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The Supreme Court cleared the way on Tuesday for relatives of Sandy Hook Elementary School shooting victims to sue the Remington Arms Company, the maker of the rifle used in the massacre. The court said that it would not hear an appeal by Remington of a ruling by Connecticut’s Supreme Court that allowed a lawsuit brought by the families of the victims to go forward. The case has been seen as a test of the ability of plaintiffs to pierce the legal immunity of firearm manufacturers in the aftermath of shootings. (Hussey and Williamson, 11/12)

The closely watched lawsuit has survived many legal twists and turns, moving from state to federal court and back, and repeatedly escaping bids by Remington and gun owners' groups to quash it. While the suit initially centered on a claim of negligent entrustment — or providing a gun to someone who plans to commit a crime with it — the case now hinges on how Remington marketed the gun. (Chappell, 11/12)

The family members of nine people slain and one survivor of the Sandy Hook massacre filed the lawsuit in 2014. Remington was backed in the case by a number of gun rights groups and lobbying organizations including the powerful National Rifle Association, which is closely aligned with Republicans including President Donald Trump. The NRA called the lawsuit “company-killing.” (Chung, 11/12)

The lawsuit says the Madison, North Carolina-based company should never have sold a weapon as dangerous as the Bushmaster AR-15-style rifle to the public. Gunman Adam Lanza used it to kill 20 first graders and six educators. It also alleges Remington targeted younger, at-risk males in marketing and product placement in violent video games. Lanza was 20 years old. Lanza earlier shot his mother to death at their Newtown home and killed himself as police arrived at the school. The rifle was legally owned by his mother. (11/12)

Lawyers for the victims sued Remington contending that the company marketed rifles by extolling the militaristic qualities of the rifle and reinforcing the image of a combat weapon -- in violation of a Connecticut law that prevents deceptive marketing practices. The rifle was "designed as a military weapon" and "engineered to deliver maximum carnage" with extreme efficiency, they argue in legal briefs. (De Vogue, 11/12)

The gunmaker argued that the state court's interpretation of the marketing exemption is, "intolerable given Congress's 'intention to create national uniformity'" with the federal law, the Protection of Lawful Commerce in Arms Act. "As the dissenters below noted, lawsuits like this one are precisely the kind the PLCAA was enacted to prevent." (Olson, 11/12)

The Connecticut Supreme Court ruled in a divided opinion earlier this year that the family members could pursue their lawsuit, rejecting Remington’s argument. The court wrote that the family members are “entitled to have the opportunity to prove their wrongful marketing allegations.” (Higgins, 11/12)

“Gun manufacturers throughout the country should be on notice that they’ll need to answer for their reckless business practices in the courts,” Eric Tirschwell, managing director of litigation for Everytown Law, said in a statement. “This reaffirms that the gun industry is not above the law and that the families of the Sandy Hook victims will have their day in court,” he said. (Marimow, 11/12)

"The families are grateful that the Supreme Court upheld precedent and denied Remington’s latest attempt to avoid accountability," the attorney representing the families, Josh Koskoff, said in a statement. "We are ready to resume discovery and proceed toward trial in order to shed light on Remington’s profit-driven strategy to expand the AR-15 market and court high-risk users at the expense of Americans' safety." (Dwyer and Svokos, 11/12)

Sen. Richard Blumenthal, D-Conn., the state's former attorney general, tweeted: "Newtown families will now have their day in court – access to basic justice – against companies that wrongly sold & promoted assault weapons." (Wolf, 11/12)

A federal judge in Seattle, Washington has ruled illegal the Trump administration's decision last year to allow a Texas company to post blueprints online for 3D-printed guns. Judge Robert Lasnik of the U.S. District Court in Seattle said in his ruling that the administration violated federal law with its July 2018 decision for failing to notify Congress in advance, and failing to provide a "reasoned explanation" of the change in previous policy. (11/13)

The CMS on Tuesday proposed a new rule that would increase transparency for Medicaid state supplemental payments and financing arrangements to help hold states more accountable for Medicaid spending. The Medicaid Fiscal Accountability Rule would help the CMS cut down back on unauthorized Medicaid spending to ensure the sustainability of the Medicaid program, CMS Administrator Seema Verma said Tuesday at a National Association of Medicaid Directors conference. (Brady, 11/12)

To ensure that the program remains sustainable for future beneficiaries, the federal government must make certain that program dollars are actually spent on patient care, said Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma during a plenary speech at the National Association of Medicaid Directors (NAMD) Fall Conference. Importantly, the agency currently doesn't have access to "timely and adequate" state Medicaid payment data to allow proper oversight of the program, a CMS fact sheet noted. (Firth, 11/12)

Kaiser Health News: Verma Attacks Critics Of Medicaid Work Requirement, Pushes For Tighter Eligibility

Seema Verma, the Trump administration’s top Medicaid official, Tuesday sharply attacked critics of her plan to force some Medicaid enrollees to work, a policy that led to thousands of people losing coverage in Arkansas. “We cannot allow those who prefer the status quo to weaponize the legal system against state innovation,” the administrator of the Centers for Medicare & Medicaid Services said in a fiery speech to the nation’s 56 state and territorial Medicaid directors in Washington, D.C. (Galewitz, 11/12)

The Trump administration will soon release guidance allowing states to block grant or otherwise cap Medicaid spending, CMS Administrator Seema Verma said this morning in her most detailed comments yet on a forthcoming plan to overhaul the entitlement. The administration will outline a demonstration program that will "provide significant and unprecedented flexibilities for program operation" and "inject vigorous accountability for outcomes," Verma said during the National Association of Medicaid Directors' conference in Washington. (Pradhan, 11/12)

