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The White House withdrew the nomination of Dr. Ronny L. Jackson, the White House physician, to lead the Veterans Affairs Department on Thursday after lawmakers went public with a torrent of accusations leveled against him by nearly two dozen current and former colleagues from the White House medical staff. In a statement released Thursday morning, Dr. Jackson announced that he was withdrawing his name for consideration to be the secretary of Veteran Affairs. (Fandos and Baker, 4/26)

“The allegations against me are completely false and fabricated,” Jackson, the White House physician, said in a defiant statement. “If they had any merit, I would not have been selected, promoted and entrusted to serve in such a sensitive and important role as physician to three presidents over the past 12 years.” (Rein, Wagner and Dawsey, 4/26)

Dr. Ronny Jackson, who is Mr. Trump’s White House physician, took himself out of the running after Democrats on the Senate Veterans Affairs Committee released a summary of allegations they had compiled through interviews with about two dozen people who have worked with him. The report described a culture of lax controls over drug prescription. Once, the report said, a prescription for a sleeping aid was written for a provider instead of for the actual beneficiary to protect the beneficiary’s identity. The report also said Dr. Jackson got drunk at a Secret Service going-away party and wrecked a government vehicle. (Nicholas, 4/26)

The document, unveiled by Sen. Jon Tester of Montana, the ranking Democrat on the Veterans’ Affairs Committee, raised concerns about Jackson’s practices prescribing medicine, his management of the work culture under him and allegations of his consumption of alcohol while on the job. The report details allegations of a work environment in which subordinates worked in “constant fear of reprisal” and described Jackson’s behavior as “unethical” and “explosive.” It also contains claims that Jackson was drunk while on duty overseas on multiple occasions, including one episode in which he allegedly crashed a government vehicle during a going-away party for Secret Service. (Lima, 4/26)

Trump on Thursday praised Jackson as a "highly respected" doctor and blamed Democrats for sinking his nomination, even though many Republicans also wanted Jackson to pull out. “These are false accusations," Trump said on "Fox and Friends." "They’re trying to destroy a man. I did say, ‘Welcome to Washington. Welcome to the swamp.’" (Weixel and Fabian, 4/26)

A new memo from the top Democrat on the Veterans Affairs Committee contains a slew of new allegations against President Trump’s pick to lead the Department of Veterans Affairs, including that he passed out controlled substances to anyone who asked. Witnesses allege that Ronny Jackson wrote himself prescriptions and on at least one occasion during the Obama presidency, “could not be reached when needed because he was passed out drunk in his hotel room,” according to the memo.  (Weixel, 4/25)

Conversations with 23 colleagues and former colleagues of Rear Admiral Jackson, most of whom are still in uniform, have raised serious concerns about Jackson’s temperament and ethics, and cast doubt on his ability to lead the second largest agency in government and one tasked with the sacred mission of fulfilling our commitment to the men and women who have served our nation in uniform and their families. Those concerns are best captured under the following three topics. (Blake, 4/25)

The firestorm over President Trump’s nominee to lead the Department of Veterans Affairs has thrust a vulnerable Democratic senator into a moment of political peril and opportunity. Sen. Jon Tester (Mont.), the top Democrat on the Veterans’ Affairs Committee, is leading the effort to dig deeper into the background of Ronny L. Jackson, who has faced accusations that he improperly dispensed drugs, created a hostile workplace and became intoxicated on duty. Ensuring capable stewardship of the sprawling Veterans Affairs is an issue certain to resonate with Tester’s constituents; nearly 1 in 10 Montana residents is a veteran. Only Alaska has a higher percentage of veterans living in-state. (Sullivan, 4/25)

Ronny Jackson, the White House physician who is battling to save his nomination to be the secretary of veterans affairs, regularly handed out the sleep drug Ambien and the alertness drug Provigil to West Wing officials traveling on overseas flights. Jackson’s nomination has inadvertently exposed the widespread use of sleep and alertness drugs among government officials from the White House and State Department to the Pentagon and Congress itself. (Johnson, Everett, Bender and Karlin-Smith, 4/25)

White House physician Ronny L. Jackson allegedly provided travelers on White House trips with Ambien, a prescription sedative that is widely regarded as a safe drug that poses little risk of addiction. Nearly 30 million Americans take it for it insomnia — the vast majority of them in its generic form, zolpidem — for a single night or for longer periods of sleeplessness. But that doesn't mean a physician can hand out the drug “like candy,” as Sen. Jon Tester (D-Mont.) said Jackson did, without inquiring about other medications a patient might be taking, drug history or other medical issues, experts said. (Bernstein, 4/25)

