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Even as the impeachment battle rumbled, senior White House and Democratic aides sat down Tuesday to discuss details of drug pricing legislation, officials on both sides said. Passing a law to curb prescription drug prices remains a top policy priority for President Donald Trump and House Speaker Nancy Pelosi, despite her decision to launch an impeachment inquiry into the president’s efforts to get a foreign leader to investigate political rival Joe Biden. Both sides stressed they were not negotiating during Tuesday’s meeting at the White House, but instead were exchanging information and asking questions. Joe Grogan, a top domestic policy adviser to Trump, called it “a very cordial and productive working session.” (Alonso-Zaldivar, 10/1)

House Ways and Means Committee Chairman Richard Neal (D-Mass.) is proposing a new way to move forward on crafting rules to protect patients from surprise medical bills. Members of both parties have made it a priority to protect patients from getting massive bills when they go to the emergency room and are treated by one or more doctors who turn out to be outside their insurance network. But the effort has stalled amid a fierce lobbying push from doctors and hospitals. (Sullivan, 10/1)

Yet, the new framework could further complicate efforts for Congress to coalesce around a consensus over how to end surprise medical bills. Under Neal’s approach, three departments — HHS, Labor and Treasury — and stakeholders would form a committee to identify standards for rates for surprise bills and decide whether to allow an option for providers and health plans to dispute payments. Then, the committee will send recommendations to agency secretaries to develop a proposed rule, with a comment period for more public feedback. (Roubein, Diamond and Cancryn, 10/1)

After back-to-back mass shootings in Ohio and Texas this summer, gun control burst back on the scene as a major political issue for Democrats. Now it risks taking a back seat as impeachment fever overtakes Washington. Gun control advocates are determined to prevent that from happening. (Ronayne, 10/2)

Former Rep. Chris Collins pleaded guilty to insider trading charges Tuesday, ending a seven-year congressional career marked by a breach of public trust that pushed the House to craft rules prohibiting members from serving on public company boards. The New York Republican pleaded to two of eight counts he was charged with: conspiracy to commit securities fraud and false statements to the FBI, each of which carry a maximum penalty of five years in federal prison, the New York Daily News reported. Under the plea deal, Collins agreed to not appeal a judge’s sentence ranging from 46 to 57 months, the newspaper reported. (Marquette, 10/1)

Former Rep. Chris Collins Tuesday pleaded guilty to two felony counts tied to an insider trading scheme in a deal with prosecutors that calls for him to spend up to 57 months in federal prison. In doing so, Collins – whose resignation from Congress took effect Tuesday – essentially admitted he had been lying when he insisted for the past 14 months that he was innocent. ... in an agreement with prosecutors, Collins pleaded guilty to one count of conspiracy to commit securities fraud and one count of making false statements to the FBI. (Zremski, 10/1)

President Donald Trump will outline his vision for the future of Medicare this week, contrasting plans with Democrats in a speech promising to strengthen the program for the elderly and disabled. Trump is scheduled to travel to Florida on Thursday where he’ll deliver a wide-ranging speech on his administration’s health policy, and announce an executive order regarding the Medicare system, titled “Protecting Medicare from Socialist Destruction.” (Jacobs, Griffin and Wingrove, 10/1)

President Trump is set to nominate Dr. Stephen Hahn to lead the Food and Drug Administration, pending completion of the vetting process, according to two people familiar with the selection process. Hahn, an oncologist, is the chief medical executive at MD Anderson Cancer Center in Houston. Trump interviewed him for the job a month ago. A third person familiar with the White House’s thinking confirmed that Hahn remained the frontrunner and that the administration was completing paperwork and final background checks. (Facher and Florko, 10/1)

The Trump administration will let states offer wellness programs in the individual insurance market that tie premium costs to health goals as part of a pilot program that drew swift rebuke from health policy analysts who said older and sicker people who can’t comply could be priced out of coverage. The Centers for Medicare and Medicaid Services issued a bulletin on Monday outlining the project, which will allow 10 states to design wellness programs that could be incorporated into insurance plans people buy on the individual market. (Armour, 10/1)

Healthcare groups including the American Hospital Association are urging the Federal Communications Commission to allow more providers to receive funding as part of a proposed $100 million pilot program to promote telemedicine services. While the three-year Connected Care Pilot program is intended to address gaps in care, only not-for-profit or public healthcare providers are eligible to participate, according to the proposal released in July. (Cohen, 10/1)

The CMS achieved savings from the Medicare Shared Savings Program last year, marking the second year in a row the agency turned a profit from the program. About 66% of the 548 Medicare accountable organizations produced a total of $1.7 billion in savings in 2018 and the CMS scored a $739.4 million gain, according to new agency data. That's significantly higher compared to 2017 when the CMS saved $314 million from the program. (Castellucci, 10/1)

The settlement makes J&J the fourth drugmaker to reach such a deal ahead of the trial, slated to begin later this month in federal court in Cleveland. The trial is considered a bellwether for thousands of opioid-related lawsuits that municipalities and states have filed against drugmakers. (Randazzo, 10/1)

“The settlement allows the company to avoid the resource demands and uncertainty of a trial as it continues to seek meaningful progress in addressing the nation’s opioid crisis,” Johnson & Johnson and its subsidiary Janssen Pharmaceuticals said in a statement Tuesday night. “The company recognizes the opioid crisis is a complex public health challenge and is working collaboratively to help communities and people in need.” Under the terms, the company resolves all claims by the counties with no admission of liability. (Higham, Horwitz and Bernstein, 10/1)

