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President Trump acknowledged Tuesday that Dr. Ronny L. Jackson, his nominee to lead the Veterans Affairs Department, is in serious trouble amid accusations that as the White House doctor he oversaw a hostile work environment, improperly dispensed prescription drugs and possibly drank on the job. Speaking at a midday news conference with the president of France, Mr. Trump strongly defended Dr. Jackson, the White House physician, as “one of the finest people that I have met,” but he hinted that Dr. Jackson might soon withdraw from consideration, blaming Democrats for mounting an unfair attack on his nominee’s record. (Fandos and Shear, 4/24)

Trump repeatedly said the choice to withdraw was Navy Rear Adm. Ronny Jackson’s, but he also questioned why he would want to go forward and take the "abuse" from politicians. “It’s totally his decision, he’ll be making a decision,” Trump said when asked about the nomination of Jackson, who is the White House physician to the president. The president said he told Jackson “this is a vicious group of people that malign. What do you need this for? … You’re too fine a person.” It is difficult to see how Jackson will remain as the nominee after Trump, who acted alone to pick him for the job, effectively told him he would be better off if he stepped aside. "If I were him, I wouldn't do it,” Trump said. (Fabian, 4/24)

Sen. Jon Tester of Montana, the top Democrat on the Veterans’ Affairs Committee, laid out the allegations in a CNN interview Tuesday night, saying the committee was investigating allegations from active duty and retired military officers who had worked in the White House medical office and who had come to the committee with numerous complaints, including that Dr. Jackson belittled lower-ranking employees, drank to excess on overseas trips, and handed out prescriptions “like candy,” walking down the aisle during flights doling out drugs to help people fall asleep and wake up. (Nicholas, Radnofsky and Hughes, 4/24)

Sen. Jon Tester (D-Mont.) said Tuesday that Navy Rear Adm. Ronny Jackson, the White House physician President Trump has nominated to lead the Department of Veterans Affairs, had been nicknamed "the candy man" for handing out prescription drugs. Tester, the top Democrat on the Senate Veterans' Affairs Committee, said on CNN's "Anderson Cooper 360" that "in overseas trips, in particular, the admiral would go down the aisle way of the airplane and say, 'All right, who wants to go to sleep?' and hand out the prescription drugs like they were candy." (Sanchez, 4/24)

Jackson had been set to have his confirmation hearing for the job on Wednesday. But that was postponed indefinitely as senators from both parties said they wanted to look into concerns that had come to light about the Navy rear admiral, who has worked as a presidential physician since the George W. Bush administration. Trump left open the possibility during a news conference that Jackson would withdraw from a political process the president described as "too ugly and too disgusting." (Rampton and Cornwell, 4/24)

A watchdog report requested in 2012 and reviewed by The Associated Press found that Jackson and a rival physician exhibited “unprofessional behaviors” as they engaged in a power struggle over the White House medical unit. The six-page report by the Navy’s Medical Inspector General found a lack of trust in the leadership and low morale among staff members, who described the working environment as “being caught between parents going through a bitter divorce.” “There is a severe and pervasive lack of trust in the leadership that has deteriorated to the point that staff walk on ‘eggshells,’” the assessment found. (Yen, Miller and Thomas, 4/25)

Rear Adm. Ronny Jackson, President Trump's pick to become the next Veterans Affairs (VA) Secretary, got drunk and banged on the hotel room door of a female employee during an overseas trip in 2015, CNN reported. The Secret Service intervened after Jackson's actions became so loud that agents worried he would wake up then-President Obama, according to CNN. (Greenwood, 4/24)

It was another episode where a previously respected figure was lifted to prominence in Trump’s orbit — only to have their sheen and reputation tarnished. Jackson had been widely hailed by three presidents and their aides as competent, charming and fiercely protective before Trump stunned Washington last month by picking the doctor to run the country’s second-largest federal agency.  (Dawsey, Kim, Rein and Wagner, 4/24)

When allegations of professional misconduct by White House physician Ronny L. Jackson started trickling during the past week to the Senate committee considering his nomination to lead the Department of Veterans Affairs, its chairman, Sen. Johnny Isakson (R-Ga.), called the White House twice seeking information. The answers did not appear to satisfy him. (Gardner, Kim and Rein, 4/24)

Ronny L. Jackson’s imperiled nomination to lead the Department of Veterans Affairs underscores the agency’s deep-seated struggle to overcome years of scandal and return its focus to serving a constituency that, historically, has remained above the political fray. “This is complete and total chaos after years of complete and total chaos,” said Paul Rieckhoff, founder and chief executive of Iraq and Afghanistan Veterans of America, an advocacy group. “Our veterans deserve so much better. Our whole country does. Especially in a time of war.” (Wax-Thibodeaux, 4/24)

President Donald Trump could have avoided the firestorm over Ronny Jackson’s nomination if he’d taken Johnny Isakson’s advice to begin with. In a private conversation with Trump last month, the Senate Veterans’ Affairs chairman mounted a strong defense of then-VA Secretary David Shulkin. But despite Isakson’s guidance, Shulkin was canned a few days later, and Jackson, the White House physician, was quickly nominated to take his place. (Everett, Johnson and Schor, 4/24)

As President Donald Trump’s pick to lead Veterans Affairs skids to a halt, senators from both parties are voicing frustration that the White House is skipping crucial vetting of nominees and leaving lawmakers to clean up the mess. That sentiment was evident Tuesday on Capitol Hill after senators delayed hearings for White House physician Ronny Jackson, Trump’s surprise pick to head the VA. Jackson is facing questions about improper workplace behavior, and even Trump himself acknowledged that there were concerns about his nominee’s experience. (Mascaro, 4/25)

Recognizing what it called “the troubling reality” that electronic cigarettes have become “wildly popular with kids,” the Food and Drug Administration on Tuesday announced a major crackdown on the vaping industry, particularly on the trendy Juul devices, aimed at curbing sales to young people. The agency said it had started an undercover sting operation this month targeting retailers of Juuls, including gas stations, convenience stores and online retailers like eBay. So far, the F.D.A. has issued warning letters to 40 that it says violated the law preventing sales of vaping devices to anyone under 21. (Zernike, 4/24)

