pharmacies as part of the agreement announced Monday. (Snowbeck, 8/29)


Doctors Often In A Special, Protected Class When It Comes To Sexual Abuse

The Atlantic Journal-Constitution looks at the disparity between how doctors and others are punished following reports of sexual abuse.

Atlanta Journal Constitution: If They Weren’t Doctors, Some Sex Abusers Might Be Facing Police
San Diego police reviewed 500 hours of security footage and charged (Luis) Ramos with touching 13 women’s breasts, genitals, groins and buttocks while they were unconscious. On Friday, a judge sentenced him to 15 years in prison for charges including sexual penetration and sexual battery of a medically incapacitated person. If justice was swift in the case, it had partly to do with how Ramos had access to patients. He was a technician in a dental office, not a medical doctor. Had he been a doctor who did the same thing to vulnerable patients, his consequences might have been different. His case might have been handed as a licensure matter, with state medical regulators treating him as an impaired professional in need of therapy, such as yoga, massages and horseback riding. (Edwards, 8/29)

Read the Atlantic Journal-Constitution's full series on doctors and sex abuse.

'Teaching With The Enemy': Med, Law Students Team Up For Mock Malpractice Cases

The project is an effort to give young doctors a taste of what a real-life courtroom will be like if they're called to the stand for a malpractice case. In other news, medical schools are starting to place more emphasis on adjusting nutrition rather than prescribing drugs.

Columbus Dispatch: Young Doctors, Law Students Get Taste Of Malpractice Cases In Mock Depositions
It’s hard to say who was more nervous during a recent final exam for a group of third-year students at Capital Law School: the would-be lawyers, being graded on how they questioned doctors in a mock malpractice deposition, or the young doctors, getting a taste of what it might feel like to be on the witness stand someday. A cynic might call it a meeting of natural adversaries: doctors and potential malpractice lawyers. Dr. Sarah Sams, associate director of OhioHealth Grant Medical Center’s family-medicine residency program, said some of her young docs joked about “teaching with the enemy.” But the joint exercise, done for the second time recently, has made for a more-realistic lesson, Sams said. (Edwards, 8/30)

Sacramento Bee: Recipes, Not Prescriptions: A Grass-Roots Movement To Prevent Disease And Treat Illness With Food
Medical schools are placing more emphasis on nutrition education. More doctors are urging patients to revamp their eating habits. And numerous resources such as and online have emerged in recent years to lay out the facts about the dire health risks of a poor diet and offer ample recipes to make this food-based cure seem palatable, if not delicious. (Robertson, 8/29)

Public Health And Education

Bitter Feud Over Parkinson's Trial Offers Rare Glimpse Of Conflicts Roiling Research Community

The fight between key scientists and the prominent Michael J. Fox Foundation highlights the tension erupting as major medical research philanthropies increasingly seek to coordinate or manage studies, or control details of how they are done.

Stat: Parkinson's Disease Study Caught In Feud Involving Fox Foundation
A crucial clinical trial of the most promising new treatment for Parkinson’s disease in decades might be delayed because of a feud between a key scientist and the influential Michael J. Fox Foundation. The prominent foundation — the richest nonprofit seeking to cure the crippling neurological disorder — initially wanted to collaborate on a study with the Georgetown University researcher. His preliminary findings last year had buoyed patients’ hopes for the first Parkinson’s medicine that might reverse some of their debilitating symptoms. The trial was supposed to begin in October, but Fox and the Georgetown team had a bitter falling out, and it’s unclear whether Georgetown will be able to obtain the medicine from its manufacturer so that the study can proceed. (Piller, 8/30)

In other news on neurodegenerative diseases —

The New York Times: The Decline Of Tube Feeding For Dementia Patients
Dementia from Parkinson’s disease was taking its toll on Joan Jewell. She could still respond to music ... but she spent most of her time in bed. ... She had trouble swallowing. Last year, her doctor pointed out that she was losing weight and that a feeding tube, surgically inserted through her abdominal wall, might help her regain a few pounds. Her son James, who served as her surrogate decision maker, responded the way a growing number of family members do: He said no. The proportion of nursing home residents with advanced dementia who receive a feeding tube has dropped more than 50 percent, a new national study has found. (Span, 8/29)

