KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Political Cartoon: 'Keep Me Posted'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Keep Me Posted'" by Dave Coverly, Speed Bump.

Here's today's health policy haiku:


Broad warning: No need …
At least that’s what execs said.
Doesn’t look good now.

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Summaries Of The News:

Campaign 2016

'Traditional Catholic' Kaine's Personal Qualms About Abortion A Contrast To Clinton

Although Hillary Clinton's running mate Tim Kaine says "the right role for government is to let women make their own decisions," he has some history with supporting anti-abortion programs that could make the topic a vulnerable spot for the Democrat in his debates with Republican vice presidential nominee Mike Pence.

The Associated Press: Kaine Liberal Appeal Muted By Energy Ties, Abortion Concerns
Hillary Clinton and running mate Tim Kaine are closely aligned on many issues, but Kaine's cautious, left-leaning political profile in a closely contested state is blurred by his ties to energy industry interests and his personal qualms over abortion. ... Clinton and Kaine are avowed champions of women's reproductive rights. But as a self-described "traditional Catholic," Kaine has long said he personally opposes abortion, a stance that drew criticism from women's groups. His personal qualms could cause complications later in the campaign when he debates Republican rival Mike Pence, an anti-abortion crusader. (7/23)

The New York Times: How Tim Kaine And Hillary Clinton Compare On The Issues
As governor of Virginia, Mr. Kaine supported some restrictions on abortion and said as a “traditional Catholic” that he was personally against abortion but supported abortion rights. As a senator, Mr. Kaine has voted in favor of funding Planned Parenthood and against attempts to restrict access to legal abortions. But he has also sought to reduce the number of abortions through education programs advocating adoption and abstinence. (Shepherd and Rappeport, 7/22)

Meanwhile, Kaine's views do align with Clinton's over improving the health law and expanding Medicaid —

Modern Healthcare: Clinton's VP Pick Kaine Is A Strong Backer Of Improving And Expanding The ACA
The man selected by presumptive Democratic presidential nominee Hillary Clinton as her vice presidential running mate is a strong ally of Clinton's in her push for improving the Affordable Care Act and expanding Medicaid to more states.Virginia Sen. Tim Kaine, whom Clinton named Friday as her running mate, has sponsored several bills to fix gaps and glitches in the ACA and to encourage more states to extend Medicaid to low-income adults. (Meyer, 7/22)

Clinton Likely To Make Health Care A Major Theme At Convention

Stat raises five questions about how the issue will play at this week's Democratic National Convention. Other media outlets look at what health care will look like under a new president and how Hillary Clinton's Medicare buy-in plan might appeal to insurers and employers.

Stat: 5 Health And Medicine Issues To Watch For At The Democratic Convention
Hillary Clinton led a health care reform effort in the 1990s, promoted medical research as a senator, and has been bashing price-hiking drug companies on the campaign trail and in TV ads. So there’s every reason to expect her to make health care a major theme when she accepts the Democratic presidential nomination in Philadelphia on Thursday night. (Nather, 7/25)

Roll Call: Clinton Medicare Buy-In Plan May Appeal To Insurers, Employers
Employers and insurers might benefit if Democrat Hillary Clinton were to win the presidency and persuade Congress to expand Medicare, policy experts say. Clinton supports allowing people to buy into the federal health program for senior citizens and those with disabilities at age 55, a decade earlier than usual. The potential for corporate backing for a Medicare expansion likely would depend on how a future president and Congress shaped such a proposal. Clinton’s platform doesn’t spell out the details. America’s Health Insurance Plans, a trade group for the health insurance industry, declined to comment, saying officials are waiting for more information. (Young, 7/22)


$1B Fraud Case Shines Light On Lucrative Medicare Black Market

Three people have been charged in the largest single criminal health care fraud case ever brought against individuals by the Department of Justice. “Medicare fraud has infected every facet of our health care system,” Wifredo A. Ferrer, the United States attorney in Miami, said Friday in announcing the indictments.

The New York Times: U.S. Says Florida Network Defrauded Medicare And Medicaid Of Over $1 Billion
In the biggest health care fraud case the Justice Department has ever brought, prosecutors charged on Friday that the owner of a network of Florida nursing facilities orchestrated an elaborate scheme to defraud Medicare and Medicaid of more than $1 billion over the last 14 years. The case, featuring allegations of bribes to Miami doctors, hush money to witnesses, and laundering of huge profits through shell companies, shone a light on a lucrative Medicare black market that has surfaced in the last decade. (Lichtblau, 7/22)

The Associated Press: Authorities: $1B Medicare Fraud Nursing Home Scam, 3 Charged
"This is the largest single criminal health care fraud case ever brought against individuals by the Department of Justice," Assistant Attorney General of the Justice Department's Criminal Division Leslie Caldwell announced in a statement. Authorities said Philip Esformes, who ran 30 nursing homes and assisted living facilities, joined with two conspirators and a complex network of corrupt doctors and hospitals to refer thousands of patients to their facilities even though the patients did not qualify for the services. Some of the treatments were harmful, they added. (Kennedy, 7/22)

