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Some skin in the game
For Medicaid expansion.
Jobs and premiums.

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Summaries Of The News:


Medicare Issues Delayed Hospital Star Ratings Despite Criticism

Many of the nation's best-known hospitals fail to nab 5 stars. But some in the industry say the ratings are an oversimplified judgment of quality. “Hospitals cannot be rated like movies,” says Dr. Darrell Kirch, president of the Association of American Medical Colleges.

Kaiser Health News: Many Well-Known Hospitals Fail To Score 5 Stars In Medicare’s New Ratings
The Centers for Medicare & Medicaid Services rated 3,617 hospitals on a one- to five-star scale, angering the hospital industry, which has been pressing the Obama administration and Congress to block the ratings. Hospitals argue the ratings will make places that treat the toughest cases look bad, but Medicare has held firm, saying that consumers need a simple way to objectively gauge quality. Medicare does factor in the health of patients when comparing hospitals, though not as much as some hospitals would like. Just 102 hospitals received the top rating of five stars, and few are those considered as the nation’s best by private ratings sources such as U.S. News & World Report or viewed as the most elite within the medical profession. (Rau, 7/27)

Modern Healthcare: CMS Releases Star Ratings For Hospitals
The CMS published the much-anticipated Overall Hospital Quality Star Ratings on Wednesday after industry stakeholders and Congress pressured the agency to continue to delay their release. The ratings are a composite metric of one to five stars, with five being the best. They intend to convey the overall quality of nearly 4,000 hospitals in the U.S and are posted to the CMS' Hospital Compare site. (Whitman, 7/27)

Morning Consult: CMS Launches Online Overall Quality Star Ratings For Hospitals
CMS delayed the release of the ratings earlier this year to allow more time for outreach to hospitals to understand concerns. That delay came after lawmakers from both parties urged the agency to delay the release of the ratings because they did not consider factors like a patient’s socioeconomic status or patient complexity. (McIntire, 7/27)

The Hill: Feds Issue Controversial Star Ratings For Hospitals
On Monday, Reps. Jim Renacci (R-Ohio) and Kathleen Rice (D-N.Y.) introduced H.R. 5927, a measure to delay the ratings until July 2017 and to require a 60-day comment period on the ratings’ data and methodology. The agency defended its work, claiming that research shows higher-rated hospitals have lower readmission and death rates. The CMS also said it took industry concerns about the differences between hospital types and sizes into consideration after the initial delay. (Clason, 7/27)

Media outlets report on the ratings from the states —

St. Louis Post-Dispatch: Several St. Louis Area Hospitals Get Low Marks In Government's Controversial Star Rating System
Not all hospitals shine brightly on the one- to five-star rating system, especially the hospitals many would expect to do well. Academic medical centers that provide highly specialized care received some of the lowest ratings, frustrating hospital leaders of those institutions. In the St. Louis area, Barnes-Jewish Hospital, a highly regarded 1,158-bed teaching hospital, garnered only a two-star rating, with five stars being the highest score. St. Louis University Hospital, also a teaching hospital, received only one star. (Liss, 7/28)

Georgia Health News: Georgia Hospital Industry Fires Back At Feds’ Quality Ratings
A federal health care agency Wednesday released its first overall star ratings for the quality of hospitals, and just two Georgia facilities earned the top five-star designation: Gordon Hospital in Calhoun, and Northside Medical Center in Columbus. ...In Georgia, five hospitals received the lowest score of one star: Grady Memorial Hospital in Atlanta; the Medical College of Georgia Hospitals and Clinics in Augusta; Phoebe Putney Memorial Hospital in Albany; Piedmont Henry Hospital in Stockbridge; and WellStar Atlanta Medical Center. The hospital industry nationally has fought against the release of the ratings, saying that those facilities that treat the most difficult medical cases were put at a disadvantage. (Miller, 7/27)


With Upbeat Earnings Report, Anthem Vows To Fight Federal Opposition To Merger With Cigna

The insurance giant tops analysts' expectations for the second quarter. It says that the planned $45 billion merger with Cigna is needed to help provide leverage to negotiate better prices for consumers and make it easier for the company to keep selling plans on the health law's online marketplaces.