Stat: Gene Wilder Wanted To Keep Alzheimer's Secret, Family Says
Cinematic comedy legend Gene Wilder died Sunday night of complications from Alzheimer’s disease. He was 83. Wilder had largely faded from public view; his last film credit was 25 years ago. But his family revealed Monday in a statement that the star of “The Producers,” “Young Frankenstein,” and “Willy Wonka and the Chocolate Factory” had been diagnosed with Alzheimer’s disease three years ago. (Scott, 8/29)

Bloomberg: Alzheimer’s, Parkinson’s Drugs May Be M&A Targets, Huang Says
Treatments for neurodegenerative diseases could emerge as the next hot spot in health-care mergers and acquisitions, Morgan Stanley’s head of M&A for the Americas said. “Several years out, demographics would point me toward things like Alzheimer’s, Parkinson’s,” Susan Huang said on Bloomberg Television’s “Deal Report” segment Monday. Oncology deals are likely to dominate transactions in the short term, with recent activity just the “tip of the iceberg,” according to Huang, who advised cancer drugmaker Stemcentrx Inc. on its $5.8 billion sale to AbbVie Inc., completed in June. Over time, M&A will be spurred by growing demand among an aging baby-boomer generation for drugs that combat neurodegenerative diseases. (Fournier, 8/29)

Lawmakers: Immediate Investigation Into Purdue Pharma's Opioid Practices Necessary

“There appears to be a pervasive disregard for patient safety and public health by some within the pharmaceutical industry," Rep. Mark DeSaulnier and Rep. Ted Lieu said in calling for the House Oversight and Government Reform Committee to take action against the drugmaker.

Los Angeles Times: California Representatives Call For Congressional Investigation Into Purdue Pharma And Other Opioid Makers
Two California representatives called Monday for a congressional investigation of opioid manufacturers, citing a Los Angeles Times investigation that found that the maker of OxyContin collected extensive evidence of criminal trafficking of its drug but in many cases did not alert law enforcement. Rep. Mark DeSaulnier (D-Concord) and Rep. Ted Lieu (D-Torrance), both members of the House Oversight and Government Reform Committee, said in a letter to the committee chairs that an immediate investigation was necessary “to fully understand the implications and consequences of pharmaceutical companies that do not fulfill their legal and ethical requirements to restrict the sale of opioids in circumstances that raise suspicion regarding inappropriate prescribing practices.” (Ryan, 8/29)

In other news on the opioid crisis —

The Associated Press: Unprecedented Overdose Spike Slows In Cincinnati
An unprecedented spike of drug overdoses in the Cincinnati area seem to be leveling off, although are still at higher than normal levels, after a stunning wave last week, authorities said. Newtown Police Chief Thomas Synan, who heads the Hamilton County Drug Coalition task force, said reports show heroin overdoses dropped to 10 to 15 a day over the weekend. Just Friday, emergency rooms reported 174 overdose cases over six days, for an average of 29 per day, although Synan said some likely were not from heroin. But he said 20 to 25 overdoses in a week would be more typical. (Sewell, 8/29)

Chicago Tribune: Families Important Factor In Addressing Drug Abuse, Local Leaders Say 
Tere's a belief that most teens are introduced to drugs at large, risque parties, but that's just not true, Porter County Sheriff David Reynolds said. ... Reynolds and other leaders from Lake and Porter counties urged the task force to consider how big of a role family dynamics play in the heroin problem in Northwest Indiana and the opioid epidemic across the state. While treatment is vital to combating this problem, the leaders said, it cannot be completely effective without prevention and education that addresses what led to the addiction. (Jacobs, 8/29)

WBUR: U.S. Surgeon General Urges Clinicians To Curb Use Of Opioid Painkillers 
More than two million health care practitioners in Massachusetts and across the country will get a letter in the next few days from U.S. Surgeon General Vivek Murthy. In the letter, Murthy is asking practitioners to help curb the widening crisis of opioid abuse — he says clinicians are crucial in this fight. Monday afternoon, WBUR's All Things Considered spoke with Murthy who said other countries also have problems with abuse — but it's worse in America. (Mullins, 8/29)

FDA To Consider More Regulations For Stem Cell Clinics

Critics say the clinics -- which offer treatments costing thousands of dollars that have often not been tested for their efficacy -- are peddling snake oil to desperate Americans. In other public health news, scientists have found another superbug in the U.S., viruses in the gut are proven to be beneficial, a caregiver's story of her husband's final months and more.