With White House physician Ronny L. Jackson’s nomination to lead the Department of Veterans Affairs in serious doubt, here are five things that veterans advocates and experts say are the most urgent needs a new VA secretary must address to successfully run the $200 billion agency that serves 9 million. (Wax-Thibodeaux, 4/25)

New, more-limited health plans may draw consumers away from Affordable Care Act coverage and drive up prices on insurance sold in the health law’s marketplaces. These “skinny” plans offer lower premiums, making them an attractive alternative for young, healthy buyers. But the plans can be loaded with restrictions. Often, people who aren’t healthy are blocked from buying them. Many don’t cover prescription drugs or pre-existing conditions, and some cap coverage, doing away with ACA requirements and potentially leaving buyers with big bills if they get sick. (Macnaughton and Wilde Mathews, 4/25)

Last year, President Donald Trump signed an executive order that promised to cut back some of the rules in the Affordable Care Act. The new "skinny plans," expected out this year, are poised to benefit some and hurt others. WSJ's Spencer Macnaughton explains. (4/25)

Anthem's first-quarter earnings shot up 30 percent, and the Blue Cross-Blue Shield insurer hiked its 2018 forecast, as a drop in medical expenses bolstered its performance. The nation's second-largest health insurer joined rival UnitedHealth Group Inc. in topping analyst expectations for the quarter and hiking its 2018 forecast. Anthem said Wednesday that it now expects 2018 adjusted earnings to be greater than $15.30 per share after saying in January that they would exceed $15 per share. (4/25)

The company announced last year it would sell fewer ObamaCare plans in 2018, citing uncertainty and instability in the markets. Instead, Anthem has focused on growing its Medicare Advantage business. Enrollment in these plans grew by 237,000 during the first quarter. Overall, however, enrollment dropped by 2.5 percent, driven mostly by the insurer's decision to sell fewer ObamaCare plans. (Hellmann, 4/25)

The head of the California ObamaCare marketplace is urging the Trump administration to restore outreach funding to encourage people to sign up, warning of higher premiums if the step is not taken. Peter Lee, the executive director of Covered California, wrote a letter to Health and Human Services Secretary Alex Azar on Wednesday calling on him to increase ObamaCare outreach funding. (Sullivan, 4/25)

If you submitted an Obamacare application in the last two weeks of December -- after the open enrollment period had closed -- because you were affected by the hurricanes and didn’t qualify for special enrollment, you might have a second chance, according to Covering Florida. The federal government announced recently that it has identified applicants who were mistakenly denied to participate in special enrollment and is now notifying them about the error. (Miller, 4/25)

A year ago, the trade group for Minnesota's nonprofit health insurers sounded the alarm over a 30 percent decline in the number of people buying health insurance policies for themselves. This year, the tally is down once again, but not by nearly such a large margin, according to new figures from the Minnesota Council of Health Plans. What's more, the number of people buying individual health plans at the end of March was up compared with the previous December — the first increase between the fourth and first quarters in three years. (Snowbeck, 4/25)

A federal judge has issued a permanent injunction blocking the Trump administration from cutting grants to Planned Parenthood that pay for a teen pregnancy prevention program in numerous states. U.S. District Court Judge Thomas Rice of Spokane issued his ruling late Tuesday, after listening to arguments from attorneys for Planned Parenthood and the U.S. Department of Health and Human Services. (Geranios, 4/25)

U.S. District Judge Thomas Rice on Tuesday issued a permanent injunction preventing the administration from ending the grants two years earlier than originally planned, saying that doing so would cause public harm. "The Court determines that the public interest weighs in favor of Plaintiffs, as it would prevent harm to the community ... and prevent loss of data regarding the effectiveness of teen pregnancy prevention," Rice wrote. (Hellmann, 4/25)

The Trump administration is preparing to submit to the U.S. Congress up to $25 billion in immediate spending cuts, including possible reductions to social safety net programs, lawmakers said on Wednesday, in a move that could upend a budget deal enacted last month. The White House plan, which has not yet been unveiled, would call on Congress to rescind funding already enacted into law. It likely would be submitted next month, sometime after a recess that ends on May 7. (Cowan, 4/25)

The Senate Health Committee will vote on a bill next month addressing increasing maternal death rates in the U.S., ranking member Patty Murray (Wash.) said Tuesday. The bill, sponsored by Sens. Shelley Moore Capito (R-W.Va.) and Heidi Heitkamp (D-N.D.), would support state-level efforts to form review committees that specifically track and investigate pregnancy-related deaths, and then look for ways to prevent future deaths from occurring. (Hellmann, 4/24)

