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Once again taking aim at President Trump, California on Monday filed its 47th lawsuit against the administration, this time to block a move that would effectively strip millions of federal dollars from reproductive health providers that perform abortions and abortion referrals. Attorney General Xavier Becerra, who has become one of Mr. Trump’s most aggressive critics, said Monday that the administration’s changes to Title X, the federal family planning program, would punish doctors and clinics for giving women a comprehensive portrait of their reproductive options. The administration announced those changes last month. (Del Real and Pear, 3/4)

Twenty states and Washington, D.C., said they would sue separately Tuesday. The states are: Colorado, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia and Wisconsin. Washington's Democratic attorney general also previously said the state would challenge the rule. Trump administration officials have told abortion opponents that they expected a number of legal challenges to the new family planning rule, which also prohibits federally funded family planning clinics from being housed in the same place as abortion providers. (Elias, 3/4)

Federal funding can't be used for abortions, but the administration argues any money that goes to abortion providers could indirectly support the procedure. Opponents call it a "gag rule" because it would ban clinics from referring women for abortions or counseling them on abortion as an option to end pregnancy. Rosenblum said the rule would force providers who receive funding to decide whether they will refuse it or "cave" to the new requirements. (Hellmann, 3/4)

The rule is designed primarily to target Planned Parenthood, the largest provider under the Title X family-planning program. The network of women’s health clinics receives about 10% of its funds from the program. The funding would instead largely shift to faith-based groups. The Title X program has become a battlefront in the U.S. fight over reproductive rights, with Democrats rallying to protect abortion rights against President Trump and Republicans who have made gains curtailing access to the procedure in this administration and in state legislatures in recent years. (Armour, 3/4)

Becerra, in the California filing, called the rule an “extraordinary overreach.” “HHS has exceeded the scope its statutory authority and acted in a manner that is arbitrary, capricious, and not in accordance with law,” he wrote. In a statement, Becerra said the rule would deny “patients access to critical health care services and prevents doctors from providing comprehensive and accurate information about medical care.” (Cha, 3/4)

“The Trump-Pence Administration has doubled down on its attacks on women’s health," Becerra said in a statement. “The Trump-Pence Administration’s sabotage of Title X services that millions of women across our nation rely on is not only irresponsible, it is dangerous to women’s health. President Trump treats women and their care as if this were 1920, not 2019.” (Leitsinger, 3/4)

More than 360 clinics in California receive federal family planning funding to provide birth control, cancer screenings, testing for sexually transmitted diseases and other health care services for primarily low-income patients. Their programs serve about 1 million people a year, more than a quarter of the Title X patients in the country. (Koseff, 3/4)

The referral restrictions are set to go into effect 60 days after the date of publication of the new regulations, while there’s a yearlong wait on enforcement of the requirement that clinics have separate entrances and exits, treatment facilities and patient records. (Mehrotra, 3/4)

Last week, Washington State Attorney General Bob Ferguson filed a separate lawsuit challenging the rule. The National Family Planning & Reproductive Health Association and the American Civil Liberties Union filed a similar lawsuit, and Ferguson said the two cases could be consolidated at some point. (Raman, 3/4)

On Monday, 21 states announced they would be filing a federal lawsuit Tuesday in Oregon, arguing the rule imposes “an unlawful and unethical restriction on health care professionals.” But facilities in New Hampshire are still bracing for sweeping reductions. Planned Parenthood’s New Hampshire clinics expect to see a quarter of their collective budget vanish if the rule moves ahead: $1.6 million over two years, according to Sabrina Dunlap, vice president of public policy at Planned Parenthood of Northern New England. And independent clinics say the funding cuts will draw away from nonabortion related care such as contraceptives and STD treatment. (DeWitt, 3/4)

A top U.S. regulator wants to meet with Walgreens leaders to discuss whether the drugstore chain has a problem with illegal tobacco sales to minors. Scott Gottlieb of the Food and Drug Administration said Monday Walgreens is a top violator among drugstores that sell tobacco products including cigarettes, smokeless tobacco and e-cigarettes. He says inspectors have found nearly 1,800 instances since 2010 in which one of the company's stores violated the law. (3/4)

The agency said its undercover inspection program had turned up high rates of tobacco violations at numerous retailers. Illegal sales of cigarettes and e-cigarettes to young people were even higher at other national gas station and convenience store chains, the agency found, but it singled out Walgreens for its harshest criticism. “The company’s stores have racked up almost 1,800 violations across the country,” said Dr. Scott Gottlieb, the agency’s commissioner, in a statement. “Both the rate of violations and sheer volume of violative inspections of Walgreens stores are disturbing, particularly since the company positions itself as a health-and-wellness-minded business.” (Kaplan, 3/4)