The Wall Street Journal: Stem-Cell Treatments Become More Available, And Face More Scrutiny
In two days of hearings next month, the U.S. Food and Drug Administration will consider if clinics offering stem-cell treatments should be more closely regulated. Stem-cell treatments aren’t approved by the FDA and not long ago, Americans had to travel to Mexico, China or elsewhere to receive them. Now, with the regulatory environment murky, clinics offering them are spreading rapidly across the U.S. A recent report in the journal Cell Stem Cell counted 570 clinics advertising stem-cell therapies directly to consumers. Many claim to treat a long list of disorders, from arthritis to Alzheimer’s disease, even though the stem-cell treatment for many of the conditions hasn’t yet been tested on humans. Treatment typically costs thousands of dollars. (Beck, 8/29)

Stat: Superbug Resistant To Two Last-Resort Antibiotics Found In US For First Time
A strain of E. coli resistant to two last-resort antibiotics has for the first time been reported in the United States. The strain was found in the urine of a man treated at a New Jersey hospital two years ago. It was tested in 2016 as part of a larger analysis of bacteria from the hospital. For hard-to-treat bacteria infections, the antibiotics colistin and carbapenem are considered the big guns — a last line of defense when nothing else is working. In recent months mcr-1, a gene which confers resistance to colistin, has been found in E. coli from over 30 countries, including bacteria isolated from pigs and people in China and a patient in New York City. (Wessel, 8/29)

NPR: Your Gut's Gone Viral, And That Might Be Good For Your Health
Everywhere you turn, it seems, there's news about the human microbiome. And, more specifically, about the bacteria that live in your gut and help keep you healthy. Those bacteria, it turns out, are hiding a big secret: their own microbiome. A study published Monday suggests some viruses in your gut could be beneficial. And these viruses don't just hang out in your intestines naked and homeless. They live inside the bacteria that make their home in your gut. (Doucleff, 8/29)

The Washington Post: For Latinos, Cancer Risks Can Depend On Heritage
If you’re Latino, you could be at risk for colorectal cancer. But the degree of that risk could depend on whether your ancestry traces to Puerto Rico or to Mexico or another Latin American country. A paper published in the September issue of Current Epidemiology Reports discusses the health implications of classifying Latinos as a homogeneous entity while analyzing existing research about their cancer risks and outcomes and those of various subpopulations. (Kelly, 8/29)

Kaiser Health News: Screening Positive For Depression Doesn’t Mean You’ll Get Treatment, Study Finds
Getting treatment for depression may sometimes be a regular part of health care for the “worried well” that leaves those who cannot afford it to suffer by themselves. A new study published Monday in JAMA Internal Medicine illustrates that phenomenon. Most Americans who screen positive for depression don’t receive treatment — while most who did receive treatment don’t actually have the condition. (Tan, 8/29)

Health IT

Can Virtual Reality Help Pain Or Depression? Some Hospitals Experiment With New Tech

As hardware prices drop, some doctors are trying out the new technology as a treatment option for a variety of conditions. In other health IT news, IBM bets big on health care. And more seniors are using mobile devices for virtual visits with their doctor.

