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A progressive leader among House Democrats on lowering drug prices is circulating a letter calling for “necessary improvements” to Speaker Nancy Pelosi’s (D-Calif.) signature legislation on the topic. The letter from Rep. Lloyd Doggett (D-Texas), obtained by The Hill, outlines changes that he says need to be made to the legislation Pelosi unveiled earlier this month, which is one of House Democrats’ top legislative priorities. (Sullivan, 9/30)

A 60-word provision tucked into Nancy Pelosi’s signature drug pricing plan could wreak havoc on hospitals that serve the poor. The provision deals with a federal drug discount program known as 340B that lets some hospitals and clinics buy medicines at a deep discount. When they’re reimbursed for the drugs at a higher price by Medicare or other insurers, they pocket the difference to help cover charity care, counseling services, and other costs. (Florko, 9/30)

Poor people in Michigan with asthma and diabetes were admitted to the hospital less often after they joined Medicaid under the Affordable Care Act. More than 25,000 Ohio smokers got help through the state’s Medicaid expansion that led them to quit. And around the country, patients with advanced kidney disease who went on dialysis were more likely to be alive a year later if they lived in a Medicaid-expansion state. Such findings are part of an emerging mosaic of evidence that, nearly a decade after it became one of the most polarizing health-care laws in U.S. history, the ACA is making some Americans healthier — and less likely to die. (Goldstein, 9/30)

Representative Chris Collins, a fourth-term Republican from Western New York who narrowly won re-election last year despite fighting federal securities fraud charges, resigned on Monday in advance of an expected guilty plea. Mr. Collins, 69, the first sitting member of Congress to endorse President Trump in 2016, had been accused of using private information about a drug company in which he was invested to help his son and others avoid financial losses. (Weiser and Wang, 9/30)

It wasn’t immediately clear exactly what charges Mr. Collins would plead guilty to Tuesday. In September, the representative from western New York pleaded not guilty to a revised set of insider-trading charges, including conspiracy to commit securities fraud. Prosecutors accused him of passing a confidential tip to his son, Cameron Collins, so he could sell shares in the biotechnology company before the public disclosure of a failed drug trial. (Ramey, 9/30)

Collins faces eight counts of federal criminal charges involving conspiracy to commit securities fraud, securities fraud, conspiracy to commit wire fraud, wire fraud and false statements. His trial is scheduled for Feb. 3. Collins, along with his son, Cameron, and Stephen Zarsky, the father of Cameron’s fiancée at the time, are alleged by federal prosecutors to have engaged in an insider trading scheme involving an Australian biotechnology company — Innate Immunotherapeutics. (Marquette and Bowman, 9/30)

As he rose in stature in the House Republican Conference after being the first GOP lawmaker to endorse Donald Trump for president in 2016, Collins even brought his business interests to the floor of the House of Representatives. Then-Rep. Tom Price, a Georgia Republican nominated to be Trump's health secretary, told senators all about it at his confirmation hearing in early 2017. Price said Collins had given him a stock tip, that he really ought to buy shares of an Australian biotech called Innate Immunotherapeutics, where Collins served on the board. Price did just that. Hearing Collins brag that Innate might be on the cusp of discovering a successful treatment for the most dreadful form of multiple sclerosis, several other members of Congress bought Innate stock, too. (Zremski, 9/30)

Collins was the largest investor and a member of the board of directors for Innate Immunotherapeutics, an Australian biotech company. He was charged with passing inside information on the company to his son and Zarsky, father of Cameron Collins' fiancee. Using that information, Cameron Collins and Zarsky were able to avoid hundreds of thousands of dollars in losses after a drug trial failed, authorities say. At that time, the Securities and Exchange Commission settled with Lauren Zarsky, Cameron Collins' fiancee, and her mother, Dorothy Zarsky, over allegations of insider trading. The pair neither admitted nor denied, but they agreed to give up "ill-gotten gains" and pay fines, the SEC said. (Bresnahan, 9/30)

The Trump administration says it has reallocated $34 million in federal funds given up by Planned Parenthood and other providers that did not want to comply with new abortion restrictions on a federal family planning program. The money will instead go to 50 grantees that decided to remain in the Title X family planning grant program, which funds birth control and other reproductive health services for millions of low-income women and men. (Hellmann, 9/30)