The Food and Drug Administration issued warnings to 40 retail and online stores as part of a monthlong operation against illegal sales of Juul to children. Investigators targeted 7-Eleven locations, Shell gas stations and Cumberland Farms convenience stores as well as vaping shops. FDA regulators also asked manufacturer Juul Labs to turn over documents about the design, marketing and ingredients of its product. The rare request focuses on whether certain product features are specifically appealing to young people. (Perrone, 4/24)

“Let me be clear to retailers,” FDA Commissioner Scott Gottlieb said in a statement. “This blitz, and resulting actions, should serve as notice that we will not tolerate the sale of any tobacco products to youth.” Juul e-cigarettes resemble a USB flash drive but contain high levels of nicotine. They come in such flavors as mango, creme brulee and cool mint and their emissions can be virtually invisible, making it difficult for teachers to spot and stop use of the product. (McGinley, 4/24)

Gottlieb said the FDA on Tuesday sent an official request for information to Juul Labs for documents to help the agency understand why their products appeal to kids. "We don’t yet fully understand why these products are so popular among youth. But it’s imperative that we figure it out, and fast. These documents may help us get there," Gottlieb said. (Hellmann, 4/24)

KandyPens Inc. is a Santa Barbara, Calif., company that sells vaporizers that resemble pens and flash drives, and highlights hip-hop videos that feature its products. KandyPens says its products aren’t intended to be used only with nicotine. “All of our products are sold empty,” said Graham Gibson, chief executive of KandyPens. “We can’t control what people put in our products.” (Chaudhuri and Chaker, 4/24)

Medicare will require hospitals to post their standard prices online and make electronic medical records more readily available to patients, officials said Tuesday. The program is also starting a comprehensive review of how it will pay for costly new forms of immunotherapy to battle cancer. (Alonso-Zaldivar, 4/24)

The Trump administration is proposing to rewrite rules on federal payments to hospitals treating older Americans on Medicare, making it easier for patients to see the prices of procedures and care. As part of annual updates to Medicare payment rules, federal health officials also want to add $1.5 billion for the coming year to the funds for so-called disproportionate share payments that help buffer hospitals from the expense of treating patients who cannot pay their bills. The increase is a sign that the government expects an influx in uninsured patients — something administration officials seldom discuss amid their policies to weaken the Affordable Care Act. (Goldstein, 4/24)

"We seek to ensure the healthcare system puts patients first," CMS Administrator Seema Verma said in a comment. "Today's proposed rule demonstrates our commitment to patient access to high quality care while removing outdated and redundant regulations on providers." (Dickson, 4/24)

The CMS is planning to launch a new pay model that would allow Medicare beneficiaries to contract directly with physicians. Under current law, physicians are paid under a fee schedule in Medicare that includes limits on the amount they can bill beneficiaries per service unless they choose to opt out of Medicare and privately contract with all of their Medicare patients. Private contracting would allow physicians to bill seniors for charges that are more than the rates approved by Medicare. These sorts of arrangements are known as balance-billing, a controversial concept that was backed by former HHS Secretary Dr. Tom Price. (Dickson, 4/23)

Sometimes forgotten in the spiraling U.S. crisis of opiate abuse is a clinical fact about narcotic pain medications: addiction is basically an unwanted side effect of drugs that are highly effective at blunting pain. Addiction, of course, is a particularly dangerous and disruptive side effect, since it hijacks a patient's brain and demands escalating doses of opioid drugs to hold withdrawal symptoms at bay. (Healy, 4/24)

The Senate Health Committee unanimously voted Tuesday to send the panel’s bipartisan opioid bill to the chamber’s floor. The panel held seven hearings on the opioid crisis, including one on the discussion draft of the bill introduced by Health Committee Chairman Lamar Alexander (R-Tenn.) and ranking member Patty Murray (D-Wash.). Lawmakers touted the bipartisan process used to craft the Opioid Crisis Response Act of 2018 aimed at combating the opioid crisis, which has shown no signs of slowing down. (Roubein, 4/24)

The House heads into a marathon opioid markup Wednesday, a day after the Senate health committee approved bipartisan legislation of its own addressing the crisis. Both chambers are eager to advance bills to combat the crisis on an aggressive timeline, with an eye toward demonstrating action before the election on an issue that affects voters representing most demographics and districts. (Raman, 4/25)

Google said that it will use its homepage and maps starting Wednesday to promote a Drug Enforcement Administration project to help combat the opioid epidemic, as regulators and lawmakers call for more direct intervention by Silicon Valley to address the drug crisis. Underneath the Google search bar, the company will promote the DEA's National Prescription Drug Take Back Day, an initiative that encourages people to anonymously take unused medications to a collection site where they can be safely discarded. The semiannual event will take place Saturday. (Shaban, 4/25)

For the second time in as many years, an analysis has found that public speakers at Food and Drug Administration advisory committee meetings have notable financial conflicts, raising questions about the extent to which such ties may somehow influence the deliberations. In the latest analysis, 25 percent of the public speakers at 15 meetings held between September 2009 and April 2017 by the Anesthetic and Analgesic Drug Products Advisory Committee, which reviews opioids and other painkillers, had conflicts of interest. (Silverman, 4/24)

Three medications have been approved by the Food and Drug Administration to treat opioid addiction: methadone, buprenorphine and naltrexone. But access to them depends largely on where you live. Methadone and buprenorphine are the two most popular options. But many California communities, particularly rural ones, have neither a methadone clinic nor a doctor who can prescribe buprenorphine. (4/24)

Almost all chronic pain patients who now take prescription opioids for relief are asked by their doctors to sign a document in which they agree to submit to random urine drug screens, pill counts and other conditions in order to receive their medication. Designed to deter abuse and the sale of prescription painkillers amidst the heroin and fentanyl overdose epidemic, there is little solid evidence that these "opioid contracts" are effective, according to research on the topic. (Zeltner, 4/25)

Osceola County is going after pharmaceutical companies. The county filed a lawsuit against several drug companies. County attorney Andrew Mai said the suit claims the companies’ distribution of opioids is costing the county. (Chavez, 4/24)