Bloomberg: Hospitals Try Giving Patients A Dose Of VR 
It’s still a new and experimental approach, but proponents of virtual reality say that it can be an effective treatment for everything from intense pain to Alzheimer’s disease to arachnophobia to depression. And as Facebook Inc., Sony Corp., HTC Corp. and others race to build a dominant VR set, the price of hardware has fallen, making the equipment a more affordable option for hospitals looking for alternatives for pain relief. The idea is that the worst pain can be alleviated by manipulating the way the human mind works: the more you focus on pain, the worse it feels. (King and Chen, 8/29)

The Boston Globe: With Cambridge-Based Watson Health, IBM Bets Big On Health Care
But IBM’s shift from computer hardware to software and services has taken the New York company deep into the world of doctors, hospitals, and drug companies. ... IBM is making a big bet on health care, and it’s doing it here in the technology and life sciences hub of Massachusetts. Since IBM Watson Health was launched in 2015, the company has made four acquisitions worth about $4 billion and forged numerous partnerships with major hospitals, drug makers, and other companies. (McCluskey, 8/30)

State Watch

California Inches Closer To Passing Measure Protecting Patients From Surprise Bills

The battle in California could influence bills pending in states across the country, including Pennsylvania, New Jersey, Georgia, Hawaii and Missouri.

California Healthline: After 16 Years Of Debate, Legislation On Surprise Medical Bills Pushes Forward
A measure to protect California consumers from surprise medical bills — among the longest-debated issues to be considered by state lawmakers — moved closer than it’s ever been to becoming law when the Senate approved it Monday with a 35-1 vote. The bill would relieve patients from having to pay surprise medical bills out of pocket by requiring insurers to reimburse out-of-network doctors and other health providers a “fair amount” and doctors to accept the payments, said its author, Assemblyman Rob Bonta (D-Oakland). That rate would be 125 percent of the amount Medicare pays for the same service or the insurer’s average contracted rate for the service, whichever is greater. (Ibarra, 8/30)

Stat: California Legislature Debates Surprise Medical Bills
For the second time in as many years, California legislators are debating a bill that would protect patients from paying surprise medical bills when they inadvertently get treatment from doctors who are not covered by their insurance. Under the bill, AB 72, consumers would only pay the equivalent of in-network rates if, for example, during surgery covered by insurance, they are treated by an out-of-network anesthesiologist, or have X-rays read by an out-of-network radiologist. AB 72 is in the California Senate and must be approved before going to the state assembly and governor. The state legislature has until Aug. 31 to act, or the bill effectively dies in committee. (Ross, 8/29)

N.Y. To Ease Restrictive Regulations Surrounding Medical Marijuana Program

The state's Health Department is issuing several new policies following criticism that the process was too cumbersome.

The New York Times: In Expansion, New York’s Medical Marijuana Program Will Offer Home Delivery
Moving to address complaints about New York’s new medical marijuana program, the state’s Health Department is making substantial changes to expand access to the drug, including allowing home delivery, quite likely by the end of September. The program, which saw its first dispensaries open in January, has struggled to gain broad traction in the medical community and with potential patients. Advocates for the medical use of marijuana have said the program, allowed by a 2014 law signed by Gov. Andrew M. Cuomo, was too restrictive, and its regulations too cumbersome to fulfill its mandate. (McKinley and Saint Louis, 8/29)

In other news —

The Washington Post: Study: Medical Marijuana Changes How Employees Use Sick Time
"Fact #1: Legalizing marijuana is bad for the workplace." That's the stark warning from the Institute for a Drug-Free Workplace, a nonprofit that works to combat drug use among American employees. "The impact of employee marijuana use is seen in the workplace in lower productivity, increased workplace accidents and injuries, increased absenteeism, and lower morale," the institute writes. "This can and does seriously impact the bottom line." Does it really, though? (Ingraham, 8/29)

State Highlights: Wis. Family Files Wrongful Death Suit Against VA Clinic; Ga.'s Emory Healthcare Partners With Stratus

Outlets report on health news from Wisconsin, Georgia, California, Maryland, Tennessee, Arizona, Ohio, Washington, Michigan, Kansas, Missouri, Texas and Florida.

