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Bipartisan efforts to protect patients from “surprise” medical bills are regaining momentum after stalling out over the summer. Leaders of the House Energy and Commerce Committee and the chairman of the Senate health panel announced a deal Sunday they said would rely on “a new system for independent dispute resolution often called arbitration." The lawmakers didn't elaborate. (Roubein and Luthi, 12/8)

The proposal would prevent doctors from sending unexpected bills to patients when they are treated in a hospital that accepts their insurance, and would establish a system for resolving related billing disputes between those doctors and insurance companies. “It is long past time that Congress protect patients and families from the devastating financial toll of surprise medical bills, and this agreement puts an end to this egregious billing practice,” said Frank Pallone Jr., the chairman of the House Energy and Commerce Committee. “I’m hopeful that this bipartisan, bicameral agreement can be voted on quickly so that it can be signed into law before the end of the year.” (Sanger-Katz, 12/8)

“I do not think it is possible to write a bill that has broader agreement than this among Senate and House Democrats and Republicans on Americans’ number one financial concern: what they pay out of their own pockets for health care,” Alexander said. “Congress should pass the bill promptly and give the American people a very good Christmas present.” Senate HELP Committee ranking member Patty Murray, D-Wash., did not sign on to Sunday’s announcement, but a spokeswoman said she is working with the other lawmakers on a final agreement. (McIntire, 12/8)

The deal also includes other health care measures, such as an extension of funding for community health centers, raising the purchasing age for tobacco to 21 and drug pricing transparency measures. Backers of the deal are hoping to include it in a must-pass government funding deal that faces a Dec. 20 deadline. There are still obstacles, though. Congressional leadership has not yet signed on to the deal. (Sullivan, 12/8)

After Lt. Gov. Dan Patrick rebuked Texas Medical Board staff for proposing a rule that he said would have undermined a new law that protects patients against surprise medical billing, the board on Friday axed the plans. The board’s proposed rule would have required all physicians to provide patients who are set to undergo a nonemergency medical procedure with a waiver outlining out-of-network charges and agreeing to pay those charges. Patient advocates feared the language would have allowed surprise billing to occur in all nonemergency health services. (Chang, 12/6)

With Democrats debating Medicare for All and public-option health plans, healthcare CEOs have become surprisingly open to the idea of negotiated caps on provider payment rates, according to Modern Healthcare’s latest Power Panel survey. While expressing strong misgivings about those Democratic reform proposals, 75% of CEOs responding to the survey last month said their organization could live with some form of price caps as long as their industry had the opportunity to negotiate reasonable levels. (Meyer, 12/7)

Senate Democrats are offering to repeal a controversial ObamaCare tax as part of a government funding deal as negotiations go on through the weekend. A congressional aide familiar with the talks told The Hill that Democratic negotiators had put repeal of the Cadillac tax "on the table in the appropriations negotiations." (Carney, 12/7) 

More than 1,000 employers, insurers, unions, and other organizations on Thursday urged Senate leaders to scrap a controversial tax on expensive employer-sponsored health plans that's set to go into effect in 2022. In a letter to Senate Majority Leader Mitch McConnell and Minority Leader Chuck Schumer, the organizations warned that the failure to repeal the so-called "Cadillac tax" on certain employer plans would lead workers to pay more for medical treatment and face narrower provider networks. Already, they wrote, employers are altering their benefit plan packages to avoid the tax. (Livingston, 12/5)

Kaiser Health News: Obamacare Back At The High Court — With Billions For Insurers On The Line

More than $12 billion is at stake for the nation’s health insurers Tuesday when the Supreme Court hears another Affordable Care Act case. For the federal government, the potential damages could be far greater, as its reputation as a reliable partner to private businesses is on the line. Unlike earlier Obamacare cases before the high court — where the entire 2010 law and health coverage for millions of Americans was at risk — the latest case has largely flown under consumers’ radar. (Galewitz, 12/9)

With support for Elizabeth Warren's White House bid sliding since the release last month of a divisive plan to overhaul healthcare, the Democratic presidential contender has made an effort to refocus her campaign in early-voting Iowa on her signature anti-corruption message. Some supporters worry that shift could end up hurting the Massachusetts senator, however. Now that Warren has put her $20.5-trillion Medicare For All plan on the table, they want the candidate to try harder to win over doubting voters. (Becker, 12/8)

Democratic presidential candidate Elizabeth Warren released results from her annual physical examination, making her the first of the top-tier 2020 candidates to continue a tradition of U.S. presidential contenders making their health details public. “Senator Warren is in excellent health and has been throughout the 20 years I have served as her physician,” Dr. Beverly Woo of Brigham and Women’s Hospital in Boston wrote in a letter released by Ms. Warren’s campaign. Dr. Woo is also an associate professor at Harvard Medical School. (Jamerson, 12/6)

Sen. Elizabeth Warren (D-Mass.) on Friday released a letter from her physician describing her as “very healthy” and issued five pages of supporting medical records, making her the first septuagenarian in the Democratic presidential contest to provide a glimpse at the details of her health. ... By releasing her records first, Warren arguably sets a bar for the others in a presidential field that includes four contenders who, if elected, would be the country’s oldest president at their first inauguration. (Liskey, 12/6)

African-American voters back Medicare for All more than other groups, polls show, but the policy’s two chief proponents in the 2020 Democratic presidential race haven’t been able to translate that into widespread black support. Instead, Sens. Bernie Sanders and Elizabeth Warren continue to lag well behind Joe Biden with black voters. The former vice president has been a chief critic among Democrats of Medicare for All and prefers a more moderate expansion of health insurance. In a recent South Carolina poll, he led Mr. Sanders and Ms. Warren by more than 30 points with black voters. (Jamerson, 12/7)