A top administration health official on Tuesday defended her office’s spending of hundreds of thousands of dollars on outside GOP communications consultants with close ties to President Trump. Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma said the use of contractors was appropriate, because the agency did not have the necessary communications staff in place to enact her “vision” for the department. (Weixel, 11/12)

Kaiser Health News: Medicaid Tweak Might Offer Means To Improve U.S. Maternal Health

When Madavia Johnson gave birth to Donald Ray Dowless III last year, she was hit by a case of severe postpartum anxiety. She was scared to carry her son downstairs or drive him in a car. She couldn’t manage to continue law school ― and could hardly leave the house ― because she didn’t trust anyone to watch him. Her weight dropped from 140 to 115 pounds. “It was very stressful for me mentally,” said Johnson, now 29, who lives in Clayton, N.C. And she found it hard to secure medical assistance because her Medicaid coverage ran out just two months after her son’s birth. Public health advocates are pushing to change that. (Bluth, 11/13)

Google’s project with the country’s second-largest health system to collect detailed health information on 50 million American patients sparked a federal inquiry and criticism from patients and lawmakers. The data on patients of St. Louis-based Ascension were until recently scattered across 40 data centers in more than a dozen states. Google and the Catholic nonprofit are moving that data into Google’s cloud-computing system—with potentially big changes on tap for doctors and patients. At issue for regulators and lawmakers who expressed concern is whether Google and Ascension are adequately protecting patient data in the initiative, which is code-named “Project Nightingale” and is aimed at crunching data to produce better health care, among other goals. (Copeland and Needleman, 11/12)

Several U.S. lawmakers called for sharper regulatory scrutiny of patient health-data deals, including one between Google and the nonprofit health system Ascension, on concerns such arrangements run afoul of federal privacy rules regarding medical records. ... Sens. Mark Warner (D., Va.), Amy Klobuchar (D., Minn.), Bill Cassidy (R., La.) and Richard Blumenthal (D., Conn.) are among legislators who separately issued statements raising serious concern over the arrangement. Mr. Warner urged Congress or the Department of Health and Human Services to halt it pending an investigation. (Needleman and Copeland, 11/12)

Google’s work to help Ascension, the nation’s largest nonprofit health system, collect and analyze data on millions of patients is coming under intense scrutiny from lawmakers and privacy advocates. The project received little attention until a Wall Street Journal report on Monday that noted the initiative may already have health data on millions of Americans and that patients had not been notified. (Rodrigo, 11/13)

Google’s top health and cloud executives said the company isn’t misusing health data from one of the biggest U.S. health-care providers, pushing back against news reports that have triggered criticism from politicians of the search giant. Google employees only have access to patient information in order to build a new internal search tool for the Ascension hospital network, said David Feinberg, head of Google Health. No patient data is being used for Google’s artificial intelligence research, he added. (De Vynck, 11/12)

A massive, secret data-sharing agreement that Google and health system Ascension entered into last year without explicit consent from patients and clinicians is arousing alarm from privacy advocates. The fact that it may all be perfectly legal suggests that current privacy laws don't guard against data sharing practices that most people find just plain creepy. (Ravindranath, 11/12)

Google announced a partnership with a large U.S. health care system aimed at modernizing its information system and providing new tools for doctors, in the tech giant’s latest foray into the health industry. Announcement of its arrangement with the Catholic health care system Ascension followed a Wall Street Journal report on Monday that Google had access to thousands of patient health records without doctors’ knowledge. (Lerman, 11/12)

Digital health companies like Omada are now booming businesses. Although their models vary, they all monitor and educate people with chronic medical conditions such as diabetes, hypertension, obesity, and depression — and make money by charging their employers or health plans, with the promise of ultimately lowering medical costs. In just the past few months, leading companies in the sector have gone public, been acquired by Google (GOOGL), and raised tens of millions of dollars of venture capital funding. (Robbins, 11/13)

As lawmakers across the country began debating and then passing a flurry of anti-abortion measures this past spring, Planned Parenthood took note of a spike in searches on both its website and online for the phrase “abortion near me.” There was rampant confusion, the organization said, with women unsure whether the procedure remained legal in their state. On Tuesday, the organization unveiled an online tool it said would offer clarity to those seeking an abortion. Called the Abortion Care Finder, it shows the nearest available Planned Parenthood abortion providers who are legally able to perform the procedure based on the user’s age, ZIP code and last menstrual cycle. (Wilson, 11/12)

The new app is available on both mobile and desktop, and will personalize info based on users' age, ZIP code and how far along in pregnancy they are. It includes data on gestational limits, parental notification and consent laws, mandatory waiting periods and other relevant rules like those requiring women to make two trips to a health care center. (Reichert and Brown, 11/12)

Though lawmakers in states like Georgia and Alabama are trying to severely limit access to abortions, they’re still legal across the United States — and women in need of one have options. Along with a surgical abortion, which occurs in a clinic or doctor’s office, women can also opt for a medical abortion, often referred to as the “abortion pill.” It’s actually the more popular of the two options, but the name is a bit of a misnomer — the procedure consists of two pills, not just one. (Mazziotta, 11/12)

A Michigan Republican legislative leader is drawing criticism from Democrats for likening abortion to slavery. Senate Majority Leader Mike Shirkey told Hillsdale College's radio station last week that allowing abortion to occur "at all" is the "scourge of our country now today." "In my mind it's comparable, and people are going to be very upset when I say this, it is comparable to the scourge that we endured when we still had slavery in this country," the business owner from Clarklake said after being asked about Democratic Gov. Gretchen Whitmer's support for newly introduced legislation that would undo abortion restrictions. (11/12)