The Associated Press: Family Of Marine Who Died At Wisconsin VA Center Files Suit
The family of a Marine veteran who died from a toxic mix of more than a dozen drugs at a U.S. Veterans Affairs facility in Tomah, Wisconsin, filed a wrongful death and medical malpractice lawsuit against the U.S. government Monday. The federal lawsuit filed in Madison, Wisconsin, alleges VA caregivers improperly prescribed and administered drugs to Jason Simcakoski, who was 35 when he died in 2014. It also alleges the VA failed to provide adequate emergency care for Simcakoski when he was found unresponsive and did not properly diagnose his mental health and substance abuse problems. (8/29)

Modern Healthcare: Emory Healthcare Throws Weight Behind Stratus Hospital Affiliates
Atlanta-based Emory Healthcare announced Monday that it would partner with Stratus Healthcare, an affiliation of 21 hospitals around Georgia, to develop a clinically integrated network and strengthen access to specialty care. The two groups also will explore expediting access to Emory Clinics for Stratus affiliates as well as closer collaboration of medical record connectivity for physicians to ensure coordination of care, the two sides said in a release. (Barkholz, 8/29)

San Diego Union-Times: San Diego's Scripps Health Partners With MD Anderson To Expand Cancer Network's Reach
In a bid to increase its reach throughout Southern California, the San Diego-based Scripps Health system on Monday finalized a partnership with the internationally known MD Anderson Cancer Network. The deal makes Scripps the only direct collaborator with Houston-based MD Anderson in an eight-county region stretching from the U.S.-Mexico border north through Santa Barbara County and east to California's border with Arizona. (Sisson, 8/29)

The Baltimore Sun: Emocha Mobile Health Lands New Contracts For Its Medication Monitoring App 
A Baltimore startup with a mobile application to keep tuberculosis patients on track with their medication regimen is expanding with new contracts in California and big ideas for how the technology can improve oversight of medications for other illnesses. Emocha Mobile Health, founded in 2013 on technology licensed from the Johns Hopkins University, has recently landed contracts with Fresno, Merced and Contra Costa counties in California. Those communities have some of the country's highest concentrations of latent tuberculosis, a form of the lung bacteria that does not have symptoms and puts patients with weakened immune systems at greater risk for developing the potentially deadly disease. (Gantz, 8/29)

The Tennessean: Judge Rachel Bell's Actions On Mental Health Commitments Questioned
Eleven people were committed against their will to a Middle Tennessee mental institution without a signed judge's order in late June, a day when General Sessions Judge Rachel Bell was supposed to hear the cases. But Bell was on vacation. The lawyer she picked to take her place on the bench said he forgot to sign the orders keeping those people in mental health facilities. Bell retroactively signed them for all 11 people six days later. (Barchenger, 8/29)

Arizona Republic: Many Small Arizona Schools Vulnerable To Measles And Whopping Cough
Sending your kindergartner to a school in Arizona with 20 or fewer students in kindergarten likely puts your child at a higher risk for catching measles than going to a larger school, according to an analysis of public records obtained by The Arizona Republic. About three out of every five kindergarten classes with 20 or fewer students had such low vaccination rates last year that measles could easily spread among the children — and even to the community. For whooping cough, or pertussis, which is less contagious but known to kill infants, it was about two out of five kindergartens with 20 or fewer kids. Compare that with schools with larger kindergarten classes: about three in eight were not protected from measles outbreaks and less than two in 12 weren't protected from whooping cough. (McGlade, 8/29)

Cleveland Plain Dealer: Electrical Shock: Two Ohio Psychologists Want FDA To Keep The Controversial Treatment
The Food and Drug Administration wants to ban electrical shock therapy, an old-fashioned behavior modification procedure described variously as dangerous, torture and a risk to public heath. Electrical jolts are applied to the skin of a deeply troubled patient and, with the shock, the patient's outbursts stop. ... Yet amid the extensive controversy stand two Ohio psychologists -- one an emeritus professor at Ohio State University, the other at Youngstown State University -- urging the FDA to beg off. (Koff, 8/30)

