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KHN First Edition: April 26, 2016


First Edition

Tuesday, April 26, 2016
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Administration Says New Rules For Medicaid Plans Will Improve Service For Enrollees
Kaiser Health News staff writer Jay Hancock reports: "The Obama administration tightened rules Monday for private insurance plans that administer most Medicaid benefits for the poor, limiting profits, easing enrollment and requiring minimum levels of participating doctors. For consumers the most visible change may eventually be quality ratings intended to reflect Medicaid plans’ health results and customer experiences. The administration agreed to move slowly on such a sensitive industry issue, saying it would develop the scores over several years. But the sweeping regulation, the biggest for Medicaid managed care in a decade, changes many aspects of how UnitedHealthcare, Aetna and other large contractors who administer care for some of the most vulnerable patients do business." (Hancock, 4/26)

Kaiser Health News: United’s Departure From Marketplaces Could Impact Consumers’ Costs, Access
Kaiser Health News staff writer Phil Galewitz reports: "UnitedHealthcare’s decision to quit insurance exchanges in about 30 states next year has patient advocates concerned that fewer options could force consumers to pay more for coverage and have a smaller choice of network providers. The company’s departure could be felt most acutely in several counties in Florida, Oklahoma, Kansas, North Carolina, Alabama and Tennessee that could be left with only one insurer, according to an analysis by the Kaiser Family Foundation (KHN is an editorially independent program of the foundation)." (Galewitz, 4/26)

Kaiser Health News: High Court Ruling May Hinder Plans’ Efforts To Recoup Consumers’ Legal Awards
Kaiser Health News consumer columnist Michelle Andrews writes: "Accidents happen, and if they’re someone else’s fault, you can go to court to try to get compensation for your medical expenses, lost wages, and pain and suffering. If you win, though, the pot of gold you receive may be considerably smaller than you expect: Your health plan may claim some or all of it as reimbursement for money it spent on your medical care. It’s completely legal and it happens all the time. But a recent Supreme Court decision gives consumers ammunition to push back." (Andrews, 4/26)

Kaiser Health News: Will Covered California Sell Health Coverage To The Undocumented?
Kaiser Health News staff writer Ana B. Ibarra reports: "California legislators are attempting to clear the way for undocumented immigrants to buy health insurance through the state’s insurance exchange — potentially setting a national precedent. The fusion of illegal immigration and the Affordable Care Act, two of the most highly charged elements on the periodic table of U.S. politics, could engender a combustible reaction, especially in an election year." (Ibarra, 4/26)

The Associated Press: Feds Issue New Standards For Medicaid Insurance Plans
The Obama administration Monday set new standards for Medicaid private insurance plans, which in recent years have become the main source of coverage for low-income people. The rules apply to insurers operating as Medicaid middlemen in 39 states and Washington, DC. Each state runs its own program, although the federal government pays most of the cost. Private insurers now provide coverage to about two-thirds of the more than 70 million Medicaid recipients, and the rules had not been updated for more than 10 years. (4/25)

Reuters: Valeant Names Papa CEO After He Resigns From Perrigo
Former Perrigo Co Plc head Joseph Papa was named Chief Executive Officer at Valeant Pharmaceuticals International on Monday, a role in which investors said he should focus on returning the company to growth. Papa will replace CEO Michael Pearson, whose years of frenzied dealmaking fueled double-digit profit increases at Valeant until scrutiny of its controversial relationship with a specialty pharmacy and history of sharp drug price increases hit its shares and sales last fall. (O'Donnell, Roumeliotis and Humer, 4/25)

The New York Times: Valeant Pharmaceuticals Picks Joseph Papa, Perrigo Chief, As C.E.O.
Mr. Papa, who will begin in May, takes over at a time of turmoil for Valeant, which has seen its stock tumble from once-dizzying heights after a series of investigations into its drug-pricing and accounting practices. Valeant is also struggling under more than $30 billion in debt and is facing default from its bondholders after failing to file its annual report on time. The company’s decision to appoint Mr. Papa, a seasoned pharmaceutical executive with more than 35 years of experience in the industry, represents a marked departure from the leadership of Mr. Pearson, a former consultant for McKinsey who had no history of leading a drug company before he became Valeant’s chief in 2008. (Thomas, 4/25)

The Wall Street Journal: Valeant Names Joseph Papa As New CEO
Valeant must overcome a number of hurdles ahead of Mr. Papa’s planned arrival. The Canada-based company said it planned to file its delayed 10-K annual report by Friday; people familiar with the company said the report could be released as early as Wednesday. If Valeant meets the filing deadline, it will no longer need waivers from bondholders, some of which have threatened to declare a default. Valeant carries roughly $30 billion in debt. (Steele, McNish and Benoit, 4/25)

