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KHN First Edition: March 23, 2016


First Edition

Wednesday, March 23, 2016
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Electronic Records Offer A Chance To Ensure Patients’ End-Of-Life Plans Aren’t Lost In Critical Moments
Kaiser Health News staff writer Shefali Luthra reports: "In a perfect world, patients with advance directives would be confident that their doctors and nurses — no matter where they receive care — could know in a split second their end-of-life wishes. But this ideal is still in the distance. Patients’ documents often go missing in maze-like files or are rendered unreadable by incompatible software. And this risk continues even as health systems and physician practices adopt new electronic health records. So advocates and policymakers are pushing for a fix." (Luthra, 3/23)

Kaiser Health New: Hackers Seek Ransom From Two More California Hospitals
Kaiser Health News' Chad Terhune reports: "Hackers demanded a ransom from two more Southern California hospitals last week and federal authorities are investigating the case. Prime Healthcare Services Inc., a fast-growing national hospital chain, said the attackers infiltrated computer servers on Friday at two of its California hospitals, Chino Valley Medical Center in Chino and Desert Valley Hospital in Victorville. The company said the cyberattack had not affected patient safety or compromised records on patients or staff." (Terhune, 3/22)

The New York Times: Supreme Court Case On Contraceptives Mandate May Offer Little Closure
The Supreme Court will return on Wednesday to the question of whether a regulation requiring many employers to provide free contraception coverage for their workers under the Affordable Care Act violates a federal law protecting religious freedom. In 2014, Justice Antonin Scalia was part of a 5-to-4 majority that voted to limit the mandate, and his death last month raises the possibility of a tie vote in the new case that would leave in place conflicting appeals court decisions and a national legal patchwork. (Liptak, 3/23)

The Associated Press: Obama Health Law Birth Control Plan Returns To Supreme Court
Contraception is among a range of preventive services that must be provided at no extra charge under the health care law. The administration pointed to research showing that the high cost of some methods of contraception discourages women from using them. Houses of worship and other religious institutions whose primary purpose is to spread the faith are exempt from the birth control requirement. Other faith-affiliated groups that oppose some or all contraception have to tell the government or their insurers that they object. The groups say doing so leaves them complicit because the government is using their insurers and health plans to provide the contraception. (3/23)

The Washington Post: Issue Of Contraceptive Coverage Returns To Supreme Court
Two years ago, Justice Anthony M. Kennedy played down the impact of the decision he had just joined in Hobby Lobby v. Burwell that relieved religiously objecting owners of certain businesses from providing contraceptive coverage to their employees. ... The solution Kennedy suggested — an accommodation that would insulate employers from providing the contraceptive coverage but still ensure that their employees receive it — will be at the heart of the discussion Wednesday when the Supreme Court undertakes its fourth consideration of what is popularly called Obamacare. (Barnes, 3/22)

The Wall Street Journal: Contraception Controversy Returns To Supreme Court
As in the Hobby Lobby case, the justices are expected to focus on the 1993 Religious Freedom Restoration Act, which bars U.S. laws that “substantially burden” religious expression unless they further a “compelling governmental interest” that can’t be achieved through less-restrictive means. This time, the justices will directly examine the system devised by the Obama administration after the 2014 case. That workaround aims to retain coverage for individuals while meeting religious objections of nonprofit employers such as the Catholic charities overseen by the bishop and for-profit employers such as Hobby Lobby. ... Most lower courts considering the workaround system have sided with the government. ​The court’s likely swing vote, Justice Anthony Kennedy,​suggested in the 2014 Hobby Lobby case that the workaround could reconcile the competing interests of religious objectors and public-health policy. (Radnofsky, 3/23)

The Washington Post: Inside The Catholic Nursing Home At The Center Of A Contentious Supreme Court Case
As she makes her nursing home rounds, as she has for 28 years, Sister Constance Veit gently grasps frail hands, steers wheelchairs with no-nonsense grace and doles out cheery compliments to those in her care. But the moment the nun gets behind the closed door of a conference room, her demeanor hardens. This is a sister at war. On Wednesday, Veit will be just a few miles from the Little Sisters of the Poor facility where she works in Northeast Washington — and a world away. She will be seated in her habit in the U.S. Supreme Court, a striking representative of the religious organizations fighting the White House health care law because of its requirement that employers cover contraception. (Zauzmer, 3/23)

USA Today: FDA Will Require Warnings On Immediate-Release Painkillers
In an effort to stem the epidemic of prescription drug abuse, the Food and Drug Administration will require its strongest warning on immediate-release opioid painkillers. The "black box" warning will alert users to the "serious risks of misuse, abuse, addiction, overdose and death" involved with taking opioids, a class of painkillers that includes morphine, Vicodin and Percocet. The warnings will appear on immediate-release painkillers, which are taken every four to six hours. (Szabo, 3/22)

The Associated Press: FDA Adds Boldest Warning to Most Widely Used Painkillers
Federal health regulators will add their strongest warning labels to the most widely prescribed painkillers, part of a multi-pronged government campaign to stem an epidemic of abuse and death tied to drugs like Vicodin and Percocet. The Food and Drug Administration announced Tuesday plans to add a boxed warning — the most serious type — to all immediate-release opioid painkillers, including some 175 branded and generic drugs.