Seattle Times: Psychiatric Hospital Western State No Longer Part Of National Accreditation Program 
The state’s largest psychiatric hospital quietly withdrew from a national accreditation program three months ago. Western State Hospital voluntarily withdrew from accreditation by The Joint Commission, a nonprofit organization, on May 24, according to a Joint Commission spokeswoman. But the state Department of Social and Health Services (DSHS), which oversees the facility, didn’t announce the decision publicly. The silence stands in contrast to other recent developments, like a hospital improvement plan that was finalized and announced in June with federal regulators. (O'Sullivan, 8/29)

Detroit Free Press: Feds Urge Cancer Doctor's Victims To Tap Into $11.9M Fund
The federal government is urging the  victims of notorious cancer doctor Farid Fata to tap into an $11.9-million restitution fund before time runs out,  noting the process for doing so is a little less daunting now than when it was originally set up. According to U.S. Attorney Barbara McQuade, the federal government hasn't yet heard from dozens of Fata victims who could benefit from the restitution fund, which has been set up to help them recover medical costs and other expenses. Fata is serving 45 years in prison for insurance fraud by intentionally misdiagnosing  or mistreating cancer patients. (Baldas, 8/29)

Kansas Health Institute: KNI Dental Clinic Continues Non-Resident Services Despite Budget Cuts 
A dental clinic at the Kansas Neurological Institute continues to serve Kansans who live outside the facility despite cutbacks two years ago. But it may need more funding if demand from non-residents increases. The clinic’s top priority is serving 147 adults with intellectual and developmental disabilities who call KNI home. But Brent Widick, superintendent of the Topeka facility, said KNI also has provided dental services for 71 non-residents with similar disabilities so far this year. (Marso, 8/29)

Columbus Dispatch: Keeping Teen Moms From ‘Turnaround’ Pregnancies
In Franklin County, about 28 percent of teen moms become pregnant with their second child within 18 months of delivering the first. The responsibility and stress of young motherhood can be a major setback. Teen pregnancy is associated with lower rates of high-school graduation and greater incidence of adult poverty and public assistance, according to the U.S. Department of Health and Human Services. (Tate, 8/30)

The Associated Press: Transgender Inmate Latest To Push For Hormone Treatment
A transgender inmate is suing the Missouri prison system for refusing to provide hormone therapy as she transitions to a woman, adding her voice to those of prisoners in other states who argue that denying such treatment amounts to cruel and unusual punishment. Lambda Legal filed the lawsuit in federal court in St. Louis last week on behalf of Jessica Hicklin, a 37-year old inmate serving life in prison after being convicted of first-degree murder at age 16, when she went by her birth name, James. She is challenging a state Department of Corrections policy that bars hormone therapy for inmates who weren't receiving it before being incarcerated. (8/29)

Dallas Morning News: Words To Live By: Baylor Scott And White To Text Poor, Chronically Ill Patients 
To remind patients about  medical visits and other issues related to their health, nurses and technicians at several outpatient charity clinics managed by the Baylor Scott and White Health System spend hours each week making phone calls. The calls are meant, in part, to reduce no-show rates among high-risk and low income patients because missed appointments can result in missed opportunities for prevention and worsening chronic conditions.  (Rice, 8/29)

Fox News: New ‘Zombie’ Drug May Be Emerging In Florida As Flakka Use Declines
When details of an attack allegedly involving a Florida State University student who police say stabbed an innocent couple to death then tried to eat the face of one of the victims were released earlier this month, many media outlets quickly pointed to flakka, a synthetic cathinone similar to bath salts that can cause violent, aggressive behavior. But if Austin Harrouff, the 19-year-old suspect who authorities say killed John Stevens, 59, and Michelle Mischon, 53, outside their home in Jupiter, Florida, was on the synthetic drug alpha-PVP, data suggests his case isn’t representative of a growing problem nationwide. (Carstensen, 8/29)

Health News Florida: Martin County Challenges New Water Standards
Pointing to concerns about increased chemicals going into Lake Okeechobee and nearby waterways, Martin County has filed a legal challenge to controversial new state water-quality standards. The case, filed this week at the state Division of Administrative Hearings, is the fourth challenge to the standards, which were developed by the Florida Department of Environmental Protection and approved last month by the Florida Environmental Regulation Commission. ... Martin County recently has grappled with algae blooms that are a result of polluted water being released from Lake Okeechobee into other waterways. (8/29)

Editorials And Opinions

Viewpoints: Examining Obamacare's Challenges; The EpiPen Controversy Continues

A selection of opinions on health care from around the country.