Diane Foley, director of the Health and Human Services office that oversees the so-called Title X family planning program said Monday the goal is to serve about the same number of women , or more, avoiding disruptions. ... About 930 clinics serving an estimated 900,000 clients have been affected by grantees leaving the program. The money returned to the government has been divided up among organizations that remained, said Foley, among them state and local health departments. However, five states will no longer be served by the federal program. (Alonso-Zaldivar, 9/30)

The recipients of the additional funds do not include two faith-based medical providers that joined the program this year: Obria in California and Beacon Christian Community Health Center in New York. Beacon confirmed to POLITICO that it applied for the supplemental funding. Obria wouldn't confirm or deny. The administration's overhaul of Title X forbids recipients of program funds from referring patients for abortions — a prohibition critics term a "gag rule." Abortion rights supporters and nearly two dozen states are challenging the policy change in federal court. (Ollstein, 9/30)

Donald Trump’s presidency has faced considerable setbacks in the courts, with judges blocking administration actions on immigration, the environment and health care. But the president’s fortunes have begun to improve with help from the Supreme Court, and a crucial set of proceedings lies ahead. This year, the country’s highest court granted interim victories to the Trump administration on several hot-button issues after the Justice Department filed emergency appeals challenging lower-court injunctions that had impeded White House plans. The decisions allowed the administration to implement its plans while litigation continues, which in some cases could run through the 2020 presidential election. (Kendall, 9/30)

Medicare's flagship accountable care organization program generated nearly $740 million in net savings last year, CMS Administrator Seema Verma announced this afternoon. Nearly 11 million Medicare fee-for-service beneficiaries were receiving care through an ACO as of July 2019, representing an uptick of 400,000 since last year, she added in a Health Affairs blog post about Medicare's Shared Savings Program. Verma, a former critic of the Obama-era program, touted recent changes that she said would lead to higher-quality, more efficient care. (Diamond, 9/30)

Kaiser Health News: New Round Of Medicare Readmission Penalties Hits 2,583 Hospitals

Medicare cut payments to 2,583 hospitals Tuesday, continuing the Affordable Care Act’s eight-year campaign to financially pressure hospitals into reducing the number of patients who return for a second stay within a month. The severity and broad application of the penalties, which Medicare estimates will cost hospitals $563 million over a year, follows the trend of the past few years. Of the 3,129 general hospitals evaluated in the Hospital Readmission Reduction Program, 83% received a penalty, which will be deducted from each payment for a Medicare patient stay over the fiscal year that begins today. (Rau, 10/1)

Kaiser Health News: Look Up Your Hospital: Is It Being Penalized By Medicare?

Each year, Medicare punishes hospitals that have high rates of readmissions and high rates of infections and patient injuries. Check out which hospitals have been penalized. (10/1)

Hospitals and health insurers may not see eye to eye on a lot, but they do agree that the federal government's proposal to make hospitals publicly post payer-negotiated rates for medical services would be bad for business and patients. In comments on the hospital outpatient prospective payment proposed rule, which were due Friday, they urged the CMS to abandon the plan. (Livingston, 9/30)

The CMS has launched a pilot project for states to implement health-contingent wellness programs in the individual market. The states will be able to offer residents lower premiums or other incentives if they choose to participate in the state's wellness program through the individual market. The CMS is currently seeking applications for the project, which will involve 10 states. (Castellucci, 9/30)

Endo International PLC, Johnson & Johnson and other drugmakers that face sprawling litigation over the opioid crisis are exploring an unusual way to settle the cases: by participating in Purdue Pharma LP’s bankruptcy, according to internal documents and a person familiar with the matter. The move, if successful, could bring an end to—or at least dramatically shrink—one of the largest and most complex pieces of litigation the U.S. has ever seen. (Randazzo and Fitzgerald, 9/30)

Ohio is suing major drug makers and distributors for their role in an opioid crisis that has stolen thousands of lives in recent years.The lawsuits boil down to a contention that those companies should have known about the problem and done more to stop it. But at least one distributor is turning the tables on the state, saying that public officials knew about the opioid crisis and should have done more to stop it. (Rowland, 9/30)