The Wall Street Journal: Justice Department Charges Three In $1 Billion Medicare Fraud Scheme In Florida
The case was brought as part of an interagency Medicare Fraud Strike Force, which operates in nine locations across the country, officials said. Since its creation in March 2007, the task force has charged nearly 2,900 defendants who have collectively billed the Medicare program for more than $10 billion, they said. Fraud continues to plague the roughly $600 billion Medicare program, though new criminal cases have slowed in recent years. (O'Keeffe, 7/22)

Bloomberg: U.S. Charges 3 In $1 Billion Miami-Based Medicare Fraud Case
The Justice Department charged three Florida health care executives for allegedly carrying out a $1 billion Medicare scam involving numerous Miami-based medical providers. ... Philip Esformes, owner of a chain of more than 30 Miami-area skilled nursing and assisted living facilities, allegedly conspired with two other people to defraud Medicare by providing medically unnecessary services to people, according to a 34-page indictment released Friday. (Strohm and Harris, 7/22)

Medicare Safeguard Leaves Taxpayers Pouring Billions Into Pharma's Pockets

Medicare's catastrophic coverage was originally designed to protect seniors with multiple chronic conditions from the cumulatively high costs of taking many different pills, with the government paying 80 percent of the cost of drugs above a catastrophic threshold. But pricey drugs are stressing the system to its limits.

The Associated Press: Pricey Drugs Overwhelm Medicare Safeguard
A safeguard for Medicare beneficiaries has become a way for drugmakers to get paid billions of dollars for pricey medications at taxpayer expense, government numbers show. The cost of Medicare's "catastrophic" prescription coverage jumped by 85 percent in three years, from $27.7 billion in 2013 to $51.3 billion in 2015, according to the program's number-crunching Office of the Actuary. Out of some 2,750 drugs covered by Medicare's Part D benefit, two pills for hepatitis C infection — Harvoni and Sovaldi — accounted for nearly $7.5 billion in catastrophic drug costs in 2015. (Alonso-Zaldivar, 7/25)

The Associated Press: What Are The Top 20 Priciest Medicare Prescription Drugs?
A look at Medicare's top 20 priciest prescription drugs in 2015, ranked by their cost above the program's "catastrophic" coverage threshold. Medicare's catastrophic protection kicks in after a beneficiary has spent a given amount of their own money, $4,850 this year. The beneficiary pays only 5 percent, while their insurer pays 15 percent, and taxpayers cover 80 percent. Catastrophic spending is a large and growing share of total costs, threatening to make Medicare's popular prescription plan financially unsustainable. (7/25)

Health Law Issues And Implementation

Federal Judge In Missouri Says Individuals Can Challenge Health Law Contraception Mandate

The case was brought by a Missouri lawmaker who argued that birth control coverage in his state-provided health insurance violated his religious beliefs. In the ruling, U.S. District Judge Jean Hamilton says federal law requires that the government shall not "substantially burden" a person's exercise of religion. Also in health law news, Humana, which announced earlier that it is leaving many state insurance marketplaces, says it will continue to sell plans in Tennessee, and Covered California gets ready for a new rule requiring enrollees have a primary care provider.

The Associated Press: Court: Birth Control Mandate Violates Religious Rights
A federal judge has ruled in favor of a Missouri lawmaker who cited religious objections while challenging the inclusion of birth control coverage in his government-provided health insurance. State Sen. Paul Wieland said Friday that the ruling, while applying only to his family, could serve as a guide for others seeking to challenge the application of a section of President Barack Obama's health care law that requires insurers to include coverage of contraceptives. (Lieb, 7/22)

The Tennessean: Humana To Remain On Obamacare Exchange In Tennessee
Humana will offer health insurance over the federally run Obamacare exchange in 2017 in Tennessee, despite announcing it will leave nearly 90 percent of the areas in the United States where the company sells its plans. The Louisville-based insurer filed responses to questions regarding its rate request from Tennessee regulators on the same day it made public plans to discontinue selling some individual coverage as it struggles with losses. (Fletcher, 7/22)

California Healthline: No Primary Care Doc? We’ll Get You One
Health insurers are gearing up to comply with a new Covered California rule that will require them next year to ensure that all enrollees have a primary care provider. The policy change for 2017 is part of a broader push by the exchange to improve the quality of care, even as it faces double-digit premium increases. (Bartolone, 7/25)


A Game Of Whac-A-Mole: Regulators' Effort To Stop Insurers' Mega-Mergers Could Backfire

Even if federal officials are able to stop the two big mergers proposed by Anthem and Aetna, insurers would likely look for other ways to bolster their competitive edge, such as buying smaller insurers.

