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The government will lower the $375,000 salary of the new director of the Centers for Disease Control and Prevention, Dr. Robert R. Redfield, after reports that he was being paid considerably more than previous directors, the Department of Health and Human Services confirmed on Monday, though it declined to say what his new pay will be. Dr. Redfield, who became the C.D.C. director in March, had been given the higher salary under a provision called Title 42. It was created by Congress to allow federal agencies to offer compensation that is competitive with the private sector in order to attract top-notch scientists with expertise that the departments would not otherwise have. News reports of his earnings sparked complaints from Senate Democrats and watchdog groups. (Belluck, 4/30)

On Monday, HHS officials said Redfield has asked for a pay reduction because the topic had become a distraction. They said his compensation will be adjusted accordingly, but did not answer questions about what the new sum is or when it will be announced. Redfield has not been doing media interviews since taking the CDC job, and he didn't immediately comment on the pay cut. A top HIV researcher, Redfield had no experience working in public health or managing a public health agency. (Stobbe, 4/30)

In a letter Friday to Azar, Sen. Patty Murray (D-Wash.) asked for the justification for offering Redfield “a salary significantly higher” than that of his predecessors and other leaders at HHS. Murray, the ranking Democrat on the Health, Education, Labor and Pensions Committee, noted news reports  last week that Redfield was being hired under a special salary program. Title 42, as it is known, was established by Congress to attract health scientists with rare and critical skills to government work. It grants federal agencies authority to offer salary and benefit packages that are competitive with those offered in the private sector and academia. (Sun, 4/30)

The use of Title 42 to justify Redfield's $375,000 annual salary was first reported by The Associated Press. Redfield’s predecessor Brenda Fitzgerald was not paid under the program, and made $197,300 annually. Neither was her predecessor, Tom Frieden, whose compensation in 2016 was $219,700. (Weixel, 4/30)

Vice President Mike Pence's physician privately raised alarms within the White House last fall that President Donald Trump's doctor may have violated federal privacy protections for a key patient -- Pence's wife, Karen -- and intimidated the vice president's doctor during angry confrontations over the episode. The previously unreported incident is the first sign that serious concerns about Ronny Jackson's conduct had reached the highest levels of the White House as far back as September -- months before White House aides furiously defended Jackson's professionalism, insisted he had been thoroughly vetted and argued allegations of misconduct amounted to unsubstantiated rumors. (Raju, 4/30)

Senate Majority Leader Mitch McConnell says the U.S. Senate is working on crafting a comprehensive package to combat the nation's opioid addiction problems and ease the transition from treatment to the workforce. The Kentucky Republican attended discussions Monday in Louisville that included business representatives and executives on the front lines of treating people battling drug addiction. McConnell emerged to promote his recently introduced measure aimed at helping people make the successful journey from treatment to the workplace. (Schreiner, 4/30)

The National Institute on Drug Abuse has hired a former drug industry researcher to oversee research into therapeutics, it announced on Monday. Kurt Rasmussen, formerly the head of Eli Lilly’s (LLY) neuroscience division, will lead NIDA’s Division of Therapeutics and Medical Consequences, overseeing a unit that studies the efficacy and safety of devices and drugs used to treat substance use disorders. (Facher, 4/30)

As the opioid epidemic rages across Appalachia, one grim consequence has played out in Kentucky's medical examiner's office: A staggering increase in autopsy requests. Autopsy requests for overdose deaths have jumped more than 26 percent since 2013. The increase has overwhelmed the State Medical Examiner's Office, which consists of nine doctors for the entire state. And it comes amid a national shortage of forensic pathologists. (Beam, 4/30)

Which government hospital a veteran in chronic pain walks into greatly determines whether that veteran will walk out the door with a prescription for opioids, according to a new study that provides valuable insight for hospitals looking to reduce their prescriptions of addictive painkillers. ... Because the VA is a national health system, the hospitals might be assumed to have uniform prescribing patterns. But, when looking at the treatment of more than 1 million veterans with chronic pain, the study found wide disparities in how often the veterans were started on long-term opioid therapy, depending on the hospital. (Ingold, 4/30)