Johnson & Johnson agreed to pay more than $20 million to avoid the first federal trial in which it faced accusations of helping fuel the opioid epidemic by mishandling its painkillers. Under the deal, announced late Tuesday, J&J will pay two Ohio counties $10 million in cash, $5 million to cover their legal expenses and make $5.4 million in charitable donations to groups fighting the opioid epidemic. The company didn’t admit any wrongdoing as part of the deal. (Feeley, 10/1)

The division of Johnson & Johnson that made the opioid products, Janssen Pharmaceuticals, has said that those products accounted for less than 1 percent of total opioid prescriptions written in the United States. The settlement was not nearly as sizable as the tentative agreement reached by Purdue Pharma with opioid plaintiffs last month, but that deal was intended to release the company from all federal litigation and many state cases as well. (Hoffman, 10/1)

Johnson & Johnson and two Ohio counties have reached a $20.4 million settlement that removes the corporation from the first federal lawsuit against opioid manufacturers, scheduled to begin later this month. In a statement released Tuesday, the healthcare giant said the agreement with Cleveland's Cuyahoga and Akron's Summit counties allows it "to avoid the resource demands and uncertainty of a trial." (Neuman, 10/2)

Teva is the only drugmaker that would remain in the Cleveland trial if Johnson & Johnson’s settlement is finalized. The other defendants still in the trial are distributors AmerisourceBergen, Cardinal Health, Henry Schein and McKesson, along with the pharmacy chain Walgreens. With most drugmakers out of the initial trial, it could mean less focus on how they marketed powerful painkillers to doctors and more on whether distributors shipped opioid orders that they believed were suspicious. (Mulvihill, 10/1)

Frank Gallucci, an attorney for Cuyahoga County, said that “this settlement represents an important milestone in the litigation as it provides much needed funding for the community while also providing financial support for programs specifically addressing opioid exposed babies and their families.” (Heisig, 10/1)

A group of drug retailers and distributors asked an Ohio federal appeals court Tuesday to disqualify the judge overseeing national opioid litigation after the judge himself denied their requests. Walmart, Walgreens, CVS, Rite Aid and drug distributors AmerisourceBergen, McKesson and Cardinal Health told the 6th U.S. Circuit Court of Appeals in Cincinnati that Cleveland-based U.S. District Judge Dan Polster is not impartial. Polster made the initial ruling on their claim, declining Thursday to remove himself from the massive multidistrict litigation and insisting he has remained neutral. (Carr-Smyth, 10/1)

Purdue Pharma LP has proposed a settlement in bankruptcy court that could provide as much as $10 billion to help U.S. communities cope with the opioid epidemic. But for some states, the moral cost of accepting the deal is too high because it relies on even more sales of OxyContin, the highly addictive painkiller that helped create the public-health crisis. The settlement offer calls for Purdue’s owners, the Sackler family, to pay at least $3 billion over seven years, with another $1 billion from current Purdue assets. (Larson and Feeley, 10/2)

Makers of prescription painkillers are climbing higher after Dow Jones reported that the companies are looking to use Purdue Pharma LP’s bankruptcy as a model to settle their own lawsuits. Mallinckrodt Plc and Endo International Plc jumped Tuesday morning as Wall Street gauged what shape their settlements might take. The two, plus drugmaker Teva Pharmaceutical Industries Ltd., are facing similar claims related to their role in sparking the opioid crisis. (Lipschultz, 10/1)

The White House declared the opioid epidemic a public health emergency in 2017, a year that saw an average of 130 opioid overdose deaths per day, according to the Centers for Disease Control and Prevention. Since 2000, there have been 300,000 opioid-related overdose deaths in the U.S. (Díaz, 10/1)

The report said the D.E.A. did not capture enough timely data on opioid abuse or other drug trends. It also noted that the agency had “recently taken steps to address the opioid epidemic, but more work remains.” A spokeswoman for the D.E.A. said in a statement that the agency “appreciates the O.I.G.’s assessment of the programs involved in the report and the opportunity to discuss improvements made to increase the regulatory and enforcement efforts to control the diversion of opioids.” (Fortin, 10/1)

Even as deaths from opioid overdoses grew dramatically, the Drug Enforcement Administration allowed manufacturers to substantially increase the number of painkilling pills they produced each year, the Justice Department’s inspector general said Tuesday in a report that offers a harsh critique of the DEA. Overdose deaths rose by an average of 8 percent from 1999 to 2013 and by a staggering 71 percent from 2013 to 2017. Yet the DEA, which sets annual quotas for narcotic painkillers produced in the United States, authorized a greater than 400 percent increase in oxycodone output between 2002 and 2013, Inspector General Michael E. Horowitz said, and did not begin cutting back until 2017. (Bernstein, 10/1)

“Unlike past drug crises, in combating the current opioid epidemic DEA failed to develop a comprehensive national strategy that could have focused and directed its regulatory and enforcement efforts,” the Justice Department’s inspector general, Michael Horowitz, wrote in the report, which was released Tuesday. (Gurman, 10/1)

The Drug Enforcement Administration fell dramatically short in regulating the prescription opioid supply over the past two decades — even as the country’s addiction and overdose crisis escalated, according to a new report from the Justice Department’s inspector general. As prescription levels and demand for pain drugs rose, the agency continued to raise manufacturing quotas for opioids with little regard to potential oversupply or misuse, according to the report. Prescription opioid oversupply is seen as a major factor in the broader drug crisis, which left 70,000 Americans dead in 2017 — roughly 48,000 from opioid-involved overdoses. (Facher, 10/1)