House Veterans Affairs Chairman Phil Roe said he expects to hold a markup the week of May 7 on an as-yet-unrelased bill to overhaul and reauthorize the Veterans Choice Program, which provides private care options for veterans facing long wait times and long distances to travel to a VA facility. "We'd like to be able to get the bill on the president's desk before Memorial Day if we can," the Tennessee Republican said. "That's a pretty aggressive goal, but that's what I'd like to do." (McPherson and Mejdrich, 4/25)

House Judiciary Committee Chairman Bob Goodlatte (R-Va.) has signed on to co-sponsor bipartisan legislation to simplify the medical marijuana research process. Goodlatte's spokeswoman, Kathryn Rexrode, told Bloomberg that Goodlatte would co-sponsor the bill with Rep. Matt Gaetz (R-Fla.).  (Manchester, 4/25)

Patients with high-deductible plans increasingly were asking St. Clair Hospital in Pittsburgh to tell them in advance how much their care would cost them out of pocket. So two years ago, the independent community hospital worked with Experian to start providing individualized cost estimates for 135 common procedures through an online tool. Hospital Chief Financial Officer Richard Chesnos claims the estimates are nearly 100% accurate. (Meyer, 4/25)

CMS may lack the legal authority to force providers to release the most useful information on health care prices, legal and policy experts say, despite the agency's signaling, in regulations released Tuesday, its desire to make hospital charges more transparent. Hospitals would have to post standard charges on the internet and make it easier for third parties to access and aggregate the data under CMS' proposal. (Pittman, 4/25)

Humana on Wednesday unveiled a program to reimburse hospitals for improvement on quality measures related to patient safety, experience and outcomes. The Hospital Incentive Program, which went into effect in January, is Humana's first value-based model that focuses exclusively on hospitals' inpatient admissions. Humana's other value-based programs like the total joint replacement episode-of-care model focus on primary or specialty care. "This is a natural extension of our other value-based models that are already out there," said Ben Lunsford, vice president of value-based strategies at Humana. (Castellucci, 4/25)

Kaiser Health News: Hospitals Lure Diabetes Patients With Self-Care Courses, But Costs Can Weigh Heavily 

When a routine physical revealed mildly elevated blood-sugar levels, Michael Phillips was strongly encouraged to sign up for a diabetes self-management class. Phillips never asked about the cost of the two half-day sessions he attended in a conference room at St. Mary’s Hospital in Athens, Ga., and doesn’t recall the instructor mentioning it. But the 64-year-old retired bank analyst was flabbergasted when he opened his bill after attending. (Appleby, 4/26)

KU Health officials said in a news release they signed a letter of intent to purchase the operations of Great Bend Regional Hospital and its affiliated clinics. They declined to provide details about the agreement, which is expected to be finalized this summer. (Marso, 4/25)

Following an internal investigation, the McKesson (MCK) board absolved senior management of any failures to oversee the distribution of opioid painkillers, an issue that has haunted several wholesalers as the opioid crisis in the U.S. worsens. Notably, the probe found that senior managers “worked in earnest” to meet Drug Enforcement Agency requirements, such as reporting suspicious orders to pharmacies, and had oversight procedures in place for a monitoring program and distribution facilities. (Silverman, 44/25)

Top Democrats on the House Energy and Commerce Committee voiced concerns over the speed at which the Republican chairman is aiming to put opioid legislation on the House floor. Chairman Greg Walden (R-Ore.) has repeatedly said he hopes the House can take up the committee’s legislation to combat the opioid epidemic by Memorial Day weekend. (Roubein, 4/25)

Democrats and Republicans sparred Wednesday as a House subcommittee began a lengthy markup of over 60 bills related to combating the opioid crisis. Democrats objected to the number and scope of the bills, a point brought up at earlier hearings to discuss the epidemic. ...Health Subcommittee ranking member GeneGreen, D-Texas, also emphasized that the committee was considering “quantity over quality” and that the number of bills being marked up on Wednesday was highly unusual. (Raman, 4/25)

Over-the-counter pain pills are safer and more effective than prescription opioids for controlling the pain following dental procedures, a review of the evidence has found. Researchers analyzed five reviews of studies of medication and medication combinations for pain relief. They included only reviews of high or moderate methodological quality. (Bakalar, 4/25)

A prescription painkiller that has been under a cloud for more than a decade is apparently safer than previously believed, a Food and Drug Administration panel concluded Wednesday. The drug celecoxib, which is sold by Pfizer under the brand name Celebrex, poses no greater risk for causing heart attacks and strokes than two other widely used pain relievers, the committee voted at the end of a two-day hearing. The vote was 15-5. One member abstained. (Stein, 4/25)