Senate Democrats on Tuesday managed to delay a key vote on a bill requiring parental consent for minors seeking an abortion, a measure abortion rights activists believe is a “Trojan horse” to overturn Florida’s broad protections for abortion rights. Republican state Sen. Dennis Baxley, a supporter of the bill, bemoaned what he called deliberate tactics by Democrats to stall the measure. (Rohrer, 11/12)

The unexpected death of Kaiser Permanente Chief Executive Bernard Tyson leaves the hospital and health-insurance giant in flux at a time of ambitious growth and it was met with shock by those who praised his work on public health and social issues. Kaiser, based in Oakland, Calif., gained heft as one of the nation’s largest hospital and health insurance systems with $83 billion in annual revenue under Mr. Tyson. He bet heavily on technology to reach more patients and set plans to expand Kaiser’s reach nationally. (Evans, 11/12)

Two Midwestern hospital giants became the latest to break off merger talks, another drag on deal making across the $1 trillion hospital sector. Sanford Health, based in Sioux Falls, S.D., and UnityPoint Health, based in Des Moines, Iowa, separately said Tuesday they had ended merger talks. Sanford CEO Kelby Krabbenhoft faulted UnityPoint for rejecting an agreement to create a major U.S. hospital system. The combination would have created a 76-hospital giant with operations across 26 states and $11 billion in operating revenue, executives said in June. (Evans, 11/12)

Sanford Health and UnityPoint Health nixed their proposed merger that would have formed an $11 billion, 76-hospital system, the organizations said late Tuesday. The not-for-profit health systems announced their letter of intent to merge in June. The combined entity would have ranked among the top 15 not-for-profit health systems by revenue, with operations across 26 states and more than 83,000 employees. (Kacik, 11/12)

UnityPoint Health, one of Iowa's main hospital and clinic systems, and South Dakota-based Sanford Health have halted plans to merge, officials with both organizations said Tuesday. The merger would have created one of the largest nonprofit health care systems in the country, with more than $11 billion in operating revenue, 83,000 staff and 2,600 physicians in 26 states and nine countries. (Rodriguez, 11/12)

The chief executive of UnitedHealth Group’s Optum division for health care services is now president of the parent company as well. Andrew Witty will oversee enterprise business strategy formulation and development among other duties while continuing as CEO at Optum, according to an announcement this week from Minnetonka-based UnitedHealth Group. (Snowbeck, 11/12)

UnitedHealth Group has tapped the CEO of its Optum business, Andrew Witty, to serve as president of UnitedHealth Group. Witty will also continue to serve as Optum's chief, the Minnetonka, Minn.-based health insurance giant said Monday. He will oversee enterprise business strategy, development and partnerships, as well as enterprise research and development and clinical capacities, the company said. (Livingston, 11/11)

KKR & Co. has formally approached drugstore giant Walgreens Boots Alliance Inc. about a deal to take the company private, in what could be the biggest-ever leveraged buyout, people familiar with the matter said. The New York private equity firm has been preparing a proposal to potentially buy out shareholders of Walgreens Boots, said the people, who asked not to be identified because discussions are private. (Hammond, Kirchfeld and Nair, 11/11)

A 17-year-old boy whose lungs were irreversibly damaged by vaping received a double-lung transplant at the Henry Ford Hospital in Detroit, a lifesaving measure taken when a patient’s own lungs are diseased or damaged beyond repair and there is no other hope of survival, doctors said on Tuesday. Without the transplant, performed last month, the patient “would have faced certain death,” Dr. Hassan Nemeh, who led the surgical team, said during a news conference at the hospital. (Grady, 11/12)

The medical team from Detroit’s Henry Ford Hospital said the patient, a 17-year-old male, underwent the roughly six-hour transplant surgery Oct. 15. He spent a month on a life-support machine after suffering “complete lung failure” and would have faced “certain death” without the operation, according to the doctors. The teen’s family described him as an athlete who was in perfect health before he was admitted to the hospital in early September with what appeared to be pneumonia. Within weeks, his condition had become so dire that he shot to the top of a national transplant list, where most patients spend months waiting for a donor. (Hawkins, 11/12)

"This teenager faced imminent death had he not received a lung transplant," said Dr. Hassan Nemeh, surgical director of thoracic organ transplant at Henry Ford Hospital, who was among the team of doctors who performed the boy's surgery. E-cigarette or vaping-associated lung injury, also referred to as EVALI, has sickened more than 2,000 people in the U.S. and one U.S. territory since March, according to the Centers for Disease Control and Prevention. (Shamus, 11/12)

The doctors refused to answer questions about what the boy had been vaping before becoming ill. Instead, they had one message: Stop vaping, whatever it is — just stop. "We beg of you," said Dr. Nicholas Yeldo, a critical care physician with the hospital system. "We don’t want to be taking care of you next." The boy's family chose not to give his name as he recovers from surgery. The family released a statement Tuesday, saying their lives have been "forever changed." (Edwards, 11/12)

The CDC announced last week that it had found evidence that vitamin E oil found in some THC products was linked to at least some of the vaping-related illnesses throughout the country. The median survival for patients who receive double lung transplants is about seven years, NBC News noted. But Dr. Lisa Allenspach, director of the lung transplant program at Henry Ford Health System, told the network that officials were optimistic that he will be "alive and well for a long time" given his youth. (Wise, 11/12)