Baltimore’s 11 hospitals have committed to a new city initiative aimed at increasing their role in fighting the opioid epidemic. Executives from each hospital joined Mayor Catherine E. Pugh and Health Commissioner Dr. Leana S. Wen Monday in announcing the efforts to screen patients for addiction, connect them to rehabilitation services and distribute the overdose reversal drug naloxone, among other ways to better help people dealing with substance abuse. (McDaniels, 4/30)

The coverage gains made under the 2010 health care law appear to be slowly eroding, a study released Tuesday by the Commonwealth Fund shows. The number of uninsured adults between ages 19 and 64 grew by 2.8 percentage points from 2016 to March of this year, the study shows. That represents an additional 4 million uninsured American adults in that time period. (McIntire, 5/1)

Changes to insurance regulations under the Affordable Care Act (ACA) were supposed to drive young, healthy men with higher incomes from the insurance market. But according to a study published earlier this month, that didn’t happen. In fact, uninsured rates dropped significantly among young, healthy men during the first few years of ACA implementation. That’s according to research by the Commonwealth Fund, which found that the uninsured rate among men 26-34 with incomes above 400% of the federal poverty level dropped from 11.7% in 2013 to 7.2% in 2015. Comparatively, uninsured men 55-64 dropped just 1.4 points from 3.9% to 2.5% over the same period. (Sweeney, 4/30)

When American soldiers bathe in Iraq, where a grimy film coats every surface, they are reminded by bathroom signs not to ingest anything that comes from the tap. So when Christopher Wilson left the Army after two tours in Iraq and sought medical care for his service-related injury at the Department of Veterans Affairs, he expected a cleaner environment than what he encountered April 5 at a VA clinic in Salt Lake City. Wilson was shocked by what he found inside a clinic room during his appointment, he told local media: an overflowing trash can, medical instruments strewn about on the counter and a filthy sink. He snapped photos of what he saw. (Horton, 4/30)

A Veterans Affairs clinic in Salt Lake City is investigating why an Army veteran was put in a room with an overflowing trash can and medical supplies strewn about after the man’s father tweeted images of the unclean space. Stephen Wilson, the father of Christopher Wilson who spent six years in the Army and was deployed to Iraq twice, posted the photos to Twitter on Friday, calling the sight “very unprofessional, unsanitary and disrespectful,” the Deseret News reported. (5/1)

The father of a veteran with post-traumatic stress disorder who was shot at a government clinic in Oregon blames Veterans Affairs for letting down his son. Gilbert "Matt" Negrete, who served in Iraq and Afghanistan, is in jail in the former timber town of Medford, charged with attempted assault and other crimes after he allegedly displayed a knife during a confrontation at the VA clinic in nearby White City on Jan. 25. A VA guard shot him in the chest. (Selsky, 4/30)

U.S. appeals court judges appear divided over whether to allow a research center affiliated with MIT and Harvard to keep patents potentially worth billions of dollars on a groundbreaking gene editing technology known as CRISPR. Patents on the technology that could revolutionize treatment of genetic diseases and crop engineering are held by the Broad Institute, which was challenged in court by a rival team associated with the University of California at Berkeley and University of Vienna in Austria. Their lawyers argued at a hearing on Monday in the U.S. Court of Appeals for the Federal Circuit in Washington that the Broad Institute’s contributions were obvious and that an administrative court decision allowing Broad’s patents to stand should be reversed. (Wolfe, 4/30)

The university clearly failed to win over at least one of the three judges and, at best, did not lose too much ground with a second (while the third asked almost no questions and so did not tip his hand). “UC came into this argument from a tough spot, and I doubt that oral arguments from either side moved the needle much,” said patent attorney Michael Stramiello of Paul Hastings, who attended the arguments at the U.S. Court of Appeals for the Federal Circuit, where attorneys for the University of California fought to get a patent win by the Broad Institute of MIT and Harvard reversed. (Begley, 4/30)

Concierge medicine — also called retainer-fee practices, cash-only practices or membership medicine — is essentially a contract in which the patient pays an annual retainer to the physician. In return, the patient has much greater access to his or her physician, with no wait times, longer appointments and typically a more comprehensive physical exam. (O'Connor, 4/29)