At least 10 people died from drug overdoses in just 26 hours in Ohio's most populous county, according to the county coroner. Franklin County Coroner Dr. Anahi Ortiz, who issues periodic alerts on overdose deaths, called this an "unusually high number" of deaths in a statement on Facebook Sunday. Ortiz urged those who use drugs to test substances for fentanyl, the powerful synthetic opioid often sold as a street drug. (Yancey-Bragg, 9/30)

Mallinckrodt PLC recently changed its severance-package policy to allow for departing executives of the drug company to receive lump-sum payouts instead of installment payments, and ensuring the policy endures should it change ownership structure, such as liquidating or reorganizing, filings show. The drugmaker, whose stock is down some 90% this year, previously hired restructuring experts as it faces several challenges, including trying to resolve thousands of lawsuits over its alleged role in helping start the nation’s opioid crisis. (Hopkins, 9/30)

Hospitals support the CMS' proposed changes to medical billing coding and new payments for opioid treatment programs, but they're worried that changes to quality measures could hurt providers. Major medical groups and hospitals back the CMS' decision to abandon a provision of the finalized 2019 Medicare physician-fee schedule rule that would have consolidated the number of evaluation and management payment levels into one payment rate beginning in 2021. (Brady, 9/30)

A University of Central Florida researcher has designed technology that allows him to study opioid overdose and the antidotes used to reverse it without human or animal testing. Nanoscience Technology Center James Hickman says microscopic liver and heart cells are attached to glass chips and then flooded with opioids to simulate the overdose and determine how different organs are affected. (Prieur, 9/30)

A Broward County registered nurse has had her license restricted by the Florida Department of Health after, the department says, she ordered 8,160 oxycodone tablets and almost 10 liters of prescription cough syrup with codeine earlier this year. Problem was, Nadia Etienne’s four patients received only one oxy tablet and no cough syrup. (Neal, 9/30)

Now, as a mysterious vaping-related lung disease has doctors and parents urging the nation’s 3.6 million young users to quit, many are finding that they physically can’t — they’re hooked. It’s exactly the kind of youth addiction crisis the Food and Drug Administration had warned of four years ago, when it tried to ban flavored fluids for e-cigarettes. If the FDA ban had gone through, the kid-friendly vaping liquids would have been pushed off store shelves. Instead, over the course of 46 days, a deluge of more than 100 tobacco industry lobbyists and small business advocates met with White House officials as they weighed whether to include the ban as part of a new tobacco control rule. (Baumgaertner, 10/1)

The vaping disease outbreak has put congressional Republicans in a bind, forcing them to choose between free market principles and the Trump administration’s plans to crack down on the industry. Many Republican lawmakers have viewed policies like banning flavored e-cigarette products as "nanny state" politics of the worst kind. But most have held their fire since President Donald Trump announced the ban, a response to the hundreds of hospitalizations and at least 13 deaths caused by vaping-linked lung illness, including among the rising population of vaping teens. (Owermohle and Ollstein, 9/30)

As health officials grapple with a public health crisis they are struggling to understand, police departments are in the midst of a swift crackdown on vaping products containing THC, the psychoactive ingredient in marijuana. In the Phoenix area, the authorities recently raided three homes over eight days, seizing hundreds of THC cartridges at each. In Wisconsin, detectives arrested two young brothers accused of running a large-scale THC cartridge assembly operation inside a condo. And in Nebraska, sheriff’s deputies found a stash of cartridges in a car parked at a truck stop. (Bosman and Smith, 10/1)

Juul Labs Inc. announced Monday that it will stop supporting a ballot measure to overturn an anti-vaping law in San Francisco, effectively killing the campaign. The nation’s largest maker of e-cigarettes said it will end its support for Proposition C after donating nearly $19 million. It was virtually the only financial backer of the measure. “Based on that news, we have made the decision not to continue on with the campaign,” Yes on C said in a statement. However, the proposition will still appear on the November ballot. (10/1)

The burgeoning push to put the brakes on e-cigarette sales started, as these vanguard movements often do, in San Francisco when the Board of Supervisors approved in June a ban on e-cigarette sales, just as health concerns over the practice were starting to ramp up. Since then, reports showing an alarming rise in vaping and e-cigarette use among teenagers have prompted a national debate — and increasingly panicked public health warnings, amid reports that hundreds of people have been sickened by mysterious lung illnesses suspected of being related to vaping. At least four states have now issued all-out bans on electronic cigarettes. (May, 9/30)