The Wall Street Journal: Anthem: Getting Past Cigna Merger Blues
Anthem hasn’t given up on its merger with Cigna just yet. But second-quarter results suggest the backup plan isn’t a bad alternative. Anthem, the second-largest U.S. health insurer by membership, reported sales of $19.9 billion and adjusted earnings of $3.33 a share on Wednesday morning. That topped analyst estimates, but the stock traded lower. Higher-than-expected medical expenses were to blame. Those amounted to 84.2% of premium revenues, more than 2 percentage points higher than a year ago. Anthem blamed the squeeze in part on margin pressure in its Medicaid business, which is Anthem’s fastest-growing membership segment. (Grant, 7/27)

The Associated Press: Anthem Prepping For Hardball Fight With Feds Over Cigna Deal
Anthem has no intention of backing away quietly from its plan to buy rival Cigna in the face of federal opposition, and the company looks ready to play hardball. The health insurer told analysts Wednesday that it is preparing to fight the government's move to block its deal, and the company said its participation in the government's health insurance exchanges — a sore subject for the Obama administration that is trying to stop the acquisition — may be at stake. (Murphy, 7/27)

Reuters: Anthem To Fight For Cigna Deal, Sees Obamacare Losses
Anthem has argued that its planned $45-billion purchase of Cigna will give it greater leverage to negotiate better prices from healthcare providers and pass on those savings to consumers, including those signing up for "Obamacare" plans on public insurance exchanges. "To be clear, our board and executive leadership team at Anthem is fully committed to challenging the (U.S. Department of Justice's) decision in court," Chief Executive Joseph Swedish told analysts on a conference call. (Berkrot and Penumudi, 7/27)

Bloomberg: Anthem Tells Judge Cigna Deal Helps Health Insurance Markets
Anthem Inc. said its proposed $48 billion merger with rival health insurer Cigna Corp. will lower consumer costs and extend coverage to more people, in response to a U.S. lawsuit seeking to block the deal. The Indianapolis-based company also said the combined carrier would fortify the online insurance exchanges created under the Affordable Care Act at a time when other insurers are withdrawing from them, according to papers filed late Tuesday in federal court in Washington. (Harris, 7/27)

Modern Healthcare: In Answer To DOJ Lawsuit, Anthem Argues Cigna Deal Would Boost ACA Exchanges
Anthem threw punches back at the U.S. Justice Department's attempt to block the insurer's acquisition of Cigna Corp. The response signals Anthem will indeed litigate the case to the end even though many analysts and policy experts say the company is unlikely to win. In a newly filed legal response, Anthem's lawyers argued the deal to buy Cigna is “procompetitive” and specifically would allow Anthem to expand its presence on the Affordable Care Act's insurance exchanges. (Herman, 7/27)

The Wall Street Journal: Anthem Projecting Losses On Affordable Care Act Plans This Year
Anthem Inc. said it is now projecting losses on its Affordable Care Act plans this year, a turnaround for a major insurer that had maintained a relatively optimistic tone about that business. Anthem said it now believed it would see a “mid-single-digit” operating margin loss on its ACA plans in 2016, due to higher-than-expected medical costs. It expects better results next year, because it is seeking substantial premium increases. (Wilde Mathews, 7/27)

DOJ Launches Criminal Investigation Into Alere's Billing Practices

The diagnostic-testing company, which is in the middle of trying to sell itself to Abbott Laboratories, received a subpoena seeking information on its efforts to collect copayments from patients.

The Wall Street Journal: Alere Faces Criminal Probe Over Medicare, Medicaid Billing
Federal investigators are seeking information about government-billing practices at Alere Inc., adding to a litany of woes at the diagnostic-testing company as it seeks to complete a deal to sell itself. The Justice Department’s criminal-fraud section sent Alere a subpoena recently seeking patient-billing records, according to people familiar with the matter. It asked for information about Alere’s efforts to collect copayments from patients, as well as forms submitted on their behalf to government programs such as Medicare, the people said. (Hoffman, Viswanatha and Rockoff, 7/27)

Chicago Tribune: Abbott Has More Reason To Walk Away From Alere Deal
There's more evidence that Abbott Laboratories' pursuit of Alere, a health care diagnostics company, may have been a bad idea. Alere faces a federal criminal investigation over its Medicare and Medicaid billing practices, according to a report by the Wall Street Journal. News of the inquiry sent Alere's shares plunging nearly 29 percent Wednesday to $31.47 on the New York Stock Exchange. (Sachdev, 7/27)

Insurers In Maryland, Pennsylvania Seek Rate Increases

In Maryland, CareFirst BlueCross BlueShield tells state regulators that it misjudged in its earlier 12-percent increase request and now wants to increase rates by at least 27 percent. In Pennsylvania, insurers say double-digit increases are needed because costs are going up.

The Baltimore Sun: CareFirst Revises Request, Seeks Higher Rate Increase
CareFirst BlueCross BlueShield said Wednesday that rate increases it requested from the Maryland Insurance Commission earlier this year are not enough to cover costs for its exchange-based plans and that it needs even larger ones. The state's largest insurer asked the commission in May to allow it to increase rates by 12 percent for the HMO plans it sells on the state's online marketplace and by 30 percent for PPO plans. The rate proposals are for individual plans with coverage beginning Jan. 1. The insurer refiled its request Tuesday and is now asking for a 27.8 percent increase on its HMO plans and a 36.6 percent increase on its PPO plans. (McDaniels, 7/27)