Loneliness isn't just a fleeting feeling, leaving us sad for a few hours to a few days. Research in recent years suggests that for many people loneliness is more like a chronic ache, affecting their daily lives and sense of well-being. Now a nationwide survey by the health insurer Cigna underscores that. It finds that loneliness is widespread in America, with nearly 50 percent of respondents reporting that they feel alone or left out always or sometimes. (Chatterjee, 5/1)

The overall national loneliness score was alarmingly high at 44 on a 20-to-80 scale, but the prevalence of social isolation among those ages 18 to 22 raises even more concern. The younger people, part of Generation Z, had loneliness scores of about 48 compared with nearly 39 for those 72 and older. The study was sponsored by insurer Cigna, which is concerned about loneliness as a societal problem but also because it's not just making us sad: It can literally make us sick. (O'Donnell and Rudavsky, 5/1)

At least a dozen and a half people have been diagnosed with a rare form of eye cancer in two locations in North Carolina and Alabama, leaving medical experts mystified about the cause. Ocular melanoma occurs in about 6 out of every 1 million people, according to CBS News, and at least 18 people who have been diagnosed with the eye cancer have connections to Huntersville, N.C., Auburn, Ala., or both locations. Marlana Orloff, an oncologist at Thomas Jefferson University in Philadelphia, is studying the cases with her colleagues, according to CBS. (Rosenberg, 4/30)

You know that getting exercise, eating vegetables and quitting smoking are good for you. A new study shows just how good they are, in terms of the number of years they can add to your life. American women who followed five "healthy lifestyle factors" lived about 14 years longer than women who followed none of them, according to a report published Monday in the journal Circulation. For men, the difference was about 12 years. The five healthy lifestyle factors identified in the study should come as no surprise to anyone: eating a nutritious diet, exercising at least 30 minutes a day, maintaining a healthy weight, not smoking, and drinking in moderation. (Kaplan, 4/30)

New research offers evidence for a claim made regularly by country music singers: Growing up with a little dirt under his nails may make a country boy a little shy. But compared to a born-and-bred city slicker, that country boy will grow up to be a stronger, healthier and more laid-back man. In ways large and small, farm kids and city kids grow up worlds apart from each other. A study published this week in the Proceedings of the National Academy of Sciences explores the possible consequences of that divergence for the health of modern men. (Healy, 5/1)

Nights of hard drinking can lead to much more than just bad hangovers. In fact, new research suggests that heavy drinkers may actually experience higher levels of "bad" bacteria in their mouths, including bugs linked to gum disease, heart disease and cancer compared to moderate or non-drinkers. (Lemon, 4/30)

Guns won’t be allowed when Vice President Mike Pence speaks Friday at a National Rifle Association convention in Dallas in order to protect his safety. The NRA says the Secret Service ordered the ban, but survivors of the Parkland, Fla., school shooting are calling the move hypocritical, noting the organization’s fierce opposition to gun-free zones in most public places. (Sweeney, 4/29)

Sounding another warning for parents of small children who play football, Boston researchers studying the donated brains of football players say they’ve found that playing tackle football before age 12 was associated with earlier onset of cognitive and emotional symptoms in those players. (Finucane, 4/30)

More adults than children are now living with congenital heart disease, the most common birth defect that is diagnosed in 1 of 100 births. About 1.4 million adults with birth defects of the heart are advised to stay under the care of an expert in the field their whole lives, according to the Adult Congenital Heart Association. ... Washington University’s adult congenital heart disease program is one of 11 accredited centers in the country and the only one in Missouri that specializes in treating this population. The clinic follows about 2,500 adults with heart defects. (Bernhard, 4/30)

Champagne bubbles danced in fancy glasses and birthday candles burned atop a cheesecake marking 104 years of a long and accomplished life.David Goodall listened quietly as his loved ones started to sing. Then he took a breath, made a wish and blew out the flames. But Goodall was not wholeheartedly celebrating the milestone this month in Perth, Australia. The botanist and ecologist, who is thought to be the country’s oldest scientist, said that he has lived too long. And now, he said, he is ready to die. (Bever, 4/30)

For today, there are no doctor’s visits. No long afternoons with nothing to do. No struggles over bathing — or not. At the National Gallery of Art in Washington, D.C., a group of older adults — some in wheelchairs, some with Alzheimer’s — and their caregivers sit in a semicircle around a haunting portrait of a woman in white.“Take a deep breath,” said Lorena Bradford, head of accessible programs at the National Gallery, standing before “The Repentant Magdalen” by Georges de La Tour. (Fetterman, 4/30)