Gas stations run under the Exxon Mobil, BP and Sunoco brands ranked worst, with violations found at 35 percent to 44 percent of all inspected stores, according to a statement from the agency. Walmart’s and Kroger’s violations fell in the 15 percent to 24 percent range. Many of the gas stations are owned by franchisees. (Edney, 3/4)

Gottlieb also requested a meeting with the corporate management of Walgreens “to discuss whether there is a corporate-wide issue related to their stores’ track record of violating the law by illegally selling tobacco products to kids.” FDA first requested a meeting last month, after the agency said the company’s stores racked up almost 1,800 violations across the country. FDA said 22 percent of the 6,350 stores it has inspected — or 1,397 locations — sold tobacco products to minors, making Walgreens the top violator among pharmacy chains. (Weixel, 3/4)

HHS Secretary Alex Azar on Monday told a crowd of kidney disease patients and advocates the Trump administration is overhauling Medicare's payment system to move the bulk of dialysis treatments from clinics to the home. He touted an existing payment demonstration launched by the CMS Innovation Center under the Obama administration in 2015, which has the backing of the dialysis industry: the End Stage Renal Disease (ESRD) Seamless Care Organizations. (Luthi, 3/4)

The Trump administration is working on a new payment approach for treating kidney disease that favors lower cost care at home and transplants, a change that would upend a dialysis industry that provides care in thousands of clinics nationwide. The goal is to reduce the $114 billion paid by the U.S. government each year to treat chronic kidney disease and end-stage renal disease, a top area of spending. (3/4)

CMS Administrator Seema Verma gave her first update on a major overhaul to the Stark law, saying that a key part of the regulation will remove a barrier to doctors participating in value-based arrangements. A major part of the agency's updates to the anti-kickback law is clarifying areas of noncompliance for doctors and updating the decades-old rules to reflect the shift from a fee-for-service model to value-based care, Verma said during the Federation of American Hospitals' policy conference in Washington Monday. (King, 3/4)

It has been two years since Rose Katz, 83, came home after an extended stay at North Shore University Hospital in Manhasset, N.Y. Back in December 2016, she was rushed to the emergency room after her heartbeat slowed and her body temperature dropped to 91 degrees. Her heart stopped twice while at the hospital, where physicians discovered a blockage and implanted a pacemaker. (LaMantia, 3/4)

The sweeping health-care law created nearly a decade ago to put insurance within reach of more Americans has left significant holes in the ability of older, middle-class people to afford coverage, particularly in rural areas, according to a new analysis. Sixty-year-olds with a $50,000 income must pay at least one-fifth of what they earn for the least expensive premiums for health plans in Affordable Care Act marketplaces across a broad swath of the Midwest, the analysis shows. In much of the country, those premiums require at least one-sixth of such people’s income. (Goldstein, 3/5)

Health care advocates say over a million Texans would get health insurance if the state expanded Medicaid. On Monday, demonstrators held a rally at the state Capitol with a string of 1,000 paper dolls that stretched from the Capitol’s south steps to Congress Avenue to illustrate how many people would be affected. A million “is a really hard number to imagine … and that’s why we have a string of people to help us do that,” said Laura Guerra-Cardus, deputy director of the Children's Defense Fund in Texas. (Sparber, 3/4)

With the Republican-dominated state Legislature reluctant to expand Medicaid, Democrats have filed legislation that would instead let voters decide the issue. Three other red states — Nebraska, Utah and Idaho — ushered in Medicaid expansion through their voters in November. (Chang, 3/4)

A bill that would permanently shorten how long patients can have Medicaid cover past healthcare bills narrowly cleared its first state Senate committee hearing Monday, advancing an estimated $104 million policy that could affect about 11,500 Floridians’ care. SB 192, which passed 6-4 in the Senate Health Policy committee on party lines, would cement a policy that restricts the period patients are eligible for Medicaid coverage to the calendar month before their application. (Koh, 3/4)

More than 88,000 applications from poor Ohioans are awaiting processing by caseworkers to determine if they are eligible for Medicaid. Nearly two-thirds of the applications have been pending 45 days or longer. The backlog actually has improved since one point last year, when nearly 110,000 requests were awaiting review, but lengthy delays continue to cause uncertainty and delayed care for needy families — and financial difficulties for many health-care providers. (Candisky, 3/4)

The Maine Department of Health and Human Services will temporarily open a Medicaid assistance call center in western Maine to help streamline enrollment in MaineCare. The move comes as Gov. Janet Mills’ administration moves ahead rapidly with implementation of voter-approved Medicaid eligibility expansion. (Acquisto, 3/4)

A simple change to state law could keep released inmates from returning to jail, overdosing on drugs or experiencing a relapse of mental illness, say advocates for two bills introduced in the Legislature. Unlike most states, Missouri terminates Medicaid health care coverage when someone is incarcerated in jail or prison. In at least 35 other states, including Illinois, Medicaid enrollment is instead suspended and reactivated upon release from a correctional facility. (Bernhard, 3/4)

