�Թϲ�����

The Trump administration, in an abrupt reversal, said Tuesday that it would restart a program that pays billions of dollars to insurers to stabilize health insurance markets under the Affordable Care Act. The administration suspended the program less than three weeks ago, saying it was compelled to do so by a federal court decision in New Mexico. But the administration said Tuesday that it would restore the program because otherwise health plans could become insolvent or withdraw from the market, causing chaos for consumers. (Pear, 7/24)

About $10 billion is at stake through a premium stabilization program. Insurers with healthier-than-average customers pay into the program, and the money goes to insurers with sicker patients. No taxpayer subsidies are involved. The administration had faced widespread criticism for its original move, with insurers warning of premium increases and exits from the market. Republican lawmakers were concerned about political fallout affecting the midterm elections. (Alonso-Zaldivar, 7/24)

The administration’s surprise suspension of the risk adjustment payments earlier this month set off a round of warnings of rising premiums and condemnation from Democrats who said it was further GOP “sabotage” of the health-care law. This final rule makes no changes to the program, and essentially just restarts it after a short pause. (Weixel, 7/24)

The new rule appears to clear the way for the planned flow this fall of risk-adjustment money tied to the 2017 plan year, a total that CMS had said amounted to $10.4 billion. “This rule will restore operation of the risk adjustment program, and mitigate some of the uncertainty caused by the New Mexico litigation,” said CMS Administrator Seema Verma.  “Issuers that had expressed concerns about having to withdraw from markets or becoming insolvent should be assured by our actions today.” (Wilde Mathews, 7/24)

The risk adjustment program, created to protect Obamacare insurers that attract sicker and more expensive customers, has been targeted in court by some companies that allege it penalizes smaller startup health plans. A federal judge in one case partially agreed, ruling in February that HHS erred in requiring that the risk adjustment program be budget neutral. (Cancryn, 7/24)

Among publicly-traded insurers, Centene Corp. and Molina Healthcare Inc. owe money to other insurers under the program, while Anthem Inc. is set to receive funds. CMS announced that the payments had been suspended on July 7. (Tracer, 7/24)

Two states so far have taken advantage of the federal government's decision to give them more leeway in defining the essential health benefits that individual and small group insurers must offer consumers. Those states—Alabama and Illinois—diverged significantly in how they responded to that flexibility. In April, the CMS finalized a rule that would allow states to determine the minimum essential health benefits that individual and small business health plans operating in the state are required to cover, beginning in 2020. (Livingston, 7/24)

Paul Mango, a former Pennsylvania gubernatorial candidate who is a fierce critic of ObamaCare, will join the Trump administration in a top health-care role. Mango will serve as chief principal deputy administrator and chief of staff at the Centers for Medicare and Medicaid Services (CMS), the agency that oversees health insurance markets. (Hellmann, 7/24)

The House voted Tuesday to repeal a 2.3% excise tax on medical devices, again showing bipartisan support for eliminating the levy. Congress created the tax in the 2010 Affordable Care Act to help pay for expanding health insurance, but medical-device companies and their home-state allies in both parties have been fighting against it ever since. (Rubin and Andrews, 7/24)

The vote comes during a week of health-care measures put forward by the GOP as they try to blunt Democratic attacks over rising premiums, a key midterm message. The vote could help Rep. Erik Paulsen (R-Minn.), the sponsor of the bill, who faces a tough reelection fight this year. “This bill reverses a harmful tax that is hurting job growth and innovation across the country,” Paulsen said. (Sullivan, 7/24)

One House bill, backed mostly by Republicans, would repeal a tax imposed on some medical devices to help pay for President Barack Obama's health care law, a statute they despise. With another, still a bare-bones outline, the GOP would make last year's $1.5 trillion tax cut permanent and expand reductions for families, homeschooling and businesses. (Fram, 7/25)

Senate Appropriations Chairman Richard C. Shelby, R-Ala., said Tuesday he now expects the chamber to wrap up a four-bill spending package in time for the Senate to take up a massive Defense and Labor-HHS-Education measure as soon as next week. The Senate is currently debating a $154.2 billion combination spending bill (HR 6147) that is expected to carry the text of not only the underlying Interior-Environment and Financial Services measures, but also the Agriculture and Transportation-HUD bills contained in substitute amendment Shelby has introduced. (Shutt, 7/24)

President Donald Trump is exaggerating the progress he's made on his campaign promise to provide veterans with quick medical treatment from private doctors if they're dissatisfied with Department of Veterans Affairs care. Speaking at a Veterans of Foreign Wars convention Tuesday, Trump prematurely described VA benefits that have yet to be implemented as immediately available and a "big success." (Yen, 7/25)

Mr. Trump is confusing an existing program for veterans’ health care with recently enacted reforms, and exaggerating the impact of the changes. The Veterans Choice Program was created in 2014 — not under Mr. Trump — after the scandal of hidden waiting lists at Department of Veterans Affairs hospitals. Under the program, veterans who do not live within 40 miles of a department hospital or face wait times of more than 30 days for care could seek private health care funded by the government. (Qiu, 7/24)

A dispute has broken out among lawmakers and the White House over how to pay for a newly expanded Department of Veterans Affairs health-care program, stalling negotiations over the first big chunk of the next fiscal year’s government funding. The fight centers on whether Congress should go around a two-year budget deal to pay for the overhaul of veterans’ health-care programs signed into law last month or cut money elsewhere to stay within budget limits lawmakers agreed to in February. (Peterson and Kesling, 7/24)

