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KHN First Edition: July 22, 2015


First Edition

Wednesday, July 22, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Despite Obamacare Promise, Transgender People Have Trouble Getting Some Care
Kaiser Health News staff writer Lisa Gillespie reports: "Transgender people are still fighting for access to crucial health services despite the Affordable Care Act’s requirement that insurance companies not deny coverage based on gender or health history. The issue stems from the fact that enrollees must check a single gender box when they sign up for a plan sold on the individual or small group markets, according to advocates and health care providers." (Gillespie, 7/22)

Kaiser Health News: Sometimes A Little More Minecraft May Be Quite All Right
WCPN's Sarah Jane Tribble, working in partnership with Kaiser Health News and NPR, reports: "It’s family vacation time, and I’ve taken the kids back to where I grew up — a small plot of land off a dirt road in Kansas. For my city kids, this is supposed to be heaven. There are freshly laid chicken eggs to gather, new kittens to play with and miles of pasture to explore. But we’re not outside." (Tribble, 7/22)

The Wall Street Journal: Government Report Cites Shortfalls In Medicare’s Screening Process For Doctors
Over the past five years, the federal Centers for Medicare and Medicaid Services, which runs Medicare, has been revamping its enrollment system and verifying provider information, such as addresses and licensure. The overhaul is partly due to requirements of the 2010 Affordable Care Act. The CMS said Tuesday that as a result of its enhanced screening efforts, it has kicked more than 34,000 providers out of the program since February 2011. The GAO says that some screening problems persist, however, among the 1.8 million providers enrolled to bill Medicare from nearly a million addresses. The report estimated that about 23,400 addresses might be invalid. (Weaver, 7/21)

The New York Times: Federal Report Says Many Doctors Use False Addresses For Medicare
Federal investigators said Tuesday that thousands of doctors and other health care providers had signed up to bill Medicare using “questionable addresses” like mailbox rental stores, vacant lots and a fast-food restaurant. The investigators, from the Government Accountability Office, said Medicare officials did not adequately verify the addresses that providers listed as their practice locations. (Pear, 7/21)

The Associated Press: Trustees Rating Health Of Social Security, Medicare
The federal government’s two largest benefit programs face short- and long-term financial problems as they close in on milestone anniversaries. The magnitude of those problems will become clearer when the trustees for Social Security and Medicare issue their annual report cards. (Ohlemacher and Alonso-Zaldivar,7/22)

The New York Times: Labor And Employers Join In Opposition To A Health Care Tax
At the paper mill in Longview, Wash., Kurt Gallow and his wife, Brenda, are worrying about his company’s proposed new health care plan, which would require workers to pay as much as $6,000 toward their families’ medical bills. ... The union is now in heated negotiations with the mill’s owner, KapStone Paper and Packaging, over benefits, among other issues. The couple and many other employees have been enrolled in a popular Kaiser Permanente health maintenance organization, which charged just $25 for a doctor’s visit. But that may change by January. Pointing to the looming new tax on high cost insurance plans imposed under the federal health care law, KapStone wants to replace its existing policies with plans that could prove far more expensive for workers and their families. By doing so, the company would save almost $3 million in additional taxes in just the first two and a half years. (Abelson, 7/21)

The Associated Press: Costs From Regulations Pile Up, Hurt Small Business Profits
It’s getting more expensive to be an employer and small business owners say that’s making it harder for them to make money. The health care law, minimum wage increases and paid sick leave laws in some states and cities are increasing costs. ... They may be required to offer health insurance starting Jan. 1 if they go ahead with plans to offer dinner at the restaurant, which now serves breakfast and lunch. The expansion could give the Lamons 50 or more workers, the point at which employers must provide coverage. (Rosenberg, 7/22)

The Washington Post: Noridian To Pay $45 Million To State, U.S. Government For Flawed Exchange
The prime contractor hired to build Maryland’s flawed online health exchange will pay $45 million to the state and federal governments to avoid a lawsuit over its performance, Attorney General Brian Frosh announced Tuesday. Maryland’s health exchange drew national attention last year when the Web site crashed moments after launching. It was plagued by glitches for months afterward. (Hicks, 7/21)