John Hickenlooper, the two-time Colorado governor and former brewpub owner who has overseen Colorado’s remarkable economic expansion, declared his candidacy for president on Monday. Mr. Hickenlooper, 67, a socially progressive, pro-business Democrat who has called himself an “extreme moderate,” had long said he was considering a run, and made early visits to Iowa and New Hampshire. (Turkewitz, 3/4)

Mr. Hickenlooper supports universal health care in principle but has refused to get behind specific proposals like “Medicare for all.” Speaking in New Hampshire last month, he said that there were “many different ways to cut the pie and work on the issue” and that intraparty arguments over the specifics were counterproductive. He did, however, explicitly reject the idea of eliminating private insurance companies, as promoted by Senators Bernie Sanders and Kamala Harris. During his governorship, Mr. Hickenlooper and Colorado’s divided Legislature expanded Medicaid under the Affordable Care Act, a fact he highlighted as speculation about a possible presidential run increased. (Astor, 3/4)

For just the second time since the global epidemic began, a patient appears to have been cured of infection with H.I.V., the virus that causes AIDS. The news comes nearly 12 years to the day after the first patient known to be cured, a feat that researchers have long tried, and failed, to duplicate. The surprise success now confirms that a cure for H.I.V. infection is possible, if difficult, researchers said. The investigators are to publish their report on Tuesday in the journal Nature and to present some of the details at the Conference on Retroviruses and Opportunistic Infections in Seattle. (Mandavilli, 3/4)

The therapy had an early success with Timothy Ray Brown, a U.S. man treated in Germany who is 12 years post-transplant and still free of HIV. Until now, Brown is the only person thought to have been cured of infection with HIV, the virus that causes AIDS. Such transplants are dangerous and have failed in other patients. They're also impractical to try to cure the millions already infected. The latest case "shows the cure of Timothy Brown was not a fluke and can be recreated," said Dr. Keith Jerome of Fred Hutchinson Cancer Research Center in Seattle who had no role. He added that it could lead to a simpler approach that could be used more widely. (Johnson, 3/4)

“I think this is really quite significant. It shows the Berlin patient was not just a one-off, that this is a rational approach in limited circumstances,” said Daniel Kuritzkes, chief of infectious diseases at Brigham and Women’s Hospital, who was not involved in the study. “Nobody doubted the truth of the report with the Berlin patient, but it was one patient. And which of the many things that were done to him contributed to the apparent cure? It wasn’t clear this could be reproduced.” (Johnson, 3/4)

A London man infected with HIV may be the second person to beat the virus that causes AIDS, researchers reported Monday, a finding advancing the costly and challenging search for a cure. Nearly three years after the man received a stem-cell transplant from a donor who was genetically resistant to HIV, extensive testing shows he has no detectable amounts of the virus, according to the research, published in the journal Nature. He has been off antiretroviral drugs for about 18 months. Those drugs keep HIV, the virus that causes AIDS, in check. (McKay, 3/4)

The erroneous suggestion that vaccines could cause autism was refuted nine years ago, when a British medical panel concluded in 2010 that Andrew Wakefield, the doctor with undisclosed financial interests in making such claims, had acted with “callous disregard” in conducting his research. But in 2019, professional epidemiologists are still devoting time and resources to discrediting Wakefield’s work, which set off a steep decline in vaccinations, including in the United States, where Wakefield moved in 2004. (Stanley-Becker, 3/5)

Over 95% of the children received the MMR vaccine, and 6,517 were diagnosed with autism. The MMR vaccine did not increase the risk of autism in children who were not considered at risk for the disorder and did not trigger it in those who were, according to the study, published Monday in the journal Annals of Internal Medicine. "This idea that vaccines cause autism is still around and is still getting a lot of exposure in social media," noted Anders Hviid, lead study author and senior investigator at Statens Serum Institut in Denmark. (Bracho-Sanchez, 3/4)

The size of this study — involving 657,461 Danish children born between 1999 and 2010 — should, in theory, bolster the argument that doctors and public health professionals still find themselves forced to make in the face of entrenched and growing resistance to vaccination in some quarters. (Branswell, 3/4)

California has one of the strictest requirements for childhood vaccinations in the U.S. after the state eliminated exemptions based on philosophical and religious grounds in 2015. Yet the state has seen a rise of unvaccinated children over the past couple years due to physicians granting medical exemptions from immunization. (Johnson, 3/4)

Rebekah Otto plans to ask her son’s pediatrician to give him a measles vaccination early, before they travel to a wedding this summer in Washington state, where there is an outbreak of the deadly disease. “It gives me a lot of anxiety,” the 32-year-old mother of two from Oakland, Calif., said of the risk of exposing her son to the highly contagious respiratory disease. Washington, New York, Texas and Illinois have reported measles outbreaks, and more than 150 people have been infected nationwide this year, according to the Centers for Disease Control and Prevention. (King, 3/4)