The Drug Enforcement Administration (DEA) allowed drug makers to increase production of opioids even as overdose deaths were skyrocketing, according to a government watchdog’s scathing report released Tuesday.  While opioid overdose deaths grew by 8 percent per year from 1999 through 2013, and by 71 percent per year between 2013 and 2017, the DEA authorized manufacturers to produce “substantially larger amounts of opioids,” reads the report from the Justice Department’s Office of the Inspector General. (Hellmann, 10/1)

Three Chinese nationals worked with a former deputy sheriff in Pennsylvania to run an international mail-order drug operation linked to five overdose deaths in the U.S., state and federal authorities said Tuesday. The Chinese nationals, using an alias, allegedly ran websites based in China that offered users fentanyl, a synthetic opioid. The drugs were then shipped to a storage facility in Pennsylvania rented by David Landis, a former deputy sheriff in suburban Philadelphia, according to William M. McSwain, U.S. Attorney for the Eastern District of Pennsylvania. (Ansari, 10/1)

A Virginia doctor who was convicted of more than 800 counts of illegally prescribing opioids faces a sentence of 20 years to life in prison. Dr. Joel Smithers, of Greensboro, North Carolina, is scheduled to be sentenced Wednesday in U.S. District Court in Abingdon. Smithers was convicted in May of illegally distributing opioids, including oxycodone and oxymorphone that caused the death of a West Virginia woman. (10/2)

A discussion on the status of the Safe Station program turned heated at City Hall Tuesday night, after some aldermen raised the idea of asking firefighters to check IDs of individuals seeking help with addiction at local firehouses, as a way to ensure Manchester residents are being helped. In August, Manchester Mayor Joyce Craig held a news conference where she demanded the state open more treatment and support options in New Hampshire for those battling opioid addiction and other substance abuse disorders. (Feely, 10/1)

The number of deaths tied to vaping has climbed to 16 across the country. State officials in Nebraska, New Jersey and Virginia each reported a death this week, though the death in Nebraska reportedly occurred in May and was only recently revealed to have been caused by a severe lung disease thought to have been brought on by excessive vape usage. (Bowden, 10/1)

Hundreds of people have been sickened by lung illnesses linked to vaping, most by using THC products. (Corum, 10/1)

New Jersey health officials have verified the state’s first death associated with e-cigarette use — an adult female from North Jersey — the state Department of Health announced today. ...The woman’s name, age and hometown were not released. She died in August, according to the health department. (Sutton, 10/1)

Put down the vape pen if you work or study at a Texas A&M University campus.Chancellor John Sharp announced Tuesday that he's banning electronic cigarettes from all Texas A&M system campuses across the state, including the flagship university in College Station and Tarleton State University and Texas A&M University-Commerce in North Texas. (Allen, 10/1)

A ban on vaping will soon extend to "every inch" of the Texas A&M University System, according to a Tuesday memorandum from Chancellor John Sharp that cites recent revelations about how electronic cigarette use or vaping can lead to lung illnesses. (Najmabadi, 10/1)

Ohio Gov. Mike DeWine wants to ban flavored vape juice and e-cigarettes but he'll need the legislature's help to do so.DeWine told reporters Tuesday that he didn't have the authority to ban the sale of flavored vape products via executive order. But he still believes they are dangerous to children and teens, luring them into a nicotine addiction with flavors like mango and mint. (Balmert and Borchardt, 10/1)

It was a public-service announcement with a touch of self-congratulation: Gov. Ned Lamont, legislators and public-health officials went to Orville H. Platt High School on Tuesday to celebrate and publicize the new law raising the age for tobacco and vaping purchases to 21. Aware that their elders have used about $2 billion of tobacco settlement money on just about everything but smoking cessation, student activists pressed them to do more to halt the rapid increase in the use of e-cigarettes by secondary-school students. (Pazniokas, 10/1)

A campaign to defeat an industry-backed e-cigarette measure on San Francisco’s ballot will push on despite the announcement by Juul Labs Inc. that it will stop financially supporting the proposal to overturn a city ban on e-cigarettes and vape product sales. The San Francisco company, the nation’s largest maker of e-cigarettes, announced late Monday that it will end its support for Proposition C after a review of company policies resulting from a leadership shakeup last week. The e-cigarette industry, and Juul in particular, face mounting scrutiny from federal and local governments over youth vaping and as the 14th U.S. death linked to vaping was reported in Nebraska. (Har, 10/1)

Juul Labs Inc., the largest maker of nicotine vaporizers in the U.S., said it will stop lobbying for a ballot measure to overturn San Francisco’s ban on the sale of e-cigarette products. The measure, called Proposition C, will still appear on the Nov. 5 ballot, but the loss of the biggest financial supporter of the effort comes at a crucial time, in the final weeks when voters are weighing the issue. Michael Bloomberg, the founder and majority owner of Bloomberg LP, is funding a campaign to defeat the measure. Ads from both sides have blanketed the city in recent weeks. (Roache, 10/1)