Modern Healthcare: Insurers Will Consolidate Even If Mega-Mergers Fail
But even if the federal government buries Anthem's $53 billion acquisition and Aetna's $37 billion purchase, the big five health insurers (which also include UnitedHealth Group) are likely to forge new transactions to scale up and improve their position at the bargaining table with consolidating hospitals and health systems. ... Centene Corp., Molina Healthcare and WellCare Health Plans, all publicly traded insurers, are logical targets because of their relatively smaller size. (Herman, 7/23)

Reuters: U.S. Government's Bid To Block Insurance Mergers Could Spawn New Ones
The potential bust-up of two mega deals among America’s largest health insurance companies may have an unintended result -- more mergers. The U.S. Department of Justice on Thursday sued to block Aetna Inc's $37 billion purchase of Humana Inc and Anthem Inc’s proposed $54 billion buyout of Cigna Corp, arguing that they would cut competition and boost rates for patients. If no settlement is reached for one or both deals, the fallback strategy for the four insurers to ensure future growth would likely be a familiar one: Another buying spree, this time of smaller insurers less likely to raise the ire of regulators. (O'Donnell and Humer, 7/22)

Women’s Health

In Marketing Effort, Planned Parenthood Uses Tumblr To Tackle 'Elephant In The Room'

The organization launches a campaign, that includes personal stories of abortion, in an effort to reach a younger audience.

The New York Times: Planned Parenthood Turns To Tumblr To Reach A Younger Audience
As it undertakes an ad campaign in celebration of its 100th anniversary, Planned Parenthood of New York City is trying to reach a younger generation with a message about sexual and reproductive health. That message does not shy away from what one expert in nonprofit marketing called “the elephant in the room” — abortion. To connect with those who were born after Roe v. Wade, the organization and its advertising agency, Kraftworks, turned to the microblogging social network Tumblr. (White, 7/24)

And in news out of the states —

The Associated Press: Alaska Parental Notification Abortion Law Struck Down
The Alaska Supreme Court on Friday struck down a state law requiring parental notification for girls under age 18 seeking abortions, agreeing with pro-abortion rights advocates that the mandate approved by voters in 2010 was unconstitutional. Justice Daniel Winfree, writing for the majority, said the court was not deciding whether abortions should be available to minors without restrictions but that the abortion notification law violated Alaska’s constitutional equal protection provisions giving the same rights to all Alaskans. (Bohre, 7/22)

The Associated Press: State Won't Enforce New Abortion Restrictions, For Now
Louisiana officials have agreed not to enforce several new restrictions on abortion pending a judge's decision on whether to block the laws. The restrictions include a requirement for a 72-hour waiting period for many women, and a ban on a common second-trimester procedure called dilation and evacuation. They were to take effect Aug. 1. Two clinics and three doctors filed a July 1 lawsuit against the new laws. (7/22)

Health IT

Hospitals Ask PokemonGo Users To Master Their Monsters Elsewhere

The hospitals are citing physical safety, patient privacy, player privacy, computer security and personal safety as concerns. In other news, inventors design technology with a focus on helping people with disabilities and doctors are optimistic about organ donor apps.

The Kansas City Star: Pik-Achoo! Hospitals Ask Pokémon Go Fans To Play Elsewhere
As you hunt for Pokémon across the Kansas City area, don’t search in hospitals or health care centers. A spot check of area hospitals shows several have requested that players, or “trainers,” master their monsters elsewhere. Playing Pokémon Go, the smartphone app game that lets users hunt for the virtual creatures in the real world, poses a real risk to patients, visitors and employees, according to a memo sent to employees of University of Kansas Hospital. (Serven, 7/24)

The Washington Post: Tinkering With A Mission: Weekend Inventors Create Affordable Technology
John Gluck’s eyes glistened with joy and amazement when a set of wooden shelves in front of him lit up in bright blue. This is no ordinary shelf: It moves up and down and in and out so that the eight-year-old, who is in a wheelchair, can easily access its contents. The special system was conceived, designed and built at the TOM:DC Makeathon, a three-day marathon design event hosted in Reston by the Tel Aviv-based non-profit startup TOM. The ‘T-O’ part of TOM, which launched in 2013, comes from “Tikkun Olam”, which is Hebrew for fixing the world. The ‘M’ stands for makers: people who take a do-it-yourself approach to inventing, designing and tinkering. TOM takes the maker movement one step further by focusing specifically on assistive technology to address unmet challenges for people with disabilities. (Hui, 7/24)

Kaiser Health News: Surgeon Says Apps May Turn Organ Donation Support Into ‘Concrete Action’
Zhai Yun Tan, for Kaiser Health News, reports: "Users of Tinder, the popular online dating app, usually swipe right on their mobile screens to gain a potential match. Come September, the same action might allow them to save lives by registering to be an organ donor. The donor registration drive is the culmination of the partnership between Tinder and a nonprofit group called Organize, which aims to end the organ donor shortage. A similar campaign between Tinder and the National Health Service was carried out in Britain last year. Organize is also partnering with the comedy video website Funny or Die, Facebook, various universities and hospitals to launch apps and social media campaigns to boost registrations for organ donations." (Tan, 7/25)

Meanwhile, a look at how technological needs are driving up physician practice mergers —

Modern Healthcare: IT Needs Are Driving The Upswing In Doc Practice Mergers
The merger-and-acquisition spree that in recent years has swept away hundreds of once independent physician practices continued unabated in the second quarter.Driven by the need to upgrade computers to meet escalating federal demands to measure quality, Tyler-based East Texas Anesthesiology Associates in June joined forces with U.S. Anesthesia Partners, a Fort Lauderdale, Fla.-based firm controlled by the private equity firm Welsh, Carson, Anderson & Stowe. (Barkholz, 7/23)

Public Health And Education

'The Babies Cannot Stop Crying': Treating Zika's Smallest Patients

Although much of the focus has been on prevention and vaccines, experts are scrambling to help doctors and families understand the lifelong ramifications of microcephaly and other Zika-related developmental disorders.