The measles outbreak in Washington state and elsewhere is prompting some states to look at tightening vaccine requirements for schoolchildren. But not in Arizona. Lawmakers there have been considering bills to make it even easier for parents to get exemptions for their kids from the usual childhood vaccinations. Supporters of the controversial bills being considered in the Arizona capitol say they are not "anti-vaccine." (Stone, 3/5)

The number of deaths from alcohol, drugs and suicide in 2017 hit the highest level since federal data collection started in 1999, according to an analysis of Centers for Disease Control and Prevention data by two public health nonprofits. The national rate for deaths from alcohol, drugs, and suicide rose from 43.9 to 46.6 deaths per 100,000 people in 2017, a 6 percent increase, the Trust for America's Health and the Well Being Trust reported Tuesday. That was a slower increase than in the previous two years, but it was greater than the 4 percent average annual increase since 1999. (O'Donnell, 3/5)

At first, she just forgot a name or two. Then, a few meetings on her schedule. A few months later, LuPita Gutierrez-Parker found herself struggling at work to use computer software she knew intimately. "In the beginning, when I wasn't sure what was happening to me, I just figured it must be stress because I was doing a lot of work and had too much on my mind," Gutierrez-Parker said. (LaMotte, 3/5)

The executives at Alkahest have heard plenty of vampire jokes. They are, after all, turning to blood from young donors in search of an elixir for diseases associated with aging. And yes, they’re in Silicon Valley. But this five-year-old biotech company led by Genentech alums is doing serious science. It just happens to be working in a field that the Food and Drug Administration rebuked last month with a stern warning, noting that plasma infusions from young people provide “no proven clinical benefit” against diseases including Alzheimer’s and Parkinson’s. (Robbins, 3/4)

A tougher strain of influenza is now responsible for nearly half of all new cases, according to the Centers for Disease Control and Prevention. This new strain, called the influenza A H3N2 variant virus, could sicken more people and extend the flu season until spring. (Washington, 3/4)

It was nearly 9 p.m., hours after the makeshift clinic for newly arrived migrants near the Mexican border in Texas was supposed to close, but the patients would not stop coming: A feverish teenager with a vile-smelling wound on his foot. A man with a head injury and bright red eyes. Children with fevers, coughs and colds. Earlier in the day, a little girl named Nancy had been brought into the clinic with a cough and shaking chills. She had been vomiting, she said, and her spine hurt. An assistant took her temperature. “She’s got 104, almost 105,” she said. (Fink and Dickerson, 3/5)

The Food and Drug Administration is expected to approve a new type of drug for depression. It is esketamine, a chemical cousin of the anesthetic and party drug ketamine. (Hamilton, 3/4)

The All of Us Research Program wants to know where you live, what you eat, how long you sleep and how often you exercise. This data – added to information from 1 million other Americans – will allow researchers to explore the intersection of behavior, genetics, environment and biology. (Washington, 3/4)

Dr. Thomas Boyce, an emeritus professor of pediatrics and psychiatry at the University of California, San Francisco, has treated children who seem to be completely unflappable and unfazed by their surroundings — as well as those who are extremely sensitive to their environments. Over the years, he began to liken these two types of children to two very different flowers: dandelions and orchids. (Davies, 3/4)

House Democrats say their increasingly visible alliance with politically active physicians helped them pass legislation mandating federal background checks on all gun sales. But they so far haven’t broken through the wall of opposition in the GOP-majority Senate. Surgeons and other health workers with experience treating firearm wounds lobbied hard for the universal background check bill the House passed last week, adding a sober, public health perspective to a debate long stuck in partisan stalemate. (Roubein AND Ollstein, 3/4)

A new study finds even moderate heat sends Northerners to the hospital, suggesting that government warnings of dangerously high temperatures are coming too late in some parts of the U.S. The research shows an uptick in hospital admissions for heat problems long before alerts go out in northern, generally cooler states. And that's happening at lower temperatures than in the toastier South, where people are more accustomed to the heat. (3/4)

OxyContin maker Purdue Pharma is asking a court to throw out a lawsuit filed by Massachusetts' attorney general that accuses the company, its owners and top executives of deceiving patients and doctors about the risks of opioids. In its most expansive response to date, Connecticut-based Purdue argued in a motion filed late Friday that the state makes "sensational and inflammatory allegations" in its bid to hold the company accountable for America's deadly opioid addiction crisis, and called for the lawsuit to be dismissed "as oversimplified scapegoating based on a distorted account of the facts." (Salsberg, 3/4)