The majority of urban hospitals don't perform well on patient safety measures, according to the latest Hospital Safety Grade report released Tuesday by the Leapfrog Group. Of the 11 hospitals in New York City included in the report, only one—NYC Health & Hospitals/Metropolitan—received an "A" grade from the Leapfrog Group in its spring 2018 report. Additionally, just three of Los Angeles' 12 hospitals got an "A" while only six of Chicago's 18 hospitals did. (Castellucci, 4/24)

Fifteen Georgia hospitals scored an “A’’ grade on patient safety in the latest Leapfrog Group report. The ratings, released Tuesday, showed that 21 percent of hospitals evaluated in the state got a top grade. (Miller, 4/24)

Maryland hospitals have made strides overall in reducing errors, accidents, injuries and infections, but still have a way to go to make their facilities as safe as they can be, according to a new safety assessment by Leapfrog Group. Maryland moved out of the bottom five in Leapfrog’s biannual state rankings of the country’s safest hospitals. Ten hospitals in the state improved their grades since they were first analyzed in 2017. (McDaniels, 4/24)

Triangle hospitals have ranked among the nation's safest health care facilities year after year, but your local hospital visit may not be as safe as previously assumed. The region got hit with surprisingly weaker safety grades in a biannual scoring report issued Tuesday by the Washington-based nonprofit Leapfrog Group. Two hospitals — WakeMed Cary and Duke University Hospital — unexpectedly dropped from top A grades to C's in Leapfrog's Spring 2018 safety ranking for errors, accidents and infections. Until this round of safety rankings, Duke University's research and teaching hospital in Durham had delivered straight A's for the past three years, whereas WakeMed Cary had been awarded A's, and one B, since last getting a C in the spring of 2015. (Murawski, 4/24)

Adventist Health Glendale aced yet another safety-care study conducted by a national hospital-safety organization. The Leapfrog Group, a nonprofit based in Washington, D.C., awarded its seventh straight A grade to Adventist Health Glendale, in its spring 2018 results released Tuesday. Leapfrog awards hospital safety grades twice a year based on a number of criteria that measure the quality of patient safety. (Landa, 4/24)

University of Mississippi Medical Center says its making strides to improve hygiene and patient safety at its main campus, and the latest scorecard from a national hospital watchdog agrees. (Wolfe, 4/24)

Illinois is home to 37 of the safest hospitals in the nation, according to a new report from a national nonprofit healthcare ratings organization. The Leapfrog Group, founded in 2000, produces a report twice a year that lists the safest hospitals in the country by analyzing 27 different "measures" of approximately 2,500 hospitals across the United States. (4/24)

Fewer hospitals in New Jersey earned an "A" for patient safety in the latest national report card released Tuesday. That drove New Jersey's national rank down from 11th to 17th best for the strategies they used to prevent infections, falls and other harmful mistakes, according to the report. (Livio, 2/24)

After getting safety grade scores of “A” and one “B” in the last three years, UPMC Pinnacle Carlisle was given a “C” score in the latest release of the Leapfrog Group’s safety grades. The Leapfrog Group is an independent, nonprofit organization dedicated to safety and transparency in the health system, and it releases its Leapfrog Hospital Safety Grade twice a year, grading hospitals across the country based on surgical issues, staffing, infections, preventing errors and other safety problems. (Creason, 4/24)

There have been a handful of case reports of kidneys being reused after the first recipient dies or rejects the donor kidney, generally just days after the original surgery and often while the recipient and organ are still at a transplant center, said Tom Mone, CEO of OneLegacy, a nonprofit organ procurement organization based in southern California. “There’s no history or practice of re-transplanting,” he said. “Among transplant surgeons, there’s a mistrust it will not work out. ”Kidneys that have been transplanted once are rarely used again, [Dr. Jeffrey Veale] said, because they are seen as damaged goods after going through not one, but two “death events” and because transplant surgery can be rough on organs — they get flushed with solution, put on ice, and are sometimes injured by the reperfusion of blood, he said. Immune-suppressing drugs can also be toxic to kidneys. (McFarling, 4/25)

For 32 years, the nonprofit United Network for Organ Sharing has held the federal contract to run the complex U.S. transplant system, a round-the-clock operation that matches donated organs with the sick people who need them. The Richmond-based UNOS has grown substantially and become more entrenched as transplantation has expanded. It collected nearly $58 million in revenue in 2015, according to federal tax records. But it has not faced competition from any other bidder since before 2005. (Bernstein, 4/24)

About 14 percent of state and federal prisoners (about 200,000) and 26 percent of jailed inmates (about 190,000) have serious mental illnesses, according to a report last year by the U.S. Department of Justice. Prison and jail officials don’t have the resources to treat them, and many deteriorate behind bars. By contrast, in some states those judged to be criminally insane receive better mental health treatment than practically anybody else — including people who have never committed a crime. (Ollove, 4/25)

Over time, Oregon lawmakers and judges have narrowed the conditions covered by a plea of “guilty except for insanity,” eliminating defendants who only suffer from personality disorders and psychosis caused by substance use. Legislators intended to make it more difficult to escape criminal prosecution. As a result, some people previously judged legally insane suddenly were eligible for release. (Fraser, 4/25)

From the outside, it looks like an ordinary commercial warehouse, only much bigger, about the size of two super Walmarts. Inside it’s dark except when motion sensors are triggered. When the lights come on, hundreds of thousands of shrink-wrapped boxes of medicines emerge from the gloom, stacked on shelves nearly five stories high. This is quite a different kind of warehouse. It and several others across the country are part of the $7 billion Strategic National Stockpile, a government repository of drugs and supplies ready for deployment in a bioterrorism or nuclear attack, or against an infectious disease outbreak — of either a known pathogen or some unknown threat with pandemic potential, which global health officials dub “Disease X” — or other major public health emergency. There are antibiotics, including the powerful medication Ciprofloxacin, vaccines for smallpox and anthrax and antivirals for a deadly influenza pandemic. (Sun, 4/24)

In certain eye diseases, cells that are crucial for vision die off, with no innate way to rebuild their supply. But scientists around the world are increasingly deploying treatments derived from stem cells, placing them in patients’ eyes in hopes of regenerating the lost tissue. Two research groups in the past two months have reported enticing results from approaches using embryonic stem cells, finding that their therapies appear to be safe and even produced some vision gains. (Joseph, 4/25)

