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In a pair of exceptionally hard-fought arguments on Tuesday, the Supreme Court struggled to decide whether a landmark 1964 civil rights law bars employment discrimination based on sexual orientation and transgender status. Job discrimination against gay and transgender workers is legal in much of the nation, and the wide-ranging arguments underscored the significance of what could be a momentous ruling. If the court decides that the law, Title VII of the Civil Rights Act, applies to many millions of lesbian, gay, bisexual and transgender employees across the nation, they would gain basic protections that other groups have long taken for granted. (Liptak and Peters, 10/8)

The nine justices heard two hours of high-profile arguments in three cases that could broaden LGBT rights involving three workers - two gay and one transgender - who sued after being fired by their employers, claiming unlawful discrimination. The Supreme Court has never ruled on transgender rights. The court’s four liberal justices signaled agreement toward arguments by the plaintiffs that gay and transgender workers are covered under Title VII of the Civil Rights Act of 1964, which bars employers from discriminating against employees on the basis of sex as well as race, color, national origin and religion. (Hurley and Chung, 10/8)

The Supreme Court appeared divided Tuesday about whether federal discrimination laws protect gay and transgender workers, and President Trump’s appointments to the court could play the pivotal roles in deciding the outcome. (Barnes and Marimow, 10/8)

The court's four liberal justices forcefully denounced the firings of two gay men and a transgender woman from Georgia, New York and Michigan and made clear they believe all three should be protected by the statutory ban on sex discrimination. "We can't deny that homosexuals are being fired merely for being who they are and not because of religious reasons, not because they are performing their jobs poorly," Associate Justice Sonia Sotomayor said, calling it "invidious behavior." ... Gorsuch said sex was at least "in play," an acknowledgment that the gay and transgender workers claiming sex discrimination have a reasonable argument. What he did not say: that the courts should fix it. Instead, Gorsuch said the "massive social upheaval that would be entailed in such a decision" in the fired workers' favor points more toward Congress. "It's a question of judicial modesty," he said. (Wolf, 10/8)

Hearing the case of a transgender woman from Redford on Tuesday morning, several U.S. Supreme Court justices seemed to struggle to find a way to balance precedents against using sex stereotypes while maintaining separate gender-based rules for bathrooms, dress codes and programs meant to ensure equality. "There are other women ... who would feel intruded upon if someone who still had male characteristics walked into their bathroom," Justice Sonia Sotomayor said, questioning how the rights of non-transgender women could be balanced with those of transgender women. "The hard question is, how do we deal with that?" (Spangler, 10/8)

“I found it a little overwhelming when I realized that I could be in the history books,” Aimee Stephens told me Monday morning. I’d just asked her how she felt about bringing the first transgender rights case to the Supreme Court. “Somebody’s gotta do it and I’d be happy and satisfied to be that person.” (Burns, 10/7)

U.S. Senator Bernie Sanders said on Tuesday he had wrongly ignored warning signs about his health before suffering a heart attack last week, but that he did not think the scare would damage his campaign for president. Sanders, one of 19 Democrats competing to take on Republican President Donald Trump in the November 2020 election, suffered chest pains on Oct. 1 while in Nevada for a campaign stop and abruptly canceled campaign events. (Lewis, 10/8)

“I should have listened to those symptoms,” he said. “If there’s any message that I hope we can get out there, is that I want people to pay attention to their symptoms. When you’re hurting, when you’re fatigued, when you have pain in your chest, listen to it.” Sanders was speaking to a room of supporters in Las Vegas one evening last week when he stopped the event and asked for a chair. He was taken to a hospital, where doctors discovered he’d had a heart attack. They inserted two stents to clear a blocked coronary artery. He spent three days in the hospital. (Finnegan, 10/8)

Senator Bernie Sanders, in a striking concession for a leading presidential candidate, said on Tuesday that he planned to slow down his pace on the campaign trail after suffering a heart attack a week ago, and acknowledged that voters would likely consider his health when deciding whether to support him. “I think we’re going to change the nature of the campaign a bit,” Mr. Sanders told reporters after a visit with a local cardiologist. “Make sure that I have the strength to do what I have to do.” (Ember and Martin, 10/8)

Sen. Bernie Sanders said the heart attack that has briefly sidelined him from the campaign trail did not mean he would be moving up the timeline to release his medical records, telling reporters they would come out “at the appropriate time.” (Oprysko, 10/8)

No chimpanzees or gorillas are in training for a fall marathon — a reflection, perhaps, of the ways in which the hearts of apes and men look and function as they do, according to a major new study of the health and evolution of cardiac muscles. The study, which involved scanning the hearts of untamed primates and a wide variety of men, indicates that hearts adapt in telling ways to the needs of their owners. The findings likewise suggest that not getting enough of the right kind of exercise could mean that our hearts start to look just a little bit less human, and could impact our long-term health. (Reynolds, 10/9)

Dog owners live longer and fare better after a heart attack or stroke compared with those who have no canine companions, two studies published Tuesday suggest. Researchers found that dog ownership was associated with a 24-percent reduced risk of death from any cause among the general public, and a 33 percent lower risk of death among heart attack survivors who live alone, according to the reports, published in the journal Circulation: Cardiovascular Quality and Outcomes. (Carroll, 10/8)

The U.S. state of Arizona withdrew its support for a proposed nationwide opioid settlement with Purdue Pharma LP, saying the maker of OxyContin sought to "undermine material terms of the deal," according to a court filing on Monday. Since Purdue filed for bankruptcy protection in September, Arizona is the first state to switch sides in the looming showdown over the privately-held company's proposed settlement, which it has estimated is worth more than $10 billion. (Hals, 10/8)