The Los Angeles County Board of Supervisors voted unanimously Tuesday to ban flavored tobacco products, including menthol, and to call on Gov. Gavin Newsom to pass a statewide ban on vaping. The board had originally held the item for discussion, but ultimately approved it without comment from any of the supervisors as the meeting ran long. The vote came in spite of protests last week by dozens of tobacco business owners and advocates who support vaping and e-cigarettes as aids to quitting smoking. (10/1)

Los Angeles County on Tuesday banned flavored tobacco products including e-cigarettes, chewing tobacco and menthol cigarettes amid concerns that the products appeal to young people. The county’s Board of Supervisors voted unanimously to adopt the ban and to call on California Gov. Gavin Newsom to pass a statewide ban on vaping as health concerns grow. The regulations are opposed by business owners and advocates of vaping who say e-cigarettes help people quit smoking. The vote came on a second reading after initial approval last week. (10/1)

Juul Labs Inc. is bringing over a second high-ranking executive from Marlboro maker Altria Group Inc. as the vaping startup attempts to repair its damaged relationship with regulators amid a rise in teen vaping. Joe Murillo, who headed regulatory affairs for Altria and previously ran the tobacco company’s e-cigarette business, is now Juul’s chief regulatory officer, according to an internal memo sent Tuesday to staff. (Maloney, 10/1)

We wanted to know how our audience was experiencing climate grief, so we asked on Twitter, and got a range of responses — from difficulty making big life decisions to having concern for kids, from accepting that the fear is based on real threats to using those threats as motivation to get involved. (Klivans and Leitsinger, 10/1)

Women who have a hysterectomy may be at increased risk for depression and anxiety, a new study reports. Researchers used medical records of 2,094 women who had had a hysterectomy without removal of the ovaries, matching them with the same number of women of the same age who had not had the operation. None of the surgeries were performed to treat cancer. They followed them for an average of 22 years. (Bakalar, 10/1)

Physically fit young adults have healthier white matter in their brains and better thinking skills than young people who are out of shape, according to a large-scale new study of the links between aerobic fitness and brain health. The findings suggest that even when people are youthful and presumably at the peak of their mental prowess, fitness — or the lack of it — may influence how well their brains and minds work. (Reynolds, 10/2)

On Wall Street, meat substitutes are all the rage. But in the world of dietary science, meat may be making a comeback. This was underscored by the publication Tuesday of findings by a team of researchers in the Annals of Internal Medicine. The team conducted four systematic reviews of various studies examining links between red or processed meat and cardiovascular health, cancer risk and other health outcomes. They concluded that the evidence isn’t strong enough to recommend that people reduce their consumption of red meat or processed meats. (Back, 10/1)

Could the leading cause of death in hospitals be curtailed with a safe and inexpensive treatment that includes vitamin C? That question has been on the minds of intensive care doctors since the spring of 2017, when a well-known physician asserted that he was saving the lives of most of his patients with sepsis by using a treatment based on intravenous vitamin C. (Harris, 10/1)

United Parcel Service Inc. said it received the first-of-its-kind federal approval to start setting up a fleet of unmanned aircraft to deliver health supplies and eventually consumer packages potentially throughout the U.S. In the latest regulatory boost for expanded commercial drone services, the company also intends to gradually phase in routine night flights and heavier cargo limits—areas now generally off-limits to most operators. (Pasztor, 10/1)

UPS has won government approval to operate a nationwide fleet of drones, which will let the company expand deliveries on hospital campuses and move it one step closer to making deliveries to consumers. Many regulatory obstacles remain, however, before UPS — or other operators who are testing drones — can fill the sky over cities and suburbs with drones carrying goods to people’s doorsteps. (Koenig, 10/1)

Over the past six months, UPS has already made 1,100 medical sample deliveries at a Raleigh, North Carolina, hospital under a government pilot program. The deliveries travel 150 meters from one hospital location to another. Now UPS plans to expand to more than 20 hospitals over the next two years. (McFarland, 10/1)

Researchers say a host of new risk factors are driving more hospital-acquired heart valve infections and that should compel healthcare providers to re-evaluate their strategies for reducing the threat to patients. A recent analysis of more than 21,000 records of hospitalized patients in New Jersey from 1994 to 2015 found that beginning in 2004, there was a sharp rise in patients developing heart valve infections while being treated for other health conditions. (Johnson, 10/1)

Hospitals that treat large populations of patients insured by both Medicare and Medicare appear to be benefiting from the changes made to the CMS' Hospital Readmissions Reduction Program with lower penalties, according to new data. In the recent release of fiscal 2020 penalties for the program, the CMS for the second time risk-adjusted hospitals into five peer groups by proportion of inpatient stays where the patient was dually eligible for both Medicare and Medicaid. (Castellucci, 10/1)

A federal program aimed at reducing hospital readmission rates has resulted in lower Medicare payments for over 2,500 hospitals across the country this year, with more than 20 hospitals and surgical centers across Louisiana receiving penalties that came in above the U.S. average. Sixty-seven of Louisiana's 84 qualifying hospitals will see their Medicare payments trimmed by the Centers for Medicare and Medicaid Services starting Tuesday. (Woodruff, 10/1)

In what's become a common refrain, a new Kaufman Hall report found softening volumes drove profitability declines for U.S. hospitals in August. Hospitals' operating earnings before interest, taxes, depreciation and amortization (EBITDA) margins fell 9.4%, or 139 basis points, year-over-year, and operating margins declined 11.4% in that time, or 122.5 basis points. (Bannow, 10/1)