In a recent motion to dismiss the case, Purdue says Massachusetts Attorney General Maura Healey (D) has created a “sensationalist and distorted narrative that ignores facts” in the lawsuit she filed last year. It alleges the company disregarded safety and addiction and deceived patients and doctors to get them to prescribe and take high doses of OxyContin and looked the other way as overdose deaths linked to prescription opioids soared. Purdue alleges that some claims made by Healey are contradicted by the Massachusetts Department of Health and the Food and Drug Administration, which approved the medication and its labeling. Purdue argues that Healey is putting forward a “misleading narrative” about OxyContin. (Zezima, 3/4)

The judge, Purdue’s motion says, should “dismiss the Commonwealth’s [lawsuit] as oversimplified scapegoating based on a distorted account of the facts unsupported by applicable law. “To be sure, there is an opioid crisis in the Commonwealth,” the motion continues, “but the responsibility for this crisis cannot, as a matter of law, be tied to one company that manufactures a tiny fraction of the prescription opioids in the Commonwealth.” (Joseph, 3/4)

The court did not initially rule on the first motion because the Attorney General's office amended the complaint. The commonwealth released the heavily redacted complaint that accuses the company of contributing to the opioid crisis. Suffolk County Superior Court Judge Janet Sanders ruled that the unredacted amended suit be released in January. The redactions revealed internal company documents and email correspondence between top executives, some of whom are named as defendants. (del Valle, 3/4)

Although a multi-state lawsuit has not been filed yet, the attorneys general hope their efforts result in a settlement, in the billions of dollars, that would allow their states to implement new prevention and treatment programs. But Jepsen said the proliferation of lawsuits by counties, cities and towns complicate the legal process “making it much harder for the state-led effort to convince the industry to agree to a comprehensive settlement.” (Radelat, 3/4)

OxyContin maker Purdue Pharma LP is exploring filing for bankruptcy to address potentially significant liabilities from roughly 2,000 lawsuits alleging the drugmaker contributed to the deadly opioid crisis sweeping the United States, people familiar with the matter said on Monday. The potential move shows how Purdue and its wealthy owners, the Sackler family, are under pressure to respond to mounting litigation accusing the company of misleading doctors and patients about risks associated with prolonged use of its prescription opioids. (3/4)

Its restructuring advisers now include AlixPartners LLP, a New York-based consulting firm known for its restructuring work, according to a person familiar with the hiring. The company last year hired law firm Davis Polk & Wardwell LLP as restructuring counsel and added longtime restructuring specialist Steve Miller to chair its board. Purdue has been targeted in lawsuits by some 1,600 cities, counties and states seeking to recoup costs incurred by widespread opioid abuse. The municipalities claim Purdue and other drugmakers’ aggressive marketing of prescription painkillers helped hook the nation on opioids, leading to a proliferation of overdoses from both legal and illegal opioids. (Randazzo and Hopkins, 3/4)

Shares of other companies named in the lawsuits fell after the reports. Drugmaker Endo International Plc was down as much as 15 percent, and Mallinckrodt Plc fell as much as 6.7 percent. Drug distributors AmerisourceBergen Corp., Cardinal Health Corp. and McKesson Corp. also fell.(Armstrong, 3/4)

The legal battle over who’s at fault for the opioid crisis, which involves more than 1,600 lawsuits in federal and state courts, could get even more complicated soon, with OxyContin manufacturer Purdue Pharma reportedly considering filing for bankruptcy. As first reported Monday by Reuters and confirmed by the Wall Street Journal, Purdue is weighing a bankruptcy filing in the face of the lawsuits, which allege the company misled doctors and the public about safety concerns as it promoted its opioid painkillers. (Joseph, 3/4)

A potential decision by OxyContin maker Purdue Pharma to file for bankruptcy could mean significant delays and complications for thousands of lawsuits accusing the company of significantly contributing to a wave of opioid-addicted deaths that ravaged communities in every corner of the country. Such a move, which was first reported Monday morning by the Reuters wire service, could mean local and state governments with lawsuits pending before a federal judge in Cleveland would have to wait to try and claw back the billions spent in medical, law enforcement and social services over the past several years. (Heisig, 3/4)

A top White House policy adviser on Monday warned hospitals that they need to address the issue of surprise medical bills if they don’t want Congress to do it for them. “If hospitals, providers and issuers don’t protect these patients from financial harm, Congress and the administration will need to act,” said Joe Grogan, director of the White House Domestic Policy Council. (Weixel, 3/4)

Pregnancy and childbirth can cost thousands of dollars, even when the doctors and services are covered by insurance. But surprise out-of-network bills add to the tab for many women, according to a study by researchers at the University of Pennsylvania and University of Missouri Kansas City published in the March issue of Health Affairs. (Gantz, 3/4)

Kaiser Health News: This Time When My Water Breaks, Take Me To A Hospital Without Surprise Bills

