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KHN First Edition: March 21, 2016


First Edition

Monday, March 21, 2016
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: California Insurance Marketplace Wants To Kick Out Poor-Performing Hospitals
Kaiser Health News' Chad Terhune reports: "California’s insurance exchange is threatening to cut hospitals from its networks for poor performance or high costs, a novel proposal that is drawing heavy fire from medical providers and insurers. The goal is to boost the overall quality of patient care and make coverage more affordable, said Lee, executive director of the Covered California exchange. “The first few years were about getting people in the door for coverage,” said Lee, a key figure in the rollout of the federal health law. “We are now shifting our attention to changing the underlying delivery system to make it more cost effective and higher quality. We don’t want to throw anyone out, but we don’t want to pay for bad quality care either.”" (Chad Terhune, 3/21)

The Associcated Press: Scalia's Death Could Affect Politically Tinged Cases
Challengers in two politically tinged cases before the Supreme Court this week face the seemingly insurmountable problem of being unable to count to five — as in five votes. The death of Justice Antonin Scalia has deprived conservatives of a reliable vote on a range of issues, including the design of congressional districts in Virginia and the Obama administration's effort to accommodate faith-based groups that object to paying for contraceptives as part of their health insurance plans. (3/18)

The New York Times: Texas Abortion Law Has Women Waiting Longer, And Paying More
When Amy found out that she was pregnant, she wasted no time seeking an abortion. Her husband had just lost his job and the couple had been kicked out of their house, forcing their family of five to move in with his parents. But she found that getting an appointment for an abortion proved almost as stressful as the unwanted pregnancy. The number of abortion clinics in Texas has shrunk by half since a 2013 state law imposed new regulations that many said they found impossible to meet. The United States Supreme Court is considering the constitutionality of that law and whether it creates too much of a burden on women seeking an abortion. (Goodnough, 3/18)

The Associated Press: No Clear Path To Government-Lowered Drug Prices
Most Americans support it. Virtually all other developed countries already do it. And the two leading presidential candidates on both sides of the aisle agree: the federal government should lower drug prices. But experts say the chances for government action in the near-term are close to nil. The reasons are familiar: political gridlock in Washington, pharmaceutical industry influence and the structure of the U.S. health system itself, which limits government intervention. (3/18)

The Wall Street Journal: Traditional Providers Get Into The Urgent-Care Game
When it comes to health issues that need immediate attention but aren’t life-threatening, more Americans are turning to urgent-care centers—and traditional health-care providers are getting into the game. Over the past two years, hospital chains and insurance companies have snapped up urgent-care centers in a spate of mergers and acquisitions. Health systems, too, are moving into this space, striking joint ventures with independent urgent-care operators, says Tom Charland, chief executive of consulting firm Merchant Medicine. (Landro, 3/20)

USA Today/The Tennessean: 'Surprise Bills' Shock Those Who Choose In-Network Care
Because patients get billed by individual providers, a patient can go in-network but still get hit with an out-of-network charge. The inadvertent out-of-network bills are called “balance billing” because patients pay the difference between the insurance plan's out-of-network benefits and the provider's rack-rate charge, which is often considerably higher than the negotiated amount with an insurer. Some insurance plans offer little to no out-of-network coverage. Hospitals encourage the doctors to accept the same insurance plans and networks as the hospital — but it’s not required. (Fletcher, 3/18)

The New York Times: Insurance For Critical Illness May Add Security, But At A Cost
It’s often pitched as an insurance policy for your health insurance policy.The product, known as critical illness insurance, promises to pay a lump sum, anywhere from $5,000 to $100,000, after someone receives some sort of dreaded diagnosis, like cancer, a heart attack or a stroke. And the coverage is not terribly expensive; if you are in your 40s, it might cost $25 to $50 a month. These policies have become increasingly popular, partly because they are being marketed as a way to provide another layer of financial support now that consumers are shouldering an ever-rising share of medical expenses out of pocket. (Bernard, 3/19)

The Wall Street Journal: Johnson & Johnson Settling Cases Tied To Device That Can Spread Uterine Cancer
Johnson & Johnson is settling a series of legal claims and lawsuits alleging that its now-discontinued hysterectomy device harmed women by spreading an undetected hidden cancer, according to court documents and plaintiff lawyers with knowledge of the settlements. An estimated 100 cases have either been filed—or readied for lawsuits—against J&J’s Ethicon unit related to a device known as the laparoscopic power morcellator, said Paul Pennock, a plaintiff lawyer and co-lead counsel on the steering committee for consolidated litigation under way in a Kansas City, Kan., federal court. (Levitz, 3/18)