The Wall Street Journal: As Its CEO Leaves For Valeant, Perrigo Continues To Struggle
Perrigo Co. investors swallowed a bitter pill Monday as Chief Executive Joseph Papa was tapped to lead Valeant Pharmaceuticals International Inc., leaving behind a struggling business months after he rallied the stockholders to fend off what now looks a favorable takeover offer. Shares of the company tumbled 18% in Monday trading to $99.40 as the maker of store-brand cold and allergy medicines slashed its guidance and announced Mr. Papa’s exit. (Steele, 4/25)

The New York Times: Advisers To F.D.A. Vote Against Duchenne Muscular Dystrophy Drug
In a confrontation between the hopes of desperate patients and clinical trial data, advisers to the Food and Drug Administration voted on Monday not to recommend approval of what would become the first drug for Duchenne muscular dystrophy. The negative votes came despite impassioned pleas from patients, parents and doctors who insisted that the drug, called eteplirsen, was prolonging the ability of boys with the disease to walk well beyond when they would normally be in wheelchairs. (Pollack, 4/25)

The Wall Street Journal: FDA Panel Votes Not To Recommend Approval For Muscular Dystrophy Drug
“I felt this wasn’t a well-controlled study,” said panel chairman G. Caleb Alexander, an associate epidemiology professor at the Johns Hopkins School of Public Health. The panel members who abstained said they were undecided because they were moved by public testimony from parents who believed their children had been helped by the drug. The decision followed decidedly negative comments from FDA reviewers who concluded that the study fell far short of producing enough evidence. (Burton, 4/25)

The Wall Street Journal: New York Insurers To Change Coverage Of Hepatitis C Drugs
Seven health-insurance companies in New York will change their criteria for covering costly drugs that cure chronic hepatitis C under the terms of agreements with the office of State Attorney General Eric Schneiderman. The agreements, expected to be announced Tuesday, require the insurers to cover hepatitis C medications for nearly all patients who have commercial insurance plans in the state. (Ramey, 4/25)

The Wall Street Journal: U.S. Health Regulators Release Lightly Redacted Theranos Letter, Inspection Report
Federal health regulators on Monday released a lightly redacted copy of the 45-page letter they sent Theranos Inc. last month proposing stringent sanctions against the Silicon Valley blood-testing company. The regulators also released a new, lightly redacted copy of the inspection report detailing the major deficiencies they said that they found last fall at Theranos’s laboratory in Newark, Calif. (Carreyrou, 4/25)

The New York Times: A Brother’s Mental Illness Influenced John Kasich’s Views
Gov. John Kasich often speaks about mental health in his campaign for president. He has defended his decision to expand Medicaid in Ohio by highlighting its benefits for mentally ill residents. He is probably the only Republican candidate this year to ask a crowd, “Do you know what it’s like for somebody to live with depression?” The question, posed at a rally in upstate New York recently, threw a hush over a room of 1,000 people. Mr. Kasich went on: “There are people here who know exactly what I’m talking about.” (Gabriel, 4/25)

The New York Times: De Blasio To Propose $2 Billion For New York City’s Hospital System
New York City’s public hospital system “is on the edge of a financial cliff,” Mayor Bill de Blasio’s administration is warning in a report to be released on Tuesday as part of his budget, which proposes a restructuring and an infusion of $2 billion in subsidies. Along with a push for new revenue and new savings for the system, Health & Hospitals, the city subsidy — a $700 million increase over the 2016 fiscal year — is intended to shrink a gap that is projected to balloon to $1.8 billion by 2020, up from a current $600 million shortfall. (Bernstein, 4/25)

The Wall Street Journal: New York City Will Seek Hospital-System Overhaul
Mayor Bill de Blasio’s administration will propose an overhaul of the cash-strapped public-hospital system in the city’s budget presentation on Tuesday, people familiar with the matter said. The overhaul is expected to turn inpatient centers—which are more expensive but often prized by communities—into outpatient centers and focus less on emergency rooms, one of these people said. It will include retraining some employees, adding billions to the system’s budget as changes are made, and attempting to revise the formula on how health care is funded. (Dawsey, 4/25)

The Associated Press: Oklahoma Bill Tying Abortions To Doctor Licenses Criticized
Of the pieces of anti-abortion legislation that Oklahoma lawmakers have considered this session, one that would strip doctors of their license to practice has abortion rights activists and the state's medical association balking. The bill would prohibit any physician who performs abortions, deemed "unprofessional conduct" in the measure, from obtaining a license to practice medicine. That would be the first such law in the nation — and an unconstitutional attempt to ban abortions, according to Center for Reproductive Rights, a New-York based abortion rights organization. (4/25)

NPR: Lesson Learned For Baltimore's Health Commissioner: 'I Like A Fight'
To wrap up [a] series on public health in Baltimore, Audie Cornish met up with Baltimore City Health Commissioner Leana Wen in Freddie Gray's neighborhood of Sandtown-Winchester. The health department recently opened a new outpost of its violence prevention program Safe Streets there, employing ex-offenders to mediate conflicts before they erupt in violence. Wen spoke about pushing a public health agenda in a city that has long struggled with poverty, violence and addiction. She also talked about what she, as an emergency physician, has learned in her first stint in government. (4/25)

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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