Leading senators are urging Medicare to allow seniors concerned about their drug plan pick for next year to switch if they received inaccurate information due to changes the agency made this sign-up season. The request from 14 Democrats and one Independent comes as open enrollment for prescription drug coverage ends at midnight Saturday. Medicare hinted Friday in a statement that it will provide such second chances. But the agency said it will post details when sign-up season is over, because a policy announcement now might create confusion. (Alonso-Zaldivar, 12/6)

Seniors would pay a smaller portion of their drugs’ cost and be shielded from huge one-time expenses under a new version of a Senate drug-pricing bill. The second draft of the Senate Finance Committee’s Prescription Drug Pricing Reduction Act lowers what Medicare beneficiaries are responsible for paying in the initial phase of their prescription plans from 25% to 20% after they’ve paid their deductibles. (Lee, 12/6)

Senate Finance Chair Chuck Grassley (R-Iowa) and ranking Democrat Ron Wyden of Oregon on Friday added several measures to their drug-pricing package and plan to use the bill's savings to cancel two years of cuts to disproportionate share hospital payments, as well as fund healthcare extenders. The drug-pricing changes would reduce costs for beneficiaries who exceed their deductible but do not reach the catastrophic phase of the Medicare Part D benefit, allow Medicare beneficiaries to spread pharmacy drug costs over time, allocate discounts more evenly across drugmakers, and pass price concessions negotiated by pharmacies to consumers. (Cohrs, 12/6)

The Medicare Payment Advisory Commission is expected to vote against a pay increase for hospice in January. Medicare hospice payments are probably too high, MedPAC's staff said at a meeting on Friday. Their research found that access to care is trending upward, while quality seems to have improved slightly. Hospices also have steady access to capital and robust Medicare margins—12.6% overall—so there's little reason to worry that beneficiaries' access to care would be hurt by financial problems anytime soon. (Brady, 12/6)

Health care already accounts for more than 10% of spending by senior households, on average. And 2020 brings more bad news for the pocketbooks of seniors on Original Medicare. Several premiums and deductibles for folks on the traditional, government-managed type of Medicare will increase in the new year, the federal government recently announced. What's more, these increases for 2020 will be significantly greater than they were for 2019. (Bowsher, 12/6)

A top Trump health appointee sought to have taxpayers reimburse her for the costs of jewelry, clothing and other possessions, including a $5,900 Ivanka Trump-brand pendant, that were stolen while in her luggage during a work-related trip, according to documents obtained by POLITICO. Seema Verma, who runs the Centers for Medicare and Medicaid Services, filed a $47,000 claim for lost property on Aug. 20, 2018, after her bags were stolen while she was giving a speech in San Francisco the prior month. The property was not insured, Verma wrote in her filing to the Health and Human Services department. (Diamond, 12/7)

The Department of Health and Human Services took the extraordinary step of bringing in outside counsel earlier this year to investigate allegations of sex discrimination, Axios has learned — a sign of how badly the working relationship had deteriorated between Secretary Alex Azar and Medicare chief Seema Verma. (Swan and Owens, 12/6)

Seema Verma doesn’t shrink from a fight, and she’s had plenty of them since she became CMS administrator in March 2017. The former Medicaid consultant has championed many policy initiatives that have polarized the healthcare world. While her agenda and personal style elicit controversy, veteran CMS watchers give Verma credit for boldly articulating and pursuing her vision of strengthening market forces to improve healthcare quality and access, and reduce costs. That includes goosing the sluggish transition to value-based payment. (Meyer, 12/6)

The 100 Most Influential People in Healthcare awards & recognition program honors individuals in healthcare who are deemed by their peers and the senior editors of Modern Healthcare to be the most influential individuals in the industry, in terms of leadership and impact. This program allows for readers to vote for their top choices and selected honorees will be published in Modern Healthcare's annual ranking. (12/6)

The Food and Drug Administration announced Friday it had issued a warning to a California company for making and selling unapproved umbilical cord blood products, and for “significant deviations” from safety practices that create serious risks for patients injected with the stem cell therapy. A year ago, the company, Liveyon, based in Yorba Linda, was tied to the distribution of another manufacturer’s contaminated umbilical cord blood products that sickened 12 people in three states. (McGinley, 12/6)

On a burning hot day last summer at the South Texas Family Residential Center, a federal detention facility for immigrant families, Kenia and her son, Michael, 11, were hunched over a foosball table in an air-conditioned recreation room when Michael dropped to the floor and started sobbing. He curled his body into a ball and writhed as if he were in pain. The other parents and children in the room looked up from their jump ropes and boomboxes as Kenia knelt down and pleaded into Michael’s ear: Would he please go back to their room before the guards noticed him? (Dickerson, 12/9)

The chairman of the House Homeland Security Committee accused the Trump administration of misleading Congress and the public about the death of a 16-year-old boy in Border Patrol custody, and he urged a swift completion of an internal investigation. Rep. Bennie Thompson, D-Miss., said a report by ProPublica on the May 20 death of Carlos Gregorio Hernandez Vasquez “calls into serious question the steps U.S. Customs and Border Protection claims to have taken to care for a child in its custody.” (Moore, 12/6)