Brnovich has not gone as far as backing out of the tentative settlement. His spokesman, Ryan Anderson, said the state is “not interested in renegotiating terms that we’ve already agreed upon.” He made waves in July, when he asked the U.S. Supreme Court to find that some of the Sackler money was fraudulently transferred from Purdue and to force family members to return it to the company so it could be part of any settlement with or judgment against the company. (Mulvihill, 10/8)

In a statement, Arizona Attorney General Mark Brnovich said: “It’s in everyone’s best interest to secure a just and timely settlement. Purdue and the Sackler family need to take responsibility for their role in the opioid crisis.” Uniquely among the states, Arizona has challenged Purdue in the U.S. Supreme Court, filing an unusual lawsuit in the nation’s highest forum in July seeking to force the disgorgement of billions of dollars collected by Purdue’s shareholders. (Scurria, 10/8)

Some of the biggest names in health care, including the Blue Cross & Blue Shield Association, will serve alongside mothers of addicted babies on a committee of creditors in the bankruptcy of Purdue Pharma LP. The unusual alliance is well positioned to play an outsized role in the coming bankruptcy battles between the pharmaceutical company and its opponents. Judges often rely on such official creditor committees to test the reorganization plans of bankrupt companies. (Church and Hill, 10/7)

A Massachusetts judge has denied a motion to dismiss a lawsuit that claims members of the Sackler family and the company they own, Purdue Pharma, helped create the nation's opioid epidemic. In a decision released late Tuesday afternoon, Suffolk Superior Court Judge Janet Sanders said Massachusetts Attorney General Maura Healey has jurisdiction to pursue the 17 individuals named in the suit. (Bebinger, 10/8)

Homeless shelters would have to increase the level of on-site medical care they provide opioid-addicted clients under a bill being considered by the New York City Council. The bill, introduced by Councilman Stephen Levin, would require all shelters to have buprenorphine, an addiction medication, available on-site, in addition to at least one physician or physician assistant familiar with treating opioid addiction. Mr. Levin called the bill a response to the growing opioid epidemic, which has contributed to a recent spike in overdoses among the homeless population in the city. (Blint-Welsh, 10/8)

Drug companies removed the father of a 4-year-old girl who died from abuse from a list of witnesses they intend to call at this month’s opioid trial, even though they still might raise the issue. The companies made clear that there is value in presenting such information to a jury, as well as evidence of problems uncovered in Cuyahoga County’s jail and with its executive’s administration. (Heisig, 10/8)

The scene is playing out in courtrooms from coast to coast — federal judges being asked to block a new Trump administration policy scheduled to take effect next week that would deny legal permanent residency to many immigrants over the use of public benefits. Almost a dozen lawsuits have been filed from New York to California with plaintiffs including states, counties, cities, service providers and immigrants to prevent the "public charge" rule from taking effect on Oct. 15. (Hajela, 10/8)

CBS News takes viewers inside the real-life challenges facing migrant families split apart by the Trump administration's "Zero Tolerance" policy. The documentary provides an immersive look at the hotly debated issue through the eyes of those impacted the most — the fathers, mothers, sons and daughters separated and unaware when they'll see their family members again. (10/7)

A Philadelphia jury on Tuesday hit Johnson & Johnson with an $8 billion verdict over its marketing of the anti-psychotic drug Risperdal, siding with a Maryland man who argued that the health care giant downplayed risks that the drug could lead to breast growth in boys. The verdict in the Philadelphia Court of Common Pleas was the first to award punitive damages against Janssen Pharmaceuticals, a Johnson & Johnson subsidiary, said Thomas R. Kline, a lawyer who is part of a legal team representing the man and more than 10,000 people in similar lawsuits. (Zaveri and Thomas, 10/8)

A law firm for the plaintiff released a statement Tuesday saying the companies used an organized scheme to make billions of dollars while illegally marketing and promoting the drug called Risperdal. Johnson & Johnson says the award “is grossly disproportionate with the initial compensatory award in this case,” and that the company is “confident it will be overturned.” (10/8)

It was the biggest award to date among more than 13,000 lawsuits against J&J alleging that Risperdal caused a condition called gynecomastia in boys, which involves enlargement of breast tissue. The lawsuits generally claim that J&J was aware of the risk of this side effect, but understated the risk to doctors. It is also the latest in a series of costly legal setbacks for J&J in a slew of lawsuits alleging injuries from products and other claims. In August, an Oklahoma judge ordered the company to pay $572 million for contributing to the state’s opioid-addiction crisis. (Loftus, 10/8)

The verdict, which is unlikely to be upheld on appeal, may nonetheless sound an ominous warning for J&J since the company still faces more than 13,000 suits over its Risperdal marketing and failure to warn teens about its health risks, according to the company’s filings with the U.S. Securities and Exchange Commission. More than 7,000 of those cases are pending in state court in Philadelphia, according to court records. (Feeley and Griffin, 10/8)

A 17-year-old Bronx boy whose death was disclosed by New York State officials on Tuesday is the first teenager in the United States to die of a vaping-related illness, according to federal and state data. The teenager died on Friday after being hospitalized twice in September with a vaping-related illness, becoming the state’s first fatality from the mysterious lung disease, according to state health officials. (Shanahan and Paybarah, 10/8)

The health department is investigating the death and exploring the possibility that the person used both THC, the psychoactive ingredient in marijuana, and nicotine products, the health department said. “This vaping is a public health crisis. It is affecting our young people,” Mr. Cuomo said Tuesday at an unrelated news conference. “Parents have to know, young people have to know, you are playing with your life when you play with this stuff.” (West, 10/8)

Melania Trump will hear directly from teens and young adults about their experiences with electronic cigarettes and vaping. The White House says she has invited a group from the Truth Initiative to participate in a "listening session" Wednesday. It will be the second time this week that the first lady has highlighted e-cigarettes and vaping among youth. (Superville, 10/8)