The Philadelphia Inquirer: Health Insurers Making Cases For Pa. Rate Hikes
Saying their own costs have risen, health insurance companies made their cases to state regulators Wednesday for double-digit rate increases next year for individual policies in Pennsylvania. The requests before the Insurance Department include proposed average rate increases of 17.2 percent for Aetna Health Inc., 25.4 percent to 48.1 percent for Highmark companies, 0.9 percent to 16.2 percent for UPMC companies, and 19.9 percent to 22.5 percent for Independence Blue Cross companies, according to the department. (Langley, 7/28)

Campaign 2016

'Affordability, Affordability, Affordability': Clinton Allies Eye Health Costs As Top Priority

At the Democratic National Convention, some of Hillary Clinton's top supporters are talking about spiking health care costs as the next step in reform. Meanwhile, as abortion remains at the forefront of convention conversation, the Los Angeles Times looks at the states where the biggest battles are being fought.

The Hill: In Philly, Clinton Allies Say Healthcare Costs Are Next Big Battle
After six years of rock-solid defense, top healthcare advocates in the Democratic Party are now willing to acknowledge that the Affordable Care Act has fallen flat on affordability. At the Democratic National Convention this week, some of Hillary Clinton’s closest allies on healthcare are setting her up for a major battle to lower the cost of care, an issue they said needs to top her agenda as president. (Ferris, 7/27)

Los Angeles Times: A Woman At The DNC Just Discussed Her Abortion. Here's Where The Battle Over Abortion Rights Is Being Fought.
Abortion continues to be an important issue in the 2016 presidential election and has been referenced several times at the DNC so far, including today, when Ilyse Hogue, the president of a national pro-choice organization, discussed her own abortion in front of the convention. The next president’s Supreme Court nominee could tip the scales when it comes to decisions similar to the one made in June striking down Texas restrictions on doctors and clinics who perform abortions. (Rañoa, 7/27)


Highly Anticipated Alzheimer's Drug Fails Final Trial Stage, But Glimmer Of Hope Remains

The drug, called LMTX, was no more effective for most people than a sugar pill, but did work for a small subset of patients.

The New York Times: Alzheimer’s Drug LMTX Falters In Final Stage Of Trials
A new type of drug for Alzheimer’s disease failed to slow the rate of decline in mental ability and daily functioning in its first large clinical trial. There was a hint, though, that it might be effective for certain patients. The drug, called LMTX, is the first one with its mode of action — trying to undo so-called tau tangles in the brain — to reach the final stage of clinical trials. So the results of the study were eagerly awaited. The initial reaction to the outcome was disappointment, with perhaps a glimmer of hopefulness. (Pollack, 7/27)

Stat: Promising Alzheimer’s Treatment Flops In New Trial, Crushing Hopes
A closely watched treatment for Alzheimer’s disease came up short in a late-stage trial, marking the latest setback in a field wracked by years of failure. The drug, from biotech company TauRx, did no better than a sugar pill at improving patients’ scores on tests of cognitive and physical function, according to data presented early Wednesday at the Alzheimer’s Association International Conference in Toronto. The study looked at roughly 900 patients with mild to moderate forms of Alzheimer’s. “I must say I’m disappointed by the results,” said Dr. David Knopman, a Mayo Clinic neurologist not involved with the study. (Garde, 7/27)

Vertex's Cystic Fibrosis Drug On Track To Become 'Blockbuster' In Its First Year

The sales from Orkambi helped the company narrow its second-quarter losses. In other pharmaceutical news, Brexit is a mixed bag for GlaxoSmithKline and Teva wins approval to purchase Allergan's generics business.

The Wall Street Journal: Vertex Pharma Loss Narrows As Cystic Fibrosis Drug Sales Grow
Vertex Pharmaceuticals Inc. said its second-quarter loss narrowed, as sales of its cystic fibrosis drugs continued to grow. The Boston-based biopharmaceutical company’s top- and bottom-line results beat expectations. Its drug Orkambi, which received U.S. Food and Drug Administration approval roughly a year ago, treats patients with a genetic mutation that is the leading cause of the disease. The drug combines Vertex’s Kalydeco, which treats a different genetic type of cystic fibrosis, with another Vertex compound. (Stynes, 7/27)

Boston Globe: Vertex’s Cystic Fibrosis Drug On Track To Top $1 Billion In Sales This Year
Vertex Pharmaceuticals Inc. said Wednesday that its cystic fibrosis drug Orkambi, approved by US regulators last July, remains on track to generate sales of at least $1 billion this year, a feat that would make it a “blockbuster” in its first full year on the market. The biotech company, based in Boston, reiterated its 2016 revenue guidance of $1 billion to $1.1 billion for Orkambi and $685 to $705 million for another cystic fibrosis drug, Kalydeco, approved in 2012, in a second-quarter financial report in line with Wall Street expectations. (Weisman, 7/28)