The Washington Post: Lifelong Care, Heartaches Ahead For Babies Born With Zika In The U.S.
At least 12 babies in the United States have already been born with the heartbreaking brain damage caused by the Zika virus. And with that number expected to multiply, public health and pediatric specialists are scrambling as they have rarely done to prepare for the lifelong implications of each case. Many of Zika’s littlest victims, diagnosed with microcephaly and other serious birth defects that might not immediately be apparent, could require care estimated at more than $10 million through adulthood. Officials who have been concentrating on measures to control and prevent transmission of the virus are now confronting a new challenge, seeking to provide guidance for doctors and others who work with young children with developmental problems. (Sun, 7/24)

In other news about the outbreak —

The New York Times: A Grim First: New York City Reports Baby Born With A Zika-Related Defect
Health officials on Friday reported the first baby born in New York City with the Zika-related birth defect known as microcephaly, a condition marked by an abnormally small head and impaired brain development. The virus has caused more than 1,500 children to be born with birth defects around the world, mostly in Brazil. As it continues to spread, doctors are struggling to understand the virus and to prepare for its effects. The baby in New York is one of a growing number of children born in the United States with microcephaly, a condition that requires intensive care and can lead to a variety of other problems, including seizures, vision and hearing loss and intellectual disability. (Santora, 7/22)

The New York Times: Summer Travel And The Zika Virus
Health officials have warned pregnant women to avoid travel to the more than 45 countries and territories in which the Zika virus is circulating. Infection during pregnancy can lead to birth defects in infants, particularly brain damage and abnormally small heads, called microcephaly. But with the Olympics nearing and summer tourism in full swing, what about other travelers? What are the risks of visiting a Zika-affected country for a woman who has no plans to get pregnant — or her partner, or her child? Here are some answers to commonly asked questions. (Saint Louis, 7/22)

Milwaukee Journal Sentinel: This Year, It's The Zika Virus. But What About Next Year?
This year, the Western Hemisphere is reeling from an outbreak of the mosquito-borne Zika virus, which has been linked to unusually small heads and brain damage in newborns. It prompted the World Health Organization to advise Brazilians to consider delaying pregnancy. And it is overshadowing the Summer Olympics set to start in Rio de Janeiro next month. On July 8, the first death in the continental United States from the virus was confirmed. But Zika is just the latest of many. (Lyon, 7/22)

How Philadelphia Became A 'Mecca' For Those Addicted To Heroin

Veteran narcotics agents describe the neighborhood a few miles from where Democrats will convene Monday as among the most flagrant open-air drug markets on the East Coast.

Los Angeles Times: Democrats Aren't The Only Tourists Flocking To Philadelphia. So Are Heroin Addicts
As Democrats from across the country flock to Philadelphia for their national convention, they won’t be the only tourists in town. Hundreds of heroin addicts from other states have washed up in Philadelphia, law enforcement officials say, drawn to a city that has become a major distribution hub for inexpensive, high-grade heroin produced by Mexico’s Sinaloa cartel. Philadelphia is a "mecca" for out-of-town addicts, said Justin Smith, 32, an addict who arrived six years ago from Ocean City, Md., and now sleeps on a stained mattress in a dank roadway tunnel in Kensington in north Philadelphia. (Bennett, 7/23)

In other news, President Barack Obama signed measures to combat the opioid crisis into law —

Reuters: Obama Signs Into Law Opioid Addiction Bill To Protect Newborns
President Barack Obama on Friday signed into law a measure that pledges greater efforts to protect drug-dependent newborns and assist their parents. The Comprehensive Addiction and Recovery Act also stresses drug treatment and overdose prevention to help stanch the nation’s heroin and opioid drug epidemic. (Wilson, 7/22)

The Hill: Obama Signs Opioid Bil
President Obama signed a bill aimed at addressing opioid addiction Friday, though he called out Republicans for the measure’s shortcomings. Lawmakers in both parties reached a compromise over the bipartisan Comprehensive Addiction and Recovery Act, though Senate Democrats held out hope until the final hour that they could win more funding for treatment. (Neidig, 7/22)

CIR: New Opiate Safety Law For Veterans Signed By President Obama
President Barack Obama signed sweeping new narcotics reforms into law Friday, that dramatically change the way the Department of Veterans Affairs dispenses and monitors dangerous and addictive opiates. The Jason Simcakoski Memorial Opioid Safety Act was prompted by an investigation published last January by Reveal from The Center for Investigative Reporting. The story disclosed that veterans at the VA hospital in Tomah, Wisconsin showed up to appointments stoned on prescription painkillers and muscle relaxants, dozed off and drooled during therapy sessions and burned themselves with cigarettes. (Glantz, 7/22)

Inexpensive Visual Training Cuts Likelihood Of Dementia Nearly In Half, Study Finds

The computerized training is designed to increase the speed at which the brain picks up and processes cues in a person’s field of vision. In other news, experts say a personality change can be an early indicator of dementia, and new research is helping doctors understand why amyloid beta isn’t properly cleared from the brain.