Los Angeles officials are considering banning all e-cigarettes and vaping devices in the city, one of the most extreme proposals yet to curb a nationwide outbreak of lung illnesses linked to vaping. Amid reports that more than 1,000 people have been diagnosed with severe lung problems, politicians across the country have been pushing restrictions on e-cigarettes, which have soared in popularity among young people in recent years. (Karlamangla, 10/8)

Alibaba Group Holding Ltd. said Wednesday that it will suspend sales of e-cigarettes and accessories to buyers in the U.S., following a rash of vaping-related pulmonary illnesses and several deaths in the country. The move aims to address U.S. concerns with underage e-cigarette usage and potential public-health issues related to such products, Alibaba said. (Wang, 10/8)

Montana is placing a temporary ban on the sale of e-cigarette flavors in the wake of rising youth vaping addictions and a vaping-related lung disease linked to at least 18 deaths nationwide. Gov. Steve Bullock (D), who is also a 2020 presidential candidate, said the ban will take effect Oct. 22, and will last for four months to give officials time to fully investigate the cause of the disease. (Weixel, 10/8)

The ban will go into effect Oct. 22 and the 120 days is the maximum time allowed by law. The state is to implement emergency administrative rules to temporarily prohibit the sale of flavored e-cigarettes. Bullock said there are 1,080 confirmed cases of pulmonary illness nationwide, including two in Montana, and 21 deaths related to e-cigarette use are in 48 states and one U.S. territory. More than half the cases are patients under 25. (Drake, 10/8)

In a complex world surrounded by seemingly endless risks, why should one, like vaping e-cigarettes, become a problem that attracts so much national attention from health officials, politicians and the press? No single answer satisfies that question, says Kasisomayajula Viswanath, a health communications expert and professor at the Harvard T. H. Chan School of Public Health. (Santhanam, 10/8)

U.S. infections from three sexually transmitted diseases have risen for the fifth consecutive year. More than 1.7 million cases of chlamydia were reported last year. The infection rate rose 3% from 2017. It's the most ever reported in a year, though the trend is mainly attributed to increased testing. (10/8)

The rate of infection climbed steadily between 2014 and 2018, resulting in a 71% jump in the number of syphilis cases, a 63% increase in gonorrhea and a 19% rise in chlamydia during that period. Budget cuts at the state and local level resulting in staff reductions, clinic closures, less screening and patient follow-up has accounted for the increased disease rates, in addition to decreased condom use, health officials said. (10/8)

It said the increase in newborn deaths was a consequence of rising syphilis rates among women of reproductive age, whom it encouraged to practice safer sex and to get tested for S.T.D.s by their health care providers. “There are tools available to prevent every case of congenital syphilis,” Gail Bolan, director of the C.D.C.’s Division of S.T.D. Prevention, said in a statement. “Testing is simple and can help women to protect their babies from syphilis — a preventable disease that can have irreversible consequences.” There were more than 1,300 cases of syphilis cases among newborns in 2018, a 40 percent increase from the previous year, the center said. The 2018 figure represented a 185 percent increase since 2014. (Stack, 10/8)

"Yet not that long ago, gonorrhea rates were at historic lows, syphilis was close to elimination, and we were able to point to advances in STD prevention," Dr. Gail Bolan, director of the CDC's Division of STD Prevention, wrote in the new report's foreword. "That progress has since unraveled. The number of reported syphilis cases is climbing after being largely on the decline since 1941, and gonorrhea rates are now increasing. "Many young women continue to have undiagnosed chlamydial infections, putting them at risk for infertility." (Howard, 10/8)

Kaiser Health News: Congenital Syphilis Continues To Rise At An Alarming Rate

In California, cases of congenital syphilis — the term used when a mother passes the infection to her baby during pregnancy — continued a stark seven-year climb, to 332 cases, an 18.1% increase from 2017, according to the federal data. Only Texas, Nevada, Louisiana and Arizona had congenital syphilis rates higher than California’s. Those five states combined made up nearly two-thirds of total cases, although all but 17 states saw increases in their congenital syphilis rates. (Barry-Jester, 10/8)

St. Louis has retained the dubious distinction of leading the nation in sexually transmitted diseases, ranking first in 2018 among counties and independent cities for the rate of gonorrhea and — after dropping to third place a year ago — regaining the top spot for chlamydia. The city was fourth for its syphilis rate. Across the U.S., the combined cases of syphilis, gonorrhea and chlamydia reached an all-time high last year, according to the annual report released Tuesday by the Centers for Disease Control and Prevention. (Munz, 10/8)

Millions of pregnant women in the United States are not getting two vital vaccines that protect not only their health, but their babies, the Centers for Disease Control and Prevention said Tuesday. The vaccines — against flu and whooping cough — are strongly recommended during every pregnancy. But only about 35 percent of pregnant women in the country are receiving both vaccines, according to a new C.D.C. report, and just over half receive one. (Belluck, 10/8)

“I want to reinforce that all expectant mothers should be up-to-date with recommended vaccinations as part of their routine prenatal care,” Robert Redfield, director of the U.S. Centers for Disease Control and Prevention, said in a news release. “CDC strongly recommends that health-care providers speak with moms-to-be about the benefits.” But the latest data show that even when providers do that, many women say “no thanks.” Although 75% of women surveyed last spring said the vaccines had been offered, 34% declined the flu shot and 30% declined Tdap. (McCullough, 10/8)

Getting these vaccines protects pregnant women. But the antibodies that are passed to the developing fetus protect their babies after birth as well, when they are too young to be vaccinated. Babies get their first shot of pertussis-containing vaccine at 2 months and can’t be vaccinated against flu until they are 6 months old. “It’s incredibly important,” said Dr. Cynthia Gyamfi-Bannerman, a maternal-fetal medicine specialist at NewYork-Presbyterian/Columbia University’s Irving Medical Center. “We have all seen pregnant women in the ICU with influenza.” (Branswell, 10/8)