The U.S. Food and Drug Administration has approved the first drug to slow kidney decline in patients with the most common inherited kidney disease. Jynarque (jihn-AR'-kew), from Japan's Otsuka Pharmaceutical, was approved Tuesday for autosomal dominant polycystic kidney disease.The progressive genetic disorder is the fourth-leading cause of kidney failure. It causes fluid-filled cysts to develop in and damage kidneys. (Johnson, 4/24)

You hear it whenever someone gets sick or dies soon after losing a spouse: Was it because of a broken heart? Stress might not be to blame for former President George H.W. Bush's hospitalization a day after his wife's funeral, but it does the body no favors, and one partner's health clearly affects the other's. A sudden shock can trigger a heart attack or something like it called broken heart syndrome. Some studies also have found that people are more likely to die soon after losing a longtime spouse. (Marchione, 4/24)

Children with a rare, incurable disease that causes rapid aging and early death may live longer if treated with an experimental drug first developed for cancer patients, a study suggests. The small, preliminary study isn't proof the drug works and it found only a small benefit: Treated children with the disease progeria were more likely than others to survive during the two-year study. But some kids taking the drug in this and other studies have lived into their late teens. Researchers and others say the results suggest a potential breakthrough for a heartbreaking condition that typically kills kids before they reach adulthood. (Tanner, 4/24)

A battle is brewing in the HIV research world about the best way to prevent HIV transmission. On one side are drugs that target the tissue where exposure to the virus occurs — think a gel or douche. On the other is a whole-body approach. (Boerner, 4/24)

Sunscreens with a rating of SPF 100 may be more effective than ones rated SPF 50, according to a randomized trial, even though the Food and Drug Administration says that any SPF above 50 offers no additional protection. The study, in the Journal of the American Academy of Dermatology, included 199 men and women given two tubes of sunscreen, one marked “right” and one “left.” They applied the cream to the indicated side of the face and neck, and then went about their normal activities on a sunny day at a ski resort. One of the tubes contained SPF 50 cream, the other SPF 100. (Bakalar, 4/24)

As 4-year-old Elianna Grace sat in the back seat of the SUV, battling her second fever in three days, her mom flashed back to the coughing and vomiting fit the preschooler had the previous weekend — and to a niggling fear about the girl's sudden illness. Elianna had spent April 14 playing in her grandparents' pool in Bradenton, Fla. She blew a geyser of water at family members with a pool noodle. One of them tried to spray her back, but Elianna was already inhaling and got a mouth full of water. (Wootson, 4/24)

It’s a challenge for people with severe mental illnesses to hold down a job or get the medical help they need. And that extends to when they try to alleviate hunger by getting on the federal Supplemental Nutrition Assistance Program, or SNAP. “(The mentally ill) have some of the highest food insecurity rates in this country,” said Craig Gunderson, a University of Illinois professor who researchers hunger and food programs like SNAP. “And this holds even after controlling for income, controlling for employment status, controlling for a whole bunch of other factors is still those with disabilities including mental health issues have substantially higher rates of food insecurity.” (Beck, 4/25)

Three years later, Breece is part of an initial group of people participating in the American Heart Association’s My Research Legacy, a new initiative aimed at collecting biometric, genetic and medical data from 250,000 volunteers. The goal is to use the information to foster scientific discoveries on cardiovascular disease and stroke and eventually find ways to predict whether someone is at risk — and prevent an event from happening. (Viviano, 4/25)

Gun deaths have fallen in California over a 16-year period ending in 2015, driven largely by a decline in gang violence and falling homicide rates among black and Hispanic male victims, a recent study of firearm violence has found. Researchers at the University of California, Davis published their findings in the May issue of the journal Annals of Epidemiology after reviewing 50,921 firearm deaths recorded in California between 2000 and 2015. The University provided the study results on Monday. (4/24)

The state Senate has given final approval to a “red flag” bill allowing authorities in Delaware to seize guns from a person deemed by a mental health provider to be a danger to themselves or others. The measure passed the Senate unanimously Tuesday after unanimous approval by the House last month. Under the bill, police who are alerted by a mental health provider could immediately ask a Justice of the Peace magistrate for a temporary order requiring the person to surrender any firearms or ammunition if there’s probable cause that he or she is dangerous. (4/24)

Gov. Ralph Northam will name a new leader for Virginia’s behavioral health system, as the state prepares for crucial decisions to transform the way it delivers services to people with mental illness, addictions and other behavioral disabilities. ...Melton, a nationally recognized family practitioner and addiction expert from Southwest Virginia, will replace Dr. Jack Barber, a psychiatrist and 30-year veteran who has served as acting behavioral health commissioner for three years. (Martz, 4/24)

Housing and Urban Development Secretary Ben Carson toured a homeless women's center on L.A.'s skid row Tuesday as part of a fact-finding trip to local public-private partnerships and faith-based programs tackling homelessness and job training. Carson, whose agency provided a record $109 million last year to L.A.'s battle with one of the nation's worst homelessness problems, also met with county and business homelessness leaders and stopped at a faith-based drug treatment residential center in Echo Park. (Holland, 4/24)

Life-threatening, pregnancy-related complications — the iceberg beneath the surface of the U.S. maternal health crisis — are on the rise in Harris County, according to a new report. The report not only confirmed the Harris County rate is worse than that of the state and nation, it found that it increased more than 50 percent between 2008 and 2015. Texas’ rate of life-threatening, pregnancy-related complications went up 15 percent in the same time period. (Ackerman, 4/24)

A plan by Senate President Chuck Morse to set aside $38 million in escrow was intended to address a looming budget shortfall the state faced over a hospital payment lawsuit. Now, New Hampshire’s hospitals are threatening more lawsuits. In a heated, two-hour hearing before the Senate Finance Committee on Tuesday, hospital representatives squared off with senators over the plan, which comes after a March federal district court ruling put the state on the hook for up to $38 million more than budgeted for in payments. Morse’s plan, presented as an amendment to House Bill 1102, would take the money from the state’s general fund and set it aside for the hospitals, but it would hold the money in escrow until all legal appeals are exhausted. (DeWitt, 4/24)