The Wall Street Journal: GlaxoSmithKline Helped And Hurt By Sterling’s Post-Brexit Fall
While Brexit provided an expected boost to core earnings for GlaxoSmithKline PLC, it also led to a big write-down—the latest in a series of surprises stemming from Britain’s vote to leave the European Union. The U.K.-based drug giant said it recorded a £1.8 billion pound ($2.4 billion) charge to earnings, resulting in a net loss for the second quarter. The charge came after the company revalued its liabilities in line with the steeply lower pound. Sterling fell sharply after the Brexit vote last month and hasn’t recovered much. (Roland, 7/27)

Reuters: Teva Is Approved To Purchase Allergan’s Generics Business
Teva Pharmaceutical Industries won United States antitrust approval to purchase Allergan’s generics business after agreeing to sell 79 generic drugs to rival firms, the Federal Trade Commission said on Wednesday. The $40.5 billion deal, which was announced in July 2015, solidifies Teva’s position as the world’s largest maker of generics while freeing Allergan to focus on branded drugs. (7/27)

In Midst Of Opioid Crisis, Quietly Passed Law Relaxes Rules For Drug Companies

Critics of the legislation say it takes pressure off companies to detect and report drugs flowing to the black market. In other news, after fatal overdoses, advocates say dealers should face punishment, the use of an elephant sedative that's 100 times as potent as fentanyl is spreading and Ohio's attorney general says law enforcement officers should be protected from field testing street drugs.

Los Angeles Times: Amid Opioid Epidemic, Rules For Drug Companies Are Loosened
When it comes to combating the nation’s opioid epidemic, politicians of all stripes say they are fully committed. ... But this spring, with little attention and virtually no public opposition, lawmakers approved and the president signed a new law that makes it more difficult for government to take action against a key player in the crisis: the pharmaceutical industry. The law allows companies accused of failing to report suspicious orders of dangerous drugs to submit a “corrective action plan” to persuade the Drug Enforcement Administration to postpone or abandon proceedings against them. The law also raises the bar for the DEA to temporarily suspend their licenses. (Ryan and Christensen, 7/27)

Minnesota Public Radio: It's An Opioid Overdose Death. But Is It A Murder?
As the number of deaths from opioid overdoses has steadily increased over the last decade and a half, some prosecutors are turning more often to a state law that allows a person to be prosecuted for third-degree murder if they provided drugs that resulted in someone's death. Some defense attorneys argue that the third-degree murder law — and its accompanying instructions for juries considering the charge — are too broadly written and can ensnare and punish others dealing with addiction. (Collins, 7/27)

The Associated Press: A New Threat In Fight Against Overdoses: Elephant Sedative
A drug used to sedate elephants and other large animals, 100 times as potent as the fentanyl already escalating the country's heroin troubles, is suspected in spates of overdoses in several states, where authorities say they've found it mixed with or passed off as heroin. The appearance of carfentanil, one of the most potent opioids known to investigators, adds another twist to the fight against opioid painkillers in a country already awash in heroin and fentanyl cases. (7/28)

The Columbus Dispatch: DeWine Warns Ohio Police About Field Testing Potent Drugs
Attorney General Mike DeWine is warning Ohio law-enforcement agencies to reconsider testing street drugs on the scene because the potency of popular drugs — including heroin, fentanyl and even elephant tranquilizers — could harm officers who inhale or touch them. ... His concerns are valid and should be heeded, Drug Enforcement Administration Special Agent Rich Isaacson said. (Perry, 7/27)

Public Health And Education

Hour Of Exercise Can Make Up For Health Hazards Of Sitting All Day

A new study calculates a formula — 30 minutes of exercise for every 4 hours of inactivity — that can lower the risk of an early death from a sedentary lifestyle. In other public health news, the 'Ice Bucket Challenge' actually helped those with ALS, doctors tackle the question of what happens to the brain while a patient is under hypnosis and more stories.

The Washington Post: A New Formula For Exercise? Study Suggests 1 Hour Of Activity Per 8 Hours Of Sitting
If you fear you're doing irreparable damage to your body because your white-collar job keeps you sitting at your desk from 9 to 5, or you regularly spend entire weekends sprawled out on your couch binge-watching Netflix, there's some good news just out from sports medicine researchers. According to a study published in The Lancet, all is not lost. You may be able to "make up" for your increased risk of death due to a sedentary lifestyle by engaging in enough physical activity. So just how much is enough? (Cha, 7/28)

Stat: Attention Desk Jockeys: Those Who Sit At Work Need An Hour Of Exercise A Day
If you want to offset the health hazards of sitting at your desk all day, you’ll need to dedicate yourself to an hour of moderate exercise a day, according to a new analysis. Previous studies had already shown that lack of physical activity, and spending lots of time sitting, both have negative health effects — including cardiovascular disease, diabetes, cancer, and early death. But nobody had done a systematic review looking at the two combined. (Swetlitz, 7/27)