The report said the low rates of vaccination during pregnancy could put moms-to-be and newborns at greater risk of infection, hospitalization and death. The two vaccinations pass on antibodies to the fetus that provide protection after birth, when babies are too young to be vaccinated. It added that pregnant women have more than double the risk of hospitalization if they get influenza compared to women of childbearing age who aren't pregnant, the CDC said. (Hunt, 10/8)

Insufficient evidence exists to recommend routine screening for pregnant women at higher risk of preterm birth for bacterial vaginosis, the U.S. Preventive Services Task Force (USPSTF) said. There was not enough evidence to determine the benefits or harms of screening for bacterial vaginosis in patients at risk of preterm birth (I statement), but the task force continued to recommend against screening pregnant women not at increased risk for preterm birth for the infection, because it does not prevent preterm delivery (D statement). (Walker, 10/8)

The nation's three largest pharmacy chains — Walgreens, Rite Aid and CVS — have stopped selling Zantac and its generic alternative. The heartburn drug, used by millions, was pulled after the Food and Drug Administration (FDA) warned this month it may contain a potentially dangerous impurity. But a CBS News investigation reveals that it might not be just an "impurity" — but something much more serious. At a Connecticut lab, called Valisure, researchers test drugs from its own online pharmacy to check for purity and quality. (Lapook, 10/8)

It was a typical Thursday in May 2015 for Rachel Zubrzycki. Amid the hustle and bustle of getting their four children ready for school, Rachel exchanged a quick "I love you" with her husband of 14 years before they split up to drop their children off and go to their respective jobs -- Edward a veteran detective with the Burlington County Prosecutor's Office major crimes unit and Rachel was getting back into the workforce as a part-time reading teacher. What happened next changed her life forever. (Carrega, 10/9)

In the vast, wild world of Instagram beauty influencers, there’s a new category of products on the block: masks, sprays, lipsticks and other cosmetics for…vulvas. They promise to make vulvas — the outside portion of the sex organ where clothes touch the skin — glowier, fresher and softer. (Leventhal, 10/8)

Ikea is recalling thousands of infant bibs over concerns their snaps could be a choking hazard if they detach. The recalled 7,000 MATVRÅ infant bibs appear as a pair in a pack, and were sold in stores online and worldwide. Each pack has a red and blue bib, both of which have the store's logo printed on a white tag on the back. "The blue bib has a green seam along the outside with white polka dots. The red bib has a yellow seam along the outside with red polka dots," IKEA said. (Karimi, 10/9)

Alex Trebek has suggested in a recent interview that his tenure as "Jeopardy!" host may be nearing an end as he battles pancreatic cancer. The 79-year-old, who has hosted the show for 36 seasons totaling nearly 8,000 episodes, told CTV his skills "have started to diminish." Trebek revealed earlier this year that he was diagnosed with stage 4 pancreatic cancer. Despite learning he was near remission in May, he needed to go for  another round of chemotherapy in September –– right as the new season of Jeopardy! began. He admitted taping the show is becoming more difficult. (Brito, 10/8)

To fill in some physician gaps, the Medical College of Georgia is planning new incentives for med students to practice in rural areas by reducing tuition and shortening their time in school. Mercer also has such a program. Mercer Medicine says its two new facilities in Peach and Clay counties will provide an educational component for rural physicians, management services and will help in the placement of future physicians. (Miller, 10/8)

Kaiser Health News: They Enrolled In Medical School To Practice Rural Medicine. What Happened?

The University of Kansas School of Medicine-Salina opened in 2011 — a one-building campus in the heart of wheat country dedicated to producing the rural doctors the country needs. Now, eight years later, the school’s first graduates are settling into their chosen practices — and locales. And those choices are cause for both hope and despair. Of the eight graduates, just three chose to go where the shortages are most evident. Two went to small cities with populations of fewer than 50,000. And three chose the big cities of Topeka (estimated 2018 population: 125,904) and Wichita (389,255) instead. (Weber, 10/9)

Dr. Amy Wheeler set a small tablet computer on the table as she turned to face her patient. Then she did something that’s become increasingly rare for doctors in the digital age: She talked to him without typing or clicking anything. Wheeler didn’t have to take notes, because the microphone on her tablet recorded everything. While she slept that night, a trained doctor working in an office building across the world in Mumbai listened to the recording and typed up a summary. (McCluskey, 10/8)

Dr. Anna Nguyen spoke with none of the five patients she treated on a recent weekday morning. She didn't even leave her dining room. The emergency physician nevertheless helped a pregnant Ohio woman handle hip pain, examined a Michigan man's sore throat and texted a mom whose son became sick during a family trip to Mexico. Welcome to the latest wrinkle in health care convenience: the chat diagnosis. (10/8)

Kaiser Health News: Medicare Fraudsters Now Tap Telemedicine In Medical Equipment Scams

Dean Ernest had been living in a nursing home about a year when his son, John, got a call last winter asking if his father was experiencing back pain and would like a free orthotic brace. The caller said he was with Medicare. John Ernest didn’t believe him, said “no” to the brace and hung up. He didn’t give out his father’s Medicare number. And yet, not just one, but 13 braces arrived soon afterward at Ernest’s house in central Pennsylvania. (Knight, 10/9)

One Medical, a chain of primary care clinics that’s backed by Google’s parent company Alphabet and tries to bring a modern feel to the typical doctor’s office, has hired banks including J.P. Morgan and Morgan Stanley for its IPO, according to people familiar with the matter. The company, which was valued at about $1.5 billion in a financing round last year, is expected to file its prospectus publicly by the first quarter of 2020 and possibly sooner, said the people, who asked not to be named because the plans are confidential. Representatives from One Medical, J.P. Morgan and Morgan Stanley all declined to comment. (Farr and Sherman, 10/8)