When it comes to having a baby, that bundle of joy may bring an unexpected price tag that can affect parents’ future health care choices. At least that was the finding of a study published Monday in Health Affairs. It examined how consumers respond to surprise medical bills in elective — or non-emergency — situations. Specifically, researchers used a large national sample of medical claims for obstetric patients who had two deliveries between 2007 and 2014 and who had employer-sponsored health insurance. (Bluth, 3/4)

When Laura Hirsch of Keller Texas had to find a rehabilitation center to help her father recover from a difficult surgery in September, the caregiving service Cariloop saved her a whole day. A case manager at Cariloop, based in Richardson, Texas, sorted through more than a dozen rehab facility options, then armed Hirsch with the right questions to ask when choosing among the final contenders. (3/4)

General Electric Co is setting aside one of the largest amounts ever to cover potential losses on policies that provide long-term care in nursing facilities and patients' homes. But insurance experts are concerned that may not be enough. GE shocked investors last year when it took a $6.2 billion after-tax charge and said it planned to set aside $15 billion over seven years to cover claims on some 300,000 long-term care policies written more than a decade ago, when actuaries did not yet know how costly the claims would become. (Scott, 3/4)

While publicly backing Cigna Corp.’s 2015 merger with rival health insurer Anthem Inc. as good for investors, Cigna’s CEO privately expressed regret about signing on to a deal that left him with a reduced role, lawyers for Anthem said in court Monday. Cigna shareholders were slated to get nearly a 30 percent premium for their stock in Anthem’s $48.9 billion buyout. But David Cordani, Cigna’s chief executive officer, lost out to Anthem CEO Joseph Swedish in a corporate duel over who would lead the combined company, set to be the largest health insurer by membership in the U.S. (Feeley, 3/4)

Last year, the insurance giant Anthem made a contract with its individual policyholders. They could keep going to their specialists, the contract said, without a referral from a primary care doctor. Now Anthem says that was a mistake. (Hart, 3/4)

Rush System for Health says personal information for about 45,000 patients has been compromised. The health system disclosed in a financial filing that the data breach, which it learned about on Jan. 22, was due to an employee at one of its third-party claims processing vendors sharing a file containing patient information with an unauthorized party. While medical history was not disclosed, patient names, addresses, Social Security numbers, birthdates and health insurance information for those tens of thousands of patients was exposed. (Goldberg, 3/4)

The breach is just the latest in what has been a continuing pattern of data security problems at hospitals across the nation. At Rush, an employee of one of the hospital system’s billing processing vendors improperly disclosed a file to “an unauthorized party,” likely in May 2018, according to a letter sent to affected patients. Rush said it discovered the breach Jan. 22. It detailed the breach in a financial filing dated Feb. 12, and it sent letters dated Feb. 25 to affected patients. It took several weeks to send letters to patients because Rush had to review the data and set up a call center to assist patients, among other things, said Deb Song, a spokeswoman for Rush. (Schencker, 3/4)

Apple is touting its new health software with an aggressive public relations strategy that worries many cardiologists, who feel the company is exaggerating the significance of the Apple Watch readings of a heart condition called atrial fibrillation. Critics are also concerned that the FDA’s unusual celebration of Apple’s new tech — which is central to the company’s move into health care — represents boosterism that distorts the agency’s role of assuring the safety and efficacy of medical devices. (Tahir, 3/4)

Women in the United States face a far greater risk of dying from childbirth complications than in many other wealthy countries. Now the federal government has taken a step toward addressing the problem with the Preventing Maternal Deaths Act, signed in December, which will provide federal grants to states to investigate the deaths of women who die within a year of being pregnant. (Kaplan, 3/5)

A mother’s health during a hospital birth may depend in part on the time of day and the kind of hospital. For a study published in Risk Analysis, researchers recorded maternal complications in more than two million births, tracking complications that can reasonably be controlled by hospital staff: severe perineal laceration, ruptured uterus, unplanned hysterectomy, admission to an intensive care unit, or unplanned operating procedure following delivery. More than 21,000 women had one or more of these complications. (Bakalar, 3/4)

For a generation of Mennonite women, Elizabeth Catlin was integral to the most joyous occasions of their lives: the births of their children. Ms. Catlin was a second mother, they said, a birthing attendant who helped them with prenatal care and then caught their babies during hundreds of natural childbirth deliveries at their homes. So it was incomprehensible to them that on a recent winter day they were in a courtroom to support Ms. Catlin, who in December had been arrested and charged with four felonies for practicing midwifery in a county about an hour southeast of Rochester. (Pager, 3/5)

Women's rights activists from 128 nations are launching a public campaign Tuesday for an international treaty to end violence against women and girls, a global scourge estimated by the United Nations to affect 35 percent of females worldwide. The campaign led by the Seattle-based nonprofit organization Every Woman Treaty aims to have the U.N. World Health Organization adopt the treaty with the goal of getting all 193 U.N. member states to ratify it. (3/4)