Some of the local growers along the coast here see it as an act of medical compassion: Donating part of their crop of high-potency medical marijuana to ailing veterans, who line up by the dozens each month in the echoing auditorium of the city’s old veterans’ hall to get a ticket they can exchange for a free bag. One Vietnam veteran in the line said he was using marijuana-infused oil to treat pancreatic cancer. Another said that smoking cannabis eased the pain from a recent hip replacement better than prescription pills did. Several said that a few puffs temper the anxiety and nightmares of post-traumatic stress disorder. (Philipps, 7/25)

The Trump administration said Tuesday it is on track to reunite the majority of separated migrant families ahead of a July 26 court deadline, but workers are still sorting through case files to determine whether hundreds of parents were deported without their children. Government attorneys told U.S. District Court Judge Dana M. Sabraw, who mandated the reunifications last month and has overseen the process, that the government has given 1,012 parents their children back so far, out of 2,551 who were separated. Hundreds more families are due to be reunited by the judge’s Thursday deadline, the attorneys said, which Sabraw praised as “a remarkable achievement.” (Miroff, 7/24)

Sabraw called the efforts a remarkable achievement and said Commander Jonathan White, who works in the Office of the Assistant Secretary for preparedness and response at the Department of Health and Human Services, should be commended. “He’s done Yeoman’s work in accomplishing that,” he said. Justice Department lawyer Sarah Fabian said the government has identified 914 parents who are ineligible for reunification, but she could not tell Sabraw how many parents have been removed from the country with their children versus without. (Wheeler, 7/24)

Two by two, they came through the double doors of the shuttered retirement home: mothers tightly clutching their children, fathers holding fast to small hands. They had been among the more than 2,500 parents stripped of their children and imprisoned after illegally crossing the U.S.-Mexico border. But now, after outrage and protests and a class-action lawsuit, the Trump administration was being forced to reunite the families ahead of a court-ordered deadline Thursday. (Miller, 7/24)

Equity Forward, an abortion-rights group, placed what it claimed was a “heavy six-figure” television buy via an affiliate that attacks Health and Human Services Secretary Alex Azar for comments made during an interview on July 10 with CNN’s Wolf Blitzer. The group, as part of its HHS Watch project, has increasingly highlighted the department’s role in the Trump administration’s “zero-tolerance” policy of separating children from families seeking asylum at the U.S. border. (Kessler, 7/25)

Some school districts are preparing for more immigrant students than usual this fall due to children who were separated from their parents at the border and others who came alone and are settling in their areas. Alberto Carvalho, superintendent of Miami-Dade County Public Schools in Florida, wrote Homeland Security Secretary Kirstjen Nielsen in June about not being told that 1,000 children were being housed at a shelter in his area. It isn’t clear if the children were separated from parents or came unaccompanied, or both. (Hobbs, 7/25)

Homeland Security Secretary Kirstjen Nielsen says it's the Trump administration's "intention" to meet a Thursday court-imposed deadline to reunite migrant families separated at the border. Nielsen told Fox News' Bret Baier in an interview on Tuesday evening that the Department of Homeland Security is "on track" to meet the deadline. (Birnbaum, 7/24)

A federal judge on Tuesday said the Trump administration's new criteria for Title X family planning funding may not prevent Planned Parenthood from securing a grant, signaling he may reject the group's second request to halt the formula changes. Currently, Planned Parenthood affiliates make up 84% of the Title X family planning providers, a statistic that U.S. District Judge Trevor McFadden said showed that many would receive funding even under HHS' new requirement that scores providers higher if they emphasize contraceptive alternatives such as natural family planning and don't mention abortion. (Dickson, 7/24)

How much alcohol can cause fetal alcohol spectrum disorder, a difficult to diagnose condition, sometimes called an "invisible disability"? Doctors don't know. While official guidelines say no amount of alcohol is safe to drink during pregnancy, women often receive mixed signals, even from their own physicians. (Nawaz, 7/24)

A new treatment for pain caused by endometriosis was approved Tuesday by U.S. regulators. The common condition involves abnormal tissue growth from the uterus that can cause severe pain and infertility. Drugmaker Abbvie said the Food and Drug Administration approved the drug, Orilissa, for pain during menstruation and intercourse and at other times. Abbvie says it's the first new pill for endometriosis in a decade. (Johnson, 7/24)

The number of Essure suits has skyrocketed over the last two years after U.S. regulators forced Bayer officials to beef up warnings about the device’s risks -- including bleeding, pain and organ damage -- and put sales restrictions on the product. Bayer announced July 20 that it would stop selling the implant in the U.S. at the end of the year because of declining sales. The company had already pulled the product from all other countries. (Feeley and Fisk, 7/25)

Internal IBM documents show that its Watson supercomputer often spit out erroneous cancer treatment advice and that company medical specialists and customers identified “multiple examples of unsafe and incorrect treatment recommendations” as IBM was promoting the product to hospitals and physicians around the world. The documents — slide decks presented last summer by IBM Watson Health’s deputy chief health officer — largely blame the problems on the training of Watson by IBM engineers and doctors at the renowned Memorial Sloan Kettering Cancer Center. The software was drilled with a small number of “synthetic” cancer cases, or hypothetical patients, rather than real patient data. Recommendations were based on the expertise of a few specialists for each cancer type, the documents say, instead of “guidelines or evidence.” (Ross and Swetlitz, 7/25)