Los Angeles Times: Brain Training May Forestall Dementia Onset For Years, New Study Says
If you’re intent on keeping dementia at bay, new research suggests you’ll need more than crossword puzzles, aerobic exercise and an active social life. In a study released Sunday, researchers found that older adults who did exercises to shore up the speed at which they processed visual information could cut by nearly half their likelihood of cognitive decline or dementia over a 10-year period. (Healy, 7/24)

Stat: Play On! In A First, Brain Training Cuts Risk Of Dementia 10 Years Later
The training nearly halved the incidence of Alzheimer’s disease and other devastating forms of cognitive and memory loss in older adults a decade after they completed it, scientists reported on Sunday. If the surprising finding holds up, the intervention would be the first of any kind — including drugs, diet, and exercise — to do that. (Begley, 7/24)

The New York Times: Personality Change May Be Early Sign Of Dementia, Experts Say
“Has the person become agitated, aggressive, irritable, or temperamental?” the questionnaire asks. “Does she/he have unrealistic beliefs about her/his power, wealth or skills?” Or maybe another kind of personality change has happened: “Does she/he no longer care about anything?” If the answer is yes to one of these questions — or others on a new checklist — and the personality or behavior change has lasted for months, it could indicate a very early stage of dementia, according to a group of neuropsychiatrists and Alzheimer’s experts. (Belluck, 7/24)

WBUR: New Alzheimer's Research Sheds Light On 'Garbage Collecting' Proteins
Researchers have linked three genetic risk factors associated with Alzheimer’s disease to an immune cell dysfunction in mice, shedding light on a biochemical mechanism behind the genes. Researchers at Genentech, a biotechnology company based out of San Francisco, published their work in a recent article in the journal Neuron. Amyloid beta is a protein that has long been known to be a hallmark of Alzheimer’s disease — if you don’t have amyloid beta, you don’t have Alzheimer’s disease. (Michaels, 7/22)

Precision Medicine Initiative Seeks Partners In Research, Not Just 'Human Subjects'

The government wants millions of volunteers to become a part of a "precision medicine cohort," with the goal of more fully understanding the causes and cures of disease. But it doesn't just want "human subjects," it wants the participants to play an active role in the long-term study.

The New York Times: Uncle Sam Wants You — Or At Least Your Genetic And Lifestyle Information
Government scientists are seeking a million volunteers willing to share the innermost secrets of their genes and daily lives as part of an ambitious 10-year research project to understand the causes and cures of disease. Those selected to be members of the “precision medicine cohort” will be asked to provide a detailed medical history and blood samples so researchers can extract DNA. They will also be asked to report information about themselves — including their age, race, income, education, sexual orientation and gender identity, officials said. (Pear, 7/23)

In other public health news, sitting increases heart disease risk if it's for more than 10 hours a day, teenagers see e-cigarettes as cool and a new study looks at football players' severe head trauma —

Reuters: Sitting Can Be Bad, Especially If You Do It For More Than 10 Hours A Day
Being sedentary in moderation is unlikely to cause heart disease, according to a new review of past research. Researchers concluded that only very high levels of sedentary time — more than 10 hours a day — are linked to an increased risk of heart attack, stroke or other cardiovascular-disease-related death. Compared with sitting for less than three waking hours a day, more than 10 hours of sedentary time was tied to an 8 percent increase in the risk of developing heart disease, according to results in JAMA Cardiology. (7/24)

WBUR: Vaping Is Cool, Smoking Is Not: Could Rise Of Teen E-Cig Use Have An Upside?
A recent study in the Canadian Medical Association Journal claims the vibe of "cool/fun/something new” is what’s motivating kids to try e-cigarettes. Many of my friends crave new experiences and sensations; plus, who doesn't want to break the rules once in a while? According to the CDC, in 2015, 16 percent of high school students reported using e-cigarettes in the last month. For comparison, teen cigarette use is the lowest it's been in 40 years, reports the CDC, with just 9 percent of high schoolers reporting smoking in the last 30 days. (Michaels, 7/22)

Athens Banner-Herald: UGA Study: Player-On-Player Hits Cause More Serious Head Impacts
In football, player-vs.-player hits will likely cause more severe head impacts than other impacts, according to a new study by a University of Georgia researcher. The research also points to potential rule changes to further protect players. The study, which is published in the most recent issue of the journal Pediatrics, analyzed nearly 7,000 head impacts during 13 games in a high school football team’s season and post-season. (Morales, 7/22)

State Watch

Hospital Roundup: Texas Providers May Lose Federal Funds; Atlanta VA Facility Battles Air Quality Issues

Hospitals in Texas, Georgia, Florida, Minnesota, Kansas and Maryland make news.