PG&E Corp. has begun to shut off power to hundreds of thousands of people in California as it seeks to prevent its electric lines from sparking more deadly wildfires, in what is believed to be the largest such pre-emptive blackout ever. The outages are poised to hit areas across the northern and central parts of the state, including the famous wine country region, the rural Sierra Nevada foothills and portions of Oakland and San Jose. (Blunt, Carlton and Ailworth, 10/9)

The blackouts will impact 34 counties in Central and Northern California. It would be the biggest power shutdown so far as utilities across the state attempt to reduce wildfire risk due to heavy wind. Utilities malfunctions have been tied to some of the state’s most destructive fires, including last year’s Camp fire, which devastated Paradise, Calif., and the 2017 wine country blazes. “It is a very blunt way of approaching the situation, but at the same time, there’s an understanding of why it’s being undertaken,” said Sonoma County Supervisor David Rabbitt, who noted PG&E’s announcement came on the second anniversary of the 2017 firestorm. “We have vulnerable populations, our elderly and young children. We’re mostly concerned about them.” (Serna, Cosgrove and McGreevy, 10/9)

"Turning off the power is an extremely difficult decision to make, because we know how much our friends, families and our communities rely on power," said Scott Strenfel, PG&E's principal meteorologist. But Strenfel said the utility was expecting strong winds with gusts as high as 70 mph, which, coupled with low humidity, could lead to "catastrophic wildfire growth" in vulnerable areas of northern and central California. (Johnson, 10/8)

Health care providers and officials around Northern California said that PG&E’s electrical grid shutdown, expected to trigger blackouts in 34 of 58 counties on Wednesday, will test on a grand scale whether residents and medical care facilities have done enough to planning for medical emergencies. (Anderson, 10/8)

Bay Area hospitals do not expect to go dark during the PG&E power shut-offs slated to begin tomorrow, but health systems that also run urgent care clinics, outpatient facilities and smaller doctors’ offices — which may not have the large backup generators that hospitals typically have — are preparing for the possibility of losing power. John Muir Health, which runs hospitals and medical centers across the East Bay, is preparing to move medications that need refrigeration from clinics in Orinda, Lafayette and San Ramon to locations where power will be maintained, said spokesman Ben Drew. Those medications include flu, shingles and MMR vaccines and osteoarthritis medicine. (Ho, 10/9)

The federal agency that oversees transplant programs said it would investigate Newark Beth Israel Medical Center after ProPublica reported that the hospital was keeping a vegetative patient on life support for the sake of boosting its survival rate. The U.S. Centers for Medicare and Medicaid Services “takes allegations of abuse and mistreatment seriously,” spokeswoman Maria LoPiccolo said in an email on Monday. “CMS is actively monitoring the situation and is in close communication with” New Jersey’s Department of Health, she added. The department said Friday that it was reviewing the allegations. (Chen, 10/8)

A private hospital room was once almost a luxury. Today, private rooms are increasingly standard at many southeast Michigan hospitals, and shared rooms are being phased out to reduce the possibility of hospital-acquired infections and improve comfort for patients and their visitors. Hospitals traditionally charged more for a private room, but this move toward more private rooms is typically not resulting in higher costs, according to health care insiders, because major payers such as Medicare and Blue Cross Blue Shield of Michigan now have policies against paying extra simply based on the sort of room a patient is in. (Reindl, 10/9)

Colorado state agencies unveiled a draft proposal of a public insurance option on Monday that they say could reduce residents' average monthly premiums, largely by paying hospitals less. The draft report on the so-called state option released by the Colorado Division of Insurance and the Department of Health Care Policy & Financing projected that people who enroll could save at least 9% to 18% on their monthly premiums compared to expected individual market rates in 2022, the year the public plans would launch. (Livingston, 10/8)

California will soon end some mandatory sentences, make it easier to expunge old criminal records, bar charging inmates for medical care and ban police from using facial recognition software on body cameras under more than two dozen criminal justice bills that freshman Gov. Gavin Newsom announced signing into law late Tuesday. The measures continue the state's march away from get-tough measures that once clogged California prisons, prompting a federal court-ordered population cap. (10/9)

The assessor of Arizona's largest county has been indicted in connection with 11 felony offenses, including human smuggling, sale of a child and communications fraud in an adoption fraud scheme, authorities said. The Arizona Attorney General's Office confirmed the 32-count federal indictment Tuesday against Maricopa County Assessor Paul Petersen for conspiracy, theft, forgery, and 29 counts of fraudulent schemes, The Arizona Republic reported Tuesday. (10/9)

Opening arguments in a landmark antitrust case against Sutter Health, Northern California’s largest health care system, are poised to begin Thursday, and industry experts say the outcome of the trial could have ripple effects for consumers nationwide. At the heart of the lawsuit, filed in 2014 by a group of self-funded employers — and joined by California Attorney General Xavier Becerra in 2018 — are allegations that Sutter abused its market power to raise prices for employers and insurers. (Ho, 10/8)

The number of inmates killing themselves in California prisons is “far too high,” the state admitted in a new report on the worsening suicide problem in California’s correctional system. The report confirms a Chronicle investigation that revealed the inmate suicide rate in California prisons has climbed four years in a row and reached an unprecedented peak last year with 26.3 suicides per 100,000 prisoners — substantially higher than the suicide rate in other large prison systems across the country. (Fagone and Cassidy, 10/8)

During the 2019 legislative session, for example, the Georgia Legislature passed bills to require parity in payment for providers offering medical care via digital or telehealth transmission. Legislation also allowed physicians to practice telemedicine across state lines so that more doctors and specialists would be available, something especially needed in rural Georgia, where we have a doctor shortage. (Miller, 10/8)