The American Civil Liberties Union filed a lawsuit Thursday to stop two U.S. immigration pilot programs that the group alleges strip asylum seekers of their legal rights and instead fast-track them for deportation back to violent countries. The Prompt Asylum Claim Review and the Humanitarian Asylum Review Process, programs that began in El Paso, deny immigrants access to adequate counsel before their interviews with asylum officers, the ACLU of Texas; ACLU of Washington, D.C.; and ACLU national office allege in the filing. The PACR program generally applies to non-Mexicans, and HARP affects Mexican asylum seekers. (Aguilar, 12/6)

A federal appeals court says the Trump administration’s decision to deny legal status and work permits to noncitizens who accept public benefits, like food stamps or Medicaid, appears to be within the government’s legal authority to prefer immigrants who are self-sufficient and should be allowed to take effect while being challenged in court. The ruling late Thursday by the Ninth U.S. Circuit Court of Appeals in San Francisco, suspending injunctions issued in October by judges in Oakland and Washington state, has no immediate effect, because judges in New York and Maryland have issued separate orders blocking the administration’s rule. (Egelko, 12/6)

Republicans on Monday are set to accelerate Capitol Hill’s drug pricing chaos with a new proposal to lower the cost of prescription medicines, according to a summary document obtained by STAT. It’s intended to compete with a Democratic package from House Speaker Nancy Pelosi that is expected to come up for a vote this week. The Republican lawmakers’ new proposal includes a collection of bipartisan proposals collectively rebranded as the “Lower Costs, More Cures Act.” The House bill, according to Republican aides, is a “good-faith effort” to overcome partisan drug pricing squabbles, and includes a number of provisions that could conceivably become law before the end of 2019. (Facher, 12/9)

House progressives are considering voting against a procedural motion to proceed to Speaker Nancy Pelosi’s (D-Calif.) signature bill to lower drug prices next week unless they get changes to the measure, effectively threatening to stop the bill in its tracks. The Congressional Progressive Caucus (CPC) on Friday is conducting a whip count of its 98 members to see how many would be willing to vote "no" on what is known as the rule for the legislation. (Sullivan, 12/6)

The Food and Drug Administration recently approved two transformative new treatments for sickle-cell disease, the first in 20 years. But the drugs are wildly expensive, renewing troubling questions about access to cutting-edge medicines. Adakveo, made by Novartis, can prevent episodes of nearly unbearable pain that occur when malformed blood cells get stuck in blood vessels. Approved only for patients aged 16 and over, it is delivered as an infusion once a month. (Kolata, 12/7)

The U.S. is approving new drugs so fast that companies are now preparing for a green light months in advance of the scheduled decision date, a pace that’s helping patients with rare or untreatable diseases but raising alarm among consumer advocates. Global Blood Therapeutics Inc., maker of a new sickle cell disease drug called Oxbryta, built a booth to showcase the medicine at the annual meeting of the American Society of Hematology that begins this weekend -- even though the Food and Drug Administration’s deadline for approval was Feb. 26. (Cortez and Flanagan, 12/6)

Add the popular diabetes drug metformin to the list of medications possibly contaminated with the carcinogen N-Nitrosodimethylamine, or NDMA. This same carcinogen has led to recalls of blood pressure and heartburn medications. (Clanton, 12/6)

Amid ongoing concern about the use of patient assistance programs by the pharmaceutical industry, two lawmakers want the Inspector General of the Department of Health and Human Services to update its oversight and require more disclosure from the foundations about their operations. In arguing their case, the lawmakers maintained that some drug makers game the system by finding ways to boost sales of their own medicines while also benefiting from tax breaks. At the same time, they contended that programs favor expensive brand-name medicines over lower-cost generics and sometimes fail to help patients with the most need. (Silverman, 12/6)

Leaders of a key Senate committee unveiled a new version of a sweeping, bipartisan drug pricing bill Friday, and they’ve devised a novel plan to get it signed into law. The bill hasn’t changed much from the version that was narrowly passed out of the Senate Finance Committee in July — though a handful of tweaks offer further benefits to seniors. Since then, however, the bill’s political prospects have grown brighter, particularly after key Trump administration officials endorsed it over a far more progressive proposal from House Speaker Nancy Pelosi. (Florko, 12/6)

Amid intense scrutiny over prescription drug costs, a new analysis finds some hospitals are spending a larger share of their budgets for new cancer and migraine treatments, as well as for a biosimilar version of a brand-name drug that is used to prevent white-cell depletion in patients given chemotherapy. Not surprisingly, the spending reflects a growing trend among hospitals to shell out more of their dollars for outpatient infusion treatments and, in particular, costly specialty drugs, according to Bonnie Lai, vice president of product management at Lumere, a research and analytics firm that focuses on hospitals and generated the data from 26 facilities across four hospitals systems. (Silverman, 12/6)

In an unusual move, an advocacy group asked federal authorities to reject a request by Gilead Sciences (GILD) for a three-year patent extension on an HIV drug because the company allegedly lied about important information in its application. The group argued in an emergency petition with the U.S. Patent and Trade Office that Gilead concealed a decision to delay development of the drug, called TAF, in order to thwart generic competition and “game” the patent system. In the process, the company reaped billions of dollars in additional sales while knowingly marketing an older drug that the company believed was not as safe. (Silverman, 12/6)

Federally funded health researchers reported more than 8,000 “significant” financial conflicts of interest worth at least $188 million since 2012, according to filings in a government database obtained by ProPublica. The database of disclosures reported to the National Institutes of Health, which has not been made public before, details the financial relationships of researchers at universities, hospitals and nonprofit organizations. These outside interests range from stock holdings in companies that may benefit from the outcome of research to payments for royalties, consulting work and speaking engagements. The total value of the conflicts is likely much higher than $188 million, in part because 44% of the disclosures did not place a dollar value on the investigator’s financial relationship. (Armstrong and Waldman, 12/6)