Click Therapeutics, based in New York, announced Monday that Sanofi (SNY) Ventures would be providing $17 million in funding, in exchange for equity in the company and a seat on its board. In April, Pear Therapeutics and Sandoz, a division of Novartis (NVS), established a partnership to commercialize their prescription app for substance abuse, which received FDA clearance in September after going through the agency’s digital health pre-certification program. And Akili Interactive closed a $55 million Series C funding round that included Merck’s (MRK) corporate venture capital fund in May. (Sheridan, 7/25)

A representative of the addiction treatment industry on Tuesday urged a key House panel to consider policies to crack down on patient-brokering—a complicated, fraudulent practice stemming from the opioid epidemic that insurance companies have been navigating for the past few years. Patient-brokering has become prevalent enough that Marvin Ventrell, executive director of the National Association of Addiction Treatment Providers, told the House Energy and Commerce oversight subcommittee that his organization adopted ethics rules in late 2017 to ban any of its members from taking part. (Luthi, 7/24)

House Energy and Commerce Oversight Subcommittee members expressed interest at a hearing Tuesday in limiting dubious advertising for potential patients looking to get treatment for their substance abuse disorder. Competition for potential patients seeking addiction treatment has resulted in some questionable marketing and advertising practices that are largely unregulated at the federal level. (Raman, 7/24)

Demi Lovato, the Grammy-nominated pop singer known for her big voice and confessional nature, was rushed to a Los Angeles area hospital on Tuesday afternoon after experiencing what the authorities said was a drug overdose, according to news reports. Representatives for the Los Angeles Police and Fire Departments said that officers responded just before noon local time to a medical emergency in the Hollywood Hills. Paramedics transported a 25-year-old woman in stable condition to the hospital, a Fire Department spokesman said, though the authorities declined to identify the person. (Coscarelli, 7/24)

The pop singer has been open about her struggles with addiction, as well as her bipolar-disorder diagnosis, and has become an outspoken mental-health advocate. (Izadi, 7/24)

Aurora Health Care and Aurora Behavioral Health Services is expanding treatment options for patients with drug, alcohol and other substance abuse issues with the opening of the new Dewey Center, a 75,400-square-foot facility located on the campus of Aurora Psychiatric Hospital, 1220 Dewey Ave. Three years ago Aurora Behavioral Health Services started a $35 million initiative to improve access to behavioral health services for people in need. (Pilarski, 7/24)

Kaiser Health News: Purdue Pharma Edits Public Service Ad In Washington Post

In a new public service ad, drugmaker Purdue Pharma suggested that taking opioids such as its painkiller OxyContin even as prescribed can prove dangerous — then appeared to backtrack a few days later. “We are acutely aware of the public health risks opioid analgesics can create, even when taken as prescribed,” Purdue wrote in a full-page advocacy ad published July 19 in The Washington Post. (Schulte, 7/24)

Gene therapies — in which a corrective gene hitches a ride on a virus into a patient’s cells — are being tested as potential cures or treatments for sickle cell, Duchenne muscular dystrophy, and a range of other diseases. Some patients have already been treated with a gene therapy for an inherited form of blindness, the first to be approved in the U.S. Now, imagine the virus-gene rig slipping into a pregnant woman’s womb, where it would reach the fetus and start remedying a disease before the baby is even born. (Joseph, 7/25)

Dozens of bioethicists and medical experts are calling for a federal investigation of clinical trials that turned agitated people being treated by paramedics into unwitting research subjects. Minnesota paramedics used either the anesthetic ketamine or a different powerful drug to sedate patients, under research studies run by Hennepin Healthcare System in Minneapolis. Patients or caregivers were not asked for permission to participate, and they were informed only later that they had become part of a medical experiment. (Johnson, 7/25)

For lifelong heart health, start exercising early in life and keep exercising often — ideally, at least four times a week, according to a remarkable series of recent studies involving hundreds of people and their hearts. But even if you have neglected to exercise in recent years and are now middle-aged, it is not too late. The same research shows that you still can substantially remodel your heart and make it more youthful by starting to work out in midlife, provided you exercise often enough. (Reynolds, 7/25)

Ann Dieffenbach got her first shot of the new shingles vaccine, Shingrix, at her CVS pharmacy in Bethesda on Feb. 25. It’s a two-injection series, the second shot recommended two to six months after the first. But Dieffenbach, 63, hasn’t yet been able to get that second shot: There has been no vaccine available. She has called numerous stores, only to be told it’s on back order. In a few weeks, her six months will be up. “It’s been frustrating,” says Dieffenbach, a retired National Institutes of Health communications director. “I haven’t even been able to find a place that will put me on a waiting list.” (Cimons, 7/24)

Common painkillers have previously been linked to heart risks. Now scientists believe the medication could also triple the side effects of dementia, according to a new report. (Parker, 7/24)

Eating substantial amounts of fruits and vegetables may lower the risk for breast cancer, a new study has found, and some kinds may be more effective than others. Researchers used well-validated nutrition questionnaires to examine the association of diet with the risk of invasive breast cancer in 182,145 women. They followed them with periodic examinations for an average of 24 years, during which there were 10,911 cases of invasive breast cancer. The study is in the International Journal of Cancer. (Bakalar, 7/24)