Former Food and Drug Administration Commissioner Scott Gottlieb is done playing nice on e-cigarettes. He’s calling on the agency to ban all pod-based e-cigarettes, a move that would likely eliminate every product sold in the U.S. by companies like Juul and Njoy. In a far-reaching and strikingly candid speech at Harvard University on Tuesday evening, the Trump appointee plans to rail against top e-cigarette makers for their role in what he calls the “travesty on top of a travesty” of youth vaping. (Florko, 11/12)

Juul Labs Inc. will eliminate 650 jobs and freeze hiring, part of a plan to cut $1 billion in costs as it pulls back on marketing and tries to get its vaping device cleared for sale by U.S. health regulators. The San Francisco-based e-cigarette company has become a target of government regulators attempting to stem an epidemic of new, young nicotine users who have flocked to the sleek device despite in many cases never having used cigarettes. (Armstrong, 11/12)

Danielle Jones sits at her dining room table, studying the recipe for Nerd Lyfe (v2) vape juice. The supplies she’s ordered online are arrayed before her: a plastic jug of unflavored liquid nicotine, a baking scale and bottles of artificial flavors that, combined, promise to re-create the fruity taste of Nerds Rope candy in vapor form. This is Jones’ first attempt to make her own e-liquid after buying it for the past five years. Jones, 32, wants to be prepared for the worst-case scenario: a ban on the sale of the e-liquids she depends on to avoid cigarettes. (Gold, 11/12)

Hate crime murders in the U.S. reached a 27-year high in 2018, according to data released Tuesday by the FBI. Hate crime murders totaled 24, which includes the 11 worshipers slain last year at the Tree of Life Synagogue in Pittsburgh, the deadliest anti-Semitic crime in U.S. history. New FBI statistics show hate crimes overall were down slightly in 2018 following three years of increases. Of 16,039 law enforcement agencies who participate in the hate crime data collection program, 2,026 agencies reported 7,120 hate crime incidents involving 8,496 offenses, meaning some involved multiple criminal charges. Most of the hate-crime incidents, 7,036, were "single bias," while the rest stemmed from multiple biases. The incidents involved 8,646 victims. (Bonaghue, 11/12)

The latest report found that 7,120 hate crime incidents were reported by law enforcement agencies to the FBI in 2018, just 55 fewer than had been reported in 2017. Between 2016 and 2017, the FBI found a 17% increase in reported incidents. The current total included 7,036 hate crime incidents involving a single identified type of bias against a perpetrator's victims, and 84 incidents involved more than one type of bias motivating the perpetrator. (Cole and Campbell, 11/12)

Levin said the increase in assaults was almost evenly distributed across demographic groups, with African-Americans, Jews, whites, gays and Latinos targeted the most. As in previous years, the majority of hate crimes reported in 2018 were motivated by bias against race and ethnicity, religion, and sexual orientation. (Treisman, 11/12)

The data points toward a change from young people committing vandalism and other property crimes toward more deliberate attacks on people, said Brian Levin, the director of the Center for the Study of Hate and Extremism at California State University, San Bernardino, who produced an independent analysis of the F.B.I.’s figures. “We’re seeing a shift from the more casual offender with more shallow prejudices to a bit more of an older assailant who acts alone,” Mr. Levin said. “There’s a diversifying base of groups that are being targeted. We’re getting back to more violence.” (Hassan, 11/12)

One player defied his team and had surgery on his damaged shoulder. Another blamed his club for not spotting a rare form of cancer sooner. Still another, according to media reports, disputed his team’s assertion that his concussion symptoms had abated. The players — former Jets guard Kelechi Osemele, Washington Redskins tackle Trent Williams and Cincinnati Bengals tackle Cordy Glenn — had very different ailments. But what they had in common was a willingness to question their employers over how their injuries were handled, and all of them appear to have paid a financial price. (Belson, 11/13)

Rep. Elijah Cummings had a rare form of cancer called thymic carcinoma when he died Oct. 17 at 68, according to his wife, Maya Rockeymoore Cummings. ...She did not say whether cancer was the cause of death, though she said it “had become a chronic thing.” Living with chronic thymic carcinoma for so long, however, may have been more rare than having the disease at all. Fewer than 400 people are diagnosed a year with the cancer, which occurs when malignant cells form on the thymus, a gland in the upper chest that is part of the lymph system, said Dr. Kevin Cullen, director of the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center. (Cohn, 11/13)

Amy Edwards got the flu precisely 2½ hours ago. It was injected into her nostrils, one at a time. “They took a syringe filled with the flu virus that they defrosted,” says the 37-year-old. “They shot one into each nostril and had us lie down.” Ms. Edwards and 19 strangers are confined to an isolation unit at the University of Maryland School of Medicine for at least a week. They’re participating in a federally funded human influenza study that is a key part of an effort to develop a better and longer-lasting flu vaccine. (Reddy, 11/12)

On Monday, for the first time in his life, Needham Mayes was a veteran on Veterans Day. His hospital bed was far from any parade, but the nation’s recognition of his service was no different from that of his fellow officers marching beneath flying flags. It was an honor hard fought, one that had taken the 85-year-old man’s entire adult life to arrive. He had been a paratrooper in the Army, among the first black soldiers at Fort Bragg, N.C., after the military was desegregated. He had an exemplary record for more than two years. It all ended in a bar fight in 1955. (Wilson, 11/12)

Controlling blood pressure in middle age may reduce the risk for dementia. The benefits of reducing blood pressure to lower the risk for cardiovascular disease are well known, but the role of blood pressure control in dementia has been less certain. Now pooled data from six large observational studies suggests that antihypertensive medicines may lower the risk for Alzheimer’s disease and other forms of dementia. The review is in Lancet Neurology. (Bakalar, 11/12)

