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KHN First Edition: March 16, 2016


First Edition

Wednesday, March 16, 2016
Check Kaiser Health News online for the latest headlines

Today's early morning highlights from the major news organizations.

Kaiser Health News: Doctors Ponder Delicate Talks As Medicare Pays For End-Of-Life Counsel
Kaiser Health News staff writer Phil Galewitz reports: "Physicians can now bill Medicare $86 for an office-based, end-of-life counseling session with a patient for as long as 30 minutes. Medicare has set no rules on what doctors must discuss during those sessions. Patients can seek guidance on completing advance directives stating if or when they want life support measures such as ventilators and feeding tubes, and how to appoint a family member or friend to make medical decisions on their behalf if they cannot, for instance. The new policy reflects Americans’ growing interest in planning the last stage of their lives when they may be unable to make their wishes known."(Galewitz, 3/16)

The New York Times: C.D.C. Painkiller Guidelines Aim To Reduce Addiction Risk
In an effort to curb what many consider the worst public health drug crisis in decades, the federal government on Tuesday published the first national standards for prescription painkillers, recommending that doctors try pain relievers like ibuprofen before prescribing the highly addictive pills, and that they give most patients only a few days’ supply. The release of the new guidelines by the Centers for Disease Control and Prevention ends months of arguments with pain doctors and drug industry groups, which had bitterly opposed the recommendations on the grounds that they would create unfair hurdles for patients who legitimately have long-term pain. (Tavernise, 3/15)

The Associated Press: CDC Guidelines Aim To Curb Painkiller Prescribing
Prescription painkillers should not be a first choice for treating common ailments like back pain and arthritis, according to new federal guidelines designed to reshape how doctors prescribe drugs like OxyContin and Vicodin. Amid an epidemic of addiction and abuse tied to these powerful opioids drugs, the Centers for Disease Control and Prevention is urging primary care doctors to try physical therapy, exercise and over-the-counter pain medications before turning to painkillers for chronic pain. Opioid drugs include medications like morphine and oxycodone as well as illegal narcotics like heroin. (3/15)

The Washington Post: CDC Warns Doctors About The Dangers Of Prescribing Opioid Painkillers
This first national guidance on the subject is nonbinding, and doctors cannot be punished for failing to comply. But the head of the Centers for Disease Control and Prevention, which issued the guidelines, said the effort was critical to bringing about “a culture shift for patients and doctors.” “We are waking up as a society to the fact that these are dangerous drugs,” Director Tom Frieden said in an interview. (Demirjian and Bernstein, 3/15)

The Wall Street Journal: CDC Issues Guidelines To Limit Opioid Painkiller Prescriptions
The CDC also recommends limiting opioid prescriptions for patients suffering short-term, acute pain to three days or less in most conditions, and says that more than seven days’ worth of opioid drugs “will rarely be needed.” “If you’re prescribing an opiate to a patient for the first time, that’s a momentous decision,” CDC Director Tom Frieden said in an interview. “That may change that patient’s life for the worse forever. So you’ve really got to think carefully before doing it.” (McKay, 3/15)

Los Angeles Times: CDC Issues New Pain Pill Guidelines Amid Epidemic Of Overdose Deaths
Doctors should be more cautious about prescribing narcotic painkillers except in the most extreme cases, federal regulators announced Tuesday, in an attempt to slow down the nationwide epidemic of overdose deaths. The U.S. Centers for Disease Control and Prevention urged physicians to have their patients try physical therapy, exercise and over-the-counter medicine before using opioids like Oxycontin and hydrocodone to treat chronic pain. (McCoppin, 3/15)

The Associated Press: Panel To Advance Budget Plan Despite Conservative Rebellion
A House panel is pressing ahead with a 10-year balanced budget plan that cuts federal health care programs and agency budgets even though tea partyers are rebelling in a setback for Speaker Paul Ryan. The Budget Committee vote on Wednesday would send the GOP fiscal plan to the full House, but it's looking increasingly likely that the blueprint may not pass. The fiscal blueprint released by Budget Committee Chairman Tom Price relies on eliminating health care subsidies and other coverage provided by Obama's health care law, makes sharp cuts to Medicaid, and reprises a plan devised by Ryan years ago that would transform Medicare into a voucher-like program for future retirees. (3/16)

The Associated Press: Ex-Officials Point Fingers At Hearing On Flint Water Crisis
Former city and federal officials pointed fingers at one another for failing to protect the 100,000 citizens of Flint, Michigan, from lead-laced water at a congressional hearing Tuesday as Republicans targeted for blame an Environmental Protection Agency executive who resigned as the crisis worsened. Amid withering criticism, Susan Hedman sought to defend the EPA's actions to deal with the contamination in the predominantly African-American city. "I don't think anyone at EPA did anything wrong, but I do believe we could have done more," said Hedman, the former director of the EPA's Midwest regional office. (Lardner and Daly, 3/16)

NPR: Before Flint, Lead-Contaminated Water Plagued Schools Across U.S.
Across the country, it's hard to know whether there's lead in school water. [Researcher and activist Yanna Lambrinidou of Virginia Tech] says for the vast majority of schools, there is no requirement to test for lead. Even if a school finds lead, there's no mandate to fix it or tell parents. "What we see again and again is that the people who first discovered the contamination were parents whose children were diagnosed with elevated blood lead levels," Lambrinidou says. Three times over the past decade, she says, Congress has declined to pass legislation that would have required schools to test for lead and make the results public. (Ludden, 3/16)