The Ebola outbreak that began in the Democratic Republic of Congo in April was declared officially over on Tuesday in what appeared to be twin triumphs for a new vaccine and rapid response. Just 33 people died, even though the outbreak reached Mbandaka, a river port city of over one million people. At one point, experts had feared the virus might spread throughout Central Africa. (McNeil, 7/24)

So you've found a tick, and it's sucking your blood. After an initial wave of revulsion, you carefully remove it with a pair of tweezers. Now you're probably wondering: What's the chance I have Lyme disease? Nick Berndt found himself in that exact situation earlier this summer. Berndt, 26, of Lancaster, Pa., felt a tick attached to his scalp three days after disc golfing in a forest near his home. (Chisholm, 7/24)

Kaiser Health News: How To Save A Choking Senator: Heimlich Heirs, Red Cross Disagree On Technique

Sen. Claire McCaskill (D-Mo.) found herself in a dangerous situation last month when she started choking during a Democratic members’ luncheon. Sen. Joe Manchin (D-W.Va.) swooped in, grabbed her around the middle and squeezed her, performing the Heimlich maneuver to dislodge the food. Manchin’s act likely saved McCaskill’s life. But in Washington, where no topic seems immune to controversy, Manchin’s use of the well-known technique has resurfaced a decades-old debate about whether to slap or squeeze. (Heredia Rodriguez, 7/25)

Massachusetts is investigating e-cigarette maker Juul Labs Inc and two online retailers to determine whether they violated state law by failing to prevent minors from buying their products, the state's attorney general said on Tuesday. The probe by Massachusetts Attorney General Maura Healey comes as the fast-growing Silicon Valley e-cigarette start-up has faced increased scrutiny due the popularity of Juul's products with teenagers. (Raymond, 7/24)

New York gubernatorial candidate Cynthia Nixon on Tuesday endorsed a state-wide single-payer health-care system amid her challenge against Gov. Andrew Cuomo (D) from the left. ... As single-payer health care gains ground in the Democratic Party, Nixon is one of several governor candidates across the country who has endorsed the idea on a state level, including Gavin Newsom in California and Ben Jealous in Maryland. (Sullivan, 7/24)

Flanked by firefighters and their families, Governor Charlie Baker formally signed legislation at Broadway Fire Station Tuesday afternoon that will designate cancer as a work-related injury for firefighters across Massachusetts. The new law — championed by State Representative Daniel Cahill, a Lynn Democrat — will cover all medical treatments for firefighters diagnosed with cancer as well as their time missed because of the illness. (Mazurek, 7/24)

A hospital operator in Rhode Island used temporary workers to care for hundreds of patients Tuesday after nurses went on strike. About 2,400 nurses and other health care workers at Rhode Island Hospital and Hasbro Children's Hospital began what's expected to be a weeklong strike Monday. Local 5098 of the United Nurses and Allied Professionals called for the strike. (7/24)

New Jersey’s largest health-care system and its largest university on Tuesday announced the launch of a partnership that would create one of the biggest health-care systems in the U.S. The agreement, which has been in the final stages for at least a year, has RWJBarnabas Health investing $100 million initially, and more than $1 billion over 20 years, into the partnership with Rutgers, the State University of New Jersey. (West, 7/24)

He woke up hot and sweaty in his tent. But when he tried to crawl out for fresh air, he found a ring of flames around the sidewalk where he’d pitched the canvas. “I rolled out and come up fighting through the fire,” 58-year-old Bobby Holiday, a tall man with a Dodgers cap and a faraway gaze, recalled on a sweltering July afternoon. “Burned my heel. All the clothes I had all got burned up.” (Kuznia, 7/24)

It was here, as a new city supervisor in the early 2000s, that [Gavin] Newsom first confronted a problem that would follow him in elected office for the next 16 years: Worsening homelessness. San Francisco’s homeless population remained prevalent under Newsom’s watch as a two-term mayor from 2004 to 2010, despite his controversial efforts to eradicate its visibility and help place the most needy into housing. (Hart, 7/25)

Texas Children's network of primary-care doctors has opened two practices in Austin, part of the Houston hospital's expansion into the central part of the state. Texas Children's Pediatrics, the nation's largest such primary-care network, opened TCP Austin Pediatrics in west Austin (5625 Eiger Road) in June and TCP Pediatric Partners in north Austin (3410 Far West Blvd.) Monday, TCH announced this week. The new locations are TCP's first outside Houston. (Ackerman, 7/24)

Young children of color or who live in rural Appalachia are more at risk of starting behind — and staying behind, well into adulthood — than their more-affluent peers elsewhere in Ohio, a new report shows.Groundwork Ohio is scheduled to release the Ohio Early Childhood Race & Rural Equity Report 2018 on Wednesday. Shannon Jones, executive director of the nonpartisan child-advocacy organization, said it was the most-comprehensive early childhood report in the state’s history. (Candisky and Lane, 7/25)

A Wisconsin program that allows special needs students to attend private schools on taxpayer-funded vouchers cost local public schools almost $5.6 million in state funding over the last two years, including hundreds of districts where no residents participated in the program, according to a new state audit and related documents. And, while parents with children in the program voiced more favorable views of the private schools than their public-school counterparts, according to the audit, it also confirmed what many critics had feared: that it would serve primarily children already in private schools and leave children with the greatest needs to the public schools. (Johnson, 7/24)