In 2009, New York Post reporter Susannah Cahalan suddenly experienced hallucinations, paranoia, seizures and catatonia. She was misdiagnosed for a month before she was finally treated for a rare autoimmune disease that can attack the brain, anti-NMDA receptor encephalitis. (Woodbury, 11/12)

Five years ago, Mary Millard went to the hospital for heart surgery. A contaminated medical instrument gave her an infection that led to septic shock. Her heart struggled and her lungs and kidneys started to fail. "What I caught was pseudomonas, and it's a very virulent superbug," says the 60-year-old former nurse who lives in Baton Rouge, La. This bacterium no longer responds to most antibiotics, and "it lives in you permanently, so I'm on lifetime antibiotics," she says. (Harris, 11/13)

In Cuyahoga County, black babies are four times more likely than white babies to die before their first birthday. Half the babies born in Cuyahoga County in 2018 were white, according to First Year Cleveland, a community movement formed to address one of the country’s highest infant mortality rates. But of the 118 babies who died in their first year, 67 percent of them were black. (DeBerry, 11/12)

Some days, it seems regular exercise has become a panacea — good for the heart, good for blood pressure, good for glucose levels, good to limit sad days and depression. But what about people tormented with the pain and stiffness of osteoarthritis, particularly in the knees and hips? What are they supposed to do? There was an era when ethical medical practice demanded a no-movement solution for people in pain. Not anymore. Today, the more than 50 million adult Americans with arthritis are advised to seek the same 150 minutes a week of moderate exercise as everyone else. (Burfoot, 11/12)

The first death occurred in late August, two days before classes began, when an incoming freshman was struck by a car while walking on a freeway near the University of Southern California. In the more than 2 months since, eight other USC students have died — three by suicide, others by unknown means. The string of fatalities has left students and faculty at the prestigious university shaken and struggling for answers. (11/12)

Winston Crisp, the university’s vice president for student affairs, said he and other administrators decided to move quickly with as much transparency as possible to quell rumors about the deaths, as well as to remind students that resources are available if anyone does need help. School administrators have faced a balancing act, trying to share adequate information with students without overloading them with unnecessary details. Although not all the deaths have been attributed to suicide, the lack of information has prompted speculation among parents and students alike, increasing concerns. (Shalby, Fry, Karlamangla and Miller, 11/12)

USC President Carol Folt and three other officials sent a letter to students Saturday, partly to counter rumors that suicide was suspected in most of the cases, and partly to urge students to seek help if they need it. "These student losses are devastating and heartbreaking for all of us," the letter reads. "People are searching for answers and information as we attempt to make sense of these terrible losses." (Mossburg and Hanna, 11/12)

Jurors have started deliberations in the civil trial involving a now-closed body donation facility in Phoenix. The relatives of 23 people whose remains were donated to the Biological Resource Center contend in a lawsuit that the facility mishandled their deceased loved ones and misled them about how the remains would be used. The suit alleges the facility committed fraud by claiming the donated bodies would be used for medical research, when in at least two cases it knew the human remains would be sold for use in destructive military testing. (11/13)

Missouri has some of the highest lung cancer rates in the country, according to an American Lung Association report released Wednesday. The culprit? You can draw a straight line between lung cancer and smoking. The second “State of Lung Cancer” report reveals the toll, state by state. Nationwide, the incidence of lung cancer — the number of new cases — is 59.6 per 100,000 people. (Gutierrez, 11/12)

With the beginning of fall comes the beginning of flu season. The contagious virus knocks millions of people off their feet every year. Maryland is one of two states in which the influenza virus has become geographically widespread, according to a Nov. 2 report from the U.S. Centers for Disease Control and Prevention. But there is a way to prevent, or at least minimize, the nasty bug, said Dr. Theodore Bailey, chief of the Greater Baltimore Medical Center’s division of infectious disease and part of GBMC Health Partners. Get a flu shot, he said. (Cohn, 11/12)

Primary care physicians trained in obstetrics and surgery will provide the bulk of the care at the maternity ward, [Jeffrey] Strickler said. Staff at the unit will assist on “low-risk” deliveries — cesarean sections or vaginal births on women who are generally healthy. An obstetrician will be available to consult, according to Strickler, who said high-risk patients, such as women carrying twins and breech babies, will be transferred to UNC Medical Center in Chapel Hill, roughly 45 minutes away. (Engel-Smith, 11/13)

Leaders of UC Davis Health said that they have not canceled any patient appointments in preparation for Wednesday’s strike by thousands of patient care and service workers, but they have alerted patients getting lab work whether they will have to go to a different facility. ...Roughly 25,000 University of California workers represented by AFSCME 3299 voted to authorize their leaders to call strikes, as needed. The union’s ranks include service workers such as custodians, gardeners, food service workers and facilities maintenance staff, as well as health care workers such as medical transcribers, phlebotomists, admitting clerks and respiratory therapists. (Anderson, 11/12)

The state attorney general's office has announced it will launch a tracking and reporting system for rape kits. The state office will work with software company STACS DNA to develop a system so victims can get status updates as their kits go through medical and law enforcement agencies. (Krebs, 11/12)

After nearly four years in the post, the head of the city’s health commission is stepping down, saying she wants to spend more time with her family. Monica Valdes Lupi, who took the job in early 2016, briefed her staff earlier this month and alerted the City Council in an e-mail last week. (Valencia, 11/12)