Farmers, lawn service scientists and educators supplied stinging criticism Tuesday of legislation that activists are pursuing to ban the use of pesticides that can be toxic to bees. A working group of the House Environment and Agriculture Committee hosted the first work session on HB 646 since the panel voted in February to hold the measure for more study. The bill would impose a ban on most uses of pesticides that are toxic to bees in response to a massive decline in the bee population here and in many other states. (Landrigan, 10/8)

Flu season is off to an early start in Maryland with health officials reporting Tuesday that the state already has 11 confirmed cases. “We don’t know yet whether flu activity this early indicates a particularly bad season on the horizon,” said Maryland Health Secretary Robert R. Neall in a statement. “Still, we can’t emphasize strongly enough — get your flu shot now. Don’t put it off. (Cohn, 10/8)

A student at a D.C. elementary school has been diagnosed with bacterial meningitis, prompting officials to alert parents of the diagnosis and urge them to have their children evaluated for the disease. An epidemiologist at the District’s Department of Health sent a letter Friday to parents whose children attend Burrville Elementary School in Northeast Washington and had been in contact with the infected student. Bacterial meningitis is a contagious and potentially deadly bacterial infection that leads to inflammation of the tissue that covers the brain and spinal cord. (Stein, 10/8)

Executives of Portland-based Mercy Corps knew co-founder Ellsworth Culver had been credibly accused by his daughter of serial sexual abuse but allowed him to continue at the renowned international relief agency in a top role for more than a decade. The $471-million-a-year charity twice rebuffed Culver’s daughter, Tania Culver Humphrey — 25 years ago when she first detailed her allegations to Mercy Corps officials and then again last year when she asked them to reexamine how they handled the initial review. (Crombie, Williams and Nakamura, 10/9)

Newton Public Schools has implemented its own system for ensuring the safety of students with epilepsy, ahead of proposed legislation at the state level, according to the city’s director of School Health Services. The proposed legislation, known as The Seizure Safe School Act, currently filed in Massachusetts would ensure school personnel — including nurses, teachers, and volunteers — are not only prepared but also can recognize and respond appropriately and efficiently to the student experiencing a seizure. (Beiner, 10/8)

Assembly Bill 1172 allows the state Department of Education to immediately suspend or revoke the certification of a nonpublic school if a student’s health or safety is being compromised. Nonpublic schools are generally private, nonreligious schools that contract with local school districts or the county office of education to serve students with special needs. (Morrar, 10/8)

As North Carolina struggles to meet the oral health care needs of many of its residents, especially in rural areas, three philanthropic organizations have come together with a promise of millions of dollars over the next five years to help expand access. The Duke Endowment and the Blue Cross and Blue Shield of North Carolina Foundation and its foundation in South Carolina announced recently that they plan to invest $35 million in initiatives and projects in the bordering states. (Blythe, 10/9)

In Monterey County, the percentage of black or African American people who are homeless is more than seven times higher than the county’s black population. It is nearly six times higher at the state level.While only 3.5% of people living in Monterey County identify as “black or African American,” 25% of the county’s homeless population identifies as such, according to the homeless census, also known as the Point-in-Time Count. (Cimini, 10/8)

The 24-year-old man accused of killing four homeless men as they slept in lower Manhattan is being investigated for an assault on another sleeping homeless man a week earlier, New York Police Department officials said Tuesday. Investigators believe Randy Santos, who is accused of bludgeoning the four men to death early Saturday, used a stick in a separate incident on Sept. 27 to strike a man sleeping near the waterfront on Manhattan’s West Side, officials said. Mr. Santos is believed to have also tried to throw the man into the Hudson River, according to officials. (Chapman and Honan, 10/8)

Nearly a dozen more cases of the highly contagious mumps virus have been reported at universities in central North Carolina as public health officials work to contain the outbreak. Elon University reported three new confirmed cases of mumps on the Alamance County campus, the school said Monday. And High Point University reported eight more confirmed cases this week, according to ABC11. (Duncan, 10/8)

During 2017 and 2018, drug makers raised prices on seven widely used medicines by large amounts, but without any new clinical evidence to justify the increases, leading patients and insurers in the U.S. to spend an added $5.1 billion, according to a new analysis. For instance, AbbVie (ABBV) boosted the price on its best-selling Humira rheumatoid arthritis treatment by 15.9%, after accounting for estimated rebates and other discounts, which caused Americans to spend an extra $1.86 billion than they would have if the company had not raised the price during that two-year period. (Silverman, 10/8)

The report looked at the seven top-selling drugs by sales revenue that had price increases of more than two times inflation, as measured by the medical consumer price index. According to ICER, a Boston-based research group, new evidence must “provide information different from what was previously believed in order to support a price increase.” None of the drugs examined showed evidence of improved safety or effectiveness, the analysis found. ICER’s report was the first on either the state or national level to examine whether certain price increases are justified by new clinical evidence or other factors. (Weixel, 10/8)

Biogen’s blockbuster multiple sclerosis drug Tecfidera may have generated more than $4 billion in sales last year, but its benefit to patients didn’t warrant a nearly 10 percent price increase over two years. That’s the conclusion of a Boston watchdog group that listed Tecfidera among the seven best-selling prescription drugs whose price increases in 2017 and 2018 had the biggest impact on the US health care system — but weren’t justified by new clinical evidence. (Saltzman, 10/8)

House Speaker Nancy Pelosi will hold a closed-door meeting in Seattle on Tuesday about lowering the cost of sky-high prescription drug prices, three weeks after she unveiled a sweeping proposal to reduce drug costs. Under Pelosi’s plan, which she unveiled at the end of September, Medicare would be allowed to negotiate lower prices on as many as 250 of the most expensive drugs each year, including insulin. Any pharmaceutical company that refused to negotiate could face a steep penalty, starting at 65 percent of the gross sales of the drug in question. (Henney, 10/8)