For nearly two decades, Dr. Neal Hermanowicz has led the movement disorders program at the University of California’s Irvine campus, where he earns more than $380,000 a year in salary and bonuses. The widely respected expert on Parkinson’s and Huntington’s diseases adds to his income by consulting for drug companies. Since 2014, 11 pharmaceutical companies have paid him a total of at least $588,000 for consulting, speaking and honoraria, according to federal data. For example, he has received more than $225,000 in speaking and consulting fees from San Diego-based Acadia Pharmaceuticals, manufacturer of a controversial drug for Parkinson’s-related psychosis. (Waldman, 12/6)

The Department of Veterans Affairs has opened a new artificial intelligence institute to pursue research and inform national strategy. The National Artificial Intelligence Institute, a joint initiative of the VA's office of research and development and the VA secretary's center for strategic partnerships, will work with public and private partners to carry out AI research and development projects, including efforts to apply AI to identify veterans at high risk for suicide or to help reduce patient wait times. (Brady, 12/6)

Achondrogenesis, Noonan syndrome and sialadenitis aren’t household names. They have something else in common: Each is a rare disease. The term applies to any disease, disorder, illness or condition that affects fewer than 200,000 people in the United States. More people have a rare disease than you might think. According to the National Institutes of Health, up to 30 million people in the United States — nearly 1 in 10 — live with rare diseases, and there could be as many as 7,000 of the conditions. (Blakemore, 12/7)

The rate of new hospital admissions for vaping-related illnesses has dropped in the past several weeks, according to data from the Centers for Disease Control and Prevention, suggesting that the outbreak is on the decline. Doctors, cannabis-industry analysts and other experts say the trend is most likely explained by wider awareness, changing consumer habits and a potential shift in the illicit market. (Abbott, 12/6)

No single product or brand is responsible for the thousands of vaping-related lung illnesses reported across the United States, according to a report released Friday by the US Centers for Disease Control and Prevention. "Nationally, Dank Vapes were the most commonly reported THC-containing product by hospitalized EVALI patients, but a wide variety of products were reported, with regional differences," the CDC said in its report. The agency uses the term EVALI as shorthand for "e-cigarette, or vaping, product use associated lung injury." (Erdman, 12/6)

A state investigation into vaping-related lung injury cases in Massachusetts has found that vape products used in six probable cases were purchased legally from dispensaries. All of the products contained THC or tetrahydrocannabinol, the primary psychoactive component of cannabis. (Howard, 12/6)

The admission, along with a Friday agreement by the state Department of Public Health to release detailed information about the cases to the state Cannabis Control Commission, headed off a highly unusual public confrontation between the two Massachusetts agencies. But the deal prohibits any immediate public release of the data, meaning uncertainty about the real cause of the six cases could linger for weeks or longer. Along with earlier conflicting warnings from health officials, the latest back-and-forth promises to further bewilder consumers about which vaping products are safe and which might make them sick. It also risks undermining confidence in the ability of Massachusetts authorities to manage a fast-evolving public health crisis. (Adams, 12/6)

Federal health officials have mainly pointed to black market THC products as a likely culprit of the mysterious vaping illness, though at least one death has reportedly been linked to oil bought legally at a dispensary in Oregon. According to the Centers for Disease Control and Prevention (CDC), products containing THC, particularly from “informal sources” such as friends, family or in-person or online dealers, are linked to most of the cases and have played a major role in the outbreak. (Weixel, 12/6)

State and local governments are moving to ban flavored e-cigarette products in response to the Trump administration’s lack of action on rising youth vaping rates. The bans are being pushed by influential anti-tobacco advocates and public health groups, who argue flavors like mint and fruit have helped create a youth vaping epidemic. (Hellmann, 12/7)

Nearly 30% of all vehicular-crash deaths in the U.S. last year were alcohol-related, and a group representing state highway-safety offices says focusing on repeat offenders is needed to tackle the problem. Last year, 10,511 people died in crashes involving at least one driver with a blood-alcohol concentration of at least .08%, the legal cutoff in every state except Utah, federal figures show. While that represented a 3.6% drop from 2017, alcohol-related fatality levels have largely stagnated for the past decade. (Calvert, 12/9)

Audrey Mash arrived at a Spanish hospital cold to the touch and all but dead: Her heart had stopped beating hours earlier, as she clung to her husband in a mountain snowstorm and her body temperature collapsed. But the cold that nearly killed her also helped to save her life. After six hours in cardiac arrest she began to breathe again, rescued by doctors who said that her hypothermic condition — almost 35 degrees below normal — protected her brain from fatal damage. (Schaverien, 12/6)

Ms. Firmender, who has a history of mental health problems, was in therapy for depression. But she also has mild cognitive impairment and can have trouble remembering what day it is. So Dr. Kiosses was treating her with a novel approach called Problem Adaptation Therapy, or PATH. The therapy, developed at Weill Cornell Medicine in New York City and White Plains, N.Y., focuses on solving tangible problems that fuel feelings of sadness and hopelessness. It incorporates tools, like checklists, calendars, signs and videos, to make it accessible for people with memory issues. A caregiver is often involved. The approach is one of several new psychotherapies to treat anxiety and depression in people with cognitive impairments, including early to moderate dementia. (Petersen, 12/8)