The Southern Poverty Law Center, Florida Legal Services and the Florida Justice Institute this year sued the state Department of Corrections and the Department of Juvenile Justice in federal court in Tallahassee, contending the agencies’ practices on isolation are unconstitutionally cruel and unusual punishment. But the agencies are fighting back against the allegations, with the latest salvo coming last week as the Department of Juvenile Justice filed a motion to dismiss the juvenile detention case and questioned the motives behind the lawsuit. (Ceballos, 11/12)

Residents of an Atlanta suburb want the federal government to investigate cases of cancer near a medical sterilization plant that uses a gas linked to an increase cancer risk. WXIA-TV reports some Covington residents are asking the Agency for Toxic Substances and Disease Registry to investigate cases near the plant, which has released leaked ethylene oxide into the surrounding air. (11/12)

The mother of Conrad Roy, the teenager who died by suicide in 2014 after another teen urged him to take his own life, testified on Tuesday in favor of a bill that would punish people who induce others to end their own lives. ...The legislation would make it a crime for anyone to encourage a person they know to be suicidal to take his or her own life, punishable by up to five years in prison. Supporters of the bill have dubbed it “Conrad’s Law.” (Greenberg and Anderson, 11/12)

San Francisco Mayor London Breed and Supervisors Matt Haney and Hillary Ronen announced a deal Tuesday reconciling their dueling plans to reform the city's fragmented mental health care system. The trio introduced the agreement outside of City Hall, following months of often tense negotiations on ways to overhaul the treatment of residents grappling with homelessness, mental health and substance abuse issues. (Wolffe, 11/12)

High rates of obesity, uninsured residents and a health care infrastructure failing to keep pace with population growth are among the greatest challenges to the well-being of Harris County residents, according to a comprehensive study released Tuesday by the county’s health department. The Harris County Public Health study, commissioned last January, aims to present a picture of the overall health of county residents and offer recommendations for improvement. The 263-page report examines many factors that influence health, including access to care, mental health, transportation, housing and environmental factors. (Despart, 11/12)

The St. Luke Community Hospital building in Arnaudville has been sold to the St. Luc French Immersion and Cultural Campus, officials announced Tuesday. Officials with St. Landry Parish government signed off on the $184,000 deal with the nonprofit, which will use the building along Guidroz Street as the first adult French immersion school in the United States. (Daigle, 11/12)

The city's emergency cold weather shelter should not be in a recently vacated jail, a leader of a homeless outreach organization in Nashville said. Open Table Nashville co-founder Lindsey Krinks said in an email sent early Monday to city officials that the new location of the shelter is causing people experiencing homelessness to choose the cold over spending the night in the Davidson County Sheriff's Office facility. (Meyer, 11/12)

With an early cold snap hitting the Granite State overnight Tuesday, organizations that serve the homeless were uncertain of what would happen when Manchester’s emergency shelter reaches capacity.A spokesman for Families in Transition stressed that the New Horizons shelter will abide by its capacity of 138. ...The National Weather Service has predicted an early cold snap for this week. The overnight low Tuesday will be about 13 degrees in Manchester with 15 mph winds gusting up to 25 mph. (Hayward, 11/12)

Georgia’s top elected leaders moved forward Tuesday with a program to provide medical marijuana to the state’s 15,000 registered patients, nearly seven months after Gov. Brian Kemp signed it into law. Kemp, House Speaker David Ralston and Lt. Gov. Geoff Duncan appointed seven members to a commission that will issue licenses for companies to grow and sell medical marijuana oil. (Niesse, 11/12)

Missouri has already approved more than 17,000 patients for its yet-to-be-launched medical marijuana program — a stark contrast to neighboring Illinois, which had fewer than 3,000 patients in the first 10 months. Licenses for Missouri’s dispensaries are expected to be awarded by January, and cannabis should be available for medical card holders by spring. At their core, Missouri and Illinois programs do the same thing: They allow doctors to certify patients to use cannabis if they have a qualifying condition. (Driscoll, 11/12)

As President Trump looks toward the next election, a new poll finds that a growing percentage of adults did not have enough money to pay for prescription medicines over the past year and only a fraction of Americans believe he is doing enough to lower drug costs, which is a key campaign issue for him. To wit, 22.9% reported they lacked the funds this past September to pay for a prescription during the previous 12 months, up from 18.9% in January. All totaled, about 58 million adults experienced “medication insecurity,” according to the latest Gallup Poll. (Silverman, 11/12)

About 1 in 5 U.S. adults say that they or someone in their household has been unable to afford drugs that were prescribed to them in the past 12 months, according to a new Gallup poll. The survey found that 22.9 percent of U.S. adults said there had been a time in the past year when their household was unable to pay for drugs they were prescribed, up from 18.9 percent in January. (Sullivan, 11/12)

More than 13% of Americans -- about 34 million people -- say a friend or family member recently passed away in the last five years after being unable to afford treatment for a condition, according to a new Gallup poll. The survey, conducted in September among nearly 1,100 people in 50 states, doesn't confirm that a lack of care directly caused the deaths. But its findings suggest the skyrocketing price of prescription drugs and necessary care are keeping US adults from addressing health issues. (Andrews, 11/12)

Kaiser Health News: Voters Say Congress Needs To Curb Drug Prices, But Are Lawmakers Listening?