Elliot Health System wants to spend $19 million to build a “one-stop” cancer center on its Manchester campus in an effort to attract patients who would otherwise seek treatment in Massachusetts.“Patients are looking for a comprehensive center that can answer their needs and they like to do it in one stop,” Dr. Greg Baxter, Elliot’s chief medical officer, said in an interview Tuesday. A portion of the existing cancer center on the Elliot campus will be torn down starting in the spring. A new 22,000-square-foot building will be attached to the existing radiation oncology section of Elliot Hospital. (Cousineau, 7/25)

The number of new HIV diagnoses in Cuyahoga County fell for the fifth consecutive year in 2017, even as the statewide infection rate continued to rise. New statistics from the Ohio Department of Health show an 18.6 percent drop in new cases in Cuyahoga County from 2016. (Christ, 7/24)

Cook County officials have asked for authorization to settle for nearly $6.5 million a lawsuit alleging that a woman’s artery was cut during a 2013 pacemaker surgery at Stroger Hospital, according to a Cook County internal memo. Attorneys with State’s Attorney Kim Foxx’s office this week requested authority from commissioners to settle the lawsuit, stemming from the death of Hermelinda Toro. (Pratt, 7/24)

An Austin woman who was experiencing a mental health crisis and hurt an officer after police were called for help could be turned over to U.S. Immigration and Customs Enforcement, according to law enforcement records. (Hall, 7/24)

With plans to turn conversation into meaningful action, over 100 officials from the Sacramento region convened last week in Del Paso Heights to begin talks about the impact of trauma in the community. Local experts discussed the effective, meaningful work that can be done to process trauma of various forms. (Holzer, 7/25)

A University of Georgia employee who appeared on a recent episode of a Netflix reality show is suing his employer, the University System of Georgia, the university’s healthcare providers and administrators over health care guidelines he believes are discriminatory to him and other transgender workers. Skyler Jay, identified in his legal complaint as Skyler Musgrove, said he was denied reimbursement for a May 2017 surgery to treat gender dysphoria, described by medical organizations as a conflict between a person's physical or assigned gender and the gender with which the person identifies. (Stirgus, 7/25)

The Midwest Direct Primary Care Alliance announced Monday that it donated about $11,000 to buy $1.47 million worth of medical debt on behalf of 784 patients in Kansas and Missouri. ...The alliance is a group of 21 medical clinics where the doctors don’t take health insurance and instead charge patients a monthly membership fee. (Marso, 7/25)

Frustrated by the lack of secure psychiatric beds in the metro area, the Hennepin County Board voted Tuesday to move forward on a plan to build its own mental health facility. The board unanimously approved $200,000 to study the feasibility of converting an abandoned building at the workhouse in Plymouth. The short-term facility would house residents or inmates who couldn’t find a secure bed at the Anoka-Metro Regional Treatment Center, are ready to leave the county jail or are temporarily at Hennepin Healthcare. (Chansen, 7/24)

When titans of the pharmaceutical industry met here last week at the opulent Mandarin Oriental Hotel, Trump administration officials issued a blunt warning to the chief executives on the soaring prices of their medicine. Eric D. Hargan, the deputy secretary of health and human services, told the board of the Pharmaceutical Research and Manufacturers of America that the Trump administration strongly favored free-market solutions. But, he said, a continuation of aggressive price increases could invite remedies they would find far more distasteful. (Pear, 7/23)

Over the past two weeks, several large drug makers have either halted or rolled back prices as political pressure mounts on the pharmaceutical industry. The moves suggest more than a little political posturing because the Trump administration is trying to follow through on implementing its so-called blueprint for lowering drug costs and, presumably, these companies hope to get something in return. (Silverman, 7/23)

Like a growing number of its peers, Roche Holding AG pledged this week not to raise drug prices for the rest of the year. Thing is, the Swiss company had already done the second of its customary two annual increases. Roche gave the U.S. government its no-price-rises promise on July 11, the company said in a statement Friday. The health system also needs to focus on “long-term, system-wide solutions that lower costs,” Roche said. “We’re committed to being part of the solution.” (Kresge, 7/20)

Kaiser Health News: Déjà Voodoo: Pharma’s Promises To Curb Drug Prices Have Been Heard Before

Prescription drug prices were soaring. Angry policymakers swore they’d take action. Pharma giant Merck responded by promising to address the problem voluntarily, vowing to keep price increases under the overall rate of inflation. “We believe these moderate increases are a responsible approach, which will help to contain costs,” the Merck CEO said at the annual shareholders meeting. That assurance wasn’t made last week, when multiple drug companies offered similar pledges amid similar criticism. It was nearly three decades ago, in 1990. (Hancock and Tribble, 7/25)

The Trump administration is taking credit for a series of announcements by drug companies to freeze drug prices for the remainder of 2018, arguing it is proof that the president’s tough talk is leading to results. Amid a pressure campaign led by President Trump himself, five drug companies have said they will not increase prices this year, while one announced decreases for some medicines. (Hellmann, 7/22)