The Wall Street Journal: FDA Weighs Danger Tied To Blood-Monitoring Devices
The Food and Drug Administration is striving to assess the scope of the danger from medical devices that sometimes produce erroneous readings of how quickly patients’ blood tends to clot when they are taking anticoagulant medicines such as warfarin. The small mobile devices, used in patients’ homes and in doctors’ offices, have malfunctioned in thousands of cases over the years, according to the FDA. (Burton, 3/18)

The Associated Press: Tiny Vermont Brings Food Industry To Its Knees On GMO Labels
General Mills’ announcement on Friday that it will start labeling products that contain genetically modified ingredients to comply with a Vermont law shows food companies might be throwing in the towel, even as they hold out hope Congress will find a national solution. Tiny Vermont is the first state to require such labeling, effective July 1. Its fellow New England states of Maine and Connecticut have passed laws that require such labeling if other nearby states put one into effect. The U.S. Senate voted 48-49 Wednesday against a bill that would have blocked such state laws. (Rathke, 3/19)

The Wall Street Journal: General Mills To Label GMOs In Products Nationwide
General Mills Inc. is changing its labels nationwide to indicate whether its foods contain genetically modified organisms, ahead of a Vermont law that will mandate it as of July. “The complexity and the cost of having one system for Vermont and one for everywhere else is untenable,” Jeff Harmening, the company’s chief operating officer of U.S. retail, said in an interview. He said he is still hopeful that Congress will pass a national law that would supersede such state laws, but the company had to move ahead to comply with Vermont. (Gasparro, 3/18)

The Associated Press: General Mills To Label Products With GMOs Ahead Of Vt. Law
General Mills said Friday it will start labeling products across the country that contain genetically modified ingredients to comply with a law set to go into effect in Vermont. The maker of Cheerios and Yoplait said it is impractical to label its products for just one state. And with no deal yet for national legislation on GMO labeling, the company said it decided to add the disclosures required by Vermont starting in July to products throughout the U.S. (Choi and Jalonick, 3/18)

Los Angeles Times: The Return Of Doctor House Calls: Convenient, But At What Cost?
Dr. Sam Kim works for Heal, a Los Angeles-based start-up that allows patients in several California counties to order doctor house calls through a smartphone app. Similar companies exist in other parts of the country, including Pager in New York City and Mend in Dallas. Health advocates generally support using technology to make medical care more convenient. As these companies grow, however, some question the return of the house call. A century ago, most medical visits were in the patient's home. But cities got bigger and doctors began using more equipment, therefore it made sense for them to not travel more than 10 steps from patient room to patient room. (Karlamangla, 3/19)

The Associated Press: As NY Demands Paperless Prescribing, Doctors Are Mixed
The scribbled, cryptic doctor's prescription is headed toward eradication in New York, where the nation's toughest paperless-prescribing requirement takes effect this month. Instead of handing patients slips of paper, physicians soon must electronically send orders directly to pharmacies for everything from antibiotics to cholesterol pills to painkillers, with some exceptions. Otherwise, prescribers face the possibility of fines, license loss or even jail. The requirement is meant to fight painkiller abuse, reduce errors and expand a practice that doctors and patients often find convenient. But physicians say digital scripts can present roadblocks for some patients and doctors shouldn't have to fear punishment over a prescription format. (3/19)

The Washington Post's Wonkblog: In A Fight Between Nurses And Doctors, The Nurses Are Slowly Winning
Amid a flurry of legislation to pass in the final days of spring state legislative sessions last week, nurses won two more victories in a long war for independence. For decades, most of the country has required physician oversight for nurses to conduct certain procedures, and especially to prescribe drugs. But that’s slowly changing, as the nation’s health-care needs rise, and nurses fight for the right to practice everything they learned in school. (DePillis, 3/18)

The New York Times: Puerto Rico Braces For Its Own Zika Epidemic
On an inexorable march across the hemisphere, the Zika virus has begun spreading through Puerto Rico, now the United States’ front line in a looming epidemic. The outbreak is expected to be worse here than anywhere else in the country. The island, a warm, wet paradise veined with gritty poverty, is the ideal environment for the mosquitoes carrying the virus. The landscape is littered with abandoned houses and discarded tires that are perfect breeding grounds for the insects. Some homes and schools lack window screens and air-conditioning, exposing residents to almost constant bites. (McNeil, Jr., 3/20)

Politico: America's Summer Threat: Zika Virus
If brokered conventions and third-party insurgencies aren’t enough, consider the chaos that Zika could bring to the United States this summer. If the mosquito-borne virus linked to birth defects hits big — and that’s a big if — it could stir a panic like Ebola, set off an epidemic of finger-pointing and create new fear and acrimony over reproductive rights, global warming and immigration, all at the height of a presidential campaign. (Allen, 3/19)