The Associated Press: Valeant Shocks With Missed 4Q Results, Slashed 2016 Guidance
Shares of Valeant Pharmaceuticals crashed Tuesday after the embattled drugmaker failed to reassure investors that it's getting back on track and even conceded for the first time that it's technically in danger of defaulting on its debt. The company faces a virtual Murphy's Law of problems: falling sales, increased pressure to cut drug prices, massive debt, three ongoing federal probes of its accounting and pricing practices, and shareholder lawsuits in the U.S. and Canada. Valeant's already depressed shares took their biggest one-day tumble ever, falling just over 50 percent Tuesday after the company finally reported its overdue fourth-quarter results, which missed profit expectations. (3/15)

The Wall Street Journal: Valeant Slashes Guidance, Warns Of Possible Default; Shares Cut In Half
Investors punished Valeant Pharmaceuticals International Inc. on Tuesday, cutting its shares in half after the drugmaker slashed its guidance and said it could be in danger of defaulting on some of its debt. Tuesday’s plunge came as Valeant outlined the potential for a default, its cuts to quarterly and annual guidance, and tweaks to its business model that would scrap many of the practices that defined the company. (Rapoport, 3/15)

The Wall Street Journal: 5 Things To Know About The Valeant Rout
Shares of Valeant Pharmaceuticals fell 51% after the drugmaker slashed its guidance, announced unaudited fourth-quarter results that were below expectations and warned it could be in danger of defaulting on some of its debt if it doesn’t file an already delayed annual report by an April deadline. (3/15)

The New York Times: Figuring Out What Valeant Is Really Worth
As investors dumped shares of the beleaguered Valeant Pharmaceuticals International on Tuesday, erasing more than $11 billion from its market value, the company’s previously large crowd of believers was becoming vanishingly thin. ... What is Valeant’s collection of businesses worth? That question has emerged as critical to the company’s future, given that its stock market value of $11.4 billion after the close of business on Tuesday was less than half of the $31 billion in debt the company carries. (Morgenson, 3/15)

The Wall Street Journal: MannKind Shares Drop On Wider-Than-Expected Loss
Shares of MannKind Corp. on Tuesday slid 10% after the biopharmaceutical firm posted a wider-than-expected loss for the final quarter of the year Monday following the termination of its agreement with its licensing partner for its diabetes treatment Afrezza. The company’s stock, which had already lost about three-quarters of its value over the past 12 months, fell to $1.27. MannKind produces Afrezza along with partner Sanofi-Aventis. (Steele, 3/15)

The Washington Post: A New Sign Obamacare Is Helping The People Who Really Need It
People enrolled in health plans through the Affordable Care Act exchanges are ramping up their use of prescription medications more rapidly than those in employer or government-sponsored plans, according to a new report from Express Scripts, the largest prescription drug benefits company. ... The rapid uptake of the prescription drug benefit suggests there was a significant unmet medical need for many people gaining insurance through the exchanges, some of whom could have preexisting conditions and may not have previously had access to medicines. (Johnson, 3/15)

The Associated Press: VA Moves To Fire 3 More Phoenix Executives In Scandal
Three more executives are being fired from the troubled Phoenix veterans hospital where a national scandal erupted two years ago over secret waiting lists and unnecessary deaths, the Department of Veterans Affairs said. Dr. Darren Deering, the hospital's chief of staff; Lance Robinson, the hospital's associate director; and Brad Curry, chief of health administration services, were all formally proposed for removal from the VA on Tuesday. The officials will be able to challenge their dismissals under VA rules. (3/15)

The Associated Press: Haley Says She's Likely To Sign Bill Restricting Abortion
Gov. Nikki Haley said Tuesday that she will almost certainly sign a bill banning abortion past 19 weeks in South Carolina. "I can't imagine any scenario in which I wouldn't sign it," said the Republican governor. She said she will look at the details once the bill reaches her desk. That could be soon. The GOP-controlled House is expected to vote Wednesday on a compromise the Senate passed last week. (3/15)

NPR: To Quit Smoking, It's Best To Go Cold Turkey
Nicola Lindson-Hawley remembers how hard it was for her mom to stop smoking. "One of the reasons I find this topic very interesting and why I went into it was because my mom was a smoker when I was younger," says Lindson-Hawley, who studies tobacco and health at the Nuffield Department of Primary Care Health Sciences at the University of Oxford. She remembers helping her mom keep track of the number of days she'd stayed away from cigarettes by putting stickers in a journal. By studying about 700 adult smokers, she found out that her mom quit the right way — by going cold turkey. The results are out in the current issue of Annals of Internal Medicine. (Bichell, 3/15)

The Washington Post: NFL Stands By Safety Official’s Acknowledgement Of CTE Link To Football
The NFL is standing by the acknowledgement on Capitol Hill by its top player safety official of a link between football and degenerative brain disease. “The comments made by Jeff Miller yesterday accurately reflect the view of the NFL,” league spokesman Brian McCarthy said in a written statement provided Tuesday to The Washington Post. Miller, the NFL’s senior vice president for health and safety policy, was asked during a round-table discussion Monday by Rep. Jan Schakowsky (D-Ill.) whether there is a link between football and degenerative brain disorders such as chronic traumatic encephalopathy, or CTE. Miller said that “the answer to that is certainly, yes.” (Maske, 3/15)

NPR: In A First, NFL Executive Admits Football Is Linked To Brain Damage
A discussion on Capitol Hill about concussion research brought a startling moment Monday, as an NFL executive acknowledged for the first time that football has been linked to a degenerative brain disease. Jeff Miller, the NFL's executive vice president for health and safety, admitted the connection when he was asked about research by Boston University neuropathologist Dr. Ann McKee, who has reported finding signs of chronic traumatic encephalopathy in the brains of 90 out of 94 former pro football players — and 45 out of 55 former college players. (Chappell, 3/15)

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2016 Kaiser Health News. All rights reserved.

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