The owners of six Massachusetts vape shops are suing the state over a new temporary ban on vaping-product sales, escalating the tension between retail businesses and public officials trying to address a nationwide public-health problem. (Kamp, 9/30)

Twice a year influenza experts meet at the World Health Organization to pore over surveillance data provided by countries around the world to try to predict which strains are becoming the most dominant. The Northern Hemisphere strain selection meeting is held in late February; the Southern Hemisphere meeting occurs in late September. The selections that officials made last week for the next Southern Hemisphere vaccine suggest that two of four viruses in the Northern Hemisphere vaccine that doctors and pharmacies are now pressing people to get may not be optimally protective this winter. Those two are influenza A/H3N2 and the influenza B/Victoria virus. (Branswell, 9/30)

Might time spent on social media — YouTube, Facebook, Instagram, Twitter and the like — affect young people’s mental health? Yes, says a report by Johns Hopkins and other researchers, published in JAMA Psychiatry. For instance, they found that 12- to 15-year-olds who typically spent three or more hours a day on social media were about twice as likely to experience depression, anxiety, loneliness, aggression or antisocial behavior as were adolescents who did not use social media. As the youths’ social media time increased, so did their risk, making them four times more likely than nonusers to have these problems if they spent more than six hours a day on social media. (Searing, 9/30)

It’s hard enough for most people to imagine what it takes for a living donor to give an organ to a friend, family member or stranger. What about those who have done that good deed twice? Only 47 people in the U.S. have donated more than one organ to two different people over the past 25 years, according to the United Network for Organ Sharing (UNOS), the nonprofit that runs the nation’s transplant system. (Another 17 people have donated two different organs to the same recipient on different dates.) Of those who donated to two different people, 43 out of 47 donated a kidney and part of their liver. (Reddy, 9/30)

Many people with asthma use inhalers to control the chronic inflammation in their lungs. But for those with more severe forms of the disease, the standard inhaled medication may not be enough to keep the wheezing, chest tightness and attacks at bay. Now, a new combination-therapy — using three drugs in a single inhaler — may provide some relief, according to doctors presenting the results of two clinical trials on Monday at the annual conference of the European Respiratory Society in Madrid and published in The Lancet. (Sheikh, 9/30)

Kaiser Health News: Skin-Lightening Cream Put A Woman Into A Coma. It Could Happen Again.

A Sacramento woman is in a coma after using a face cream from Mexico. It is the nation’s first case of methylmercury poisoning from a cosmetic, and public health officials can do almost nothing to prevent other contaminated cosmetics from hitting the shelves. (Almendrala, 10/1)

Analyzing the data from five studies that encompassed 54,000 people, the researchers did not find a significant association between meat consumption and the risk of heart disease, diabetes or cancer. They also found a vegetarian diet provided few, if any, health benefits. Given the enthusiasm among meat eaters for steaks and burgers, the impacts would have to be much greater to suggest curtailing red and processed meat, said Bradley Johnston, associate professor in the department of community health and epidemiology at Dalhousie University and the lead researcher on the study. Johnston acknowledged the study’s recommendations are contrary to almost all other guidelines that exist. (Reiley, 9/30)

Public health officials for years have urged Americans to limit consumption of red meat and processed meats because of concerns that these foods are linked to heart disease, cancer and other ills. But on Monday, in a remarkable turnabout, an international collaboration of researchers produced a series of analyses concluding that the advice, a bedrock of almost all dietary guidelines, is not backed by good scientific evidence. (Kolata, 9/30)

Their conclusions were swiftly attacked by a group of prominent U.S. scientists who took the unusual step of trying to stop publication until their criticisms were addressed. The new work does not say red meat and processed meats like hot dogs and bacon are healthy or that people should eat more of them. The reviews of past studies generally support the ties to cancer, heart disease and other bad health outcomes. But the authors say the evidence is weak, and that there’s not much certainty meat is really the culprit, since other diet and lifestyle factors could be at play. (Choi, 9/30)

Recommendations from the American Heart Association and the American Cancer Society, as well as the U.S. Dietary Guidelines, all call for limiting red meats and processed meats. "I am outraged and bewildered," says nutrition scientist Christopher Gardner, a professor of medicine at Stanford University. "This is perplexing, given the ... clear evidence for harm associated with high red meat intake," says Frank Hu, the chair of the Department of Nutrition at the Harvard T.H. Chan School of Public Health. (Aubrey, 9/30)