The New York Times: Obamacare Marketplaces Are In Trouble. What Can Be Done?
It has been a hard couple of weeks for Obamacare. The law’s online marketplaces — where people were supposed to be able to easily shop for health insurance — have been suffering from high-profile defections and double-digit premium increases. Critics of Obamacare have pointed to the recent problems as proof the market is not working, while even the law’s staunchest defenders are arguing that the marketplaces need some fixes. Here are four key challenges to the program and a survey of some possible solutions. (Reed Abelson and Margot Sanger-Katz, 8/29)

The Wall Street Journal: The ACA Marketplace Problems In Context (And Why They Don’t Mean Obamacare Is ‘Failing’)
Problems in the Affordable Care Act marketplaces are the big story in health care, spurred by Aetna’s pullback in participation. With headlines questioning whether these problems mean the ACA is “failing,” let’s take a step back for perspective. The marketplaces have a special role in health insurance, and they face real challenges, but they are a modest part of the overall insurance system. They are also only one part of the ACA – if an important part – and they are not having trouble in all states. (Drew Altman, 8/29)

Bloomberg: Modesty Could Have Averted The Anguish Of Obamacare 
The last few weeks have featured a great deal of news for Obamacare, most of it bad. Insurers are pulling out of the exchanges and premiums are rising. Coverage has been expanded, but it increasingly looks as if that coverage will mostly consist of companies taking their Medicaid managed care plans and repackaging them for private customers. Call it “Medicaid with premiums.” Or worse, that the exchanges will enter into a cycle of premiums rising and healthier customers dropping their insurance, until some markets have no insurance available at all. (Megan McArdle, 8/29)

The News & Observer: EpiPen Scandal Not Over By A Long Shot
Why did the Mylan execs raise the price of an old treatment sixfold? Because they could get away with it. Why could they get away with it? Because the United States Congress let them. The U.S. is the only advanced country that doesn’t routinely negotiate drug prices with the makers. (The Department of Veterans Affairs and Medicaid are exceptions.) Mylan surely didn’t want this scandal leading to serious efforts in Washington to start regulating what drug companies may charge the American people. Better to stage this semi-retreat and change the subject. (Froma Harrop, 8/29)

The Boston Globe: Generic EpiPen? Mylan Finds One More Way To Game The System
It’s almost as if Mylan, maker of the EpiPen, had drawn up a list of ways to game a dysfunctional health care system — and decided to check off every last one. ... News of a $300 generic version could help get Congress off the company’s back. But for Mylan and its CEO, Heather Bresch, the generic is also a shrewd business move. The price is still high enough to generate lots of money. Indeed, it’s more than the brand-name EpiPen cost as recently as a few years ago. (Dante Ramos, 8/29)

The Fiscal Times: Here’s How To Stop Price Gouging By Drugmakers Like Mylan
Generic drug manufacturer Mylan’s extreme price hike for the EpiPen soared to the top of the headlines last week. This product, consisting of an auto-injector devised by the U.S. military, combined with a $1 dose of epinephrine used to save the life of people suffering from a serious allergy attack, costs no more than $20 to manufacture. ... But the government already has the power to prevent such behavior. They don’t need to pressure Mylan to “fix” the problem itself; they don’t even need to pass a new law. Multiple federal agencies could solve this simply by exhibiting the political will to use their authority to take on the drug companies.  (David Dayen, 8/30)

Tennessean: How Consumers Can Cope With Rising Health Insurance Premiums
Consumers have likely seen the headlines that Tennessee health insurers are asking for big premium increases in 2017. On the marketplace, BlueCross BlueShield has asked the state Department of Insurance for a 62 percent increase. Cigna and Humana originally asked for less than half of that, but then requested to refile with higher rates—46 percent and 44.3 percent, respectively. It isn’t just the marketplace, either—employer premiums are going up 5 percent, according to the National Business Group on Health, a rate that’s outpacing wage growth. (Alex Tolbert, 8/28)