The Washington Post: FDA Adds New Warnings On Risk Of Addiction, Overdose And Death For Prescription Opioids
In a briefing for reporters, FDA Commissioner Robert Califf called opioid addiction one of the most "urgent and devastating public health crises facing our nation" and said the new labels were just part of the government's larger strategy for addressing it. But Sen Edward Markey (D-Mass.), who delayed Califf's confirmation while he demanded that the FDA overhaul its approval process for opioid medications, issued a statement saying that "the labels given by the FDA have done little to prevent opioid addiction. Unfortunately, it has taken the FDA far too long to address the grave risks of these drugs that have claimed the lives of thousands this year alone." (Bernstein, 3/22)

The Wall Street Journal: FDA Sets New Requirements To Address Opioid-Abuse Concerns
The actions follow separate FDA requirements unveiled last month, including that any new opioid go before an outside committee of experts unless the product has abuse-deterrent properties. In 2013, the agency mandated labeling changes for extended-release and long-acting opioids, which generally pack a larger load of medicine and tend to be favorite choices of addicts. But the immediate-release versions make up about 90% of the market, said FDA officials. The new rules—expected to go into effect by the end of the year, following comment—clarify that immediate-release opioids should be reserved for severe pain with inadequate treatment alternatives, the agency said. (Beilfuss and Burton, 3/22)

NPR: FDA Requires Strong New Safety Warnings For Opioids
Califf said the FDA wants to warn doctors and patients about the dangers of the drugs while ensuring they remain available for patients who need them to alleviate pain. However, Califf stressed the drugs should be reserved for severe pain for which no alternatives are available. In addition to the risks of addiction and overdose from opioids, the new labels will also warn that chronic use of the drugs by pregnant women could lead their newborns to suffer from neonatal opioid withdrawal syndrome. (Stein, 3/22)

The New York Times: Medicare Proposal Takes Aim At Diabetes
The Obama administration plans on Wednesday to propose expanding Medicare to cover programs to prevent diabetes among millions of people at high risk of developing the disease, marking the sixth anniversary of the Affordable Care Act with the prospect of a new benefit, federal officials said. Sylvia Mathews Burwell, the secretary of health and human services, is scheduled to announce the proposal at a Y.M.C.A. here. Under the plan, Medicare would pay for certain “lifestyle change programs” in which trained counselors would coach consumers on healthier eating habits and increased physical activity as ways to prevent Type 2 diabetes, formerly called adult onset diabetes. (Pear, 3/23)

The Associated Press: J&J Expands Project That Aims To Predict, Prevent Diseases
Johnson & Johnson has ramped up its ambitious project to learn how to predict who will develop particular diseases and find therapies to prevent or stop the disease early, when it’s most treatable. Since the health care giant announced its groundbreaking project in February 2015, it’s expanded to include two dozen research programs with partners — in government, universities, patient advocacy groups and other drug and diagnostic test companies. On Tuesday, J&J gave an update and announced the latest two projects. They’re meant to identify which pregnant women will develop gestational diabetes, and to identify and treat people at risk of or in early stages of chronic obstructive pulmonary disease, the third-leading cause of death worldwide. (Johnson, 3/22)

The Associated Press: Insurers Plot Test To Build Better Provider Directories
Some health insurers are hoping to ease headaches that can flare when customers try to confirm whether a doctor is covered in a plan's network of providers. The trade association America's Health Insurance Plans will soon start testing a more efficient way to update insurer provider directories, which are becoming critical for finding the right fit as insurance evolves and coverage networks shrink. America's Health Insurance Plans, known as AHIP, will attempt to streamline directory updates by testing a new concept next month in California, Florida and Indiana. AHIP will have one health information technology company contact providers for regular updates on standard information like whether they are accepting new patients and if they are still in a coverage network. Then AHIP will share that information with several insurers. (3/22)