The New York Times: The ‘Ice Bucket Challenge’ Helped Scientists Discover A New Gene Tied To A.L.S.
It turns out those much-mocked Ice Bucket Challenge videos helped do a lot of good. Two summers ago, the challenge, designed to raise money for research into amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, took the internet by storm. Supporters ended up raising over $115 million for the A.L.S. Association. Over two years, money from the challenge has helped fund the research and development of treatment drugs and has been used as prize money to entice people to design technology for people living with the disease, which causes a rapid breakdown in a person’s ability to control muscle movement. (Roger, 7/27)

Stat: In Patients Under Hypnosis, Scientists Find Distinctive Patterns In The Brain
Psychiatrists have been using hypnosis on patients for decades — to help them reduce their pain or kick a smoking habit, among other reasons. But what, exactly, is happening to the patients’ brains when they are in a hypnotic state? To tackle that question, David Spiegel, a psychiatrist at Stanford University School of Medicine, and his colleagues recently decided to scan patients’ brains and see if hypnosis left a mark. It did. (ZImmer, 7/28)

The Washington Post: E-Cig Vapor Releases Two Cancerous Chemicals, New Study Says
Vapor from electronic cigarettes contains two previously undiscovered cancer-causing chemicals, according to a new study. Researchers at the Lawrence Berkeley National Laboratory found propylene glycol, an eye and respiratory irritant, and glycerin, a skin, eye and respiratory irritant, among 29 other chemicals released in e-cigarette vapor. Both are considered “probable carcinogens” by federal health officials. They’re used in e-cigarettes to create artificial smoke. (Bogage, 7/28)

KQED: Could ‘Brain Training’ Games Actually Work? New Study Surprises Scientists
We’ve seen — and done — some negative coverage of the so-called brain training industry, in which companies provide computerized games that ostensibly improve memory, attention, and other mental capabilities while — so some of the ads suggested — warding off cognitive decline. In January, one of the leading brands in this space, Lumosity made a deal with the Federal Trade Commission to cough up $2 million for partial refunds as compensation for deceptive advertising. (Brooks, 7/27)

Two More Possible 'Home-Grown' Zika Cases Spark Concerns Virus Is Spreading

Officials still do not expect a widespread outbreak in the continental U.S., but Florida is particularly vulnerable to the virus because of its climate.

Stat: New Zika Cases Suggest Florida May Be Seeing Viral Outbreak
Mosquitoes in the continental United States may now be spreading the Zika virus. Health officials in Florida said Wednesday they were investigating two Zika cases that could have been spread by local mosquitoes, in addition to the two similar cases they announced last week. None of the infected individuals has been confirmed to have acquired the virus from mosquitoes, but it seems increasingly likely that a local outbreak is occurring. (Joseph, 7/27)

Health News Florida: 2 More Possible Non-Travel-Related Cases Of Zika Investigated In South Florida
Two more possible non-travel-related cases of Zika virus are being investigated in South Florida, the Florida Department of Health confirmed Wednesday. The new cases are in Miami-Dade and Broward counties, the same areas where health officials began investigating two similar cases last week. The health department began going door-to-door in the area where the cases were found to determine if anyone else is infected. Officials are also collecting mosquitoes in the area for testing. (Ochoa, 7/27)

As Superbug Threat Looms, Scientists Discover New Antibiotic In Human Nose

The new antibiotic can kill MRSA, the poster child for drug resistance and the culprit behind the most pernicious hospital-acquired staph infections.

The Washington Post: Scientists Find New Antibiotic In The Human Nose
Scientists have discovered a bacterium living inside the human nose that produces an antibiotic capable of killing one of the most hard-to-treat pathogens — a pathogen that causes serious, even deadly skin and wound infections, bloodstream infections and pneumonia. German researchers found that this antibacterial substance was effective in treating skin infections in mice caused by Staphylococcus aureus bacteria, according to a study published Wednesday in Nature. The scientists said the substance, which they named lugdunin, has potent antimicrobial effects against a wide range of bacteria, including antibiotic-resistant strains such as methicillin-resistant S. aureus (MRSA) and vancomycin-resistant Enterococcus bacteria. (Sun, 7/27)

NPR: 'Nose-y' Bacteria Could Yield A New Way To Fight Infection
The scientists already knew that S. aureus lives in the noses of about 30 percent of humans, usually without causing harm — most people never know they are carriers of the bacterium. But if the body becomes compromised (whether by surgery, physical trauma, an underlying illness or suppressed immune system) the little cache of S. aureus in the nose can suddenly launch an attack against its human host. And if the strain of bacteria is MRSA, that infection can be lethal. (Beans, 7/27)