St. Louis Post-Dispatch: A Welcome Law To Protect Consumers From Insurance Company Greed
Insurance companies in Illinois and Missouri for years have been pocketing hundreds of millions of dollars from life insurance policies when beneficiaries don’t step forward to file claims. For once, Republicans and Democrats are lining up on the same side to fight corporate greed. Illinois State Treasurer Michael Frerichs has been on a statewide campaign to halt this practice and alert citizens that they’re leaving too much money on the table. Last week, Gov. Bruce Rauner signed a law, House Bill 4633, requiring insurers to locate beneficiaries and hand over unclaimed cash. A similar law went into effect in Missouri this month, having passed both houses by overwhelming majorities. (8/29)

Health Affairs Blog: The Need For Additional Flexibility In Medicare Advantage
The Centers for Medicare and Medicaid Services (CMS) has recently exercised its Section 1115A waiver authority to allow Medicare Advantage plans in seven states to offer benefit flexibility in the form of Medicare Advantage Value Based Insurance Design (MA-VBID). The model will launch on January 1, 2017 and run for five years. (Megan Katherine McGrath and Kenneth Thorpe, 8/29)

Bloomberg: Aging Candidates' Health Is Voters' Concern
Like all of us, Hillary Clinton and Donald Trump are going to die. Will it be in the next four years? Probably -- ideally -- not. But for voters, that’s a reasonable question, especially given that Clinton is 68 and Trump, 70. Unfortunately, the candidates have refused to divulge the kind of information that would enable anyone to arrive at an informed opinion about their health. (8/29)

The New York Times: Doctors Will Play A Critical Role In The Opioid Epidemic
About half of opioid overdose deaths involve prescription drugs. With that stark fact in mind, the surgeon general, Dr. Vivek Murthy, sent an unusually direct plea last week to 2.3 million doctors and other health care workers to help fight the opioid epidemic by treating pain “safely and effectively.” A website for his “Turn the Tide” campaign highlights alternative, nonaddictive treatments for pain. Not only doctors but also policy makers, insurance companies and other players in the health care system should pay attention. (8/30)

The New York Times: Surprisingly Little Evidence For The Accepted Wisdom About Teeth
I brush my teeth twice a day, but not for as long as my dentist would like. I’d like to say I floss regularly, but that would be stretching the truth. I don’t scrape my tongue, I don’t rinse with mouthwash and I don’t use an interdental brush or Waterpik. However, I have one filling in my mouth, and I got that only when I had braces as an adult 15 years ago. My wife, on the other hand, cares for her teeth fastidiously. She does all the things you’re supposed to do, and then some. But she has more fillings than I can count. I remember once, years ago, when one of her teeth broke while she was eating scrambled eggs. Clearly, the stuff we’re doing might not make as much of a difference as we think. (Aaron E. Carroll, 8/29)

Miami Herald: We Must Protect Pregnant Women From The Zika Virus
For a pregnant woman and her developing baby, Zika can be devastating. If a mother-to-be is infected with Zika — either from a mosquito or through unprotected sex with an infected partner — the virus can cause severe damage to the developing fetal brain resulting in microcephaly and other serious, irreversible birth defects. (Dr. Tom Frieden and Heidi Murkoff, 8/29)

Dallas Morning News: Texas Lawmakers Who Shuttered Abortion Clinics Need To Be Just As Worried About Moms' Mortality Rates
It would be presumptuous to draw a straight, unbroken line between Texas lawmakers' draconian, unconstitutional war on family planning clinics and a frightening surge in the number of Texas women dying of pregnancy-related causes. A 2011 law forced through by the state's Republican-led Legislature placed such demanding restrictions on clinics performing abortions that dozens of them have shut down. In some cases, women in poor and rural areas have been left with no access to reproductive care at all. The law was overturned by a sharply worded U.S. Supreme Court ruling in June, but the damage has been done. (Jacquielynn Floyd, 8/29)