The demand for new needles continues to grow and so do the number of ZIP codes from which drug users travel to obtain the needles. ZIP code data also point to a growing concentration of drug users in particular suburbs, including Lakewood, Parma and Middleburgh Heights, that currently do not offer harm-reduction programs such as a needle exchanges. (Naymik, 4/26)

To help police officers breathe easier when they find suspicious white powders at crime scenes, Sen. Sherrod Brown says he'll introduce a bipartisan bill to fund purchases of high-tech portable drug screening devices for local law enforcement. (Eaton, 4/25)

Wise County, a sparsely populated area in Southwest Virginia that has been ravaged by the opioid epidemic, this week became the first locality approved for a needle exchange program in the state. The approval comes nearly a year after the service became legal in Virginia. (O'Connor, 4/25)

The first thing you see when you enter Lemonaid Health’s offices is a dazzling bright yellow accent wall. Doctors work at desks clustered together in an open-plan office, ducking into smaller offices to conduct video visits with patients. The engineering, design, and data science teams sit just steps away. Hanging from a standing coat rack is a king’s crown, like the kind found in a child’s dress-up drawer, that employees wear proudly on their work anniversary. (Robbins, 4/26)

In 2016, executives at the buzzy telemedicine startup Nurx spoke openly about their ambitions. By the following year, the company’s online services for birth control and the HIV prevention pill would be available in all 50 states. That never happened. Today, Nurx operates in just 17 states and Washington D.C. Nurx is part of a new wave of businesses that have attracted lots of excitement and investment for an idea that seems intuitive: Allowing patients to use online forms and chat messages to quickly get prescription drugs to treat simple conditions like urinary tract infections, erectile dysfunction, and hair loss. (Robbins, 4/26)

More than half a dozen governors — most of them Democrats from the Northeast — announced plans Wednesday to launch an “unprecedented” multistate consortium that will study gun violence as a public health issue. The governors said they were upset at the lack of action from Washington and are looking to fill a void left by the Centers for Disease Control and Prevention, which has been restricted in its ability to collect data to advocate for gun control. (Hutchins, 4/25)

After a shooting that killed 17 people at a Parkland, Fla., high school, the mayor of nearby Weston wanted to prohibit people from carrying guns in public buildings and parks — a move that could lead to him being kicked out of office and on the hook for thousands of dollars in fines and attorney’s fees. Florida law prohibits local municipalities from passing ordinances that regulate firearms or ammunition, and if one is passed that violates the state statue, it will be declared void. Elected or appointed officials involved in the drafting or passage of such local rules face fines of up to $5,000, will be unable to use a city attorney and could be held responsible for footing up to $100,000 of the legal bills for anyone who challenges the local rule in court. The governor is also given the power to kick them out of office. (Zezima, 4/25)

Dr. Oliver Sartor has a provocative question for patients who are running out of time. Most are dying of prostate cancer. They have tried every standard treatment, to no avail. New immunotherapy drugs, which can work miracles against a few types of cancer, are not known to work for this kind. Still, Dr. Sartor, assistant dean for oncology at Tulane Medical School, asks a diplomatic version of this: Do you want to try an immunotherapy drug before you die? (Kolata, 4/26)

A medical device that can add years to the lives of cancer patients is about to become unavailable, because its manufacturer has decided to stop producing it. The device, the size of a hockey puck, is implanted in the abdomen to pump high doses of chemotherapy directly into the liver for cancer that has spread there, usually from colon or rectal tumors. The treatment can help prevent tumors from recurring after they are removed from the liver, and can shrink inoperable growths in the liver so that they can be cut out. (Grady and Kaplan, 4/25)

Kaiser Health News: ‘Rapid Autopsy’ Programs Seek Clues To Cancer Within Hours Of Death

After Keith Beck died of bile duct cancer last year, family members said more than 900 people showed up to pay respects to the popular athletic director at the University of Findlay in northwestern Ohio. Many were former students who recalled acts of kindness during Beck’s nearly 30-year career: $20 given to a kid who was broke, textbooks bought for a student whose parents were going through bankruptcy, a spot cleared to sleep on Beck’s living room floor. (Aleccia, 4/26)

U.S. health officials say the E. coli outbreak linked to tainted romaine lettuce has grown and sickened 84 people from 19 states. The U.S. Centers for Disease Control said Wednesday that at least another 31 cases are believed to be tied to romaine lettuce grown in Yuma, Arizona. The agency says those infected range in age from 1 to 88. More than half are female. Forty-two people have been hospitalized, including nine battling kidney failure. (4/25)