Legislators sent a bill to expand background checks on private gun sales in New Mexico to the governor's desk Monday for certain approval after a bruising series of debates and objections from county sheriffs across much of the state. Democratic Gov. Michelle Lujan Grisham has vowed to sign the legislation and immediately issued a statement that applauded final legislative approval by the House on a 42-27 vote, after legislators exhausted a three-hour limit on floor debate. (3/5)

A 42-year-old man was charged on Monday in connection with a fire that was set at a Planned Parenthood clinic in Columbia, Mo., last month. The man, Wesley Brian Kaster, was arrested Saturday, about three weeks after the authorities began investigating what they called a suspicious fire at the clinic on Feb. 10. Don Ledford, a spokesman for the United States Attorney’s office, declined to elaborate on a possible motive. “It’s early in the case,” he said. “It’s still an ongoing investigation.” (Zaveri, 3/4)

Methamphetamine and cocaine use are on the rise in Pennsylvania while prescription drug and heroin deaths are leveling off in some areas, data that appears to reflect nationwide trends. Jennifer Smith, secretary for Pennsylvania's Department of Drug and Alcohol Programs, told a state Senate committee Monday that the state is seeing "quite an uptick" in cocaine and methamphetamine use in three early warning areas. (3/4)

A former Hacienda HealthCare board member is speaking out about a patient rape case that he says has turned into a "political circus" and says the remaining board should resign. In order to restore public trust, Phoenix pediatrician Dr. Kevin Berger, who was the only physician on the board, says Hacienda HealthCare's remaining five board members should step down. (Innes, 3/4)

In every Texas legislative session in recent memory, there's been at least one showdown over abortion legislation — and this year's is unlikely to be an exception. Despite the fact that lawmakers have so far been focused on bipartisan "bread and butter" issues like property taxes and school finance, more than a dozen abortion-related bills are circulating in the state Capitol — and advocates on both sides of the issue are honing their strategies. (Evans, 3/5)

The number of Georgians dying from Alzheimer’s disease is growing at a staggering pace, far exceeding the national average, according to a new study released Tuesday. The costs also are rising sharply as more people grapple with the grueling toll of caring for family members with the mind-robbing disease, according to findings from the Alzheimer’s Association. (Oliviero, 3/5)

Public hearings begin this week on the state's proposed drinking water regulations for toxic PFAS chemicals.Regulators have devised standards for four types of PFAS. They would require all public water systems to regularly test and potentially treat for the chemicals. (Ropeik, 3/4)

Monday morning was the inaugural press conference and rally for KC Tenants, a group founded by Tara Raghuveer, a Harvard grad who began her work on housing policy with research into evictions in Kansas City. The grassroots group will advocate for Kansas City tenants’ rights and push for more livable, stable and affordable housing. (Kite, 3/4)

The state Legislature is considering a bill that would protect tenants from retaliation by a landlord after they file a complaint about unhealthy conditions. House Bill 346 is sponsored by Rep. Sharon Cooper (R-Marietta), chair of the House Health and Human Services Committee. At a hearing last week on the legislation, Cooper cited the ‘‘terrible’’ conditions in certain Cobb apartments. (Miller, 3/4)

A bill to address the financial challenges faced by poor Wyomingites who are elderly or totally disabled did not make it out of this year's legislative session. House Bill 127 would have restored a decades-old program that provided a small tax rebate to qualified applicants. (Watson, 3/4)

Cuyahoga County’s Board of Control on Monday approved up to $500,000 to hire temporary nurses to continue supplementing the health-care staff at the county jails. The contract with Alliance Healthcare Solutions LLC will serve as a backup to an existing contract with Educare Medical Staffing. Nurses from that agency are used to supplement the county’s own jail nurses. (Astolfi, 3/4)

After years of revelations about inmate abuse at Wisconsin's youth prison, and the decision by state lawmakers to shut down the facility, there’s little disagreement about bringing Milwaukee’s youngest offenders closer to home. But deciding where to house them has been anything but easy. (Spicuzza, 3/5)

Faster identification and treatment of sepsis by Allina Health hospitals in Minnesota has reduced deaths from the infection-related condition. Doctors and nurses at Allina started re-examining how they treat sepsis in 2014, after being dismayed at the number of deaths and learning that the condition was three times more lethal than strokes and heart attacks. ...They found that too many cases weren’t being detected quickly, because symptoms such as dizziness, elevated pulse and confusion are common to other conditions. And they found avoidable delays in two keys to sepsis treatment — fluid replacement to restore failing organs and antibiotics to fight underlying infections. (Olson, 3/4)

Buyout firm Nordic Capital is considering a sale of health-care data collection company ERT Operating Co., people with knowledge of the matter said. Nordic has held talks with potential advisers about strategic options for Philadelphia-based ERT, said the people, who asked not to be identified because they weren’t authorized to speak publicly. ERT could fetch about $2.5 billion in a sale, one of the people said. Nordic hasn’t made a final decision on whether to pursue a sale and could still elect to keep the business, they said. (Porter and Tan, 3/4)