Dietary guidelines from groups as diverse as the Department of Agriculture to the World Health Organization urge all of us to eat less red meat — much less. But the authors of four new studies, published on Wednesday in the Annals of Internal Medicine, report there is no compelling evidence that reducing consumption of red or processed meats will be beneficial to an individual. A furious backlash is already unfolding. Here are five takeaways from the debate. (Kolata, 9/30)

Getting a lot of vitamin A in your diet is tied to a lower risk for squamous cell carcinoma, a common form of skin cancer, a review of studies has found. Squamous cell carcinoma, a slow-growing cancer usually found on sun-exposed areas, is easy to treat if found early, although in rare cases it can spread to other tissues. (Bakalar, 10/1)

Serving up drinks at the American Legion post in Concord, Jeff Holland gets a little testy when the talk turns to smoking. A Marine veteran who enjoys lighting up, the 44-year-old Holland fought unsuccessfully against a ban at the post that went into effect earlier this month. And starting Tuesday, he will be prohibited from smoking when he visits the nearby Manchester VA Medical Center in New Hampshire. It is part of a nationwide smoking ban outside all VA medical facilities that applies to visitors, patients and employees. (Casey, 10/1)

At the main entrance of the New Orleans Veterans Affairs Medical Center, a large white easel with the words “No Smoking” sits about 50 feet from a long line of benches where several veterans are perched with cigarettes. Starting October 1, those veterans will be asked to move completely off campus to smoke. A nationwide smoking ban will be implemented at all veteran’s affairs facilities, including the Southeast Louisiana Veterans Health Care System, which includes eight clinics serving 23 parishes. (Woodruff, 9/30)

The pharmacy chains Walgreens, Rite Aid and CVS have moved to stop selling the heartburn medicine Zantac and its generic versions after the Food and Drug Administration warned this month that it had detected low levels of a cancer-causing chemical in samples of the drug. A Walgreens spokesman said in a statement on Monday that the company had pulled the drug from its shelves “while the FDA continues its review of the products.” A Rite Aid spokesman said the company was “in the process of removing Zantac and generic versions sold under the Rite Aid name from its shelves.” (Garcia, 9/30)

The decision by the pharmacy giants adds to a flurry of worldwide concern about the drug. Major manufacturers of the generic form, ranitidine, have announced recalls, and other countries have requested that companies halt distribution of the drug or issued recalls. The U.S. Food and Drug Administration has been investigating the possible risk to patients, as well. (Johnson and Bellware, 9/30)

Some Zantac products, known in generic form as ranitidine, have been recalled in the U.S. by manufacturers. Pharmacies are also beginning to halt sales of the drugs until more is known about the levels of a likely carcinogen that regulators around the world have found in the medicines. (Edney, 9/30)

Sanofi, the company that makes Zantac, said in a statement that the FDA has found the amounts of the carcinogen NDMA in its drug “barely exceed amounts found in common foods.” “We are working closely with the FDA and are conducting our own robust investigations to ensure we continue to meet the highest quality safety and quality standards,” the company said. (Sullivan, 9/30)

Google parent Alphabet has hired former Food and Drug Administration Commissioner Dr. Robert Califf to oversee strategy for two of the company's health divisions. Califf will serve as head of strategy and policy for Google Health and Verily Life Sciences, according to a blog post from Duke Forge, a health data science center at Duke University. Califf will step down from his role as Duke Forge's director in November to accept the full-time position at Alphabet. (Cohen, 9/30)

There have been a lot of changes at athenahealth over the last few years. The latest one will change the formerly highflying heath data IT company from a landlord into a tenant. In a deal that real estate experts say could fetch hundreds of millions of dollars for athenahealth’s new owners, the company is selling its 29-acre campus on Arsenal Street in Watertown. (Logan, 9/30)

Littleton Regional Healthcare is partnering with Children’s Hospital at Dartmouth-Hitchcock and Dartmouth-Hitchcock Connected Care to provide critical neonatal services to its patients via telemedicine. ...Through the use of state-of-the-art telemedicine technology, a board-certified Dartmouth-Hitchcock neonatologist will join the local bedside team in Littleton to provide neonatal care and support for a wide variety of diagnoses, according to the news release. (9/30)