The Dallas Morning News: Dallas’ Parkland Hospital Could Lose Federal Windfall
Federal officials have clamped down on a Medicaid windfall for private nursing home chains and scores of county hospital districts in Texas that have rushed to assume ownership, at least on paper, of nearly 250 nursing homes. The stampede by chains to “flip” their licenses to public hospitals, while continuing to operate them, began after the federal Centers for Medicare & Medicaid Services in October 2012 approved a little-noticed Texas twist to its Medicaid program for the poor. (Garrett, 7/24)

WSB-TV: Air Quality Problem Growing At Atlanta VA Hospital
In a written statement, the VA said the [Atlanta] hospital experienced an, "environmental issue in the operating suite between June 27 and July 6" and corrective measures were taken. But sources told Diamant more than 50 workers have gotten sick so far from a ventilation problem, not just in that second floor operating room suite near a construction site, but also on the first floor as recently as Thursday. With no answers from the VA about the problem's source, union leaders contacted federal investigators. (Diamant, 7/22)

Health News Florida: Health First Arms Security Guards After Deadly Shooting
Central Florida hospitals are increasing security in the wake of a deadly shooting inside a Brevard County hospital. Thursday was the first day some security guards at Health First Hospitals started carrying guns and batons. Health First has four hospitals in Brevard County, but doesn’t own Parrish Medical Center, where last Sunday’s deadly shooting happened. Parrish Medical Center is also considering new security measures like metal detectors. (Aboraya, 7/22)

Star Tribune: Mothers Emerge As A Force For Change At Minnesota State Mental Hospital
What began as a small group of mothers airing their grievances has evolved into something broader and more permanent. Between 20 and 40 people attend the council’s monthly meetings in St. Peter, including family and friends of patients as well as hospital administrators. Sharing a mutual concern for patients, they have become a vital part of the hospital’s efforts to improve care and could become a model for the rest of the mental health system, state officials say. (Serres, 7/24)

Kansas Health Institute: Osawatomie State Hospital: A Leading Light For Mental Health Care Slowly Dims
The final federal inspections of Osawatomie State Hospital in 2015 painted a picture of a place where both employees and patients were in danger and low staffing levels compromised care. It wasn’t always that way. At one time, the hospital was considered by some to be a leading light in treating people with serious mental illnesses. The Centers for Medicare and Medicaid Services decertified OSH in December 2015 because inspections found dangerous conditions for patients and staff. Since then, the decertification has cost the state about $1 million per month in federal payments. (Hart, 7/22)

The Washington Post: Health-Care Exec: Expect An ‘Oligopoly Of Hospitals’ For The Future
Health-care service is changing not only in Prince George’s County but across the nation. The shifts are so dramatic that small hospitals in communities across the nation will likely not survive what is coming their way, says Neil Moore, chief executive of the private nonprofit Dimensions Healthcare Systems — which operates hospitals in Prince George’s County. (Hernández, 7/22)

State Highlights: Questions Emerge Over Loan Funds To Aid Care For Disabled In Colo.; Talks Between Allina Health, Nurses Move On Key Issue In Minn.

Outlets report on health news from Colorado, Minnesota, Georgia, Kansas, California, Ohio and Pennsylvania.

The Denver Post: State Has No Idea If Loan Funds Are Spent Properly
Receipts for 98 loans totaling more than $660,000 from the Family Support Loan Fund — half of which are in default — are virtually nonexistent. As a result, officials with the Colorado Department of Health Care Policy and Financing, which administers the loan program, do not know whether borrowers used the money properly or as promised. The department was able to produce receipts for only 10 loans when The Denver Post asked to review paperwork for all 98 active loans. And four of the project receipts the state provided appear to be for loans paid off years ago and not part of the 98. (Migoya, 7/25)

Minnesota Public Radio: Allina Nurses Offer Deal On Health Insurance
There's been some movement on a key issue in contract talks between Allina Health and some 4,800 unionized nurses. In their last day of scheduled contract talks on Friday, nurses offered to eliminate two of their health insurance plans and increase out-of-pocket costs for remaining plans. In exchange, nurses want wages hikes of 4, 3 and 3 percent over three years, along with improved staffing and workplace safety. (Moylan, 7/22)

Augusta Chronicle: Grants Help Augusta University Train Advanced Nurses
Registered nurses who want to provide advanced care can get help with going back to school full time through two federal grants to the College of Nursing at Augusta University (in Georgia). The U.S. Department of Health and Human Services announced this week that its Health Resources and Services Administration was sending grants of $350,000 and $39,567 to the college to help train advanced practice nurses and nurse anesthetists, part of $4.6 million the agency was sending to agencies in the state. The programs are for training people who are already nurses to go back and get the advanced degrees. (Corwin, 7/21)