Five Louisiana residents and one South Carolina man have been accused in health care fraud and kickback schemes designed to cash in on bogus testing, medical equipment prescriptions and mental health billings worth nearly $250 million to federal health insurance programs for the poor and elderly. Among the schemes is Louisiana's piece of one of the largest health care frauds ever uncovered in the United States, totaling more than $2.1 billion nationally, state and federal prosecutors said. (Mitchell, 10/1)

A Katy woman has been charged with defrauding the Department of Veterans Affairs of more than $600,000 in prescription medication reimbursements, the U.S. Attorney's Office announced Monday. Tammy Wilson, a 49-year-old widow of a military veteran, was accused of submitting falsified prescription summaries to the Civilian Health and Mental Program of the Department of Veterans Affairs, which reimburses eligible candidates for out-of-pocket prescription expenses, according to a releases from the attorney's office. (Gill, 10/1)

Novartis and Microsoft announced they are joining forces to apply artificial intelligence to some of the most intractable problems in healthcare, in one of the most expansive tie-ups so far between big pharma and big tech. Under one part of the five-year agreement, which will be reviewed annually, Microsoft will work on new tools intended to make it easier to apply AI to all areas of the Swiss pharmaceutical company’s business, from finance to manufacturing. (Neville and Waters, 10/1)

If the technology holds up, Caption, until recently called Bay Labs, could succeed in solving the problem of making heart sonograms easier to obtain. It’s already impressed some in the life sciences. Among them is health care executive Andy Page, who spent four years as Anne Wojcicki’s right-hand man at 23andMe and a year as the president and chief financial officer at digital health startup Livongo. He was introduced to Caption Health last fall by one of its investors, the billionaire Vinod Khosla. He has chosen to become its chief executive. (Herper, 10/1)

Biogen announced Tuesday that its R&D chief is leaving for a venture capital firm and CEO job, only six months after the high-profile failure of the company’s Alzheimer’s drug. His duties will be taken over by Al Sandrock, Biogen’s chief medical officer, who has become more synonymous with Biogen (BIIB) than any other executive. In the end, that could be a good thing. (Herper, 10/1)

Bayer AG Tuesday appointed a prominent U.S. agriculture expert to its board in the German chemicals and pharmaceuticals company’s latest effort to convince investors that it has its troubled crop-science business under control. Bayer said Ertharin Cousin, a former director of the United Nations World Food Program, would succeed German manager Thomas Ebeling on its supervisory board. (Bender, 10/1)

Zantac and its generic varieties are coming off store shelves after the Food and Drug Administration revealed it found a chemical that could be linked to cancer. Monday, pharmacy chains CVS and Walgreens announced they would suspend sales of Zantac brand pills and generic versions that contain ranitidine, the active ingredient of the drug commonly used to treat heartburn after the FDA found a "low level" of a possible carcinogen called nitrosodimethylamine (NDMA). Although the chains suspended sales, the FDA said it's not recommending users stop taking the drug. Zantac maker Sanofi said it isn't halting shipments of the drug in the USA. (Molina, 10/1)

North Carolina Republican legislators and Democrats led by Gov. Roy Cooper tried on Tuesday to bring renewed energy toward resolving a summer budget stalemate that’s drifted into fall. But their hoped-for outcomes remain different. Republican Senate leader Phil Berger announced his chamber will adjourn for the year by Oct. 31 with or without an enacted budget. He also kept open the idea of passing a spending plan by completing the override of Cooper’s budget bill veto or working out a side deal with Senate Democrats. ... Cooper vetoed the GOP’s two-year state budget in late June largely because it lacks Medicaid expansion for hundreds of thousands of low-income adults and what he considers robust pay raises for teachers. (Robertson, 10/1)

North Carolina Democrats at the legislature are trying to build momentum to expand Medicaid to more low-income residents now that some House Republicans recently revived the idea. The House and Senate minority leaders scheduled a hearing for Tuesday at the Legislative Building on the need to offer Medicaid to more uninsured adults. Other expansion advocates planned a news conference earlier in the morning. The hearing isn’t an official committee meeting, so no bill can move through the legislative process there. (10/1)

State health officials recommended limited cuts to a Medicaid program for people with disabilities Monday, after months of deliberating on potential changes that could affect more than 34,500 clients who depend on the program for services. The recommended cuts were much lower than advocates for clients with developmental disabilities had feared. But the decision will be up to the Legislature, which ordered a redesign of the program and will consider the recommendations in its 2020 session. (Koh, 10/1)

Gov. Ron DeSantis’ administration on Monday recommended the state keep intact a Medicaid “waiver” program for people with developmental and intellectual disabilities but called for a redesign of how the so-called iBudget program works, including capping amounts people could spend annually on services designed to keep them at home. The DeSantis administration turned over to legislative leaders a required report that contains 11 recommendations for lawmakers to consider when they begin the 2020 session in January. (Sexton, 10/1)

Gov. Gretchen Whitmer defended at a news conference Tuesday her extraordinary use of line-item vetoes to slash close to $1 billion from the 2020 state budget and called on Republican leaders to meet with her Thursday to restart negotiations on the spending plan. ...Some of the cuts resulting from vetoes appeared targeted at rural areas that tend to elect Republican lawmakers. Those include $13.1 million for secondary road patrols, $16.6 million for rural hospitals, and close to $8 million to pay for rural obstetricians. Whitmer also vetoed tens of millions of dollars in rate increases for hospitals, pediatric psychiatrists, neonatologists, and private duty nurses. (Egans, 19/2)