The massive not-for-profit system CommonSpirit Health is going to be late filing its first annual financial statement following its creation earlier this year, a development that didn't come as a surprise to analysts watching along. Leaders of the Chicago-based system, formed through the merger of Catholic Health Initiatives and Dignity Health, have had their work cut out for them since well before the deal became official on Feb. 1. (Bannow, 9/30)

When the administrator of the Washington County Jail in southwest Alabama answered the phone on the evening of June 20, 2016, he learned of a health emergency playing out in the jail he oversaw. ... The nearest hospital is only 1 ½ miles away, but Weaver remained in the jail as Busby directed staff to first figure out who would pay for her medical care. “See if she had insurance, if she had Medicaid,” he told the dispatcher, who was referred to only as Kelly on the call. A recording of the conversation was provided to AL.com and ProPublica by Henry Brewster, a lawyer for Weaver’s family in a lawsuit filed in U.S. District Court for the Southern District of Alabama in Mobile in February 2018. If Weaver was covered by Medicaid or private health insurance, then her medical bills would not be the county’s responsibility if the sheriff’s office released her from its custody. (Sheets, 10/1)

A federal judge on Monday upheld a Virginia law requiring women to undergo an ultrasound and wait at least 24 hours before having an abortion, as well as the state’s “physician-only law” barring nurse practitioners and physician’s assistants from performing abortions. The ruling by U.S. District Judge Henry Hudson came in a lawsuit that challenged four Virginia laws that opponents say restrict access to abortion in the state. Hudson overturned two state laws, including one requiring all second-trimester abortions to be performed at a licensed outpatient hospital and regulations that would have required clinics that provide first-trimester abortions to meet the same facility requirements as general and surgical hospitals. (Lavoie, 9/30)

[Michigan Gov. Gretchen] Whitmer also faulted GOP legislators for spending less than what she proposed in three departments: Corrections, Technology, Management and Budget, and Health and Human Services. The funding levels would likely force up to 250 layoffs and cease electronic tracking of released sex offenders and other inmates, according to her office. The budgets also would weaken cybersecurity and public safety communications, and not fund the implementation of Republican-backed work requirements for people enrolled in the state's Medicaid expansion program, Whitmer said. (Eggert, 9/30)

A new analysis underscores the enormous challenges that Georgia faces in fighting HIV. The state ranks No. 3 in HIV risk in the U.S., trailing only Ohio and Nevada, according to the study from Health Testing Centers, which used data from the CDC. Georgia has the leading rate of new diagnoses among states, with 30 per 100,000 people. Only Washington, D.C., has a higher new diagnosis figure. (Miller, 9/30)

State health officials recommended limited cuts to a Medicaid program for people with disabilities Monday, after months of deliberating on potential changes that could affect more than 34,500 clients who depend on the program for services. The recommended cuts were much lower than advocates for clients with developmental disabilities had feared. But the decision will be up to the Legislature, which ordered a redesign of the program and will consider the recommendations in its 2020 session. (Koh, 9/30)

Suspicious deaths and allegations of mistreatment in senior care facilities can routinely go unreported to law enforcement and prosecutors, a breakdown that allows abusive or neglectful caregivers to escape punishment and continue to work around seniors, an Atlanta Journal-Constitution investigation found. There’s no public record that police were notified in 40% of physical and sexual abuse allegations detailed in inspection reports by the Georgia Department of Community Health. (Schrade and Teegardin, 9/30)

Tens of thousands of California child care providers gained new rights to bargain for better wages and health benefits under a new law Gov. Gavin Newsom signed on Monday, the labor unions sponsoring the bill announced. The new law will apply to more than 40,000 workers who care for families that receive child care cost assistance from the state. (Bollag, 9/30)

On a quiet Sunday afternoon at the University of Pennsylvania, a dozen students sat in a circle, turned to one another, and asked: “Are you thinking of killing yourself?” ... With 14 student suicides in the past six years, this Ivy League university has been asking hard questions and has bolstered its mental-health resources. But the recent death by suicide of a high-profile mental-health administrator—Gregory Eells, executive director of Penn’s Counseling and Psychological Services program that provides therapy sessions for students—highlighted the complexity of the school’s continuing battle against suicide. (Calfas, 9/30)