On March 29, MedStar Georgetown University Hospital opened a proton-therapy cancer unit that is expected to treat about 300 patients a year at premium prices using what its proponents promote as the most advanced radiology for attacking certain tumors. At the facility’s heart is a 15-ton particle accelerator that bombards malignancies with beams of magnet-controlled, positively charged protons designed to stop at tumors rather than shoot through them like standard X-ray waves, mostly sparing healthy tissue. (Hancock, 5/1)

The new interoperability is upon us. Healthcare data, once confined to a single hospital or system, are increasingly moving more freely outside the constraints of an electronic health record system, giving patients added control over their care and arming providers with the information they need to close gaps in care. The data are moving more easily thanks to interoperability driven not by EHR technology but by the standards supporting the systems. This new type of data exchange looks different from that of the past. It's more comprehensive, with data traveling as discrete elements, rather than in clunky PDFs. (Arndt, 4/28)

Kaiser Health News: Telemedicine Opening Doors To Specialty Care For Inmates

When an inmate needs to see a medical specialist, getting that care can be complicated. Prisons are often located in rural areas far from medical centers that have experts in cancer, heart and other disease treatments. Even if the visit just involves a trip to a hospital across town, the inmate must be transported under guard, often in shackles.The whole process is expensive for the correctional facility and time-consuming for the patient. (Andrews, 5/1)

Kansas lawmakers gave the go-ahead Monday to expand telemedicine services after reaching agreement on abortion language that had threatened to scuttle the move. The bill cleared the state Senate and House by large margins, but only after eleventh-hour brinksmanship that gave anti-abortion forces the assurances they demanded. Kansans for Life, the state’s largest anti-abortion organization, fought for weeks to maintain a clause in the legislation designed to discourage a court challenge over its ban on drug-induced abortions. (McLean, 4/30)

A major funder of cancer research in Texas is offering up to $3 million in seed funding to help lure startups to the Lone Star State — and keep them here. On Monday, the Cancer Prevention and Research Institute of Texas announced a new Seed Award, which will target startups trying to introduce disruptive technologies in the cancer-care market. The institute has already doled out more than $1.9 billion to cancer research and prevention programs statewide since 2007. But the new grant is unique in that it specifically targets companies that are just getting started, an area where venture capital funds are sparse. (Rice, 4/30)

Two related lawsuits contend that Arizona businesses and individuals marketed and profited from weight-loss operations in Mexico that led to the death of one patient and harmed several others. (Alltucker, 4/27)

Public and private agencies that serve people with developmental disabilities say they are embracing various initiatives — from recruitment campaigns to longevity pay and an emphasis on the emotional rewards — to attract the workers the system so desperately needs. (Price, 4/30)

The three-year Community Cessation Initiative, referred to as CCI, will place special emphasis on people who are pregnant, have low socioeconomic status or have mental-health and substance-abuse disorders, Health Commissioner Joe Mazzola said. But any resident can participate, and advocates hope to reach about 26,250 people, or 15 percent, of the roughly 175,000 tobacco-users in the county. (Viviano, 4/30)

The first four-year medical school established in South Georgia aims to address the primary care physician shortages in underserved areas of the state. ...While rural areas in Georgia account for 18 percent of the population, only 7 percent of Georgia’s physicians currently practice in rural area. (Miller, 4/30)

The doctor accused of branding female members of a New York "sex cult" worked at Columbia St. Mary's Hospital and two of its affiliates as recently as last summer — and reportedly tried to recruit at least one of her Milwaukee patients. Danielle D. Roberts, a 36-year-old family doctor, has been identified in multiple media accounts as a leader of Nxivm, a controversial self-help group. (Bice and Spicuzza, 4/30)

As more people with disabilities leave government-run institutions and work programs, the need for workers to assist them at home and in their communities has dramatically increased. The compensation of those who work for private companies and nonprofits, however, generally hasn’t matched that of public employees. (Price, 4/29)