More than a third of all House lawmakers represent districts where a mass shooting has occurred this year, highlighting the bipartisan pressure on Congress to take action on gun legislation after a wave of killings in Texas and Ohio during August. An analysis by The Hill found that about two-thirds of those shootings have taken place in districts represented by Democrats, many of whom represent cities hard-hit by the scourge of gun violence, while a third occurred in Republican-held districts, from the suburbs to rural communities. (Lancaster, Jarvis, Dunwoodie and Hill, 10/2)

California firefighters and first responders now have a stronger chance at earning workers’ compensation when they are diagnosed with post-traumatic stress disorder from job-related injuries. Gov. Gavin Newsom’s office announced he signed Senate Bill 542 on Tuesday to create a rebuttable presumption that a worker’s mental health struggles are an occupational injury, which could qualify them for paid time off to recover. (Wiley, 10/1)

A federal judge in Nashville ruled this week that Tennessee’s treatment of prisoners with hepatitis C is not grossly inadequate but warned the state to make good on its promises to treat more patients more quickly. In a Monday ruling, U.S. District Judge Waverly Crenshaw noted that Tennessee has made a number of changes to improve treatment of the sometimes deadly disease within the past few months. (Loller, 10/1)

A transgender University of Georgia employee and his legal team are hailing a lawsuit settlement they hope will encourage employers to expand health care benefits to transgender workers statewide. The UGA worker, who goes by the name Skyler Jay, 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, 10/1)

The University System of Georgia has agreed to cover medical care related to gender transitions after an employee challenged policies that denied health-insurance coverage for sexual-reassignment surgery. Skyler Jay, a University of Georgia catering manager who is transgender, sued the public university system last year, alleging that its health plan was discriminatory. Jay, a graduate of the university, was a guest on season two of the Netflix series “Queer Eye.” (Tozzi, 10/1)

San Francisco Supervisors Hillary Ronen and Matt Haney will unveil a series of modifications Tuesday to their plan to overhaul the city’s mental health care system. The changes don’t move the measure — dubbed Mental Health SF — away from its ambitious central goal of providing free, efficient and round-the-clock access to psychiatrists and pharmacists for any San Franciscan 18 and older. (Fracassa, 10/1)

The Ohio Department of Health is celebrating the 100th anniversary of its Children with Medical Handicaps program. The program, which has sometimes fought to survive budget cuts, helps pay for treatment and care for children whose medical needs are not met by insurance. (Price, 10/1)

Thousands of Georgians with Anthem insurance are now out of network if they visit hospitals and other facilities run by a Gainesville-based health system. The contract between Anthem, the state’s largest health insurer, and Northeast Georgia Health System (NGHS) expired early Tuesday. (Miller, 10/1)

The UAW's lead negotiator in talks with General Motors told striking union members Tuesday afternoon the two sides remain far from a tentative agreement on the 16th day of a nationwide strike. In a letter to members, Terry Dittes said that GM made a "comprehensive proposal" at 9:40 p.m. Monday. "This proposal that the company provided to us on day 15 of the strike did not satisfy your contract demands or needs. There were many areas that came up short like health care, wages, temporary employees, skilled trades and job security to name a few. (LaReau, 10/1)

The estimated $800 million program will make it easier for workers to take care of personal medical needs or family members, or bond with a new child with less financial worry. The benefits will be available to every worker in the state and affect every employer. (Enwemeka, 10/1)

Cleveland is one of seven communities in the country that was awarded a new “High Impact Neighborhood” grant by the the U.S. Department of Housing and Urban Development. Cleveland’s $9.7 million award, announced Monday, will allow the city to mount an intense effort to cleanup lead paint hazards and improve the health of housing in a section of Glenville, a neighborhood with historically high rates of lead poisoning. (Dissell, 10/1)

Artificial stone used to make kitchen and bathroom countertops has been linked to cases of death and irreversible lung injury in workers who cut, grind, and polish this increasingly popular material. The fear is that thousands of workers in the United States who create countertops out of what's known as "engineered stone" may be inhaling dangerous amounts of lung-damaging silica dust, because engineered stone is mostly made of the mineral silica. (Greenfieldboyce, 10/2)

Tests have shown a Michigan man was infected with pulmonary tuberculosis while hunting deer, but an Iowa wildlife expert says hunters here face no increased risk. Rachel Ruden, the Iowa Department of Natural Resources' wildlife veterinarian, said the outbreak of deer-transmitted bovine tuberculosis has been contained to four counties in Michigan's Lower Peninsula. "Bovine tuberculosis has not been detected in Iowa" deer herds, Ruden said. "This is a wildlife health issue specific to Michigan." (Eller, 10/1)

Minnesota is one of seven states receiving a federal grant to study the prevalence and treatment of sickle cell disease, an inherited blood disorder that causes extreme bouts of pain and can lead to early death. Every year Minnesota's newborn health screening program identifies about 30 children who are born with sickle cell disease, but the total number of children and adults who have the illness is a mystery because there is no central registry. Public health officials and advocates say getting more information will help them identify gaps in care so treatment and support services can be improved. (Howatt, 10/1)

Reports of sex offenses at the University of Southern California rose sharply last year, a spike that campus officials say results from a mass of allegations of sexual misconduct against former campus gynecologist George Tyndall. The annual security and fire safety report, released by the university Tuesday, shows 92 reports of rape and 25 reports of fondling last year, a combined increase of more than 200% from the prior year. In 2017, the university received 17 reports of rape and 17 reports of fondling, according to the document. (Fry, 10/1)