The Associated Press: Contractor For Maryland Health Exchange Website To Pay $45M
The main contractor in Maryland's initially flawed health care exchange website has agreed to repay $45 million to avoid legal action over its performance, officials announced Tuesday. Maryland's website crashed right after opening Oct. 1, 2013, as part of President Barack Obama's health care law, and it wasn't the only state to have problems. Oregon, Nevada and Hawaii abandoned their state-run exchanges and now use the federal one. (7/21)

Politico: What Do Highways Have To Do With Planned Parenthood And Obamacare?
Clumped together in the single digits in recent national polls, GOP Sens. Rand Paul of Kentucky, Marco Rubio of Florida, Ted Cruz of Texas and Lindsey Graham of South Carolina sense an opportunity to get some much-needed traction in the must-pass legislation. And they’re seizing it, with plans to tack on controversial proposals — or potentially hold up the entire bill if they don’t get what they want. Paul is pushing an amendment to defund Planned Parenthood precisely at the moment the women’s health group is under siege for videos showing officials discussing harvesting organs from aborted fetuses. The Kentucky lawmaker, of course, is well practiced in the art of taking over the Senate floor to promote his causes, most recently forcing the PATRIOT Act to lapse temporarily. (Everett, 7/21)

The Associated Press: A 2nd Covert Video Targets Planned Parenthood On Fetal Parts
Anti-abortion activists on Tuesday released a second undercover video aimed at discrediting Planned Parenthood's procedures for providing fetal tissue to researchers. The video shows Dr. Mary Gatter, a Planned Parenthood medical director in Southern California, meeting with people posing as potential buyers of intact fetal specimens. Much of the conversation on the video deals with how much money the buyers should pay. (7/21)

The Wall Street Journal: Novartis Can Sell Copycat Of Amgen’s Neupogen In September, Court Rules
An appeals court ruled that Novartis AG could begin the first U.S. sales of a knockoff biotech drug on Sept. 2, a key step in efforts to contain spending on high-cost therapies through lower-priced competition. The ruling Tuesday by the U.S. Court of Appeals for the Federal Circuit in Washington came on the same day Switzerland-based Novartis said its second-quarter profit fell 32% amid a strengthened U.S. dollar and a weak result from the company’s eye-care-treatment business. (Rockoff, 7/21)

The Wall Street Journal: Novartis Blurs Vision Of Its Potential
Novartis has taken one in the eye. Flat sales in its eye-care business, Alcon, which accounts for about a fifth of revenues, hit second-quarter results. That sent the stock skidding, despite strong results in its pharmaceuticals and generics units. The result also dashed hopes for an increase in its full-year guidance and emphasizes that the Swiss company’s challenge is to live up to high expectations. (Thomas, 7/21)

The Wall Street Journal's Pharmalot: How High? The Backlash Over Rising Prescription Drug Prices Gains Steam
If you had any doubt that prescription drug prices are the proverbial hot potato for the pharmaceutical industry, consider some recent developments. The Laura and John Arnold Foundation plans to give a $5.2 million grant to the Institute for Clinical and Economic Review, a non-profit that examines the value of new medicines, so it can double its staff and produce more reports suggesting benchmark prices for up to 20 drugs over two years, according to The Wall Street Journal. (Silverman, 7/21)

The Washington Post: New Cholesterol-Lowering Medications Likely To Trigger Fight Over Prices
The Food and Drug Administration this week is expected to approve the first in a new class of cholesterol-lowering medications that could represent the most significant advance in cardiology since statin drugs hit the market decades ago. But, in part because the new treatments have yet to demonstrate that they reduce the incidence of strokes and heart attacks, their approval appears set to trigger the latest fight over the high price of many drugs in the United States. (Dennis, 7/21)

The Washington Post: Meet Deep Genomics, A Start-Up Bringing The Power Of Deep Learning To Genomics
A deep learning system that’s able to digest a massive amount of genetic data has the potential to understand the impact of genetic mutations better than humans ever have. The impact of mutations depends on their context. As Frey gets access to more data sets, of say individuals with autism, the deep learning system can better draw conclusions about how genetics is driving real world outcomes. (McFarland, 7/22)

The Washington Post: Groups Supporting Scott Walker Have Raised $26 Million
The Unintimidated PAC, which was started in April by two of Walker’s closest political advisers, has collected just over $20 million, The Washington Post has learned. The super PAC was named for Walker’s 2013 book that chronicled his highly visible fight with public-sector unions and is able to accept unlimited donations, although it is required to disclose its donor list. (Johnson, 7/21)