Providing free medications increased adherence among patients and led to improvements in both their health outcomes and their perceptions of the quality of their care, according to a new study. JAMA Internal Medicine on Monday released a study that examined medication adherence rates of more than 780 patients at primary-care sites throughout Ontario, Canada, from June 2016 through April 2017. (Johnson, 10/7)

The CEO of a leading drug industry lobby will depart at the end of 2020, he announced Tuesday, setting up the organization for a major transition as the pharmaceutical industry faces one of its toughest political environments in years. CEO Jim Greenwood will leave the Biotech Innovation Organization after 15 years atop the trade group, which represents companies ranging from Pfizer and Merck to startups that have no approved medicines. BIO also lobbies on behalf of biotechnology innovators in agriculture and energy. (Karlin-Smith, 10/8)

Greenwood, 68, will leave the trade and lobbying organization at the beginning of 2021 after serving in its top post for 15 years. BIO, as the group is known, represents some 1,000 biopharmaceutical companies ranging from pharmaceutical bellwethers like Pfizer Inc. to smaller drugmakers such as Intercept Pharmaceuticals Inc. (Griffin, 10/8)

Michigan's Medicaid program would like to stop using pharmacy benefit managers to oversee prescription drug claims and negotiate prices with drugmakers, according to a notice from the Michigan Department of Health and Human Services. The state proposed that it would start managing drug coverage on its own beginning Dec. 21. Michigan hopes the move will save Medicaid money by increasing its portion of drug rebates and slashing administrative costs. The department expects the proposal will save the state about $40 million. (Brady, 10/8)

Drugmakers are only partially complying with a new California law that requires they disclose price increases; most ignored the requirement that they cite reasons for those increases. Among the 1,020 drug price increase reports submitted to the Office of Statewide Health Planning and Development, or OSHPD, 68% did not give any explanations, despite the law's requirement that they show how expenses and drug improvements necessitated the price increases. (Bannow, 10/8)

The federal government should be allowed to negotiate the cost of brand name drugs with their manufacturers, U.S. Rep. Frank Pallone told seniors here Monday in a bid to build support for a bill he is sponsoring. Pallone, D-N.J., and chairman of the House committee that oversees health care legislation, said the bill would bring U.S. drug costs more closely in line with other countries, even as it runs into fierce opposition from drug companies that also are in his district, which stretches from Monmouth to Middlesex counties. (Diamond, 10/8)

The U.S. Supreme Court on Monday declined to hear Acorda Therapeutics Inc's appeal of a lower court ruling that allowed generic versions of its multiple sclerosis treatment Ampyra and caused the drug's sales to plummet. The justices refused to review a September 2018 decision by the U.S. Court of Appeals for the Federal Circuit to cancel Acorda's patents covering Ampyra, a ruling the Ardsley, New York-based company and the pharmaceutical industry portrayed as a threat to innovation and bad for patients. The court's action came on the first day of its new term. (Chung, 10/7)

Cutting-edge science and the development of groundbreaking and lifesaving drugs get a lot of attention, but the everyday practice of medicine is often more mundane: It doesn’t involve being CRISPR’d or having gene therapy delivered into your cells. The truth is that most people who are very sick and visit their doctor get treated with very ordinary and sometimes very old drugs. But in recent years supplies of some of these critical standby medicines have become disrupted. The shortages have forced doctors to make hard treatment decisions. Drugs have to be rationed or, in the worst cases, patients who need care can be turned away. (Feuerstein, Garde and Robbins, 10/4)

An executive at Swiss drugmaker Novartis AG has said that an eye-disease treatment for the elderly has the potential to become a blockbuster drug. On Tuesday, the drugmaker said the U.S. Food and Drug Administration has approved Beovu as a treatment for wet age-related macular degeneration. Novartis President of Pharmaceuticals Marie-France Tschudin pointed to demographics as a driver for sales of the newly-approved drug. (Martuscelli, 10/8)

Since its recall in 2004, the pain drug Vioxx has been a symbol of pharmaceutical danger, starring in countless daytime legal advertisements explaining how you, or perhaps a loved one, might be entitled to millions in settlement dollars. But one company believes the infamous drug deserves a second chance, and is plotting to resurrect the former blockbuster as a treatment for a rare, incurable condition. (Garde, 10/9)

Biotech investors are discovering that there isn’t necessarily strength in numbers. After surging about 30% in the first quarter of the year, a broad index of biotech stocks has since given up most of those gains. The S&P Select Biotechnology Index is down about 9% since the middle of September. Investors have lately been reducing risk in their biotech portfolios, according to Jared Holz, health-care equity strategist at Jefferies. Interest is even limited for stocks with potential catalysts, like clinical data, expected soon, he added. (Grant, 10/7)

Clinuvel Pharmaceuticals Ltd. surged the most in five years after the U.S. Food and Drug Administration approved its treatment for a rare skin disorder that causes sensitivity to light. Shares of the Melbourne-based bio-pharmaceutical firm jumped as much as 57% in Sydney, the most since October 2014, after the U.S. allowed the use of the drug Scenesse to treat erythropoietic protoporphyria. Clinuvel rose to a record high of A$44.39, valuing the company at A$2.2 billion ($1.5 billion). (Edwards, 10/8)

One of the few things Democrats and Republicans can agree on these days is that drug prices are out of control. A recent study quantifies the absurdity: U.S. drug costs are almost four times higher than the average in 11 similar countries.What to do about it, of course, is the hard part. But there are signs of a bipartisan consensus forming. (10/4)

With impeachment in high gear, Democrats may not have time or interest to legislate. This is just as well on drug prices, where Nancy Pelosi has proposed price controls and President Trump cheered her on. Mrs. Pelosi’s legislation would direct the secretary of Health and Human Services to “negotiate” a “fair price” with drug manufacturers for the most expensive 250 patent-protected brand drugs. The government would issue a take-or-leave-it offer with a tax sword hanging over drug makers. (10/4)