Mayor-elect LaToya Cantrell will replace New Orleans Department of Health Director Dr. Joseph Kanter, who took over the post last year after Mayor Mitch Landrieu replaced Marsha Broussard. Kanter, reached Monday (April 30), confirmed his departure but declined to comment further. Three sources familiar with internal discussions on Cantrell's transition team said that Broussard's name has been floated for a possible return to City Hall in an oversight role at the health department. (Litten, 4/30)

A federal judge dismissed physician staffing firm Envision Healthcare's lawsuit against UnitedHealth Group in a case involving a payment dispute. The U.S. District Court in Miami said late last week that the two companies must resolve their dispute through arbitration, as outlined in their contract. (Livingston, 4/30)

When student leaders from all 23 California State University campuses came together last fall to set priorities for the academic year, improving campus mental health services received more nominations than any other issue. It beat out even that perennial concern, tuition costs. (Mello, 4/30)

A few months ago, a patient left a glowing, exclamation-point-heavy review on her doctor's Facebook page: “My primary care physician is truly the most incredible woman that I have ever met in my life!!!!!!!” Marian Antoinette Patterson “takes the time to listen to me, converse with me, figures out a solution to every problem that arises,” the patient said. The physician was sensitive to her financial situation, too, giving her free samples of a vital medication and even consulting by phone to save the patient money. Patterson, the patient said, “is truly an angel and the meaning of what a doctor should be.” (Wootson, 4/30)

The fiery backlash against the White House Correspondents’ Association dinner held on Saturday night continues, with one hot take after another about whether the annual fête has become an anachronism (it has) and whether comedian Michelle Wolf went too far with her jokes (she did not). And yet, what should have been the main takeaway of the whole affair was a line that Wolf saved for the kicker, appropriately. “Flint still doesn’t have clean water,” she said. But instead of focusing on Flint, Mich., media Twitter accounts were brimming with angst about Wolf’s brand of humor. The hyperbole is particularly disingenuous when it comes from conservatives who have consistently tolerated a vulgar, bullying president. But tough love from a comedian whose job was to speak truth to power, and get some laughs in the process? An outrage. (5/1)

In early April, the Michigan Department of Environmental Quality (DEQ) approved Nestlé’s permit to pump 60% more Michigan groundwater to expand its bottling operations. Days later, Gov. Rick Snyder announced that the state will no longer provide free bottled water to the thousands of families in Flint who still don’t trust their tap water. But it’s not only Flint. There are families in Rockford, Alpena, Grayling, Oscoda, Marquette and nine other communities that cannot drink the water flowing out of their taps due to PFAS contamination. Toxic chemicals are seeping through the groundwater in places like Mancelona and Ann Arbor, threatening well water along with local businesses and real estate values. And, more than 17,000 Detroit residents face water shutoffs, a move the United Nations has called a violation of human rights. (Lisa Wozniak, 4/29)

Conservative writer Kevin D. Williamson says that, past comments to the contrary notwithstanding, he doesn’t think women should be hanged for having abortions. But he still wants them to be punished somehow. So really we’re just negotiating the terms. Williamson made headlines in April for being hired and, after his views touched off a firestorm online, he was very quickly fired by the Atlantic magazine. Now he aims to make clear what he says the so-called Twitter mob — actually, women and men across the country with real concern about his beliefs — wasn’t interested in knowing: What Williamson truly thinks the punishment for abortion should be. “Only real-world experience will show what is effective, and our preference should be for the least-invasive effective settlement,” he writes in a Post op-ed. I suppose that’s meant to be reassuring. (Ilyse Hogue, 4/30)

Though they are frequently met with judicial opposition, anti-abortion lawmakers continue to test boundaries in their attempts to severely or totally outlaw abortion access in their states. Americans themselves are split on abortion, and attitudes toward the legality of the procedure have remained remarkably stable over the last two decades. But a new poll released by the Public Religion Research Institute (PRRI), where I work as a contributing researcher and organizational strategist, shows that the general stability of public attitudes is only part of the story when it comes to whether and how Americans are shifting on abortion. Over the past few years, young Americans have actually become more supportive of legal and widely available abortion — expanding the generational gap and suggesting that anti-abortion lawmakers are increasingly out of step with younger voters on this issue. (Carolyn J. Davis, 5/1)