Sterigenics, the medical supply sterilization company that has been battling lawsuits and claims of increased cancer rates from fumes, announced Monday it has decided against reopening its suburban Chicago plant. The company said it will close the plant in Willowbrook, blaming “inaccurate and unfounded claims regarding Sterigenics and the unstable legislative and regulatory landscape in Illinois.” (9/30)

Not-for-profit healthcare providers dominate the Indiana market, creating an anticompetitive dynamic that has driven higher-than-average healthcare spending, according to a new study. Households in the most concentrated healthcare markets pay more than double per procedure compared with those in the most competitive markets, a new policy brief from Ball State University's Center for Business and Economic Research shows. (Kacik, 9/30)

The Colorado Division of Insurance receives hundreds of complaints a year from consumers, but few trouble chief deputy commissioner Kate Harris as much as the ones she began hearing earlier this year. They concerned a company called Aliera Healthcare and an organization it administers called Trinity Healthshare. Trinity is a so-called health care sharing ministry, a group that pools members’ money to help pay medical bills but, because of an exemption in the law, doesn’t have the legal obligations that modern insurance companies do. ... [Harris'] investigation has already led to ... cease and desist letters sent to both Aliera and Trinity. The letters accuse the companies of essentially marketing themselves as insurance providers without offering the same level of security. (Ingold, 9/30)

A decreased birthrate in Hawaii has larger population and economic implications for the state now and in the future, officials said. ... Hawaii’s current birthrate is 10% lower than in 2008. The economic effects include reports by at least two Oahu hospitals of decreases in work shifts for maternity ward nurses and a reduction in new nurse hiring. (10/1)

In the two years since the deadliest mass shooting in modern U.S. history, the federal government and states have tightened some gun regulations. But advocates say they’re frustrated that more hasn’t been done since 58 people died at a concert on the Las Vegas Strip, and that mass shootings keep happening nationwide. “People are genuinely afraid of going places,” Nevada Assemblywoman Sandra Jauregui said. (Ritter and Price, 10/1)

Baltimore County soon may ask a federal judge to force agriculture chemical company Monsanto to pay for the cleanup of environmental toxins, following a series of similar lawsuits filed by a dozen cites and states in recent years. County Executive Johnny Olszewski Jr. wants the County Council to approve a contract with three law firms to represent the county in a lawsuit to be filed against the company and two former divisions it sold off. (Nobles, 10/1)

David Lane Byrns, the ex-chief executive of Putnam County Memorial Hospital, a 15-bed federally designated critical access hospital in Unionville, Missouri, was accused in federal court in Kansas City of one charge of conspiracy to commit health care fraud. Byrns, according to an 11-page charging document filed on Friday, was part of a scheme to submit fraudulent claims for reimbursement on laboratory tests to insurance companies on behalf of the hospital in Unionville from patients who never visited the facility or had any connection to it. (Vockrodt, 9/30)

An indictment alleges Peter Port, 64, Brian Dublynn, 62, and Jennifer Sanford, 57, were instrumental in getting Safe Haven Recovery Inc. and several other clinical laboratories to bill health insurance companies for services that were either not performed or unnecessary. The trio made at least $13 million from their alleged scam, court documents show. (Smalls II, 9/30)

South Florida cancer patients and the Sylvester Comprehensive Cancer Center participated in a clinical trial that could have wide-ranging implications for how doctors treat ovarian cancer. The results of the study, published Saturday in the New England Journal of Medicine, concluded that an anti-cancer drug called veliparib — which works as a “parp inhibitor,” targeting the way DNA repairs itself — could help more patients than initially understood. The trial confirmed that the benefits of the drug could extend to up to 30 percent more of ovarian cancer patients. (Conarck, 9/30)

Every year, the number has gone up — from 11 percent in 2017 to 21 percent in 2018 to 25 percent this year. That is the share of high school seniors who admit to having used e-cigarettes in the past month. And it’s not just almost-18-year-olds who are vaping: A fifth of 10th-graders report doing so in the past month. E-cigarettes vaporize a nicotine-rich — or, increasingly, a THC-laced — liquid, and when they first came on the market, all that many people saw was their upside. Finally there was a product that allowed smokers to mimic the act of smoking a traditional, combustible cigarette but with apparently fewer toxic chemicals. When the Food and Drug Administration moved to regulate the industry, critics warned that the federal government was poised to crush mom-and-pop e-cigarette purveyors selling innovative products that improve their customers’ health. (9/30)