State Watch

Alabama Governor Proposes Lottery To Help Fund Medicaid, Other State Services

Gov. Robert Bentley will call the legislature into a special session to consider the plan. Also, a report finds that profits rose for Michigan's Medicaid managed care plans. Gov. Robert Bentley To Call Special Session For Alabama Lottery
Gov. Robert Bentley announced he will call a special session of the Legislature to consider a proposal for a lottery to help fix the state's persistent problem with funding state services. ... The most pressing issue, for now, is the Alabama Medicaid Agency, the largest consumer of dollars from the state General Fund and a program that serves about one million Alabamians. Earlier this year, lawmakers overrode Bentley's veto and approved a budget that appropriated $700 million from the General Fund for Medicaid for the fiscal year that starts Oct. 1. Bentley said Medicaid needs $785 million to maintain services and to sustain a plan to changed Medicaid to a managed care program run through regional care organizations, or RCOs. (Cason, 7/27)

Detroit News: Michigan’s Medicaid HMOs Earn Highest Profits In Decade
The state’s Medicaid HMOs defied predictions they’d lose money on the Healthy Michigan Plan, Michigan’s expanded Medicaid program, earning its highest profits in more than a decade last year, according to a new report. Michigan HMOs’ combined net income totaled $331 million in 2015, according to the Michigan Health Market Review, released Wednesday. The industry’s 2014 net income was $170 million. The decade’s previous high water mark was 2012 when net income for HMOs totaled $311 million. (Bouffard, 7/27)

UPMC Pays $2.5M To Settle Overbilling Charges In Federal Whistleblower Lawsuit

In other news, Beth Israel Deaconess Medical Center moves forward in its plan to develop closer ties with two other hospitals, Pennsylvania's Riddle Hospital receives a $16 million gift and a Florida malpractice case raises questions about the business of medicine.

The Associated Press: Hospital Network Paying $2.5M To Settle Overbilling Claims
The University of Pittsburgh Medical Center has paid $2.5 million to settle some claims in a federal whistleblower lawsuit accusing the hospital network of overbilling government insurance programs for neurosurgery. UPMC, Pennsylvania's largest private employer with 60,000 workers, didn't acknowledge wrongdoing in the settlement announced Wednesday by the U.S. Attorney's Office in Pittsburgh. The nonprofit reported $12 billion in revenue last year. (7/27)

The Boston Globe: Beth Israel Affiliation Plan Moves Forward
A state watchdog agency on Wednesday signaled its support for Beth Israel Deaconess Medical Center’s plan for closer ties with two hospitals, part of the health system’s effort to compete more aggressively against Partners HealthCare and other providers. Beth Israel Deaconess is seeking a clinical affiliation with MetroWest Medical Center, which would allow it to expand specialty medical services at MetroWest while gaining a new source of patient referrals from the Framingham-based hospital. It also wants to add MetroWest and New England Baptist Hospital to its affiliated network of health care providers that negotiates contracts with insurers. (McCluskey, 7/27)

The Philadelphia Inquirer: Riddle Hospital Getting $16M Gift
Riddle Hospital, part of Main Line Health, said it will receive a $16 million gift, the largest since the Delaware County hospital opened in 1963 and the largest gift in the Main Line system in the last 10 years. The money is from a trust created by John Bancker Gribbel who died in 1947 after being a long-time patient of Charles H. Schoff, who founded Riddle's predecessor, Media Hospital, in 1909, Main Line said Wednesday. (Brubaker, 7/27)

Health News Florida: Malpractice Case Against St. Pete Hospital Questions 'Business Of Medicine'
Most of Steve Kenan was laid to rest in St. Petersburg after his unexpected death in 2013. But not his heart. That organ, preserved in formaldehyde, has traveled more than 1,000 miles to be studied by pathologists in three states. So far, they can’t agree on what killed him; was it his chronic heart condition or a medical mistake? It’s an important question to St. Anthony’s Hospital, where Kenan died three hours after undergoing a non-emergency procedure that drained liquid from his chest. (Gentry, 7/28)

State Highlights: In Mass., Lyme Disease Legislation Highlights Division; In La., Federal Judge Saves Clinic From Eviction

Outlets report on health news from Massachusetts, Louisiana, Tennessee, Michigan and Maryland.

Boston Globe: Legislation Highlights Divisions On Lyme Disease
Health insurers would have to cover long-term antibiotic treatment for Lyme disease under a measure approved by the Massachusetts Legislature — a vote that places Governor Charlie Baker in the crossfire between mainstream medicine and patient activists. Baker has until midnight Thursday to sign or veto the legislation or to let it become law without his signature. The governor, a former health insurance executive, has reservations about the bill. In a letter to lawmakers, he wrote that “long-term antibiotic therapy is not clinically recognized as an appropriate form of treatment.” (Freyer, 7/28)

The Tennessean: Healthways To Sell Division, Brand To Sharecare In Major Corporate Shake-Up
Healthways has reached an agreement to sell a key division — as well as its name and brand — to Atlanta-based digital health company Sharecare. Under the deal, Sharecare is getting a variety of Healthways' signature programs, including its Blue Zones Project, Dr. Ornish's heart disease reversal program, Gallup-Healthways Well-Being Index, Healthways' stake in a joint venture in Brazil and a weight-loss collaboration with Johns Hopkins Medicine. (Fletcher, 7/27)