River Place Behavioral Health, an 82-bed inpatient facility, opened Tuesday (April 24) in LaPlace. The joint venture between Ochsner Health System and Acadia Healthcare, announced two years ago, repurposes the existing River Parishes Hospital building to provide much needed mental healthcare services in the region. Recently updated population estimates for the region show a need for more than 400 additional behavioral health beds than are currently in the greater New Orleans and Baton Rouge areas, according to data cited by Ochsner Health System in a news release. The River Place facility is a step toward filling part of the gap, the release said. (Clark, 4/24)

Minnesota health officials say sexually transmitted disease cases in the state rose to a record level in 2017. Overall the number of cases in Minnesota jumped 8 percent last year. ...Gonorrhea transmissions rose 28 percent; chlamydia infections 4 percent. (Zdechlik, 4/24)

The Laurie M. Tisch Illumination Fund has pledged $10 million to fund arts programs focused on mental health issues in New York City. The new initiative is an open-ended commitment that seeks to improve the lives of those with dementia and Alzheimer’s disease, fight stigma around mental illnesses and help people overcome trauma. The nonprofit Arts & Minds, for example, takes people with Alzheimer’s disease into museums for tours and hands-on projects in order to spur emotional connections and stimulate memories. (Chow, 4/24)

AB3087 proposes to task an independent state agency with setting payment rates for all health-care providers. Such authority conveys substantial power to alter the market. However, the temptation for regulators to overreach presents a threat to rate setting’s success. (Clemens and Ippolito, 4/24)

Regions of the state with combined high poverty rates and concentrated African-American populations have higher percentages of low birth weight babies, according to data from the U.S. Census and the Missouri Department of Health and Senior Services. The data indicates that geography, race and poverty – and the resulting chronic stress those factors cause – can combine to create lower health outcomes for infants. (Fentem, 4/25)

Afternoon naps are a time-honored tradition in many child-care centers, as toddlers snuggle up on soft mats to drowse, daydream or fidget. The possibility that those mats could be exposing kids to toxic chemicals might come as a surprise to most parents and day-care workers. But a new analysis found potentially harmful flame retardants in the majority of mats at some day cares across Seattle. The study was a small pilot, sampling only seven child-care centers in neighborhoods from the University District and Wallingford, to South Seattle and the Central District. Nap mats in all but one of the centers contained the flame-retardant chemicals. (Doughton, 4/24)

After resisting for years, Massachusetts dentists are now throwing their support behind legislation that would create a new kind of midlevel provider of dental care. ...The compromise would require dental therapists to have a master’s degree and to pass a clinical exam. For the first 2,500 hours or first two years of practice, whichever is longer, dental therapists would have to work under the direct supervision of a dentist, and in the same location as that dentist. (Dayal McCluskey, 4/25)

America’s Home Health Services owes a total of $2.13 million, including interest, to the Ohio Department of Medicaid.The company billed the state a total of $4.59 million from July 2013 to June 2016, according to an audit by the state auditor’s office released Tuesday. (Leckrone, 4/24)

Supporters of a paid family and medical leave bill are trying to salvage their plan after a key Senate committee decided it wasn’t ready for passage. The bill passed the House three times with bipartisan support, despite opposition from Gov. Chris Sununu and Republican leadership along the way. (McDermott, 4/25)

The family of Robert Ethan Saylor, a man with Down syndrome who died after three off-duty Frederick County sheriff deputies forced him from a movie theater, have reached a settlement with the state of Maryland, the deputies and the management company of the shopping center where the theater is located. The $1.9 million settlement will mark the end of a long-standing lawsuit and comes more than five years after Saylor’s death led to public outrage and a call for better training of law enforcement officials. (Vargas, 4/24)

While drug price growth has ebbed in recent months, the problem has led providers to battle unexpected price hikes for decades-old drugs and has cost consumers dearly at the pharmacy counter and in the form of rising insurance premiums. So what could rein in rising drug prices? Modern Healthcare sought to find out. (Kacik, 4/21)

There are a lot of legitimate ways to bring down drug costs; there are also a lot of empty gestures masquerading as real change. Here's a guide to the kinds of ideas and the odds that they'll actually happen. (4/23)

Americans spend more money on prescription drugs than anyone else in the world. CNNMoney's Christine Romans explains why spending on drugs keeps rising. (4/24)

A House Republican on Tuesday unveiled a proposal that would require hospitals participating in the 340B drug discount program to disclose how much care they provide to low-income patients. But healthcare stakeholders warn the bill could place unfair reporting burdens on providers in medically vulnerable communities. Rep. Earl "Buddy" Carter (R-Ga.) said the 340B Optimization Act would fix reporting issues with the program, claiming the current system does not provide an accurate measurement of how many low-income patients receive care at a health system's hospitals, outpatient facilities and pediatric clinics. (Johnson, 4/24)

When Martin Shkreli, former CEO of Turing Pharmaceuticals, raised the price of Daraprim, which treats dangerous infections, from $13.50 to $750, the public was appalled. But lost in the outrage over predatory pricing was one crucial fact: What Shkreli did was completely legal—and common. Between 2012 and 2017, for example, the price for Nitrostat, which prevents and treats chest pain, increased by 477 percent, from $15.91 to $91.76. Nothing about the medication changed during those years—not its chemical formula, not its uses and not the manufacturing process. Pfizer, which sells Nitrostat, offered no explanation for the spike. (Wapner, 4/24)

Drug manufacturers are pushing back against one of the administration’s major proposals to bring down drug prices: a proposal to shift chemotherapy drugs and others administered in the hospital into a different part of Medicare. The idea — which Health and Human Services Secretary Alex Azar first hinted at in his confirmation hearings and then proposed in the Trump administration’s fiscal year 2019 budget — would give insurance companies and pharmacy benefit managers new power to negotiate discounts on some of Medicare’s costliest drugs. That could mean big savings for the Medicare program itself, which might be passed on to consumers. (Mershon and Swetlitz, 4/24)

Mylan headquarters searched by law enforcement in 2016U.S. prosecutors are nearing their first charges against companies in an almost four-year-old criminal investigation into alleged price-fixing by generic-drug makers, according to people familiar with the matter. At least two companies are on track to be indicted in the coming months, in addition to several executives, said two people, who spoke on condition of anonymity because the investigation is confidential. Another company could agree to plead guilty before then, said one the people. (McLaughlin and Armstrong, 4/24)