Imagine driving into a gas station to fill up your car’s gas tank and seeing this stark notice affixed to the pump: “Warning: Burning fossil fuels kills.” Tobacco packages all over the world display warnings like that. It makes sense, since tobacco kills as many as 8 million people a year around the globe. Burning fossil fuel doesn’t get the same kind of attention, even though the toxic air pollution it creates kills 7 million people a year. Burning oil, natural gas, and coal releases gases and tiny particles that harm human health, leading to respiratory diseases such as asthma, cardiovascular diseases, cancer, and more. In 2018, the World Health Organization recognized air pollution as a major health risk factor, alongside tobacco use, harmful use of alcohol, unhealthy diets, and physical inactivity. (Lourdes Sanchez and Nina Renshaw, 10/1)

Gov. Gavin Newsom insisted he takes “a back seat to no one” on environmental advocacy just before he vetoed the most significant environmental-protection bill of the legislative session. His rejection of Senate Bill 1 puts Newsom squarely at odds with just about every major conservation group in the state in fortifying defenses for endangered species against the Trump administration’s efforts to weaken federal law. (9/30)

When we need to give medicine to newborns in our hospital, we often have to guess at the correct dose to give them. That’s a problem: give too little and the medicine might not work; give too much and it might cause harm. Dosing newborn babies with greater precision has been a challenge because it is difficult to conduct studies in this population, many of whom are very small and often critically ill. For researchers trying to determine the appropriate dosing for a medicine for adults, the FDA has clear guidelines on how to give the medicine, collect blood samples, examine the drug level in the blood, apply math to analyze how the level changes over time, and make decisions based on these analyses. But these guidelines don’t necessarily work for studying drugs in full-term and premature babies, who could weigh as little as 1 pound. (Michael Cohen-Wolkowiez and Kanecia Zimmerman, 10/1)

We are living in an era of epidemics. From communicable diseases like Ebola and measles that have the potential to become true epidemics, to other health threats that are branded epidemics like opioids and vaping, serious health threats are in the news and on our minds almost every day. And for good reason. These public health crises seem to arise quickly and circulate rapidly through the population, prompting swift action to stem their spread. But there are other health problems that have reached epidemic proportions that haven’t captured our attention or inspired action in the same way. Among these is obesity, which is a real epidemic with significant consequences now and in the future in the United States and around the world. (Brian B. Parr, 9/30)

One subgenre in the fake news section that we cannot keep ourselves from visiting is health care. Patients are no longer content with being passive consumers of health information. They want to play an active role in their own health and the health of others, and their main vehicle for delivering that information is social media. At times, social media can be a harbinger for good — think of GoFundMe pages, online support groups and heartwarming stories about overcoming a disease. But the spread of false claims and fake news can have damaging effects on patients' health, their relationship with doctors, and the very foundation of our health care system. (Brian Carr, 10/1)

It was the most important thing I would do that week. One morning, I walked around the hospital introducing myself to patients. I stopped by the room of a woman in her late 80s with dementia. Her ability to swallow — to ensure that food and water and saliva reached her stomach and not her lungs — had grown tenuous: This was her third bout of pneumonia in as many months. After restricting her diet for fear of worsening her breathing, her family had now decided that she should enjoy what she could in the time she had left. (Dhruv Khullar, 9/30)

No one in America should have to fund his or her healthcare with a red bucket placed at a drive thru window. And it’s not just the working poor who can’t afford health care. I have friends who have lost their jobs and when it’s between paying for COBRA or keeping a roof over their family’s head (because COBRA was more than their mortgage). Guess what wins? (Sherry Kuehl, 10/1)

Developing effective treatments for cancer is perhaps the greatest health care challenge facing modern society. One-third of adults will develop some form of this disease within their lifetime. Because it touches so many of us, we are all invested in trying to find cures. But in this pursuit, we must avoid the risk of over-investing emotionally, scientifically and financially in one approach at the expense of another.I fear a trap we have fallen into is our commitment to the philosophy of “Big Data” and “machine learning” in attacking cancer. The belief is that if we collect enough data on enough patients, then we will be able to find statistical patterns indicating the best way to treat patients and find cures.This is fundamentally misguided. (Thomas Yankeelov, 9/30)