The search for the source of the outbreak is ongoing. The CDC and the Food and Drug Administration say the Yuma, Ariz., growing region is the source, but no farm has been identified. The Yuma area grows most of the lettuce harvested in the United States during the winter months, but officials say that lettuce now in stores or at restaurants is probably from California's Central Valley or Salinas Valley and has not been implicated in the outbreak. (Sun and Alchenbach, 4/25)

Bits of human brain tissue no larger than a pea are forcing scientists to think about questions as large as the nature of consciousness. These clusters of living brain cells are popularly known as minibrains, though scientists prefer to call them cerebral organoids. At the moment, they remain extremely rudimentary versions of an actual human brain and are used primarily to study brain development and disorders like autism. (Hamilton, 4/25)

In research that promises a new approach to treating an age-old human scourge, scientists have found a way to weaken the bacterium that causes tuberculosis and boost its vulnerability to drugs that are rapidly losing their power to cure. A study published Wednesday in the journal Science and Translational Medicine outlines a new assault against TB by a team led by researchers from Weill Cornell Medical College in New York. (Healy, 4/25)

For nearly two decades, the University of Illinois at Chicago has touted child psychiatrist Mani Pavuluri as one of its stars: She founded a renowned clinic to treat children with bipolar disorder and secured millions of dollars in coveted federal funding to help unlock the mysteries of the disease. ...In December, the university quietly paid a severe penalty for Pavuluri’s misconduct and its own lax oversight, after the National Institute of Mental Health demanded weeks earlier that the public institution — which has struggled with declining state funding — repay all $3.1 million it had received for Pavuluri’s study. (Cohen, 4/26)

Researchers have identified a low-cost medication that they say could protect millions of young children in poor nations from dying of pneumonia, malaria and other preventable diseases. But they and other experts acknowledge they will have to decide carefully how best to deploy the new tool—an antibiotic widely prescribed in the U.S. for bacterial infections—because heavy use could fuel antibiotic resistance. Taking antibiotics at a young age may also increase the risk of other health problems later on, some experts say. (McKay, 4/25)

Researchers from the University of Toronto have created a shoebox-sized laboratory that can do blood testing in remote, low-resource settings, quickly determining from a drop of blood whether a person has antibodies to specific infectious diseases. The device, which they called the MR Box — short for measles and rubella, the first diseases for which they tested — is still being fine-tuned. But their hope is that eventually it could be used to test for a variety of diseases, for both outbreak control and research purposes, in parts of the world where conventional lab support is hours — or farther — away, the scientists reported Wednesday. (Branswell, 4/25)

If you have ever run a marathon, you know that the effort can cause elation, exhaustion, achy legs, blackened toenails and an overwhelming urge to eat. But it is unlikely to have made you vulnerable to colds or other illnesses afterward, according to a myth-busting new review of the latest science about immunity and endurance exercise. The review concludes that, contrary to widespread belief, a long, tiring workout or race can amplify immune responses, not suppress them. (Reynolds, 4/25)

Hit-and-run crash deaths are rising nationwide, and pedestrians and bicyclists account for close to 70% of the victims, according to a new report, as more people cycle to work and motor-vehicle fatalities are at a near-decade-high level. The number of hit-and-run fatalities jumped 61% from 2009 to 2016, the most recent year for which data are available, according to the report from the AAA Foundation for Traffic Safety. (Calvert, 4/26)

A study of veterans’ medical records over the past decade, found those with traumatic brain injuries had a higher risk of developing Parkinson’s Disease. But Florida Hospital’s Anthony LoGalbo cautions that more studies at the molecular level are needed before TBIs can be proven to be a direct cause. (Prieur, 4/25)

Add cigarettes to the list of things that the family-friendly Walt Disney Company has to figure out as it prepares to integrate the sharper-edged 20th Century Fox movie and television studio. Robert A. Iger, Disney’s chief executive, announced at a shareholder meeting in 2015 that Walt Disney Studios would “prohibit smoking in movies across the board: Marvel, Lucas, Pixar and Disney films.” He said the policy, which put Disney at the forefront of antismoking efforts in Hollywood, “was the right thing for us to do.” The decision brought cheers from activists concerned about the power of movies to promote tobacco use. (Barnes, 4/25)

Disease hunters are using genetic sequencing in their investigation of the ongoing food poisoning outbreak linked to romaine lettuce, a technique that is revolutionizing the detection of germs in food. The genetic analysis is being used to bolster investigations and — in some cases — connect the dots between what were once seemingly unrelated illnesses. It also is uncovering previously unfathomed sources of food poisoning, including one outbreak from apples dipped in caramel. (4/26)

Advocates are making another push for a New York law banning therapy that attempts to change the sexual orientation or gender identity of minors. Dozens of social workers joined students, LGBT activists and lawmakers Wednesday at the state Capitol to call on the Republican-led Senate to take up the legislation banning gay conversion therapy. The measure has passed the Democrat-controlled Assembly several years in a row. (4/25)