The Washington Post: A Legal Loophole Might Be Exposing Children To Lead In The Nation’s Schools
Children drinking from water fountains at the nation’s schools — especially in aging facilities with lead pipes and fixtures — might be unwittingly exposing themselves to high levels of lead, which is known to cause brain damage and developmental problems including impulsive behavior, poor language skills and trouble remembering new information. Under federal law, the vast majority of schools don’t have to test the water flowing out of their taps and drinking fountains, and many states and districts also do not mandate water testing at schools. Even when districts do test their water, they don’t always tell parents about the problems they find. (Brown, 3/18)

NPR: A Family Engulfed By Heroin Fights To Keep A Son Alive
Here's how I knew I liked Patti Trabosh. It goes back to the very first time I called her out of the blue to ask whether I might profile her family for a story on opioid addiction. The very first words out of her mouth were, "I'm pissed off!" Trabosh went on to explain why she was angry. First, it was the struggle to find a bed in a drug treatment program for her 22-year-old son Nikko Adam. He had become addicted to prescription painkillers and then heroin when he was still in high school. He'd been in rehab twice before, and relapsed both times. Once she found an available treatment slot, it was the seemingly endless and maddening battles with her insurance company, trying to get them to cover Nikko's treatment. (Block, 3/19)

NPR: Aspirin Both Triggers And Treats An Often-Missed Disease
A few unusual symptoms helped Allison Fite eventually figure out that she had a little-known disease shared by 1 to 1.5 million Americans. She has asthma, a loss of smell and taste, and a strong, adverse reaction to alcohol. "Before I could finish [a drink], I started to get these really bad headaches," she says. "I really am allergic to fun." And she had nasal polyps, which are benign growths in the sinus cavities. When she was 20, she had them surgically removed for the first time. At age 25, she flew back from where she was living in Thailand to the U.S. for a second operation. But this time the polyps reappeared even faster, a mere eight weeks after the surgery. ... [A] doctor mentioned that aspirin can cause nasal polyps. This was Fite's first real clue about her illness. It's called aspirin-exacerbated respiratory disease, or AERD. (Chen, 3/21)

The Wall Street Journal: Christie Urges Hospital Tax Freeze
New Jersey Gov. Chris Christie proposed a two-year moratorium Friday to stop local governments from collecting property taxes from nonprofit hospitals. Mr. Christie’s proposal comes nearly nine months after a court ruling paved the way for localities to pursue these taxes. The hospitals have maintained that their nonprofit status exempts them from paying property taxes. The governor said he would advance legislation to put on hold municipalities’ legal efforts to recover the property taxes from the hospitals. (Haddon, 3/18)

The Washington Post: Bowser’s Pick To Lead St. Elizabeths Came From Troubled Hospital In S.D.
D.C. Mayor Muriel E. Bowser’s choice to lead the District’s public psychiatric institution had only one other hospital stint on his résumé: chief executive of a hospital on an Indian reservation where emergency services were halted because they posed a risk to patients, according to federal and tribal officials. James Edward Kyle, 50, who took over as chief executive of St. Elizabeths Hospital in Southeast Washington on March 2, also was found unqualified for a job at the University of the District of Columbia after regulators discovered he lacked the proper credentials, according to records kept by the District’s Board of Nursing. (Nirappil, 3/18)

The Wall Street Journal: Connecticut Moves Away From Private Insurers To Administer Medicaid Program
At a time when most states are paying private insurers to provide health care for their Medicaid recipients, Connecticut says it has saved money and improved care by going the opposite way. In 2012, Connecticut fired the companies that were running Husky, as its Medicaid system is known, and returned to a more traditional “fee-for-service” arrangement where the state reimburses doctors and hospitals directly. (Beck, 3/18)

The Associated Press: Costs May Scuttle Oklahoma Anti-Abortion Curriculum Bill
Legislation that would mandate Oklahoma’s public schools to teach that life begins at conception may fail not because of its controversial nature but because the suddenly financially strapped state could have trouble paying for the course materials. The National Right to Life Committee backs the Oklahoma bill and calls it the first of its kind in the nation. Under it, public high schools would be required to provide the information “for the purpose of achieving an abortion-free society.” Parents would be able to pull their children from the classes, and none of the state funding could be used for abortion counseling or sex education. (Talley, 3/19)

The Wall Street Journal: Connecticut Studies ‘Yes Means Yes’ Sexual Consent Policy
Connecticut is weighing whether to join a growing number of states that have required universities to adopt policies for sexual interactions known as affirmative-consent. A proposal before state legislators would create a so-called “yes-means-yes” standard that would be used when investigating sexual-assault complaints. The push comes as an alleged sexual-misconduct case has shaken up Yale University, in New Haven, with the captain of the men’s basketball team expelled after a campus committee ruled he had violated the school’s policies on sexual conduct. (De Avila, 3/18)

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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