HHS received over 3,000 comments on the Trump administration's Blueprint to Lower Drug Prices, which was released in May. Hospitals, health insurers and drugmakers had plenty to say on how to address soaring drug prices. Here are some edited excerpts from those comments. (Dickson, 7/21)

America's Health Insurance Plans (AHIP) is fighting back against recent claims that drug rebates have been the primary driver of the rising cost of prescriptions, releasing their own report Friday about the impact of the discounts. The report (PDF), prepared by the consulting firm Milliman, relied on publicly available data on Medicare Part D drug spending. The analysts tracked the growth of list prices and rebates among drugs covered by Medicare Part D, as well as the number of competitors for those drugs. (Richman, 7/23)

Analysts agree Trump’s prescription drug plans look ugly -- but they are divided on the real financial impact of the changes on the pharmaceutical supply chain. While Jefferies expects the rebates debate to be an overhang, they only see a “modestly negative” impact in the worst case scenario, with Medicare beneficiaries and the federal government shouldering the bulk of the costs if rebates were eliminated. (Flanagan, 7/20)

The White House has been quick to claim credit for numerous drug companies’ decisions to back off planned price hikes for the remainder of 2018. But such crowing from the Trump administration has not sat well with Democrats, who this week unveiled a pair of bills aimed at lowering prescription drug costs. (Facher, 7/24)

Executives at Eli Lilly, one of the nation’s largest pharmaceutical companies, are denouncing the Trump administration’s proposal to consider ways to import prescription drugs from other countries. During the company’s second quarter earnings call Tuesday, executives said the idea of importing drugs from abroad, even in narrow circumstances, is concerning. (Weixel, 7/24)

After months of anticipation, a federal appeals court ruled Friday that a Native American tribe cannot claim sovereign immunity in order to avoid a certain type of patent challenge. The decision is another blow to Allergan (AGN), which last fall famously transferred patent rights to one of its biggest-selling medicines to the St. Regis Mohawk Tribe in hopes of thwarting generic competition. In reaching its decision, the court upheld a ruling issued earlier this year by the U.S. Patent Trial and Appeal Board, which handles inter partes reviews, a type of patent challenge that has vexed drug makers since going into effect six years ago, because these are easier and faster to file than patent lawsuits. (Silverman, 7/20)

Seeking to widen access to a pricey HIV prevention pill, a group of prominent AIDS activists is urging the federal government to create a national public health program that could lower costs by sidestepping patents held by Gilead Sciences (GILD), the manufacturer. At issue is the cost of Truvada, which is also known as PrEP and was approved six years ago as the first pill to prevent HIV. Despite clinical trials demonstrating a high degree of safety and efficacy, however, the uptake in the U.S. has been slow, falling far short of the potential to have a significant impact. (Silverman, 7/24)

In Washington, congressional aides waiting for the bus to take them to Capitol Hill stand by signs that picture a unicorn and ask: “What's rarer than a unicorn? A lifesaving program that costs taxpayers nothing. Congress please: Let340B.org.” A visit to the Let340B.org website, paid for by the AIDS Health Foundation in California, finds patient stories and the office phone numbers of lawmakers on the Senate Health, Education, Labor and Pensions Committee, where serious talks over whether the program needs an overhaul started a few months ago. (Luthi, 7/21)

With political pressure rising and the midterm elections approaching, a top drug industry trade group has set another record for lobbying spending in Washington. The Pharmaceutical Research and Manufacturers of America spent $15.5 million lobbying the federal government in the first half of this year. That’s the most PhRMA has spent in a comparable six-month period since at least 2001, the earliest year online records are available, according to lobbying disclosure filings updated on Friday. (Robbins, 7/20)

"What, exactly, is this meeting for?” It might seem an odd, even brusque question, especially when asked to the CEO of a major pharmaceutical company by a recently hired employee. But it’s how Hal Barron, the new chief scientific officer of GlaxoSmithKline, likes to kick off meetings, even when he is meeting his boss, Glaxo chief executive Emma Walmsley. (Herper, 7/24)

Drugmaker Pfizer Inc. plans to expand manufacturing in Michigan and add 450 jobs under an incentives deal approved Tuesday by the state’s economic development arm. The company is expected to spend $465 million building a new facility in Portage near Kalamazoo, with production starting in 2024. The Michigan Strategic Fund Board approved an $11.5 million package, including $10.5 million in tax incentives and a $1 million grant for the creation of 450 qualified new jobs. (Eggert, 7/24)

Many Medicare patients could find that Walmart's $4 generic prescription drug program is cheaper than their own health insurance plan, according to a Yale School of Medicine study published on Tuesday (July 24). The authors of the study analyzed Medicare prescription drug plan data from June 2017 to determine out-of-pocket costs for the lowest priced dose of every drug on 622 different Medicare drug plans and 1,533 different health insurance plans known as Medicare Advantage. (Clark, 7/24)

Hundreds of drugs have been dropped from insurers’ lists of covered medications in favor of cheaper alternatives, such as a new generic or a competing brand offered at a steep discount. Pricey drugs that remain on insurers’ formularies often can be had only after patients try cheaper ones and can prove they aren’t working as well, a process called step therapy. (Gantz, 7/18)

Franklin County Common Pleas Judge Jenifer French asked for the delay to allow CVS Caremark time to identify information in the 51-page report that it considers proprietary and believes should be redacted before the report is released to the public and lawmakers. ...Instead, she ordered Medicaid and CVS officials back to court on July 25 after they’ve had a chance to discuss the concerns. (Candisky and Sullivan, 7/17)