A new Maryland law that creates a prescription-drug affordability board to help the state regulate drug prices may be a harbinger of what’s to come in drug-pricing legislation. The law permits cost reviews when drug prices or price increases exceed specified thresholds. (Tara Sklar and Christopher Robertson, 10/3)

The Institute for Clinical and Economic Review, commonly known as ICER, wants everyone to believe that it cares about patients and that its value assessments of new drugs and treatments are intended to help them. How do we know that? It’s become the organization’s central talking point as it makes the rounds in advance of finalizing its revised Value Assessment Framework for 2020, which describes the methodology the organization will use in its assessments beginning next year. (Patricia Goldsmith and Carole Florman, 10/9)

Fewer biotechnology startups are being acquired as a result of large pharmaceutical-company mergers and a strong market for initial public offerings, industry watchers said. Twenty U.S. venture-backed biotechs were acquired in the first three quarters of the year, the fewest since the same number of biotechs were purchased in the same period in 2012, according to VentureSource, a market tracker owned by WSJ Pro Venture Capital publisher Dow Jones & Co. (Brian Gormley, 10/8)

Senior Executive Editor David Shipley presents an editorial arguing that leaders in both parties now support reforms to make prescriptions more affordable. (10/7)

When I was health commissioner in Baltimore, my single greatest frustration was inaction around the opioid epidemic. Every day, more than 130 Americans die from opioid overdose, and Baltimore has not been spared. In 2017, nearly 700 city residents died from this preventable tragedy. Even though I had written a blanket prescription that made the opioid antidote naloxone readily available, limited funding forced first responders to ration this lifesaving medication. Science is unequivocal that addiction is a disease that can be treated. But in Baltimore, and throughout the United States, only a fraction of patients with addiction are getting the treatment they need. (Leana S. Wen, 10/8)

Two years ago, when Australia had a terrible flu season, ours mirrored that, with nearly 49 million people sickened in the United States, almost 1 million hospitalizations, and 79,400 deaths. The number of cases was the highest since the 2009 H1N1 pandemic. It is impossible to know how closely our flu season will mimic the one ending in Australia, but public health officials consider it a generally good indicator and a reason to set up a vaccination appointment now for ourselves and our children. Doctors recommend making sure those vaccinations take place by the end of October. Timeliness is especially important when you consider that it takes two weeks for the flu to take effect. Delay can be tragic. (Allison Winnike, 10/4)

Influenza — the flu — is more than a bad cold. Seasonal outbreaks mean not only misery but increased hospital admissions and deaths. The last flu season, from October 2018 until May 2019, caused up to 42.9 million illnesses, up to 647,000 hospitalizations and up to 61,200 deaths, according to preliminary numbers from the Centers for Disease Control and Prevention. Those figures are slightly higher than the average over the last decade.What can we expect this year? Australia’s flu season, which runs ahead of ours (May to October), is often a good predictor. Its onset this year was early and there was a higher than average number of cases. The U.S. should prepare for a robust flu season, starting this month. (Henry I. Miller, 10/9)

Paul Armentano’s opinion in The Hill, “What the Surgeon General gets wrong about marijuana,” disputes several facts that Surgeon General VADM Jerome Adams discusses in Surgeon General’s Advisory: Marijuana Use and the Developing Brain Armentano asserts the surgeon general is wrong about the harms and risks of marijuana. He selects limited data in support of his argument about the benefits of marijuana use to further the goals of his organization, the National Organization for the Reform of Marijuana Laws.  Examination of the scientific literature cited in the advisory emphasizes the importance of protecting Americans from the risks of use, specifically during adolescence and pregnancy. (Elinore McCance Katz, Patricia Santora and Thomas Clarke, 10/8)

As Mark Twain reputedly said about the weather, everybody talks about waste in the U.S. healthcare system, but nobody does anything about it. A new study puts numbers on the scale of that waste and nails down its sources. But it leaves open the question of what to do about it. That’s especially true of the largest single source identified by the authors: “administrative complexity,” which accounts for as much as $265.6 billion in waste a year, or as much as one-third of the total. Yet that’s the one category for which the authors could find not a single article offering solutions for cuts. (Michael Hiltzik, 10/8)

The selling of illegal drugs online is not a matter of free speech, but is a crime and should be treated as such. Just last month, the FDA and DEA sent a first-of-its-kind joint warning letter to 10 websites who were illegally marketing and selling opioids. This is a great step, but it is not enough. (Ryan Costello, 10/9)

The dangers of lead poisoning were laid bare in Flint, Michigan, where contaminated water exposed thousands of children to the dangerous neurotoxin – but Flint is not alone. A 2016 investigation by Reuters found nearly 3,000 areas with lead poisoning rates at least double of Flint at the peak of its crisis, caused by the remnants of lead once used in paint, water pipes and gasoline.And everywhere it’s found, even at levels lower than those found in Flint, it has a profound and permanent effect on the health of children, affecting the development of their brains and nervous systems. It costs the United States dearly, too – billions of dollars in health care, special education and criminal justice spending. (10/9)

Every day, in every community, all around the world, people with differences are demeaned. Whether they have autism, cerebral palsy, deafness, visual impairment, dyslexia, depression, ADHD or something else, they are being treated as abnormal and deficient in school and at work, as well as in families and communities. And there are consequences. (Jonathan Mooney, 10/9)

Last month and at my urging, the Santa Clara County Board of Supervisors voted to move $600,000 from county reserves to provide the YWCA Silicon Valley in San Jose and Community Solutions in Gilroy the resources they needed to staff 24-hour counseling and other response services to rape victims. The decision means that our county’s two rape crisis centers can continue to provide much-needed services to victims of domestic and sexual violence. (Cindy Chavez, 10/7)