Stateline: Decades After Ban, Lead Paint Lingers
In the wake of the Flint water crisis, states are rushing to test for high levels of lead in drinking water. But many are failing to come to grips with a more insidious problem: lingering lead paint in homes and schools. Paint, rather than drinking water, remains the main source of lead poisoning of young children in the U.S. (Wiltz, 7/27)

Boston Globe: Marijuana Candy Sends Two Teens To Hospital
Hingham police are warning teenagers and parents about the dangers of marijuana-laced candy after a teenager last week called 911 to report that his friend was having an allergic reaction to food. Under questioning from a dispatcher, the 18-year-old boy said that the girl, who is 17, was “reacting to marijuana-laced candy,” according to a statement issued Wednesday by the police. (Quintana, 7/27)

The Baltimore Sun: NCAA, State Reach Settlement In Case Of Frostburg Football Player Who Died After Head Injury
The National Collegiate Athletic Association and the state of Maryland have reached settlements with the family of a Frostburg State University football player who died from concussion-related injuries in a case that could have nationwide implications for college sports...The [Board of Public Works] voted in favor of the proposed $50,000 payout to the family of Derek Sheely, who died in 2011 after he collapsed on the practice field from a traumatic brain injury. (Dresser, 7/27)

Weekend Reading

Longer Looks: Treating Addiction; An Ex-Con's Biotech Venture; And Oscar Takes On Patient Choice

Each week, KHN's Shefali Luthra finds interesting reads from around the Web.

The Washington Post: ‘How’s Amanda?’
She had already made it through one last night alone under the freeway bridge, through the vomiting and shakes of withdrawal, through cravings so intense she’d scraped a bathroom floor searching for leftover traces of heroin. It had now been 12 days since the last time Amanda Wendler used a drug of any kind, her longest stretch in years. “Clear-eyed and sober,” read a report from one drug counselor, and so Amanda, 31, had moved back in with her mother to begin the stage of recovery she feared most. (Eli Saslow, 7/23)

Stat: An Ex-Con Is Taking His Debt-Ridden, Cash-Burning Biotech Public. Why Are People Investing?
Its founder did time in federal prison for his role in the insider trading scandal that put Martha Stewart in handcuffs. Its CEO has a decades-old drug trafficking charge on his résumé. The company is also laden with debt and burning through cash at a rate that threatens to bankrupt it by year’s end. Yet biotech startup Kadmon has convinced investors to back an initial public offering that values the company at more than $800 million. It’s expected to raise $100 million on the New York Stock Exchange this week. (Damian Garde, 7/26)

The New York Times: Skinny And 119 Pounds, But With The Health Hallmarks Of Obesity
Claire Walker Johnson of Queens was a medical mystery. No matter how much she ate, she never gained weight. And yet Ms. Johnson, with a long narrow face, had the conditions many obese people develop — Type 2 diabetes, high blood pressure, high cholesterol and, most strikingly, a liver buried in fat. She and a very small group of very thin people like her have given scientists surprising clues to one of the most important questions about obesity: Why do fat people often develop serious and sometimes life-threatening medical conditions? (Gina Kolata, 7/22)

The Atlantic: A Psychedelic Can Cure Heroin Withdrawal
Drug recovery begins, so the story goes, with a crucial insight when an addict hits “rock bottom” and finally becomes ready to change. Given the notorious savagery of heroin withdrawal—along with the perceived importance of insight —ibogaine sounds like a panacea. The trouble is, the problem with heroin addiction is not withdrawal. (Jessa Gamble, 7/25)

Vox: A Google-Backed Health Insurer Wants To Disrupt Insurance By ... Limiting Patient Choice?
The health insurer Oscar launched in 2014 with $40 million in venture capital and a plan to disrupt America’s $1.8 trillion health care industry. Oscar positioned itself as a "simple, smart" alternative to stodgy industry giants — a health plan meant to live on smartphones and deliver virtual doctor visits. The timing seemed perfect, too: The new Obamacare marketplaces created an easy way to pitch consumers directly on a better experience. (Sarah Kliff, 7/26)

Editorials And Opinions

Viewpoints: Despite Good News, Anthem May Have Worries; Health Care And Partisanship

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

Bloomberg: Anthem's Good, Bad And Ugly News
Anthem had some good headlines on Wednesday. The insurer reported second-quarter earnings and revenue that topped estimates, with the latter jumping 7.2 percent from a year earlier. It expects to insure more people than it initially forecast this year, after surprisingly robust growth in its Medicaid business. But beneath the good, there was also bad and ugly. (Max Nisen 7/27)

news@JAMA: JAMA Forum: The Partisan Divide On Health Care
Now that the party platforms for the 2016 campaign are written and posted online, we can see that Republicans and Democrats are as far apart on health care as they have been for quite some time. Platforms are never implemented as written, and not all candidates endorse every plank in them. However, they signal which issues are important to the parties and, broadly speaking, what candidates aim to do about them. (Larry Levitt, 7/27)