The already baffling emergency room billing landscape is about to become even more perplexing for some consumers covered by Blue Cross and Blue Shield of Texas, the largest health insurer in the state. Starting in June, when some policyholders go to the emergency room, if their ailment is later determined to be not be serious enough, they could be on the hook for 100 percent of the medical costs. In a memo shared with brokers and consultants on April 18, Blue Cross said the new policy — which takes effect June 4 — applies to fully insured group and retail HMO members.  (Rice, 4/25)

A memo sent to all University Hospitals employees outlined the steps the fertility center there has taken to improve safety after a freezer incident in March. ... This week, Cuyahoga County Common Pleas Court presiding Judge John Russo ordered that the more than 40 lawsuits filed against University Hospitals' fertility clinic will be joined into a single case. (Washington, 4/25)

Select Specialty Hospital-Western Missouri, a long-term acute care facility on East Meyer Boulevard in Kansas City, is closing its doors and laying off 105 employees. The hospital announced the closure in a notice to the state of Missouri under the Worker Adjustment Retraining and Notification Act. According to the notice, employees losing their jobs include nurses, nursing assistants, physical therapists, respiratory therapists and other personnel. (Margolies, 4/25)

The Cook County Health and Hospitals System is standing by its mission to provide care for all after a March report by County Independent Inspector General Patrick Blanchard found that not following guidelines set by insurers resulted in the hospitals system being denied over $66 million in 2017. Stipulations by private insurers, as well as government programs, like Medicaid and Medicare, dictate whether or not the insurers pay up after people receive care. (Hinton, 4/25)

An information-gathering initiative unveiled Wednesday by Rice University, the Environmental Defense Fund and the Houston Health Department seeks to better quantify it. The Hurricane Harvey Registry will collect responses to an online survey that asks Houston-area residents about where they rode out the storm and their health condition — physical and mental — before and after. (Collier, 4/25)

The nation's first full-service urgent care located in an airport is opening at Phoenix Sky Harbor International Airport. The urgent care, located in Terminal 4, is equipped to offer patients physicals, drug tests, lab tests, X-rays and prescriptions, as well as treat numerous ailments and injuries. (Gebers, 4/25)

Louisiana House Republican Chairman Lance Harris, R-Alexandria, is pushing legislation that would make it harder for people the governor appoints to run state agencies to keep an outside job, a proposal that might affect the current Department of Health Secretary Dr. Rebekah Gee. House Bill 849 would require agency heads appointed by the governor to refrain from being paid and otherwise compensated for outside work if it's for an entity or industry their agency oversees. Department secretaries would also be prohibited from volunteering or working for free for any nonprofit or group if the entity benefiting is regulated by the agency they lead or receives funding from that agency.  (O'Donoghue, 4/25)

Tracy Ryans got mail — straight from the Texas Health and Human Services Commission, including a box full of state assistance application forms with hundreds of people’s social security card numbers, green card certificates, billing statements, check stubs and photocopies of driver’s licenses. HHSC wasn’t supposed to have sent them. (Evans, 4/25)

Health officials have confirmed three cases of Legionnaires' disease, one of them fatal, at an apartment complex in the Bronx. The New York City Health Department says the three cases occurred within the past year and center on three connected buildings at Co-op City. Investigators are looking into the building's internal plumbing. The building does not have a cooling tower. (4/25)

The parents of a 2-year-old Pennsylvania girl have been spared jail time in the pneumonia death of their daughter after vowing to seek medical care in the future for their other children. Jonathan Foster, 35, and Grace Foster, 34, were sentenced Wednesday to five years' probation on involuntary manslaughter and child endangerment convictions in the November 2016 death of daughter Ella Grace in Upper Tulpehocken Township, about 45 miles northeast of Harrisburg. (4/25)

Americans love to contemplate — and legislatively promote, to whatever degree possible — the virtue of hard work. Here in the United States, we already work more hours per year than our English-speaking counterparts in Britain, Canada and Australia — not to mention those enviable denizens of European social democracies, who enjoy the kind of leisure time only our highest-paid workers can afford. So perhaps it’s not surprising that several new pro-work policy ideas are enjoying attention on the left and the right. On the right, work requirements for Medicaid, food stamps and housing assistance represent the latest conservative effort to make sure Americans work for any benefits they receive. Meanwhile, on the left, the idea of a federal job guarantee has gained increasing attention, showing up in statements from the likes of Sen. Bernie Sanders (I-Vt.) and Sen. Cory Booker (D-N.J.). (Elizabeth Bruenig, 4/25)