A 36-year-old man born without testicles received one transplanted from his identical twin brother in a six-hour operation performed on Tuesday in Belgrade, Serbia, by an international team of surgeons. The surgery was intended to give the recipient more stable levels of the male hormone testosterone than injections could provide, to make his genitals more natural and more comfortable, and to enable him to father children, said Dr. Dicken Ko, a transplant surgeon and urology professor at Tufts University School of Medicine in Boston, who flew to Belgrade to help with the procedure. (Grady, 12/6)

For years, California law required psychotherapists to report any patient who admitted developing, duplicating, printing or exchanging material depicting an obscene act involving a child. The therapists accepted that requirement. They regarded it as an obligation to report producers and distributors of child pornography. (Dolan, 12/8)

Three months after his bone marrow transplant, Chris Long of Reno, Nev., learned that the DNA in his blood had changed. It had all been replaced by the DNA of his donor, a German man he had exchanged just a handful of messages with. He’d been encouraged to test his blood by a colleague at the Sheriff’s Office, where he worked. She had an inkling this might happen. It’s the goal of the procedure, after all: Weak blood is replaced by healthy blood, and with it, the DNA it contains. (Murphy, 12/7)

SCAN, a product sold by a company called the Laboratory for Scientific Interrogation (LSI), has, in the words of four scholars in a 2016 study, “no empirical support” — meaning, there’s no dependable research showing that it works. Scientific Content Analysis is akin to other investigative tools scrutinized by ProPublica, including bloodstain-pattern analysis and photo analysis. These analytical techniques promise a degree of certainty — about how blood came to spray across a wall, or whether a particular plaid shirt was worn by a robber — that can guide an investigator or shore up a case. The trial evidence presented against Joyner included yet another example: a prosecution expert testified that two plastic garbage bags — one found in Joyner’s apartment, the other around Hernandez’s head — had “definitely” once been connected. (Armstrong and Sheckler, 12/7)

Ashley Sicher had an invisible itch. It had begun in early spring 2017, in the third trimester of her first pregnancy. During the day, the itch was noticeable, but concentrated on her palms and feet. At night, the itch became unbearable, spreading up her arms and torso. She furiously scratched at the subterranean itch with the bristles of a hairbrush, until she broke the skin. Sicher had no rash, and her obstetrician at the time assured her that itching was a normal symptom of pregnancy. Yet this didn’t feel like a normal itch. It was a penetrating, psychologically infuriating itch. (Porter, 12/8)

Your gastrointestinal system contains about a hundred trillion bacteria. That may sound scary, but it’s actually beneficial because these bacteria help with digestion, immunity and other important functions. Even though they are basically helpful, the bacteria can go astray in disagreeable ways. (Rosenbloom, 12/7)

There was a notable face missing at last fall’s Ironman 70.3 World Championships in France. Instead of racing as expected, American Lauren Goss, 31, who had a string of wins at the distance and was feeling fit and ready to compete, was stuck on the sidelines. She’d been banned from competition for six months, lost her main sponsor and is mulling retirement. (Loudin, 12/7)

Listen closely: Can you hear that noisy static in your brain? Neurobiologist Nina Kraus can. At her lab at Northwestern University called "Brainvolts," she and her colleagues can attach a series of electrodes to your scalp and record the electricity your brain produces in response to a sound. (LaMotte, 12/9)

When students in wilderness EMT Alice Henshaw's training courses grab practice dummies for CPR drills, they have their choice of a traditional, flat-chested training manikin or one that looks a little different: a manikin zipped into a neoprene vest with silicone breasts. That's the Womanikin, a universal attachment for CPR dummies created by New York-based ad agency Joan Creative in partnership with The United State of Women. The idea behind this breasted vest — and the related awareness campaign — is to address gender disparities in training and performance of CPR, which is vital for anyone experiencing cardiac arrest. (Treisman, 12/7)

Even moderate alcohol consumption may increase the risk for cancer. Japanese scientists compared the drinking habits of 63,232 cancer patients in Japan with those of an equal number of healthy controls. All reported their average daily alcohol intake and the number of years they had been drinking. (Bakalar, 12/9)

How many rounds of antibiotics does it take to raise a Danish pig? If it is one of the 35,000 piglets raised each year on Soren Sondergaard’s sprawling farm, odds are the animal will get just a single course before it goes to slaughter. At times, a quarter or more of his swine arrive at the abattoir without ever having received any antimicrobial drugs at all. (Jacobs, 12/6)

Farmworkers face major challenges when it comes to staying healthy. They often spend hours daily performing physical labor that taxes the body, while language barriers and lack of employer-paid health insurance complicate their access to care. But the Southeast Arizona Area Health Education Center is working on a unique way to improve health care for these workers. (Abbott, 12/6)

People have been playing music together in the small Appalachian town of Hindman, Ky., since it was founded in the late 1800s. Today, one of the few businesses still open in the town is the Appalachian School of Luthiery, which teaches people how to build wooden stringed instruments. Now that school is playing a role in helping the local community overcome drug addiction. (Tan, 12/6)

There's not much solid data about how widespread the use of a psychoactive plant called kratom is in the U.S. But if what Dr. Marvin Seppala is seeing in addiction treatment centers all over the country is any indication, use of kratom isn't just on the rise; it's becoming normalized. (Robinson, 12/7)

On a brisk, 40-degree afternoon two days before Thanksgiving, Portland police responded to a call from the city’s psychiatric hospital and found a man sitting on the ground of the ambulance bay, handcuffed and shivering in just a T-shirt and shorts. A security guard told two officers that the man had been released from the Unity Center for Behavioral Health but wouldn’t leave. The guard told police the man apparently had taken crystal methamphetamine and should go to detox. (Bernstein, 12/8)