Modern Healthcare: Democratic Policy Experts Warn The ACA Is In Big Jeopardy If Trump Wins
Many healthcare industry leaders believe the Affordable Care Act is too deeply entrenched to be repealed, as Republican presidential candidate Donald Trump and his party promise to do. But in the Democratic National Convention's only public discussion on healthcare policy, architects of the Affordable Care Act Wednesday warned he and congressional Republican leaders could indeed abolish key elements and roll back the insurance expansions and consumer protections. (Harris Meyer, 7/27)

San Francisco Chronicle: Depersonalization Of Health Care Not Discussed By Candidates
Gone are the days when most patients were discharged with clear diagnoses and in a stable condition. Not only was this good for patients but it served young doctors in training as well. For they saw a patient who had pneumonia or who had an appendectomy go through the full gamut of symptoms and treatment and on to recovery. This gave them confidence in their diagnostic and treatment skills. Now they are deprived of that. (Edward Volpintesta, 7/27)

The New York Times: In A Hospital, Health Care Until The Clock Runs Out
Once hospitals were where you found a doctor when you suddenly needed one; now doctors are all over the place, from big-box stores to storefront clinics. Hospitals were where you were headed if you were very sick; now you can heed your insurer’s pleas and choose a cheaper emergency center instead. Hospitals were where you stayed when you were too sick to survive at home; now you go home anyway, cobbling together your own nursing services from friends, relatives and drop-in professionals. (Abigail Zuger, 7/25)

The New England Journal Of Medicine: Caring For High-Need, High-Cost Patients — An Urgent Priority
Improving the performance of America’s health system will require improving care for the patients who use it most: people with multiple chronic conditions that are often complicated by patients’ limited ability to care for themselves independently and by their complex social needs. Focusing on this population makes sense for humanitarian, demographic, and financial reasons. From a humanitarian standpoint, high-need, high-cost (HNHC) patients deserve heightened attention both because they have major health care problems and because they are more likely than other patients to be affected by preventable health care quality and safety problems, given their frequent contact with the system. Demographically, the aging of our population ensures that HNHC patients, many of whom are older adults, will account for an increasing proportion of users of our health care system. And financially, the care of HNHC patients is costly. One frequently cited statistic is that they compose the 5% of our population that accounts for 50% of the country’s annual health care spending. (David Blumenthal, Bruce Chernof, Terry Fulmer, John Lumpkin, and Jeffrey Selberg, 7/27)

Stat: I’m An Immigrant And A Muslim. And I’M Here To Cure Cancer
It’s a long way from where I grew up in Karachi, Pakistan, to the dining room in Vice President Joe Biden’s home at the Naval Observatory in Washington, D.C. Yet that’s where I found myself one day last December, along with a handful of other cancer specialists. We had been invited to offer our perspectives on the current cancer landscape, which contributed to shaping the “cancer moonshot.” I’m convinced that my perspective on medicine as an immigrant is what ultimately got me to the table. (Azra Raza, 7/28)

The New York Times: Fraud And Other Threats To Medicare
Last week, when the Department of Justice charged three people in Miami with fraud and other crimes in a $1 billion scheme to bilk Medicare, it was the single largest criminal case in the nine-year history of the Medicare Fraud Strike Force, a coalition of federal, state and local law enforcement agencies. A month earlier, a crackdown by the strike force led to civil and criminal charges against 301 people in dozens of schemes totaling $900 million in allegedly false billings. Clearly, health care fraud is vast. Less obvious is that prevention, detection and punishment of fraud have improved in recent years, though that would be threatened if the Affordable Care Act of 2010 were weakened, as Republicans have long demanded. (7/28)

The New York Times' Upshot: Stem Cell Therapies Are Still Mostly Theory, Yet Clinics Are Flourishing
Health regulators in the United States are talked about as the best in the world, but a new study on the spread of stem cell clinics shows what can happen when regulations fall behind. Out of nowhere, over the past two to three years, the clinics have sprung up — 570 in the United States, according to a recent paper — offering untested stem cell treatments for just about every medical use imaginable. (Gina Kolata, 7/28)

Stat: Trying To Find Adequate Elder Care Is A Bureaucratic And Personal Nightmare
At age 83, my mom became steadily incapacitated by Parkinson’s disease and a gradual loss of vision. Finding care for her was a challenge, especially from 1,200 miles away. I quickly learned that my research had vastly underestimated the complications of long-distance caregiving. Problems emerge often, whether you are readily available or not, and they tend to demand immediate attention. Nor had I fully comprehended the extent of the vigilance required to protect against insufficient, low-quality services, whether by home health agencies, nursing homes, assisted living facilities, or hospitals. (Laura Katz Olson, 7/27)