My sister was not a “drunk, drugged-up loser.” Yet language like this, used to describe addicts, has consequences in the opioid crisis. I experienced my sister Jenny’s opioid addiction, her suffering and her death in just six days last July. She was part of the 90 percent of the 21 million Americans struggling with substance use disorder who never seek treatment. Our family’s story isn’t unique, and it isn’t the saddest story. But it’s a chilling example of how derogatory language, stigma and denial render families helpless in this health crisis. Jenny was a college-educated, middle-class suburban mom. She didn’t do a single stint in rehab or have any interventions. She died without our family ever having an honest conversation about her illness. She never had a chance, because she was too ashamed to ask for help. (Kelly O'Connor, 4/25)

An examination of data from 10 U.S. states found that more than half the people who died of opioid-related overdoses during the second half of 2016 tested positive for fentanyl. As the United States faces this unprecedented epidemic, there are lessons to be learned from Canada, which has taken bold action on a number of fronts with the aim of reducing deaths related to fentanyl, fentanyl analogues, and other opioids. For instance, in March 2016, the Canadian government made the overdose-reversal drug naloxone available without a prescription. Although naloxone is also increasingly available in many regions of the United States, laws in 14 states provide no immunity from criminal prosecution for health care providers who prescribe or distribute it to laypersons. Furthermore, in 36 states, existing laws make possession of naloxone without a prescription illegal. (Evan Wood, 4/26)

As the toll of opioid-overdose deaths in the United States rises, we face an urgent need for prevention. But preventing such deaths will require a better understanding of the diverse trajectories by which overdoses occur, including the distinction between intentional (suicide) and unintentional (accidental) deaths, be they in patients with chronic pain who overdose on their opioid analgesics or in those with a primary opioid use disorder (OUD). Interventions to prevent overdose deaths in suicidal people will differ from interventions targeted at accidental overdoses. Yet most strategies for reducing opioid-overdose deaths do not include screening for suicide risk, nor do they address the need to tailor interventions for suicidal persons. Moreover, the inaccuracy of available data on the proportion of suicides among opioid-overdose deaths — which are frequently classified as “undetermined” if there is no documented history of depression or a suicide note — hinders deployment of appropriate prevention services. (Maria A. Oquendo and Nora D. Volkow, 4/26)

Dr. Ronny L. Jackson, President Trump’s personal physician and his pick to lead the Veterans Affairs Department, is now alleged to have inappropriately dispensed drugs, including the opioid Percocet, to others, and to have prescribed himself medication. In an interview with CNN, Senator Jon Tester of Montana said Dr. Jackson was known as the “candy man” inside the White House. Mr. Tester said a number of sources had told the Senate Veterans’ Affairs Committee that, on overseas trips, Dr. Jackson would “go down the aisle way of the airplane and say, ‘All right, who wants to go to sleep?’ And hand out the prescription drugs like they were candy.” Then, the senator continued, Dr. Jackson would “put them to sleep and then give them the drugs to wake them back up again.” (Richard A. Friedman, 4/26)

Advocates for White House–backed legislation intended to make it easier for sick patients to get access to experimental drugs are frustrated, believing that congressional momentum behind “right to try” has ground to a halt. Despite vocal support from President Trump and Vice President Pence, the House and Senate have made little if any progress on bridging differences with each other over separate bills that have passed each chamber. (Rachel Roubein, 4/26)

As a libertarian, I fully accept the motto that what a woman chooses to do with her own body is her business. As someone who can count, I believe that abortion involves two bodies. That’s what makes it a difficult question. So what would it mean as a practical legal matter to outlaw abortion? That is a question I have been asked frequently since being fired by the Atlantic over a four-year-old, six-word tweet and accompanying podcast in which I was alleged to have voiced an extremist view on the matter of criminalizing abortion — that it should be punished by hanging. (Kevin Williamson, 4/25)

Fertility treatments are sounding more and more like something out of a science fiction movie. Artificial intelligence and embryonic gene editing pose potential solutions to infertility and disease. Scientists are discovering how to turn human stem cells into sperm and eggs. Slices of ovarian tissue and immature eggs can now develop into mature eggs. And, fertility treatments are being used to save species at risk of extinction like the northern white rhino and coral in the Great Barrier Reef. Recent advances in fertility treatments also allow women to freeze their younger eggs to use at an older age. ...Amidst the glitz and glamor of celebrities and swanky parties, the truth about egg freezing has gotten lost. (Angela Lawson, 4/25)