Recent indications that the owners of St. Joseph’s Hospital in downtown St. Paul may be considering major changes, including its possible closure, have prompted concerns among community members and caregivers. Fairview Health Services, the health system that owns the hospital, is losing tens of millions of dollars and looking to cut costs systemwide. Late last week, it announced cuts at its Bethesda Hospital location in St. Paul. (Zdechlik, 12/9)

Partners HealthCare ended the 2019 fiscal year with $485 million in income from operations, as it prepares to invest in several new initiatives. Officials at the state’s largest nonprofit health system said Friday that their hospitals treated a growing number of seriously ill patients and benefited from payment rate increases, boosting revenue to about $14 billion in the year that ended Sept. 30. (Dayal McCluskey, 12/6)

Executives with two Seacoast hospitals seeking an affiliation with Massachusetts General Hospital are taking their campaign to another level with paid media, polling and a public call to action. The goal is to leverage enough community concern to convince Attorney General Gordon MacDonald to negotiate an end to his opposition to the deal over antitrust concerns. MacDonald has said that his office has been willing to talk, but lawyers for the hospitals need to make the next move. (Landrigan, 12/8)

In 2015, the California regulator overseeing PG&E Corp. opened an inquiry into whether the state’s largest utility put enough priority on safety. Since then, a federal jury has found PG&E guilty of violating safety regulations for natural-gas pipelines and a federal judge later placed it on criminal probation. Its electrical equipment has sparked more than a fire a day on average since 2014—more than 400 last year—including wildfires that killed more than 100 people. It filed for bankruptcy protection this year, citing $30 billion in fire-related liabilities, and started blacking out millions of customers to try to avoid sparking blazes during strong winds. On Friday, it agreed to pay $13.5 billion to wildfire victims in a settlement deal. (Blunt and Gold, 12/8)

A concerned parent of an inmate recently told the Post-Dispatch that the jail has been out of basic supplies such as shampoo and feminine hygiene products for weeks. ...Unlike about 30 other states, Missouri has no statewide jail standards. Local authorities determine what’s best. That can mean big differences in jail conditions across the state. And while county jails that house federal inmates are supposed to get an added set of eyes from the U.S. Marshals Service, testimony in the November trial of a man convicted of sexually assaulting a fellow federal inmate at the nearby Dunklin County Jail indicated that jailers lied about routine safety checks and allowed inmates to cover the windows of their cells without scrutiny. (Bogan, 12/8)

Across California, patients like Williams are wading into years of debt because of high-interest credit cards used to finance dental treatment. They have succumbed to requests by dentists to put their high-priced services on a controversial segment of the health care industry: companies that offer loans for “out-of-pocket” medical care. (Tobias, 12/9)

In the past two weeks in Baton Rouge, there were three attacks on medical professionals by patients in their care that resulted in arrests. The latest happened Thursday night, when a Baton Rouge man was arrested after he struck a nurse in the face with a plastic fork, breaking the nurse's skin, the arrest report says. CJ Grigsby III, 20, got into an argument with his nurse over eating his meal in his room, according to the arrest report. Grigsby then struck the nurse with the fork twice and punched him in the arm. (DeRobertis, 12/6)

Florida’s Baker Act directs police officers and some mental health professionals to hospitalize the mentally ill, but it was never intended to be used on children with autism or children who act out in class. The 48-year-old law even says those with developmental disabilities should not be committed unless they’re also mentally ill and a danger to themselves or others. But more and more kids who do not meet the criteria are being taken from schools to crisis centers for up to 72 hours and more. Across Florida, the number of children involuntarily transported each year to a mental health center has doubled in the last 15 years to about 36,000, or 100 a day, according to the Baker Act Reporting Center at the University of South Florida. (Anton and Pendygraft, 12/8)

Agencies across the country count the number of people experiencing homelessness at the end of each January. In Texas this year, organizations and volunteers counted 25,848 people experiencing homelessness. (Adeline and Garnham, 12/9)

This year’s flu season has had its fastest start in Florida, and among other southern states and Puerto Rico, in 15 years, according to the Centers for Disease Control and Prevention.“Seasonal influenza activity in the United States has been elevated for four weeks and continues to increase,” the CDC reported on Nov. 30 at the end of week 48 of the year. Florida is one of the leading flu season states where “activity increased and remained above levels observed at this time in previous seasons,” according to the Florida Department of Health. (Cohen, 12/7)

In the Sacramento region, Anthem Blue Cross is disrupting the typical U.S. health care model to improve health outcomes for high-risk patients. Doctor-led teams go to patient homes to remove social barriers, treat patients and coordinate care. (Hodenfield and Anderson, 12/6)

California may have some of the nation’s most restrictive gun control laws, from bans on assault rifle sales to mandatory background checks for ammunition sales, but that isn’t stopping Golden State residents from buying firearms. A quarter of Californians live in a house with a gun, according to a new survey. (Sheeler, 12/6)

Filthy, unsanitary, and often lacking basics like toilet paper and hot water, the bathrooms of the city’s public schools are, far too frequently, in appalling condition. It is not a conventional measure of success or failure in the city’s schools, but it is a telling one: What does it say to the children of the schools that they are expected, as they strive to learn, to put up with such facilities? Or avoid them at all cost — and great discomfort? (Vazquez Toness, 12/7)