Drug seller Aceto Corp. in Port Washington said Monday it has received a subpoena in the federal investigation of price fixing allegations in the generic drugs industry. Aceto said it “is one of many operating companies in the generic pharmaceutical industry to receive a subpoena from the Department of Justice relating to its yearslong investigation into the industry. The company is currently preparing its response to the subpoena,” it said in a securities filing. (Madore, 4/23)

They are little-known lawyers and professionals — with almost no experience in health care. And yet they are poised to play an outsized role in the federal effort to bring down high prescription drug prices. The five men and women are in line to take charge of the Federal Trade Commission — a role that will let them decide whether to investigate companies over potentially anti-competitive tactics, whether to block mergers or acquisitions, and whether to demand more information about secretive business practices. (Mershon, 4/23)

Biogen’s unexpectedly successful new rare-disease drug, Spinraza, delivered another surprise in the first quarter: flat sales. The drug, which treats spinal muscular atrophy, ran off to an impressive start last year, topping analyst estimates and beating even Biogen’s projections. But everything leveled off between the fourth quarter, when revenue hit $363 million, and the first three months of 2018, when Biogen booked $364 million in Spinraza sales. Analysts had expected first-quarter sales of about $383 million. (Garde, 4/24)

The largest U.S. manager of prescription benefits is telling drugmakers that the current pricing model is broken, and taking aim at Amgen Inc and other makers of new migraine medicines to try and fix it.Express Scripts told Reuters it is pressing them to forego the usual strategy of setting a high U.S. list price, then lowering the cost for health plans through hefty rebates. It is also seeking a refund if the drugs don't work within a defined timeframe. The shift could help Express Scripts and other pharmacy benefits managers (PBMs) bring prices down, and deflect growing criticism of their role as "middlemen" in the drug supply chain. (4/24)

In a blow to the pharmaceutical industry, the U.S. Supreme Court ruled that a controversial procedure for reviewing patent disputes does not violate the constitutional rights of patent holders. Known as inter partes reviews, these are heard before a U.S. Patent and Trademark Office appeals board, not a court, and anger drug makers because they are easier and faster to pursue than typical patent lawsuits. Drug companies have argued patents are private property that may be revoked only by a federal court and the review process violates a constitutional right to be heard by a court and jury. (Silverman, 4/24)

Japanese drugmaker Takeda has reached a tentative agreement to buy Ireland-based Shire Plc for 46 billion pounds ($64 billion) in one of the biggest pharma deals to date. Takeda has offered the equivalent of 49 pounds in cash and stock for each share of Shire, almost 25 percent more than Tuesday’s closing price. Shire said Wednesday that it is prepared to recommend the deal to shareholders, pending agreement on other terms. (4/25)

If successful, the move would cap a weekslong battle by Takeda to buy the European company and mark the largest-ever acquisition by a Japanese company of a Western rival. On Tuesday, Takeda proposed a sweetened deal to acquire Shire at £49 ($68.53) a share, its fifth attempt to buy the Dublin-based drugmaker. The new offer is marginally higher than the £47 it proposed Friday. Both companies said a revised proposal was on the table Tuesday, but didn’t disclose its financial value until Wednesday. (Rana, 4/25)

Biogen will pay Ionis Pharmaceuticals $1 billion to expand the companies' collaboration around brain drugs for another ten years. Their first collaboration, Spinraza, a treatment for a deadly rare disease called spinal muscular atrophy, generated $884 million sales last year, its first on the market. In a study of the infant form of the disease, 40% of children on the drug reached a major motor milestone, compared to none on a sham treatment. Spinraza costs $750,000 for the first year of treatment, and $350,000 thereafter. (Herper, 4/20)

Congress hasn’t done much to rein in the costs of prescription drugs, so states are taking matters into their own hands. While lawmakers have railed against pharmaceutical executives and accused them of jacking up prices, they haven’t passed major legislation on the issue. That lack of action has, in part, spurred state legislatures to consider a slew of bills aimed at decreasing the cost of drugs, increasing price transparency and cracking down on controversial industry practices. (Roubein, 4/20)

Massachusetts is, in theory, ahead of many states because doctors, hospitals and insurers are required to help patients find the price of services. But that requirement does not apply to pharmacies or prescriptions, and there's no move to amend the law. (Bebinger, 4/19)

With only two weeks left in the legislative session, a Democratic lawmaker and the state comptroller are feverishly working to bring to the House floor proposed legislation that is considered Connecticut’s most comprehensive effort so far to control high prescription drug costs. The bill aims to shine light on the murky supply chain and money flow in the prescription drug industry and to save residents money at the pharmacy counter by passing down to them some of the discounts that are negotiated with manufacturers. (Rigg, 4/25)

In the spirit of the pharmaceutical industry’s advertising campaign slogan, “Let’s Talk about Cost,” let’s do just that. More specifically, let’s talk about the skyrocketing costs of prescription drugs and what they mean for patients and our health care system. Two recent analyses within the span of as many weeks revealed the extent to which drug prices have soared. A recent Pharmacy Benefits Consultants review of average wholesale drug prices from January 2017 to March 2018 found “twenty prescription drugs saw their prices rise by more than 200%.” (Rick Pollack and Jo Ann Jenkins, 4/23)

M&A shouldn't be this easy. London-listed drugmaker Shire Plc has nudged Japan's Takeda Pharmaceutical Co. to up its takeover proposal twice to 44 billion pounds ($62.5 billion). Allergan Plc said on Thursday it was considering a bid only to say it wouldn’t after its shares suffered a bad reaction. This auction may have a bit further to go. Takeda must have thought it was dangling a knockout price for Shire. While the target rejected the 46.50 pounds-a-share proposal, it has at least opened talks. Not surprising given the price mooted is 51 percent higher than where Shire's shares stood before the would-be purchaser popped up. (Chris Hughes and Max Nisen, 4/19)

The president, as we have all come to know, appears to devote far more attention to the politics of public policy than to the underlying policy itself. Indeed, he has tossed aside the script of formal speeches because the wonkish details offered by his aides were “a little boring.” Although this is a disconcerting trait in the leader of the free world, it can be illustrative and even helpful in framing the conundrum that is drug pricing policy. (David Beier and John Osborn, 4/20)