The overwhelmed foster care system in opioid-ravaged West Virginia has failed to protect children, according to a federal lawsuit filed Monday. The lawsuit seeking class-action status was filed in U.S. District Court on behalf of a dozen children against Gov. Jim Justice, the state Department of Health and Human Resources and other state officials. (Raby, 10/2)

Using patents licensed from the University of California, Davis’ tiny Evolve BioSystems funneled every dollar it could raise into figuring out how to correct dangerous imbalances in the guts of newborn infants and developing supplements to foster the growth of healthy bacteria. The company’s investment and intellectual property now stands at risk of being compromised because pharmaceutical industry giant Abbott Laboratories is introducing a product that would infringe upon UC and Evolve patents, leaders of the Davis company and UC alleged in a lawsuit they announced Monday. (Anderson, 10/1)

A federal judge on Tuesday temporarily blocked Georgia’s restrictive new abortion law from taking effect, following the lead of other judges who have blocked similar measures in other states. The law signed in May by Republican Gov. Brian Kemp bans abortions once a “detectable human heartbeat” is present, with some limited exceptions. Cardiac activity can be detected by ultrasound as early as six weeks into a pregnancy, before many women realize they’re expecting, according to a legal challenge. (Brumback, 10/1)

After a legal challenge from abortion rights advocates, Judge Steve Jones of the U.S. District Court for the Northern District of Georgia issued a preliminary injunction blocking the law while it is argued in court. Jones wrote the plaintiffs met their burden of showing the ban would cause “irreparable harm” and violate a woman’s constitutional right to privacy. He also stated that the U.S. Supreme Court has “repeatedly and unequivocally” held that a state cannot ban abortion before viability. (Schmidt, 10/1)

The Georgia law, signed by Gov. Brian Kemp in May, would have gone into effect in January. It would prohibit most abortions once doctors can detect a fetal heartbeat, which occurs around six weeks of pregnancy. Current Georgia law restricts abortions after 20 weeks of pregnancy. (Zaveri, 10/1)

The heartbeat bill's exceptions include cases that involve rape or incest when the woman files a police report. It allows for abortions when a fetus is determined not to be viable or the mother's health is in jeopardy. The current Georgia law allows abortions up to the 20th week of pregnancy. (Terry Ellis, 10/1)

The ACLU, Center for Reproductive Rights and Planned Parenthood sued the state after Republican Gov. Brian Kemp signed the ban into law in May, arguing that it violates Roe v. Wade's prohibition on banning abortion before a fetus is viable, which occurs at about 24 weeks of pregnancy. A fetal heartbeat usually can be detected around six weeks of pregnancy. The law would impose criminal penalties including jail time for abortion providers and was set to take effect in January. (Ollstein, 10/1)

“This case has always been about one thing: letting her decide. Everyone is entitled to their own opinion, but every woman is entitled to her own decision,” Sean J. Young, legal director of the ACLU of Georgia, said in a statement Tuesday. (Axelrod, 10/1)

The number of abortions performed in Ohio dropped last year by 2% from the year before and hit an all-time low since the Ohio Department of Health first kept statistics on pregnancy terminations in 1976, according to an Ohio Department of Health report released Monday. A total of 20,425 induced pregnancy terminations were reported in Ohio for 2018. Ninety-four percent were obtained by state residents. (Hancock, 10/1)

The latest count marks a 53% drop in abortions since a peak of more than 45,000 in 1982, closely tracking the national trend. The decline has done little to quell the debate over abortion rights, which is as heated as it’s been since Roe v. Wade, the U.S. Supreme Court’s landmark ruling in 1973 legalizing abortion up to viability, roughly 22 weeks of pregnancy. Abortion is still legal, but in Ohio and elsewhere, opponents have been successful in chipping away at women’s access to the procedure. (Candisky, 10/1)

Kansas conservatives are trying to overturn a state Supreme Court decision that protects abortion rights and threatens years’ worth of Republican-enacted restrictions, guaranteeing an election-year fight over amending the state constitution. A legislative study committee opened two days of hearings Tuesday on a ruling in April by the state’s highest court that access to abortion is a fundamental right under the Kansas Constitution. The Republican-led committee is expected to urge the full, GOP-controlled Legislature to put a proposed constitutional change on the ballot next year for voters to consider. (Hanna, 10/1)

A federal judge in Virginia has upheld the state’s law requiring women to have an ultrasound at least 24 hours before obtaining an abortion and a separate measure requiring physicians to perform the procedure. Abortion rights activists and providers had challenged Virginia laws they said unnecessarily restrict access, particularly for poor women, and make it difficult and expensive for clinics to operate. After an eight-day trial in federal court in Richmond, the question for the judge was whether regulations affecting health-care providers, facilities and patients present a substantial, unconstitutional obstacle for women seeking abortions. (Marimow, 10/1)

Such restrictions aren’t just about limiting when and under what circumstances women can get abortions — these laws can also affect how much the procedure costs, research suggests. And those who are denied the procedure fare worse economically, some studies have shown. (Jagannathan, 10/2)

Former Baltimore health commissioner and city resident Dr. Leana Wen was removed in July as head of Planned Parenthood, but she quickly returned to a teaching position at George Washington University. The trained emergency physician plans to remain an advocate for public health, and with all of her experiences, she now has a few more things to say about it. (Cohn, 10/1)