Every year on World Malaria Day, April 25, the international community reaffirms its commitment to eliminate this treatable and preventable disease. Targeted investments by the U.S. and others drove deaths down 60% between 2000 and 2015—saving at least six million lives. In 57 countries, malaria cases dropped by 75% or more.But progress appears to have stalled. More than 60 countries have reported that malaria-carrying mosquitoes are becoming resistant to insecticides. In Southeast Asia, the malaria parasite itself is developing resistance to the drug artemisinin, today’s standard treatment. Africa could be next. Unchecked, drug resistance could cause more than 100,000 new deaths each year. This tragedy can be averted—and malaria defeated—with decisive action. (Vas Narasimhan, 4/24)

The loud, unwieldy bipap machine seemed to smother Hannah as she was wheeled out of the pediatric ICU for the last time. The apparatus thrust air into her leukemia-riddled lungs with such force it was hard to tell whether she had anything to do with the mechanical, rhythmic rise and fall of her chest. Eight years old, Hannah had relapsed acute myelogenous leukemia. After exhaustive attempts to control her disease and a month of steady decline in the ICU, it was time for her to go home. Her parents held onto hope — in part for a cure, but in larger part for just getting her home. They simply wanted to take their daughter back to their cozy double-wide trailer that had been lovingly prepared for her arrival. What happened after that, well, the Lord would take it from there. (David N. Korones, 4/25)

Last week, the mayors of 12 cities in South Orange County had the opportunity to cut the Gordian knot that is homelessness. They met at the behest of U.S. District Court Judge David O. Carter, who'd issued them a warning: Step up and help solve this problem, or I'm striking down the HOA-approved hedge of laws you think guard your perimeter. See, for decades cops and sheriff's deputies in South County have picked up the destitute and then dropped them off in blue-collar North County towns including Costa Mesa and Anaheim, but especially Santa Ana, which just happens to be the most Mexican city in Orange County. (Gustavo Arellano, 4/25)

At first glance, it seems a preposterous and careless proposal: Spend $5.4 million to hire 200 unlicensed social workers to investigate reports of child abuse and neglect around Kansas. The Kansas Department for Children and Families, already under heavy criticism for its decisions in the death of 3-year-old Wichita boy Evan Brewer and the disappearance of 5-year-old Wichita boy Lucas Hernandez (and other cases), wants neophytes watching over our state’s most vulnerable children? It does seem crazy — until considering the alternative. (4/25)

Students across Iowa walked out of school last week to protest gun violence. Like many adults, they are tired of easy access to firearms resulting in accidents, suicides and murders. Some of these teens will be old enough to vote in November’s elections, and their concerns about guns are legitimate. Every 39 hours, someone is killed by a firearm in Iowa. Guns are the most common method to commit suicide, and long guns were used in more than 40 percent of domestic violence gun homicides of Iowa women from 2007 to 2016. These are among the findings in a new report from the Center for American Progress and Progress Iowa. The report also offers some common-sense recommendations Iowa lawmakers should consider to prevent firearm injuries and deaths. (4/25)

Travis Reinking, accused in Sunday’s shooting rampage at a Nashville Waffle House, makes the perfect case for the Red Flag proposals moving through Congress. ...Clearly, this is a guy who should have never been allowed near a gun. That’s the sort of intervention Red Flag laws are designed to enable. Proposals in Congress, including one co-sponsored by Michigan Reps. Debbie Dingell, D-Dearborn, and Fred Upton, R-St. Joseph, would give police or family members the ability to petition a court to remove guns from individuals who are determined to be a danger to themselves or others. Reinking certainly fits into that category. He has struggled with mental illness for years. And yet despite his many encounters with law enforcement agencies and concerns expressed by his family about his mental state, he was apparently able to bring a small arsenal to Nashville to carry out a mass shooting. (4/25)

With Gov. Larry Hogan's focus on putting Marylanders to work and ensuring our state is "open for business," worker health and safety should be a top priority. But when it comes to protecting the health and safety of the 2.5 million workers across our state, the main cop on the beat, the Maryland Occupational Safety and Health (MOSH) division, is exhibiting lackluster performance. (4/25)

Ohio is facing the most gripping addiction and mental health crisis in our history, and the Ohio Department of Medicaid is about to make it worse. Policy changes implemented on January 1 slowed resources for the current capacity of addiction and mental health treatment, and additional modifications scheduled for July will negatively exacerbate the situation. (Lori Criss, 4/25)

Assembly Bill 1795, introduced by Assemblyman Mike Gipson, D-Carson, would give counties authority to allow specially trained paramedics to transport intoxicated adults directly to sobering centers when it’s determined they do not have an underlying medical issue. Sobering centers offer a safe and effective alternative. (Shannon Smith-Bernardin, 4/25)