Illinois consumers, businesses, taxpayers and government face sticker shock as prescription drug prices spiral out of control. And nothing seems to be able to stop prices from continuing to spike. Congress has so far proven unable to rein in prescription drug costs. Federal court rulings forbid the Illinois General Assembly to enact reforms aimed at rising brand-name prescription drugs. But a new proposal in the Illinois General Assembly could provide some predictability to drug prices. (Howard Peters, 4/19)

If you talk to many seniors today the most disturbing issue with them are the outrages high prices of prescription drugs. Many will tell you that they must choose between paying the rent, utilities, medical premiums and buying food because of the high cost that they must pay for prescription drugs. Many seniors cut their daily prescriptions usage in half so that it will last twice as long. This problem is not only a senior problem but a problem for many normal families in this country. The majority of incumbent politicians have looked the other way for many years because of the strong lobbying by the pharmaceutical companies. Our politicians rely on large campaign contributions from the pharmaceutical companies to help fund their re-election bids for there perspective office. (James Sharik, 4/23)

Jay Bradner is the president of Novartis’ Institutes for BioMedical Research, the organization entrusted with Novartis’ R&D budget of $9 billion -- one of the largest in the industry. Furthermore, Novartis is a leading innovator in the oncology field with targeted therapies as well as the recently launched CAR-T therapy Kymriah for a deadly childhood leukemia. Given his important, influential role in the future of oncology research, one can’t ignore the question he asked in a self-described “soapbox moment”: “Can we as a society be over-invested in working to cure cancer?” (John LaMattina, 4/24)

Biogen Inc. is in one of the strangest situations in the pharmaceutical industry. It's getting a small cut of the sales of another company's booming multiple sclerosis drug, but that drug is also competing directly with its own critical MS franchise. Biogen's first-quarter earnings report on Tuesday highlighted just how untenable this is and how much more aggressive management needs to be about pursuing new assets. (Max Nisen, 4/24)

Employers are fed up with the U.S. health care system. That was my major takeaway from the National Business Group on Health's conference, which I attended this week alongside the benefits leads from some of the largest U.S. companies, including Amazon, Honeywell and IBM. As you might expect, representatives from these companies talked about the innovative technology on the market and they talked up their new benefits and perks, like genetic tests and fertility treatments. (Christina Farr, 4/22)

On Monday morning, Donald Trump complained about Democratic delays in the confirmation of his executive branch and judicial nominees. On Monday night, it appeared that his nomination of Ronny Jackson for Secretary of Veteran's Affairs was potentially falling apart. You know what? Given the track record of Trump's nominees, Democratic foot-dragging on Trump's selections seems absolutely appropriate. (Jonathan Bernstein, 4/24)

As senators consider the nomination of the next secretary of veterans affairs, they should first reflect on the story of an Army veteran named Jason White. White served our country in Afghanistan, where he was severely injured by an IED explosion. His spine was crushed, and he suffered a traumatic brain injury, but thanks to the skill and training of our nation’s brave combat medics, he survived. Yet on his return to the home front, he battled the hidden wounds of war — insomnia, depression and the effects of post-traumatic stress disorder. He was not alone. Four members of his unit killed themselves after they got home. And after struggling with his mental and physical wounds for five years, White decided to do the same. One day in 2016, he came home, put a pistol to his head and pulled the trigger. (Marc A. Thiessen, 4/24)

Operations when death is all but assured are called suicide missions, and it’s beginning to look as if Rear Admiral Ronny Jackson was sent on a political version. The nominee to run Veterans Affairs has been under siege from the agency’s bureaucracy, anonymous press leaks, and on Tuesday even friendly fire from the President who nominated him.The Senate Committee on Veterans’ Affairs on Tuesday postponed Dr. Jackson’s Wednesday confirmation hearing amid allegations of misconduct during his nearly five-year tenure as physician to the President. The charges have been mostly vague and anonymous, such as running a hostile work environment, which could mean anything or nothing. (4/24)

It’s hard to argue that any one cabinet member or nominee tells the Donald Trump story better than another, but I’m tempted to say exactly that about Ronny Jackson, the president’s hasty, irresponsible and — the way things are looking now — doomed choice to lead the Veterans Affairs Department. (Frank Bruni, 4/24)

Whether the rumored personal flaws are true or not, Ronny Jackson shouldn’t be President Trump’s pick to run the Veterans Affairs Department. The agency, one of Washington’s biggest, demands a health care manager, not a personal favorite of the president. (4/24)

“Democrats are obstructing good (hopefully great) people wanting to give up a big portion of their life to work for our Government,” President Trump tweeted last week. “They are ‘slow walking’ all of my nominations — hundreds of people. At this rate it would take 9 years for all approvals!” Echoed by Trump surrogates and other Republicans, this was just the latest of Mr. Trump’s regular attempts to shift the blame for his understaffed government onto Senate Minority Leader Charles E. Schumer (D-N.Y.). And foot-dragging Democrats surely bear some responsibility. But as Mr. Trump’s latest nomination fiasco unfolds at the Department of Veterans Affairs, it becomes ever more obvious where most of the blame lies. (4/24)

President Trump just dumped White House physician Ronny L. Jackson, his ill-chosen nominee to become the Veterans Affairs secretary. ...Jackson, a Navy rear admiral, was a poor selection from the start, given his lack of experience at running anything that resembles the gargantuan agency that features more than 375,000 employees and a budget that exceeds $185 billion. Then came word late Monday that his confirmation hearing before the Senate Committee on Veterans’ Affairs was being delayed because of allegations the panel received regarding Jackson’s oversight of the White House medical staff, as well as his conduct while in that job. (Karen Tumulty, 4/24)

The nation’s opioid epidemic has no real cure, but law-enforcement officers and other first responders are saving lives when they carry the overdose antidote, naloxone. Earlier this month, leaders of the Seattle Police and the King County Sheriff’s Office announced they would equip their officers with the powerful medicine, designed to rapidly reverse opioid overdose. An injector or nose spray can give addicts a chance to survive an accidental overdose, get help, detox and, hopefully, find a way to start over in life. (4/24)