Biotechnology firms have a clear favorite in the race to represent industry hub Kendall Square and surrounding communities in Congress: They like the incumbent, U.S. Rep. Michael Capuano. Defending his seat against a fellow Democrat, At-Large Boston City Councilor Ayanna Pressley, Capuano has received donations from the Massachusetts Biotechnology Council's political action committee, and PACs affiliated with more than a dozen life sciences companies: AbbVie, Amgen, AstraZeneca, Biogen, Eli Lilly, EMD Serono, Emergent BioSolutions, Genentech, Merck, Novartis, Novocure, Sanofi, Shire, Thermo Fisher and Vertex. (Borchers, 7/17)

Drug companies are falling over themselves with plans to halt or defer price increases to get on Donald Trump’s good side. They seem to believe his approval comes cheap. Pfizer Inc. started things off earlier this month by agreeing to roll back mid-year price hikes and delay them — for a few months. Similar efforts announced this week by Novartis AG and Merck & Co. arguably won’t be any more consequential. But Roche Holding AG takes the cake by promising to not raise prices for the rest of 2018, shortly after it hiked prices for the second time this year on its biggest drugs. (Max Nisen, 7/20)

At first glance, last week’s decision by Pfizer to postpone price hikes seemed like a victory in the fight to reduce the crushing costs of medications. President Donald Trump certainly saw it that way, declaring it was “great news for the American people!”Indeed, Pfizer’s plans and Trump’s talk of curbing drug prices are far more placebo than meaningful treatment — and patients will continue to feel the pain in their wallets. (7/21)

In May, our editorial board called on Gov. John Kasich and his administration to review its reliance on costly Medicaid prescription drug contracts with managed-care plans that in turn hire middle men to contract with drug stores. Those middle men, known as pharmacy benefit managers, then take another cut for themselves. The Columbus Dispatch has reported that West Virginia saved $38 million in the first year it canceled similar contracts and switched to a fee-for-service approach. Ohio's setup also creates transparency problems by masking additional profits PBMs might create for themselves, for instance, by pocketing discounts drug makers might pay for having their drugs listed as preferred, or by squeezing pharmacists on reimbursements. Currently, the PBMs don't reveal to Ohio taxpayers how much extra profit they make off the system. Excess profits would drive up what taxpayers have to pay to subsidize the whole arrangement. (7/25)

Donald Trump’s drug-price push is steering right into health megadeals. The Trump administration’s budget office was sent a proposal by the Health and Human Services Department late Wednesday that seems to target pharmacy benefit managers — the middlemen in the pricing process — as part of efforts to change the way drugs are paid for. In doing so, the measure stands to alter the math of two huge pending tie-ups in the industry: the $67.5 billion acquisition of insurer Aetna Inc. by PBM giant CVS Health Inc., and the $54 billion takeover of PBM Express Scripts Holding Co. by insurer Cigna Corp. (Max Nisen, 7/19)

A poster on the side of a bus stop in downtown Washington D.C. read: “Let 340B,” clearly a sign of an organized campaign asking Congress not to interfere with the gravy train for some hospital systems that this obscure provision has become. The safety net drug program, usually referred to as 340B for the section authorizing it in the Public Health Service Act, was created by Congress in 1992 to require pharmaceutical companies participating in Medicaid to provide their drugs at deeply discounted prices to hospitals and other facilities that serve a disproportionate number of indigent and uninsured patients. (Grace-Marie Turner, 7/19)

In a First Opinion piece on how blockchain technologies could affect health care and the life sciences, its landscape map included 48 projects covering areas like decentralized health records and data marketplaces. Just six months later, the map has tripled in size, covering nearly 150 projects that have raised more than $660 million in private and blockchain-funded (crypto) markets. (Andy Coravos and Noah Zimmerman, 7/25)

In February 2013, I received the greatest gift of my life, the birth of my son. Over the next three years, I watched him grow into a clever, energetic and humorous little boy. He embodies the best qualities of his mother and his father, in all the ways a parent dreams. And even though I have primary progressive multiple sclerosis, the condition didn’t hinder my ability to be a father to him. His mother and I provided a loving and supportive environment. (Jason DaSilva, 7/24)

Senate Bill 541, introduced last year by Sen. Mike Shirkey, R-Clarklake, would create another avenue for care by adding a mid-level dental professional, much like a physician’s assistant. The bill is currently under review in the House. If it passes, it would create a new licensed professional called a dental therapist who would be able to perform small procedures such as filling cavities. The bill contains a requirement that would mandate dental therapists in private dental offices  ensure half their patients are Medicaid recipients. Public health care providers are on board with this provision. The Mackinac Center for Public Policy suggests that the implementation of dental therapists would ensure Medicaid recipients receive the care they need while reducing Medicaid costs. Many Medicaid patients do not have access to dental care and small issues can grow into dangerous abscesses and infections that lead to expensive emergency room visits, which Medicaid still has to pay. (7/24)

It's a new era for New Jersey under Gov. Phil Murphy with a state budget that invests in communities and fairness for working families, but that's just part of the story. The governor's stronger and fairer New Jersey is also a healthier New Jersey. The new state budget signed by the governor includes several steps to finally update and modernize New Jersey's Medicaid program. This means better health care options for the 1.7 million New Jerseyans enrolled in this vital program. (Carole Johnson, 7/24)