The Associated Press: Groups Raise $32M To Support Gov. Walker's Presidential Run
Three groups supporting Scott Walker's run for president have raised $32 million, which is less than what two of his Republican rivals have collected but on target with the Wisconsin governor's goal for this point in the campaign. ... Walker was first elected governor in 2010 and within months proposed effectively ending collective bargaining for most public workers, coupled with requiring them to pay more for health insurance and pension benefits to help solve a budget shortfall. The fight led to a 2012 recall election against Walker, which he won, further raising his national political profile in advance of this year's announcement that he hopes to run for the White House. Walker won re-election last year. (7/21)

The Wall Street Journal: Bernie Sanders’ Record Shows Knack For Voter Appeal
While most of his successes have produced incremental change, Mr. Sanders was responsible for the biggest legislative victory for Senate Democrats last year. At the time, he was chairman of the Senate Veterans Affairs Committee and, after extensive negotiations with Sen. John McCain (R., Ariz.), the committee’s top Republican, and House Veterans Affairs Committee Chairman Jeff Miller (R., Fla.), he passed a measure to shorten wait times at the Department of Veterans Affairs after agency leaders were accused of abandoning patients and cooking the books to get bonuses. The agreement marked the largest expansion of government services since Republicans took control of the House in the 2010 elections. (Hughes, 7/21)

The Washington Post's Wonkblog: Why Activists Think Sanders Is More Electable Than Hillary Clinton
It sounds odd to argue that by moving left, a Democratic candidate can capture disaffected voters in the center or even on the right. ... Sen. Claire McCaskill (D-Mo.) ... She told MSNBC's "Morning Joe" that Sanders wanted a single-payer system in insurance and more generous entitlements and that he opposed free trade. Polls suggest that support for a single-payer system is limited to liberals, and while polls on expanding Social Security suggest the idea could win the support of a large majority, most Americans think that free trade has been good for the country. (Ehrenfreund, 7/21)

The Wall Street Journal: Women With Memory Impairment Deteriorate Faster Than Men, Alzheimer’s Study Shows
Women with early memory problems worsen significantly faster than men at the same stage of dementia, according to a new study that offers what is perhaps the best evidence yet suggesting sex differences in vulnerability to Alzheimer’s disease. The results come from an analysis of 398 people with mild cognitive impairment enrolled in a large, national, long-term study called the Alzheimer’s Disease Neuroimaging Initiative, or ADNI. (Wang, 7/21)

NPR: Women's Brains Appear More Vulnerable To Alzheimer's Than Men's
There's new evidence suggesting that women's brains are especially vulnerable to Alzheimer's disease and other problems with memory and thinking. Women with mild cognitive impairment, which can lead to Alzheimer's, tend to decline faster than men, researchers reported this week at the Alzheimer's Association International Conference in Washington, D.C. (Hamilton, 7/21)

Los Angeles Times: St. John's Hospital Foundation Sues To Enforce Donation Pledge
Paula Kent Meehan made a fortune after launching the Redken hair-care products company in the 1960s. She spent the last years of her life giving that money to charity. One of the biggest beneficiaries was supposed to be St. John's Health Center, a storied Santa Monica hospital founded by Roman Catholic nuns that has cared for celebrity patients such as Michael Jackson, Elizabeth Taylor and President Reagan. But in 2013, Meehan revoked her pledge to the St. John's foundation after the ouster of the hospital's top executives and the proposed sale of the nonprofit Catholic hospital. And now the hospital's foundation is suing her estate for the $5 million that she originally promised. (Pfeifer, 7/21)

Los Angeles Times: Lt. Gov. Gavin Newsom Releases Report On Guidelines For Marijuana Legalization
A panel chaired by Lt. Gov. Gavin Newsom hopes to guide the debate on the legalization of marijuana in California with an emphasis on limiting children’s access to cannabis, reducing illegal activity and tightly regulating the drug's growth and sales. In a report released Wednesday, the group lays out 58 recommendations and goals for implementing general legalization -- an issue expected to go before voters next year. The document offers broad principles --“protecting California’s youth” -- as well as nitty-gritty suggestions for collecting data and limiting advertising. (Mason, 7/22)

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.

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