Planned Parenthood Affiliates of California today named Jodi Hicks, a longtime Sacramento health care lobbyist, as its new CEO and president.Hicks has been serving as acting CEO since June, after Crystal Strait, who had been at the helm for two years, stepped down in May for personal reasons. Hicks assumed the role on a permanent basis effective immediately. (Colliver, 10/1)

House Democrats’ headlong rush to impeach President Trump will have many implications for American politics and the presidential election. On policy, it could have a salutary effect for conservatives, by precluding the enactment of harmful policies that would push our health care system in the wrong direction. Congress should of course do something about our health care system, particularly the millions of individuals priced out of insurance by Obamacare, also known as the Unaffordable Care Act. But in recent weeks, it appears that Republicans have fallen into the typical definition of bipartisanship—when conservatives agree to do liberal things. As a result, if the controversy over impeachment leads to a legislative stalemate over health care, it will at least prevent Congress from making our current flawed system any worse. (Christopher Jacobs, 10/1)

E-cigarettes were marketed to Americans as safe alternatives to traditional tobacco products, but it is becoming increasingly clear that their safety has been dramatically overstated, putting millions of lives in danger. States have the ability to restrict the sale of tobacco and vape products while researchers study their effects. New Jersey must follow the lead of states like Massachusetts — where the governor recently banned the sale of all vaping products for four months — and ban the sale of vaping products until we understand the health risks associated with them. (Carmen Rodriguez, 9/30)

Juul spent more than $10 million on a campaign to regain its ability to sell vaping products in San Francisco. On Monday, it withdrew from the fight for its Proposition C. It was a smart move, one that saved the company millions of additional dollars it had been prepared to spend on an exercise in futility. Its campaign was as disastrous as it was disingenuous, and it was against the backdrop of an onslaught of national news stories about the concerns over the health hazards of vaping. (10/1)

Political leaders in Iowa and in Washington, D.C., have made it their mission to politicize reproductive health care. As a result, Iowa now faces a public health crisis.  In a two-year span, these lawmakers’ reckless policies have decimated Iowa’s once robust safety net that ensured people could get affordable reproductive health services. Now, Iowa’s most vulnerable citizens are faced with losing the care they need or paying out of pocket for it — which many can’t afford. (Erin Davison-Rippey, 10/1)

Joyce Viets’ dad was in the life insurance business, so she knew from an early age that you have to plan ahead. “I heard about actuarials my entire life,” the Temecula resident told me. Viets, 82, purchased long-term care insurance nearly two decades ago, anticipating there would come a time when she’d be glad to cover the costs of a nursing home, which can run nearly $300 a day in California for a private room. So it was with more than a little dismay — and a strong sense of betrayal — that she received a recent letter from her long-term care insurance provider, Genworth Financial, informing her that her monthly premium is rising by 80%, to $530.71 from $294.84. (David Lazarus, 10/1)

It should be shocking that 48 Maine military veterans died by suicide in 2017, according to a new report from the U.S. Department of Veteran Affairs. Sadly, it is not. It’s not surprising because, despite a dip to 30 in 2016, Maine has suffered an average of 43 such deaths a year since 2010, every one a tragedy. It’s not surprising because despite the attention the rise in veteran suicides nationwide has brought to the issue, the number has continued to increase through the last decade. (9/30)

More than 6 million California students returned to school over the past few weeks; many excited to reunite with friends, dive into new classes or engage in sports, clubs, and other activities. Nevertheless, a significant number of our students struggle to make it through each day and need our support and help. According to the U.S. Department of Health and Human Services Office of Population Affairs, one in three high schoolers reported feeling sad or hopeless almost every day for two or more weeks in a row.  While their faces may not always show their depression, nonetheless they struggle under the weight of it on a daily basis. (Mary Ann Dewan, 10/1)

Kids are walking around middle schools and high schools with smartphones and apps that have become a bully’s best friend. Live grenades, you might even say. And all we parents are doing, it seems, is watching, helplessly, as Big Tech keeps getting bigger and bigger while our kids get sucked deeper and deeper into the diabolical depths of their profit-making devices and apps. (Maria Panaritis, 10/2)

At this point, over a year later, I can’t remember if I asked Senator Elizabeth Warren about the Spock ears, or what. She had called me on the phone at my house in Maine. This was a couple of months after I had devoted one of my Times columns to hearing aids. I had lamented a number of things in that essay, especially the cultural stigma associated with the devices. Cool glasses? You’re Elton John. Hearing aids? You’re a little old lady. (Jennifer Finney Boylan, 10/1)

As a health administrator and as a patient who has been poked, prodded, and stitched up by the best and worst of them, I think I know a great doctor when I see one. That is why the recent death of a respected surgeon I was privileged to know as my doctor and as the genius whose amazing surgical skills gave my husband a new life has underscored my recognition of what a precious and rare gift a truly exceptional healer is. (Mary Ann Sorrentino, 10/2)

Families in nearly every neighborhood of our country have suffered because of the opioid and substance abuse epidemic. For years, the situation just seemed to get worse as addiction hurt more families. Kentucky has tragically been among the hardest-hit states. Thankfully, however, our years-long efforts are finally producing a glimmer of hope.A new report released this summer showed overdose deaths in Kentucky declined last year by nearly 15% — the largest drop in more than a decade. Across the country, states saw similar good news culminating in a 5% decrease nationwide. (Sen. Mitch McConnell, 9/26)