The Kansas City Star: Lead Problem (If There Is One) Remains A Frustrating Mystery In Salina, Kan.
In the coming weeks, the [Kansas Department of Health and Environment] will send teams to the homes of the 32 children, ages 6 months to 15 years, whose blood tests showed levels of at least 5 micrograms per deciliter. Health officials consider that reading too high. Until the investigations are completed, the Saline County seat of Salina, population 48,000, will fret over the possibilities: Could the drinking water be poisonous, as residents of Flint, Mich., discovered? (Montgomery, 7/24)

The Mercury News: Long-Delayed New Building At Valley Medical Center Set To Open In 2017
Santa Clara Valley Medical Center's new bed building is on track to be completed next June after years of delays and rising costs for which the recently reconciled county and Turner Construction Company both blamed each other. The building will open its doors to patients near the end of 2017, and officials from both sides were eager to put the difficulties behind them during a Friday media tour of the ongoing construction. (Knowles, 7/23)

Columbus Dispatch: Engaged Disabled Couple Would Lose Benefits If They Wed
The Scioto County couple is fighting for the right to marry without becoming impoverished or losing important Medicaid-funded services — trade-offs that many Americans with disabilities have long decried as unfair. Marriage affects various government-benefit policies and programs, including the $700-a-month Supplemental Security Income payment that Daniel, 53, relies on to round out her very modest earnings as a Project STIR (Steps Toward Independence and Responsibility) coordinator through the Scioto County Board of Developmental Disabilities. Adams, 43, a self-advocacy specialist through the board, said he receives about $1,100 a month in Social Security Disability Insurance. (Price, 7/24)

Editorials And Opinions

Viewpoints: Insurers, Mergers And Obamacare; Doctors Should Talk To Patients About Guns

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

The Wall Street Journal: ObamaCare And Big Insurance
Politicians tend to be most enraged by the problems they cause, and the liberal fury against insurance mergers is a classic of the genre. ObamaCare was designed to create government-directed oligopolies, but now its authors claim to be alarmed by less competition. Last week federal and 11 state antitrust regulators filed a double lawsuit to block the pending $54 billion insurance tie-up between Anthem and Cigna and the $37 billion acquisition of Humana by Aetna. The mergers would reduce the national commercial insurers to three from five, and Attorney General Loretta Lynch says the government won’t cede such “tremendous power” over health care to a more concentrated industry. (7/24)

The New York Times: When Health Insurers Merge Consumers Often Lose
A wave of mergers in many sectors of the economy over the last several decades has significantly reduced competition and hurt consumers. That’s why the lawsuits filed last week by the Department of Justice and state attorneys general in federal court challenging two big heath insurance mergers were so important. Antitrust officials say Aetna’s $37 billion acquisition of Humana and Anthem’s $54 billion purchase of Cigna will reduce the number of large national health insurers to three, from five today. (7/25)

Modern Healthcare: Don't Shed Tears For Health Insurers
A superficial reading of the latest headlines about the health insurance industry suggests it is facing serious problems. Rates on the Obamacare exchanges are set to rise at double-digit rates next year. California, a bellwether state, announced an average premium increase of 13.4% for 2017. UnitedHealth Group, the nation's largest insurer, has pulled out of most markets. (Merrill Goozner, 7/23)

Reuters: Doctors Should Be Able To Ask Patients About Guns
It is part of my job as a physician to ask patients about behaviors that may affect their health. Examples are smoking, drinking and wearing bicycle helmets. But if I were practicing in Florida, I might be legally restrained from asking whether they own a gun and, if so, whether it is stored safely. In addition, unlike, say, an embarrassing medical problem, any information regarding gun ownership cannot be entered into the patient’s medical record. This law, like recent attempts to block women’s access to abortion clinics in Texas, represents misappropriation and misuse of health concerns to advance other political agendas. (Michael Rosenbaum, 7/24)

Modern Healthcare: You Thought Obamacare Was A Big Deal? Take A Look At The GOP's Proposed Medicare Overhaul
In its 2016 platform released this week, the Republican Party took a political risk by embracing House Speaker Paul Ryan's longstanding proposal to convert the highly popular Medicare program from a defined-benefit system into a defined-contribution, “premium support” model. It's not surprising that the proposal wasn't mentioned by Republican presidential nominee Donald Trump at the GOP national convention, since he repeatedly has promised during the campaign that he wouldn't touch Medicare. (Harris Meyer, 7/22)

The Wall Street Journal: Telemedicine Runs Into Crony Doctoring
Telemedicine has made exciting advances in recent years. Remote access to experts lets patients in stroke, neonatal and intensive-care units get better treatment at a lower cost than ever before. In rural communities, the technology improves timely access to care and reduces expensive medevac trips. Remote-monitoring technology lets patients with chronic conditions live at home rather than in an assisted-living facility. Yet while telemedicine can connect a patient in rural Idaho with top specialists in New York, it often runs into a brick wall at state lines. Instead of welcoming the benefits of telemedicine, state governments and entrenched interests use licensing laws to make it difficult for out-of-state experts to offer remote care. (Shirley Svorny, 7/22)