House Democrats are poised to pass sweeping legislation to lower drug prices using strategies President Donald Trump has endorsed. A Trump aide urged the Republican-controlled Senate to vote on a different package curbing drug prices that was drafted by a senior Republican. But at least right now, neither measure appears likely to attract enough bipartisan support to become law. (Huetteman, 11/11)

There’s a logic to out-of-pocket medical payments. They’re supposed to make patients think twice before spending money on unnecessary health care. When it comes to drugs, however, they’re often preventing people from getting necessary care. A recent data brief from the National Center for Health Statistics said about a quarter of adults who had diagnosed diabetes asked their physician if there was a lower-cost medication they could try, even if things were working for them. (Carroll, 11/11)

They and other leaders of small biotech companies — most of whom stick to science, not politics — are speaking up now because they are uniquely worried that the policies included in Democrats’ marquee bill will dry up the venture capital funding that drives their industry and, in turn, make it impossible for the similarly small startups that turn basic research into new medicines to get off the ground. ...Theirs is an important perspective — and one that, until now, has been virtually erased from the debate over the landmark legislation. That conversation has focused almost entirely on large pharmaceutical companies — enterprises that, at least as many supporters of the legislation argue, would be able to withstand diminished investments or other financial changes. (Florko, 11/12)

China’s plan to make its health-care system better and more affordable is throwing up opportunities for global drugmakers. There has been a tectonic shift in China’s drug policy in the past couple of years. The government is approving innovative foreign drugs at a record pace, while trying to push down sky-high prices. Fifty-one innovative drugs, 80% of them from global pharmaceutical companies, were approved last year, up from just five in 2016, according to Deloitte. (Wong, 11/11)

When HealthPartners closes 30 retail pharmacies and its mail-order pharmacy business early next year, about 300 people will lose their jobs, including 100 pharmacists. The insurer, which also runs clinics and hospitals, declined to discuss the closures. The retail pharmacy industry has been shrinking for more than a decade, starting with the closing of many independent pharmacies in rural areas.That trend is likely to accelerate, said Sarah Derr, executive director of the Minnesota Pharmacists Association. (Gunderson, 11/8)

Amid ongoing criticism of discount cards for prescription medicines, a new study finds these marketing tools increased costs for private insurers in Canada by 46% because patients were not motivated to pursue lower-cost generics. The analysis examined 2.8 million prescriptions for 89 different drugs for which brand-name discount cards were available between September 2014 and September 2017. Of nearly 940,000 claims filed with private insurers, $69.4 million was paid out compared with roughly $47.7 million for a mix of equivalent generics, a difference of $21.7 million, or 46%. For each prescription, this amounted to an extra $23.09. (Silverman, 11/11)

Allergan Chairman and Chief Executive Officer Brent Saunders talks about how he built up the pharmaceutical giant, the pending sale of Allergan to Abbvie, why he took a huge pay cut to come to Allergan, and the controversial subject of drug pricing. He talks to Bloomberg's Caroline Hyde in New York. (11/11)

Each of those countries meets the World Bank's definition of a middle-income country: an average annual income (known as the gross national income, or GNI, per capita) between $1,026 and $12,375. In Nigeria alone, 3 million kids are undervaccinated. That's 15% of the world's total of children who lack key vaccinations. By contrast, vaccination rates can be high in poor countries, according to global health researchers, who say that Gavi has boosted the numbers. (Huang, 11/12)

Gov. Charlie Baker's administration was ready. Thirty letters requesting meetings to discuss deeper drug discounts arrived in the inbox of major pharmaceutical executives just weeks after Baker gained leverage that would compel many of those executives to respond. The Massachusetts Medicaid program had already asked some of these same drug makers to talk about taking less for new, high-priced medications, and the companies had refused. (Bebinger, 11/6)

For Teva Pharmaceutical Industries shareholders, a little improvement goes quite a long way. The beleaguered generic drugmaker’s third-quarter earnings, while mixed, gave investors some reason for optimism. Sales of $4.3 billion fell by 6% from a year earlier, while the net loss widened to 29 cents a share from 27 cents a year ago. However, the positives were strong enough to send shares 11.6% higher Thursday morning: Teva generated $551 million of free cash flow in the quarter and raised the low end of its profit and cash flow guidance. (Grant, 11/7)

There is no shortage of good intentions and even better ideas on how to bring sanity to the overwhelming complexity of rising drug prices — and doing so without blocking the pipeline of life-saving new drugs. None of those ideas, however worthy, are likely to make any headway in gridlocked Washington today. So it rests with the states to fix that which can be fixed. Massachusetts Senate leaders introduced their entry into the debate last week, teeing up the Pharmaceutical Access, Cost and Transparency Act for floor debate Thursday. (11/11)

Congressional leaders like Sens. Chuck Grassley, Kevin Cramer, and others are advancing critically important work to address prescription drug pricing. However, we would like to take the opportunity to clarify some misconceptions. Pharmacy benefit managers are an integral part of the solution to high prices, working on behalf of hundreds of millions of consumers to make treatments more accessible and affordable, and supporting policies to lower costs and improve patient care. (J.C. Scott, 11/8)

At nearly every major industry conference — from HLTH to CNS Summit, Exponential Medicine, and Rock Health Summit — speakers are talking about the benefits of decentralized clinical trials and digital endpoints. We are quite excited about the latter. For a new drug to be approved, the manufacturer must provide the FDA with substantial evidence that it has a clinically meaningful effect on patients. It does this by providing data on endpoints, like survival or a substantial reduction in a biomarker like LDL cholesterol or hemoglobin A1c. Digital endpoints are the newest type of endpoint. They are assessed using data captured by a sensor, typically outside of the clinic during activities of daily living. (Jen Goldsack, Rachel A. Chasse, and William A. Wood, 11/6)

Artificial intelligence has become a crucial part of our technological infrastructure and the brain underlying many consumer devices. In less than a decade, machine learning algorithms based on deep neural networks evolved from recognizing cats in videos to enabling your smartphone to perform real-time translation between 27 different languages. This progress has sparked the use of AI in drug discovery and development. Artificial intelligence can improve efficiency and outcomes in drug development across therapeutic areas. (Charles K. Fisher, 11/7)