Conservatives should ask themselves: Just how much tax money are they willing to spend to deny people health care?T his question is becoming more urgent as the Trump administration encourages states to follow Gov. Matt Bevin’s lead by enacting work requirements and other bureaucratic barriers to health care for low-income people. The cost of Bevin’s Medicaid red-tape machine recently caught the eye of Fitch Ratings. The credit rating agency reports that Kentucky’s Medicaid administrative costs are rising 40 percent or $35 million from the previous biennium, mostly attributable to the cost of Bevin’s proposal for new “engagement” requirements, frequent income reporting deadlines, collecting small premiums and co-pays, and temporarily locking out from coverage those who fail to comply. (7/24)

An estimated 87,000 Missourians who could and should have health care coverage today don’t, because of Republican lawmakers’ years-long, hyper-partisan campaign in Jefferson City to ensure that the Affordable Care Act fails. Now, petition-wielding activists in a few other states are charting a path that Missourians of conscience could follow: using ballot measures to get around obstructionist politicians who have until now stymied the expanded coverage that most Americans want. (7/24)

Judging by the daily headlines and late-night television conversations, there’s not much that Republicans and Democrats agree on. But as governors from two different sides of the political spectrum and the country, we know there are many issues that affect us all. One is Alzheimer’s disease. Alzheimer’s disease doesn’t care if you’re a Republican or a Democrat, if you’re from Massachusetts or Montana. The truth is that even if you are someone who does not develop Alzheimer’s, almost everyone could someday find themselves caring for a loved one with the disease. Alzheimer’s is the most expensive disease in America, and the only leading cause of death in the U.S. that cannot be prevented, cured, or even slowed. (Governors Steve Bullock (D-Montana) and Charlie Baker (R-Mass.), 7/24)

Pot shops will soon be officially open for business in Massachusetts. While this may be good news for the marijuana industry and its lobbyists, state officials need to proceed with caution — especially when regulating high-potency pot products such as gummies, lollipops, and other treats aimed at children. The fact is that we really don’t know what’s in these products, nor do we know about their long-term effects. More awareness is desperately needed about the dangers of today’s highly potent marijuana. Public health — not the pot industry — should be leading this conversation. (Kevin Sabet, 7/24)  

The opioid crisis is devastating families and communities across the country. To tackle this emergency and reduce the number of overdose deaths, Congress is considering an extensive package of bipartisan legislation to address various specific aspects of the crisis. As they search for solutions, lawmakers would do well to examine the innovative strategies several states have adopted to expand access to medication-assisted treatment (MAT), which combines Food and Drug Administration-approved medications with behavioral therapies such as counseling. Experts agree MAT is the most effective way to manage opioid use disorder, but the strategies for delivering this evidence-based treatment vary—as evidenced by successful approaches taken by states as demographically diverse as Rhode Island, Virginia, Indiana, and Wisconsin. (Allan Coukell, 7/24)

In the 1990s, the United States was among the first countries to start granting sanctuary to LGBTQ refugees and asylum seekers fleeing persecution stemming from their sexual orientation or gender identity in their home countries. Now the Trump administration, intent on turning back the clock on almost every major facet of immigration policy, is increasingly complicit in their mistreatment. As administration officials have intensified their efforts to hollow out the asylum system — narrowing eligibility criteria, creating bottlenecks for would-be asylum seekers at legal ports of entry and tearing apart families as a means of deterring future applicants — LGBTQ individuals have suffered inordinately. (7/24)

The Federal Emergency Management Agency admitted this month that it failed to prepare properly to mobilize the robust response that Puerto Rico needed. Today, about 1,000 Puerto Rican families taking part in FEMA’s transitional housing program are still living on the brink of homelessness as a result of the storm, and that doesn’t include evacuees who have likely gotten lost in the system as we saw after Hurricane Katrina. (Ana Marie Argilagos, Aaron Dorfman and Nelson I. Colón, 7/24)

In a First Opinion piece on how blockchain technologies could affect health care and the life sciences, its landscape map included 48 projects covering areas like decentralized health records and data marketplaces. Just six months later, the map has tripled in size, covering nearly 150 projects that have raised more than $660 million in private and blockchain-funded (crypto) markets. (Andy Coravos and Noah Zimmerman, 7/25)

In the midst of St. Louis County’s opioid epidemic, we find ourselves in a criminal justice crisis. Drug addiction is a disease, not a crime. Prosecutors must stop packing our jails and prisons with those who need treatment, not punishment. The effect of this overcriminalization is undeniable: Nine out of every 10 people in Missouri’s correction centers need addiction treatment. In fact, 35 percent of the new admissions to state prison in 2017 were explicitly sent to receive help with their addictions. (Jeffrey A. Mittman, 7/24)

An Arizona law that allows an unrelated third party to get between a patient and a doctor’s orders should be repealed. The so-called “conscience clause” is an invitation to interference by pharmacists into medical decisions they know nothing about – and should not be questioning. (7/24)

Councilwoman Jolie Justus has introduced an ordinance that would prevent landlords from evicting tenants or their dependents who are victims of domestic abuse or stalking. ...This provision is obviously essential for stalking victims. (7/24)