There appears to be change afoot in the area of gun violence research. For example, at the federal level, the new CDC Director Robert Redfield agrees that there’s no ban on gun violence research, and on the state level, seven (so far) governors have recently created a consortium to study the problem of gun violence.We are nurses who have a vested interested in the health of the public. Each of us has many years of experience working in practice, and in teaching public health, mental health, and women’s health. Gun violence touches on all these areas. We agree that there’s a need for gun violence research but we also think about the root cause. By definition, there would be no gun violence if there were no guns. (Mona Shattell, Ellen Olshansky and Sarah Oerther, 4/30)

Fatal overdoses of prescription opioids were rare before 1999. Then doctors, influenced by pharmaceutical industry marketing, began prescribing them for chronic non-cancer pain. By the end of 2016, prescription opioids — not illicit heroin or fentanyl — had claimed 200,000 lives. Now, at last, the opioid wave has crested. Per capita usage declined for the sixth straight year in 2017, according to IQVIA Institute for Human Data Science , a health-care consulting group. Changes in public policy, including long-awaited prescribing guidelines issued by the Centers for Disease Control and Prevention (CDC) in March 2016, promise to sustain this life-saving progress. (Charles Lane, 4/30)

Like all parents of teenagers, I worry that my children will engage in risky behavior, including drinking, smoking and drug use. The more time they spend doing healthier extracurricular activities — soccer, piano, cleaning their rooms (ha!) — the better. But it turns out that what they do in school can also affect their choices outside the classroom. (Austin Frakt, 4/30)

One in seven Texans, nearly 4 million of us, benefit from the Supplemental Nutrition Assistance Program. But changes to the welfare program in the House Agriculture Committee’s proposed Farm Bill will push needy, hardworking Texans off the program while failing to provide a path to higher-paying jobs. By the time the Farm Bill — a massive omnibus package passed every five years — makes it to President Donald Trump’s desk, Congress must restore these cuts to SNAP. (5/1)

Last week, Judge Catherine Blake of the U.S. District Court for the District of Maryland ruled in Baltimore City’s favor in its Teen Pregnancy Prevention suit against the U.S. Department of Health and Human Services (HHS). Judge Blake granted the City’s motion for summary judgment, ruling that HHS’s decision-making was arbitrary and capricious. By issuing this ruling, Judge Blake vacated HHS’s decision to prematurely terminate Baltimore’s five-year Teen Pregnancy Prevention Grant and ordered HHS to process Baltimore’s application for continued funding under the grant. This ruling is a victory for the youth of Baltimore City and it’s a victory for the use of science and evidence in education and health. (Leana S. Wen, 4/30)

Chronic Traumatic Encelphalopathy, commonly referred to as CTE, is a devastating illness that impacts people of all ages who suffer from numerous concussions or repeated head trauma. It was discovered in 2002 after several former NFL football players took their own lives or suffered early deaths after bouts with depression and other mental illnesses. However, we continue to learn every day this tragic illness impacts a growing number of families, including Iowans who lose a child. Recently, I attended an event hosted by friends whose child suffered from CTE and took his own life. The event was meant to heighten the awareness of CTE, signs of brain injury and concussion prevention. Concussions are a common injury reported in children. This injury often occurs during high contact sports and other activities. As a former athlete, I understand the dangers concussions may pose and advocated for this bill, which we had tried to move forward during past legislative sessions. We were successful in getting this legislation passed this session. (Jack Whitver, 4/30)

Truth is, we all have a breaking point — whether in response to the death of a loved one, the end of a relationship, unemployment, chronic poverty, a violent encounter, the loss of a pet, or exposure to abuse and bullying as a child. These types of traumatic experiences, these moments of breaking, can cause any number of behavioral or physical health issues, from depression to anxiety to heart disease. (Randy Callstrom, 4/30)

Like sailors drawn to sirens’ songs, we seem perilously drawn to the tantalizing ringing, beeping and buzzing of our phones – all too often with the same destructive results. Everyone in Maine probably has their own list of Top 10 places to go and things to do in the summer. I know I do – but I’ve learned that a winter’s worth of planning for these warm, sunny days can be undone in an instant by a multi-tasking motorist who is distracted. As we look to a season full of people walking, biking and driving in Maine, it’s worth thinking about distracted driving, its destructive consequences and the tools we can and should use to prevent it. (Michael R. Rifkin, 5/1)