The New York Times: Nursing Home Residents Still Vulnerable To Abuse
People entering nursing homes need to know that all reasonable safeguards are in place to ensure quality care. But federal rules to be finalized soon fail to hold nursing homes truly accountable to patients, their families or the law. At issue are arbitration clauses in nursing home contracts that require consumers to settle any disputes that arise over products or services through private arbitration rather than through lawsuits. Corporations of all sorts love forced arbitration because it overwhelmingly tilts in their favor and shields them from liability. But in the process, it denies justice to consumers, investors, patients and others who find they have no legal recourse when wronged. (7/25)

The Wall Street Journal: Why Are They Trying To Make Us Kill Our Patients?
I am an oncologist/hematologist who has been practicing in California, primarily at Eisenhower Medical Center in Rancho Mirage, for 39 years. It has been my privilege to have treated and cared for more than 16,000 patients with cancer or blood diseases and to have provided pain relief and comfort for the dying. I am also one of six concerned physicians who, along with the American Academy of Medical Ethics, have sued in a California Superior Court to try to block as unconstitutional the state’s Physician Assisted Suicide law, which went into effect on June 9. More recently, a group of doctors and health-care professionals in Vermont joined a lawsuit filed July 19 to try to block the way that state’s 2013 assisted suicide law is being interpreted and misapplied. (Philip B. Dreisbach, 7/24)

The Washington Post: The Wrong Way To Fight Disease
By inaction, Congress has left federal, state and local public health agencies scrambling to find resources to cope with the Zika virus carried by mosquitoes, for which there is no vaccine or effective cure. The virus is a serious threat to pregnant women, because it can lead to birth defects. It was irresponsible of Congress to leave town for the summer with President Obama’s $1.9 billion request up in the air. It also underscores a larger problem: The system for financing public health emergencies is flawed. (7/24)

The Washington Post: Return Of RAM: Another Year Without Health Care For Virginians
On a muggy summer day last year, I drove up the winding roads of Coeburn Mountain (sometimes called Wise Mountain, depending on which of those towns you call home). The founder of Remote Area Medical, Stan Brock, known around here as the Appalachia messiah, was coming to town again. I wanted to see what it was like to wait in a RAM line, as my grandfather, my friends and my neighbors have. It was foreboding. No one should feel like that, especially at a festive fairground, even when it morphs into a field hospital in the holler for the 17th time. (Matt Skeens, 7/22)

The New York Times' Upshot: You Probably Don’t Need Dental X-Rays Every Year
My dental hygienist complimented me on the health of my teeth and gums. Then she said something that you, too, have undoubtedly heard while sitting back in the dentist chair. “Would you like bitewing X-rays? It’s been a year since your last ones. Your insurance will cover them annually.” The easy answer was: “Yes. Bring on the bitewings!” They are, after all, painless, don’t take much time, and, as I was reminded, would not cost me a penny because they are covered by my insurance. But the easy answer isn’t necessarily the right one. Do I need bitewing X-rays every year? (Austin Frakt, 7/25)

Los Angeles Times: Should We Pay Women To Donate Their Eggs For Research? No, And Here's Why.
"Not everything in life is for sale, nor should it be.” That’s what California Gov. Jerry Brown said in 2013 when he vetoed a bill allowing women to be paid to donate their eggs for scientific research. “In medical procedures of this kind,” he added, “the long-term risks are not adequately known. Putting thousands of dollars on the table only compounds the problem.” But bad ideas don’t always die in Sacramento; they just hibernate. The proposal to repeal a 2006 ban on any payment beyond reimbursement for time and travel expenses is back this year, with barely a single word changed from the 2013 measure. Passed by the Assembly in April by a 65-3 vote, it will be taken up by the Senate after lawmakers return from vacation next month. (Michael Hiltzik, 7/22)

Raleigh News & Observer: Like Mental Health Reform, NC Medicaid Changes Would Be Disastrous
Over 10 years ago, I was chairman of the Mental Health Committee of the N.C. Pediatric Society and intimately involved in the early stages of reform, working with state government officials to try to make the best decisions we could. Because the mental health care delivery system was extremely expensive, North Carolina decided to get out of the mental health business by privatizing delivery. It would dismantle the system of government-run Area Programs and replace them with privately run Local Management Entities. The state was excellent at tearing down the infrastructure for mental health care delivery. The private sector, however, was not so good at replacing it. (David A Horowitz, 7/24)

Milwaukee Journal Sentinel: The Cancer Moonshot Summit And What It Takes To Cure Cancer
On June 29, more than 350 oncologists, researchers, data and technology experts, clinical laboratory organizations, cancer patients, patient advocates and others involved in cancer research and patient care were in Washington, D.C., for the National Cancer Moonshot Summit at the invitation-only summit hosted by Vice President Joe Biden. Aurora Cancer Care was among those invited to be a part of the discussion to find a cure. ... As a guest at the summit, I can tell you we're taking great strides in the battle, and two particular strategies discussed at the event are paramount to our efforts to beat cancer — molecular genetic testing and clinical trials. (James L. Weese, 7/24)