Rather than helping develop care plans that would allow them to live in their own homes or apartments, counties across the state continue to steer thousands of Minnesotans with disabilities into facilities that promote dependency and isolation. State spending on group homes, for Minnesotans with disabilities who receive a coveted form of assistance known as a Medicaid “waiver,” now totals about $1.5 billion a year. That represents about two-thirds of total spending on waivers for people with disabilities — and is more than the combined state spending on agriculture, higher education and pollution control. (Serres and Howatt, 12/8)

State health officials are investigating an outbreak of a common respiratory virus that has appeared on three college campuses across Wisconsin. Adenovirus, an infection that causes respiratory symptoms ranging from cold and flu-like symptoms to bronchitis and pneumonia, has been confirmed at the University of Wisconsin campuses in Madison, La Crosse and Oshkosh. (Shastri, 23/6)

Georgia continues to rank among the states with the highest rates of maternal mortality, low birth rate, preterm birth and infant mortality. The findings are part of a report released Thursday by Healthy Mothers, Healthy Babies Coalition of Georgia. (Moffatt, 12/6)

This week in our state: weed and taxes! With less than one month left of 2019, and with recreational marijuana set to become legal on Jan. 1, officials in cities and towns across the state are wrestling with the issue and determining where they’ll stand. Some of the biggest news on the issue this week occurred in Evanston, where the City Council voted Monday to use sales tax revenues from marijuana to fund a local reparations program, according to the Chicago Tribune. (Jaffe, 12/6)

Kaiser Health News: ‘Warm’ Hotlines Deliver Help Before Mental Health Crisis Heats Up

A lonely and anxious Rebecca Massie first called the Mental Health Association of San Francisco “warmline” during the 2015 winter holidays. “It was a wonderful call,” said Massie, now 38 and a mental health advocate. “I was laughing by the end, and I got in the holiday spirit.”Massie, a San Francisco resident, later used the line multiple times when she needed additional support, then began to volunteer there. (Stephens, 12/9)

A pregnant inmate had complained of pain numerous times to staff at York Correctional Institution during the week before she gave birth in her cell last year, but medical workers did not perform an assessment that would have determined she was in labor, nor did they tell a doctor about her abdominal pain or send her to an emergency room, according to a report unsealed Friday by a federal judge. (Lyons and Carlesso, 12/6)

People with autism and other neurodevelopmental disabilities often have few places to go for diagnosis and treatment when they are no longer children. The University of Maryland School of Medicine and others plan to announce Friday that they have created a set of centers specifically for adults. With $500,000 in state funding to launch, the school, the University of Maryland Medical Center and the Tuberous Sclerosis Alliance will operate two centers to provide evaluation, care and treatment for disorders that also include epilepsy, intellectual disability and tuberous sclerosis complex. (Cohn, 12/6)

At Connecticut College, almost a third of students get mental health services in a given year and half of all students get that help at some point before they graduate. At Trinity College, close to half of the student body comes into the counseling center in a given year.By contrast, at Manchester Community College, very few mental health services are available. (Megan, 12/9)

The St. Louis Area Regional Commission on Homelessness found homes for hundreds of veterans this year. Now, the local homeless agencies that comprise the commission are using what they’ve learned to improve how they serve the region. The commission, a partnership between St. Louis-area counties in Missouri and Illinois, aimed to house every homeless veteran in the region this year. By Nov. 11, it helped find homes for 93% of the 217 vets it found homeless in February. (Petrin, 12/8)

Cancer Treatment Centers of America has agreed to pay more than $5 million into a state fund for indigent care as part of the organization’s expansion of its Newnan facility. There’s no apparent explanation for the payment in the Nov. 22 agreement between CTCA and the state’s Department of Community Health. But CTCA had been accused by hospital groups of not meeting its obligation to provide care to Medicaid and indigent patients since the facility opened in 2012. (Miller, 12/6)

An Alaska dentist accused of fraud and unnecessarily sedating patients also performed a procedure while riding a wheeled, motorized vehicle known as a hoverboard, authorities said. Prosecutors charged 34-year-old Seth Lookhart with felony Medicaid fraud and reckless endangerment. A former patient testified Wednesday at his trial that she was angered when an investigator showed her an unauthorized 2016 video of Lookhart extracting one of her teeth while she was sedated and he was riding the hoverboard. (12/6)

Democratic presidential candidates Sens. Bernie Sanders and Elizabeth Warren want you to believe Canada’s health care system is a dream come true. And they want to make the dream even better with their “Medicare-for-all” plans. Don’t believe them. In truth, Canada's system of socialized medicine is actually a nightmare. It has left hospitals overcrowded, understaffed and unable to treat some patients. Americans would face the same dismal reality if Canadian-style "Medicare-for-all" takes root here. (Sally Pipes, 12/8)

Understanding and navigating the health care system is more challenging for patients than at any time in history. The complexities and variations among insurance plans on issues of coverage, out-of-pocket costs, and payment for care are extraordinary as compared to other consumer services. One of the most pressing examples is “surprise medical billing.” Such instances occur when a patient receives medical services and is unknowingly cared for by a clinician from outside of the patient’s insurance network. The predictable and understandable result is stress, anger, confusion, and despair.Local and national policymakers are correctly focusing attention on this issue. When surprise billing occurs, patients are unfairly put in the middle of a matter that should be resolved by their health plan and provider. Corrective actions are long overdue. (Maryanne C. Bombaugh, 12/9)