Americans are worried about drug prices. To address these concerns, lawmakers in both chambers of Congress have introduced measures to restructure Medicare’s drug benefit. While it’s great to see both parties working together, this approach — which would enable government officials to set drug prices — is penny-wise and pound-foolish. Their efforts ultimately threaten small and midsize biotech firms that develop important medical innovations. And the cures of tomorrow may be put out of reach for millions of patients as a result. (Sandip Shah, 11/7)

It’s time to lower prescription drug costs in Pennsylvania. Pennsylvania’s Medicaid program is paying billions more than it should for prescription drugs, due to the growing influence  of pharmacy benefit managers. Designed to save Medicaid dollars, these benefit managers have seen their payments from the commonwealth increase by more than $1 billion in only four years to $2.84 billion. These exorbitant profits are increasing prescription drug costs at community pharmacies for countless Pennsylvanians. (Patricia Epple, 11/13)

Ground-breaking research on the microbiome — the collection of bacteria, fungi, and other microbes that live in the gut, on the skin, and within other human tissues — is creating new ways to treat disease. What started as a “bugs as drugs” approach to treatment is expanding to embrace the use of small molecules, biologics, phages, and engineered bacteria to modify the microbiome and prevent or alter disease progression. (Peter Bak, 11/13)

The wall of invulnerability around U.S. gun manufacturers just cracked a bit.The U.S. Supreme Court on Tuesday allowed a civil lawsuit to proceed against Remington Arms alleging the gunmaker bears some responsibility for the use of its Bushmaster AR-15 style semiautomatic rifle in the shooting deaths of 26 children and teachers massacred at Sandy Hook Elementary School almost seven years ago. (Scott Martelle, 11/12)

The nation is facing two distinct vaping-related health crises: surging e-cigarette use among teenagers and a lung-injury outbreak that has sickened more than 2,000 people and killed at least 40. Both have exposed yawning gaps in the nation’s public health apparatus. But instead of closing those gaps, policymakers have turned to a much more straightforward fix: banning products. A federal ban on flavored e-cigarettes is reportedly in the offing. Several states have already enacted their own flavor bans. And Massachusetts and several California cities have taken steps to outlaw e-cigarettes altogether. (11/12)

As Democrats debate the best way to achieve universal coverage and lower health care costs, the Trump administration has a different approach to the challenges of our current system. It’s working overtime to make the system more fragile for the sick and the poor, even as it misrepresents to Congress and the American public what it’s up to. Speaking to reporters in late October, President Trump said that “we have a great Republican plan” to replace the Affordable Care Act. “Much less expensive. Deductibles will be much lower.” His statements came on the heels of a congressional hearing in which one of his top health officials, Seema Verma, said that the administration would do “everything we can” for Americans with pre-existing conditions. Under oath, she swore that the administration was aiming to help people find a pathway out of poverty. (Nicholas Bagley, 11/12)

The Trump administration has placed an unprecedented priority on improving the health of Americans living in rural areas. Last year, the Centers for Medicare & Medicaid Services announced their Rural Health Strategy, which focuses on applying a rural lens to the vision and work of CMS, to strengthen the rural health care system and avoid unintended consequences from government regulations. (Seema Verma, 11/13)

As the opioid epidemic and drug overdose fatalities continue to plague America, the opening of supervised injection sites —where addicts can use drugs in a safe environment —is again on the agenda. A federal court ruling last month removed a legal obstacle to opening the first such U.S. facility, in Philadelphia, and other cities are considering a similar move. While it’s not certain when this might happen, questions remain regarding how such sites will help move users into drug treatment. (Mitchell St. Rosenthal, 11/11)

Kudos to David Lind for his op-ed highlighting the waste that is baked into our healthcare system. (“We cannot afford $1 trillion waste in healthcare,” Oct. 30) Here at the Iowa Healthcare Collaborative, since 2005 we’ve been working directly with health practitioners and hospitals in nearly every county in Iowa to help them get better outcomes at reduced cost. Hospitals and clinicians have willingly participated in quality improvement initiatives that reduce unnecessary hospital admissions, readmissions, medical errors, infections, falls, adverse drug events, childbirth complications, and many other worthy outcomes because they know it is the right thing to do. (Tom Evans, 11/12)

In a frightening illustration of how completely Americans today have lost control over their personal data, Google has partnered with Clayton-based health care giant Ascension to collect detailed medical information on millions of Americans — including patient identities and dates of birth — without notifying them or their doctors. The search-engine behemoth, trying to nose in on one of the most lucrative segments of the economy, says it wants to improve health care for everyone. Even if that’s the goal, it doesn’t justify these truly Orwellian means. (11/12)

There may be no more toxic topic than race. But when it comes to the shockingly disparate health outcomes in Cuyahoga County between black and white babies, having that conversation has become essential.Discussing racial health disparities is by nature a difficult discussion -- even moreso since evidence is mounting that historically rooted biases and stressors might be at its root. That encompasses ingrained prejudices many white people may be unaware of, and toxic stressors among people of color after generations of discrimination. (11/13)

Ballot measures are San Francisco’s favorite substitute for responsible policymaking. Rather than hash out differences and come to a consensus, the city’s politicians are all too quick to go to the initiative process and force voters to do their jobs for them. The city’s response to the mental illness crisis on its streets was headed in that direction until this week, with Supervisors Hillary Ronen and Matt Haney preparing for a ballot battle with Mayor London Breed. By reaching a compromise instead, both camps did a service for the voters and, let’s hope, the San Franciscans who need help. (11/12)