The Wall Street Journal: Why Health Insurers Are The New 800-Pound Gorillas
Health insurers’ bargaining power is set to grow. That is an issue for all health-care investors. The latest reminder: news Monday that health insurer Anthem is suing one of its vendors, the pharmacy-benefit-management company Express Scripts Holding. And this isn’t a small-change legal action. ... Major insurers such as Anthem have been bulking up of late. Last summer, Anthem agreed to purchase Cigna for $48 billion, while Aetna agreed to purchase Humana for $34 billion. The companies expect the deals to close sometime this year. Assuming they do, these deals would give the insurers more leverage than ever before as they negotiate prices with health-care companies. That could have implications for the pricing power of companies throughout the system. (Grant, 3/22)

The Wall Street Journal: Merck Gets Win Over Gilead In Hepatitis C Drug Patent Dispute
Merck & Co. won a legal victory over rival Gilead Sciences Inc. on Tuesday when a California jury upheld the validity of two patents that Merck says should entitle it to a portion of the multibillion-dollar annual sales of Gilead’s hepatitis C drugs. Financial repercussions of the decision weren’t immediately clear. The jury still must consider what damages to award to Merck and its co-owner of the patents, Ionis Pharmaceuticals Inc., for past sales, Kenilworth, N.J.-based Merck said in a statement. A judge then will decide on potential royalties on future sales. (Loftus, 3/22)

Reuters: Merck Wins Hepatitis C Drug Patent Claim Against Gilead
A federal jury on Tuesday upheld the validity of two Merck patents in a dispute with Gilead Sciences, which could be forced to hand over a portion of the billions of dollars in revenue from its blockbuster cure for hepatitis C. The verdict in federal court in San Jose, Calif., is a setback for Gilead, whose drugs Sovaldi and Harvoni brought in $19.2 billion in worldwide sales last year. Merck has demanded more than $2 billion in damages and a royalty of 10 percent of Gilead’s sales going forward. The jury must now decide exactly how much Gilead owes. (3/22)

The Associated Press: Heroin Overdose Antidote Offers Hope For Vulnerable Inmates
Naloxone, also known by the brand name Narcan, has become a key tool in curbing overdoes resulting from the nation’s opioid abuse epidemic. The class of drug that includes prescription painkillers and heroin was involved in a record 28,648 deaths in 2014, and opioid overdoses have more than quadrupled since 2000, according to the Centers for Disease Control and Prevention. Recently released inmates are particularly vulnerable. Officials already widely distribute the drug to police, paramedics, drug users and their families. The push to equip inmates is new, fueled by research showing former prisoners in Washington state were nearly 13 times more likely to die of an overdose in the two weeks after their release than other people. (Gurman, 3/23)

The New York Times: Dementia Care, Tailored To N.F.L. Retirees
With the expectation that more N.F.L. players will suffer dementia from repeated head hits, businesses that cater to people with memory loss are gearing up for what could be droves of new clients in the near future. One company, Validus, based in Tampa, Fla., has gone the furthest, striking a deal last year with the N.F.L. Alumni Association to provide special treatment to former players with dementia. (Belson, 3/22)

NPR: Lessons From Rubella Suggest Zika's Impact Could Linger
As scientists struggle to understand the threat posed by Zika virus, there's another viral infection that's a known danger in pregnancy and that harms 100,000 babies a year, even though it has been preventable with a vaccine since 1969. The disease is rubella, or German measles. Like Zika, the rubella virus often causes either a mild rash or no symptoms at all. ... As researchers try to figure out how much risk Zika virus poses to a fetus, Plotkin says it's deja vu for folks who lived through that extensive rubella outbreak. (Greenfieldboyce, 3/22)

NPR: That Cabernet Might Not Be Good For Your Health After All
You've probably heard that a little booze a day is good for you. I've even said it at parties. "Look at the French," I've said gleefully over my own cup. "Wine all the time and they still live to be not a day younger than 82." I'm sorry to say we're probably wrong. The evidence that alcohol has any benefit on longevity or heart health is thin, says Dr. Timothy Naimi, a physician and epidemiologist at Boston Medical Center. He and his colleagues published an analysis 87 of the best research studies on alcohol's effect on death from any cause in the Journal of Studies on Alcohol and Drugs on Tuesday. "[Our] findings here cast a great deal of skepticism on this long, cherished belief that moderate drinking has a survival advantage," he says. (Chen, 3/22)

NPR: For Chronic Low Back Pain, Mindfulness Can Beat Painkillers
Last week, the Centers for Disease Control and Prevention told doctors they should really, really think twice before prescribing opioids for chronic pain. And now the doctors are telling us that meditation and cognitive behavioral therapy often work better than pain meds and other medical treatments for chronic back pain. It's the latest in a series of studies saying that low-tech interventions like exercise, posture training, physical therapy and just the passage of time work better than opioids, imaging or surgery for the vast majority of people with chronic back pain. (Shute, 3/22)

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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