The big picture: The new data underscore the importance of a legislative solution to help patients who are powerless to protect themselves. Details: People having surgery or receiving mental health and substance abuse treatment at an in-network hospital are the most likely to experience a surprise bill from an out-of-network provider. Among people with employer-based insurance, out-of-network charges were 50% higher among heart-attack victims than for other diagnoses. 21% of women undergoing mastectomies experienced out-of-network provider charges. My thought bubble: It’s hard to imagine many patients who are so prepared and insurance-savvy that they could protect themselves from an out-of-network bill in the middle of a heart attack. (Drew Altman, 12/9)

It’s that time of year — when we enroll in health insurance. Whether you are shopping for individual coverage or have coverage through your employer, there is a good chance you are comparing health plans and getting ready to make one of the biggest financial decisions of the year. (Dania Palanker, 12/9)

Much of what we accept as legal in medical billing would be regarded as fraud in any other sector. I have been circling around this conclusion for this past five years, as I’ve listened to patients’ stories while covering health care as a journalist and author. Now, after a summer of firsthand experience — my husband was in a bike crash in July — it’s time to call out this fact head-on. Many of the Democratic candidates are talking about practical fixes for our high-priced health care system, and some legislated or regulated solutions to the maddening world of medical billing would be welcome. (Elisabeth Rosenthal, 12/7)

James Madison called Congress’s power of the purse “the most complete and effectual weapon” for restraining “the overgrown prerogatives of the other branches of the government.” On Tuesday the Supreme Court will consider in Maine Community Health Options v. U.S. whether Congress can limit the spending discretion it has previously granted to the executive branch. Four health insurers have sued the government for not making payments they say they are entitled to under the Affordable Care Act’s “risk corridors.” (12/8)

Millions of Americans are hunting for health insurance. The Affordable Care Act's open enrollment period ends in just two weeks. Consumers in more than three dozen states are running out of time to log onto HealthCare.gov to shop for coverage for the coming year. The process can be intimidating. Every policy offers a different mix of premiums, deductibles, benefits, and provider networks. (Janet Trautwein, 12/5)

As a rural business owner, most people assume I am against a single-payer, government-run model. But I am not. I want a bold, new, affordable health care model that takes care of my employees, my business and my family. I know we can accomplish this. The State Accident Insurance Fund is but one example of an efficient and properly-run single payer system for workers compensation right here in Oregon. In July, I co-sponsored with Warren George, who is also a rural Oregon businessman, a poll of Oregon voters that determined most Oregonians feel the same way. According to the poll, conducted by Elway Research: 62% of us would likely support a new health tax to replace insurance and provide universal care. (Ron Loe, 12/8)

Democrats recently notched big gubernatorial wins in deep red Louisiana and Kentucky, and they took full control of the Virginia state legislature — all of which were driven in no small part by bruising local debates over the Medicaid expansion. Now Democrats are hoping that this momentum for the Medicaid expansion, combined with the growing popularity of the proposal even in Republican territory, could finally produce a breakthrough that they’ve long coveted: in still-reddish North Carolina. (Greg Sargent, 12/6)

In a rare moment of bipartisanship, Congress rejected President Trump’s efforts on last year’s farm bill to impose new food stamp restrictions that would have cut benefits for more than a million needy people. So Trump decided to pursue the changes through executive action. On Wednesday, the U.S. Department of Agriculture finalized the first of three new regulatory changes to food stamps, formally known as the Supplemental Nutrition Assistance Program, just in time for the holidays. And boy, it is just as punitive and miserly as we feared. Bah, humbug! (12/9)

The Supplemental Nutrition Assistance Program (SNAP) is our nation’s first line of defense against food insecurity. It’s a lifeline that can provide enough food for all household members to lead healthy and active lives. As a fundamental component of America’s public health and economic infrastructure, SNAP helps sustain people when the economy goes into recession, disasters happen, life takes unforeseen turns, wages are too low, or work is hard to find. The research is clear: food insecurity and hunger are linked to negative health outcomes across the lifespan, like anemia, developmental delays, and suicidal thoughts in children and adolescents, and depression, diabetes, and high blood pressure in adults. This is why SNAP is important medicine. (Stephanie Ettinger De Cuba, Diana B. Cutts and Allison Bovell-Ammond, 12/6)

In histories written about Alzheimer’s disease, 2019 will turn up as a landmark year, one in which researchers, clinicians, patients, and their families were whipsawed from crushing despair to giddy optimism. The year unfolded with a string of disappointments. One of the biggest came on March 21 when Boston-based Biogen announced it had pulled the plug on two clinical trials of aducanumab, a promising treatment for individuals with Alzheimer’s disease. Five months later, at the Clinical Trials in Alzheimer’s Disease (CtAD) conference on Thursday, December 5, I and other Alzheimer’s researchers gathered once again in California. This time the mood was giddy.( Jason Karlawish, 12/6)

Both of us have sleep apnea, and both of us receive treatment that makes a world of difference. It could make a big difference in your life, too. Sleep apnea is quite common, with estimates that it affects up to 17 percent of men 50 to 70, and 10 percent of men 30 to 49. But there’s a problem. In the American health system, we often make it hard for people to get care, and the same is true here. (Aaron E. Carroll and Austin Frakt, 12/9)

The Trump administration announced last week a new program that will provide HIV prevention medications free of charge for uninsured patients. These pre-exposure prophylaxis (or PrEP) drugs are highly effective in preventing HIV, but with a cost of $2,000 a month, they are far too expensive for people without insurance. This new program will provide PrEP at no cost for up to 200,000 uninsured patients a year. Supporters have lauded this move as a major step toward President Trump’s plan to end HIV in the United States. Others have criticized it as not going nearly far enough: They would rather the government expedite generic drug production and lower the cost of PrEP. (Leana Wen, 12/8)