I’m an addiction specialist, and my voice-mail inbox is always nearly full. Some messages are from desperate individuals looking for outpatient treatment or help finding a detoxification program. Others are from patients needing a letter confirming their treatment for a child-custody dispute or care providers informing me that my patients have been hospitalized. It’s hard to know what to expect, but invariably one type of message awaits: voice mails from pharmacies informing me that a patient’s insurance provider will not approve payment for the medication to treat their opioid addiction unless I obtain prior authorization from the insurer. (Brian Barnett, 4/24)

Combatting opioid abuse is a battle that must be fought on a number of fronts, including the household medicine cabinet. Too many patients are hanging on to unused pills instead of disposing of them once they’re no longer needed. That increases the chance that the opioids will be abused, either by the patient or another party. A majority of opioids prescribed after surgery go unused, according to researchers at John Hopkins University. Yet 90 percent of patients fail to dispose of the leftover pills, instead choosing to stash them away, most often in unlocked drawers or cabinets. (4/24)

More than 45 years since the Roe v. Wade decision legalized abortion in the United States, Ohio is moving to implement yet another restriction on this safe and legal health care. Ohio is one of many states -- including Arkansas, Hawaii and Maine -- where ongoing lawsuits challenge restrictions that could disproportionately impact women in rural areas. (Reilly Wieland, 4/25)

Authorites don't know why Travis Reinking allegedly went to a Waffle House in Antioch, Tenn., and opened fire Sunday, killing four people and injuring others. What they do know is that the suspect never should have had access to the AR-15 style weapon reportedly used in the mass shooting. Last year, that assault rifle, along with three other firearms and ammunition, were seized by law enforcement officials. Weeks earlier, Reinking, who had a history of erratic behavior, was arrested for breaching a White House security barrier. Still, even after his firearm owner’s ID card was revoked, Reinking was allowed to decide who could keep his guns — he chose his father, who returned them to his son. The Waffle House tragedy highlights why strong “red flag” laws should be implemented nationwide. (4/25)

The deadliest animal is not the snake, dog, wolf, lion or hippo. It's not even the human, responsible for murdering some 437,000 of its kind a year. Rather, the deadliest animal is the tiny mosquito. (Nicholas Kristof and Jessia Ma, 4/24)

As Finland retracts its socialism, communists if not by name but in policy are out in the open in America. Sen. Bernie Sanders (I-Vt.) plans to announce a federal jobs proposal that would guarantee every adult American a job with at least a $15 per hour wage and health benefits. We’ve seen this play before after the Bolshevik revolution 101 years ago. Ask yourself the question, was Joe McCarthy right to the extent that they are here and they have continued to fester and grow in the underpinnings of our society? (David Webb, 4/24)

I provide therapy to people from all socio-economic and racial backgrounds. I am the only black female clinical psychologist on the faculty of the department of psychiatry at Northwestern University, and black women often come to me in secret, feeling alone and embarrassed. They come despite friends and family telling them to “just pray.” They come because they are “desperate” and “can’t take it anymore.” I often get requests for informal consultation via email, LinkedIn, even Facebook. They’re skeptical about mental health treatment. They don’t want therapy, just to talk, and maybe get some advice. (Inger E. Burnett-Zeigler, 4/24)

For decades, the marijuana industry operated underground, outside the confines of the law. But even though at the federal level possession and the use and sale of marijuana remain illegal, 29 states and the District of Columbia now allow medicinal marijuana to be sold for the treatment of specific diseases. Moreover, nine states now permit its recreational use. As a linguist, I’ve been interested in exploring how legalization has changed the way we talk about the drug — specifically, how new dispensaries are marketing their product. (Frank Nuessel, 4/24)

In a promotional video, the MD Anderson Cancer Center advertises clinical trials alongside immunotherapy and proton-beam therapy as one of its many ways of “fighting cancer.” Cancer Treatment Centers of America promotes clinical trials as part of its “commitment to bringing our patients new and innovative cancer treatment options.” You may have seen billboards or heard radio spots with similar messages. But what you are actually seeing and hearing in such advertising is a betrayal of ethics and science. (Jonathan Kimmelman and Alex John London, 4/25)

Expansion of KanCare, the Medicaid program that provides health insurance to low-income individuals, is about people and not politics. It is about making sure we do whatever we can to keep our families, friends and neighbors healthy in mind, body and spirit. (Robert Schremmer, 4/24)

Missouri families stuck with astronomical air ambulance bills need legislative help, because it’s pretty clear that insurers won’t be coming to the rescue. Insurers pay only part of the charges of medical evacuations to air ambulance companies that haven’t negotiated rates with them, leaving families with big bills from emergencies that left them no other options. (4/24)

To repair some of the damage caused by criminalization, the city should set aside the millions of dollars it expects to bring in over the coming years from marijuana taxes and invest that money in children and youth services, and in economic development in those neighborhoods most impacted by the decades-long war on drugs. It should create a public planning process on how to use those revenues to build economic health and well being in Stephon Clark’s neighborhood and in neighborhoods like it. (Malaki Seki Amen, 4/24)

Without access to treatment, people with a severe psychiatric illness, such as schizophrenia and bipolar disorder, fall prey to their psychosis and may engage in a range of illegal behaviors, from public urination to violent offenses. This leads to people being incarcerated simply because they need medical care. Such “criminalization of mental illnesses” happens across the nation. And it is shameful. Maryland knows these problems firsthand. Officials within the state’s Department of Health were held in contempt of court last year for failing to hospitalize inmates with mental illnesses for weeks after they had been ordered to do so. These wait times are akin to torture. (Evelyn Burton, 4/24)

This is a pivotal moment for Nevada when it comes to health care. A 2017 report, “Health Workforce Supply in Nevada,” evaluated the supply of physicians, nurses and other health care workers in the state. Alarmingly, they found that the health care workforce in Nevada is in bad shape. Ranked among U.S. states, Nevada comes in 48th for the number of physicians per capita, with just 245 physicians per 100,000 residents. And when it comes to primary care, the outlook is even worse: Nevada is ranked 50th, with just 88 primary care physicians per 100,000 residents. According to the report, “it is abundantly clear that Nevada’s health workforce supply falls well short of national averages for most of the key professions needed to ensure access to basic primary, preventive, and specialty services.” And the situation could become even more desperate as the state’s population grows and ages over the next few years. Enter physician assistants. (Julie Thomas, 4/21)