The rollout of the recreational marijuana industry in Massachusetts has been slow. And it has barely begun for two important sectors: minority entrepreneurs and residents of neighborhoods that have been disproportionately hurt by the war on drugs. Those are people and places the new law was supposed to help. (Mullins and Jolioceur, 3/4)

In recent weeks, Pinterest, YouTube, Facebook, and Amazon have done something previously thought unimaginable—they’ve censored potentially dangerous health information, at last addressing a problem that started in the late 1990s. ...Although marginalized, activists haven’t given up, turning their attention from mainstream media to social media, where their misinformation continues to mislead the public and cause harm. It is here that the anti-vaccine groups have thrived. Antivaccine blogs, websites, books, live streamings, podcasts, chat rooms, and Facebook pages dominate the landscape. Recently, and surprisingly, social media outlets have started to push back. (Paul Offit, 3/4)

The debate over drug pricing has featured complicated arguments over profit, innovation, and fairness. At the end of the day, it’s all about patients being able to afford medicine – and Monday brought one of the biggest victories yet on that front. Eli Lilly & Co. announced that it's launching an authorized generic version of its best-selling insulin Humalog and that the list price of the drug – the pre-discount sticker price of the medicine – will be 50 percent lower than the current prescription brand. A vial of the new cheaper product will cost $137.35. (Max Nisen, 3/4)

The Brits and Canadians I know certainly love their single-payer health care systems. If one of their politicians suggested they should switch to the American health care model, they’d throw him out the window. So single-payer health care, or in our case “Medicare for all,” is worth taking seriously. I’ve just never understood how we get from here to there, how we transition from our current system to the one Bernie Sanders has proposed and Elizabeth Warren, Kamala Harris and others have endorsed. (David Brooks, 3/4)

The president of the United States gave a rambling and incoherent two-hour speech in which he raved like a lunatic and told crazy, self-serving lies from start to finish. If that no longer qualifies as alarming, we’re in serious trouble. (Eugene Robinson, 3/4)

Access to quality health care took a direct hit with the release of a new, finalized rule governing the Title X Family Planning Program — the nation’s only dedicated federal source of funding providing family planning services and supplies to low-income people. (Ginney Ehrlich, 3/4)

The gun-reform bills the House passed last week are likely not going to pass the Senate. And even if they do, the president won’t sign them. And why not? Because people don’t care enough about gun regulation. Of course, plenty of people support gun regulation. In fact, most people do. The vast majority of the U.S. public supports expanded background checks. And after the horrific shooting in Parkland, Fla., a little more than a year ago, support for stricter gun laws surged to close to 70 percent, including more than 50 percent of Republicans. (Robert Gebelhoff, 3/4)

It isn’t easy to ruffle my friend of 30 years, one of the best gastroenterologists in Boston, a town known for top-notch medicine. But he was ruffled when he told the story of giving a patient anesthesia and performing a medically unnecessary procedure—only he hadn’t known it was unnecessary because the patient’s electronic health record, or EHR, didn’t function as promised. If you’ve heard of EHRs, you know that many doctors consider them a pain in the neck. Not much is said, however, about the harm EHRs can cause to patients. There’s a reason for that: Gag clauses prevent EHR users from talking publicly about their specific problems. (John Levinson, 3/4)

Diversity and inclusion tend to get more lip service than action, often because business leaders don’t always recognize the connection between the two and company performance. That’s a mistake, because they are inextricably linked. In fairness, creating a diverse company can be a challenge if you’re leading a new company and don’t know where to start, or if you’re a more established leader whose company didn’t prioritize diversity early on. But it’s a challenge worth tackling head on: fostering a culture of diversity isn’t just the right thing to do for your people, it’s good business. (Jude Komuves, 3/4)

The nation is awash in leftover prescription opioids. Approximately 1.4 billion opioid prescriptions were dispensed from 2012 to 2017. Of those, we know that up to 70% of opioids prescribed for post-surgical use were leftover and unused. A 2017 study published in JAMA found that among patients prescribed opioids following surgery, 67 percent to 92 percent reported having unused opioids. Its authors concluded that, “Unused opioids prescribed for patients after surgery are an important reservoir of opioids available for nonmedical use and could cause injuries or even deaths.” It is time for a nationwide intervention — one home at a time. (Mary Bono and Arthur Dean, 3/4)

Texas faces a fast-approaching health care crisis that no one is talking about: the expiration of an agreement with the federal government that would strip the state of $6 billion a year. Texas relies on this funding to care for Texans. It supports hospitals, especially in rural areas, and makes vital medical and behavioral health care more available throughout the state. (Doug Curran, Rebecca Hart, John Henderson and Ted Shaw, 3/4)