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Walmart stepped forcefully into the national gun debate on Tuesday, saying it would stop selling ammunition that can be used in military-style assault rifles, would discourage its customers from openly carrying guns in its stores and would call on Congress to increase background checks and consider a new assault rifle ban. One month ago, a gunman killed 22 people at a Walmart store in El Paso, a massacre that put pressure on the company to respond to the wave of mass shootings across the country. It is the nation’s biggest retailer, and a large seller of firearms and ammunition. (Corkery, 9/3)

Additionally, in the more than two dozen states with open carry laws, Walmart is "respectfully requesting that customers no longer openly carry firearms into our stores and Sam's Clubs��... unless they are authorized law enforcement officers,'' said Dan Bartlett, executive vice president of corporate affairs. That action follows "multiple cases'' in which people entered their stores with visible weapons, upsetting customers and employees, Bartlett said. (Jones, 9/3)

The policy change takes effect immediately, with stores ceasing to offer those products after selling through existing inventories. The retailer stopped selling handguns in all U.S. stores except those in Alaska over two decades ago but will now cease such sales in that state as well. “As a company, we experienced two horrific events in one week, and we will never be the same,” Walmart Chief Executive Doug McMillon wrote in an email to employees Tuesday. “Our remaining assortment will be even more focused on the needs of hunting and sport-shooting enthusiasts.” (Nassauer, 9/3)

Walmart is a major player in the $2-billion U.S. ammunition market: Its approximately 20% share means it sells about $400 million of ammunition a year. Chief Executive Doug McMillon predicted its market share will drop to between 6% and 9% after the changes. The Bentonville, Ark., company does not break out sales figures for firearms and ammunition. (Masunaga and Peltz, 9/3)

McMillion, who said he was a gun owner himself, took pains to avoid alienating customers. "We will treat law-abiding customers with respect, and we will have a very non-confrontational approach," he said. "Our remaining assortment will be even more focused on the needs of hunting and sport shooting enthusiasts." (Meyersohn, 9/3)

Some politicians saw this as a moment to push their own agendas. Presidential contender Beto O’Rourke praised Walmart’s decision but said the move wasn’t enough. “We can’t rely on corporations to stop gun violence,” he wrote on Twitter. Sen. Elizabeth Warren, D-Mass., wrote on her Twitter account that this was a “good start — but it’s not nearly enough. Walmart can and should do much more. And we need real gun reform, now.” (Thomas, 9/3)

Democrats have seized on the latest news to renew their calls for action, putting new pressure on the GOP. “It’s time to lead on this issue. Put the House-passed background checks bill on the Senate floor for debate and a vote,” Senate Minority Leader Charles Schumer (D-N.Y.) said Tuesday in a tweet directed at Senate Majority Leader Mitch McConnell (R-Ky.).��Sen. Dianne Feinstein (D-Calif.) separately questioned “when will enough be enough?”��(Carney and Lillis, 9/3)

The National Rifle Association (NRA) in a Tuesday statement slammed Walmart's changes to its gun policies as "shameful" after a mass shooting last month in one of its stores. "It is shameful to see Walmart succumb to the pressure of the anti-gun elites. Lines at Walmart will soon be replaced by lines at other retailers who are more supportive of America’s fundamental freedoms," the statement said. (Frazin, 9/3)

The NRA has been a powerful force in recent discussions of potential new federal gun regulations. President Donald Trump acknowledged that he spoke to leaders of the group last month, as Democratic lawmakers clamored for new measures that the NRA opposed. (Higgins, 9/3)

Congressional Republicans are waiting for the White House to chart a path forward on gun violence legislation, Senate Majority Leader Mitch McConnell said Tuesday, effectively putting the burden on President Donald Trump to decide the GOP's legislative response to the spate of mass shootings that included another deadly attack in Texas over the weekend. Asked about prospects for a Senate vote on legislation passed by the Democratic-controlled House to expand background checks for gun purchases, McConnell said, "The administration is in the process of studying what they're prepared to support, if anything." (Daly, 9/3)

"The administration is in the process of studying what they are prepared to support, if anything. And I expect to get an answer to that next week," McConnell, a Republican, said in the interview. Congress returns to work next week after its August recess. "I said several weeks ago that if the president took a position on a bill so that we knew we would actually be making a law and not just having serial votes, I’d be happy to put it on the floor," McConnell said. (9/3)

White House officials have been meeting with lawmakers and their staffs for weeks about improving background checks, temporarily taking firearms away from dangerous people and boosting mental-health services. But Mr. Trump has yet to endorse a specific legislative package, raising doubts that anything will get done. With 2020 elections looming, fellow Republicans are looking to the president to provide them political cover if they are to support legislation that would restrict gun ownership. (Andrews and Restuccia, 9/3)

Among the ideas under discussion are so-called red flag laws, which would allow a family member or a law enforcement official to petition a court for an order to take guns from individuals who may be a threat to themselves or others. But Democrats say those laws are not enough and have called on McConnell to bring up the House’s universal background checks bill, which passed earlier this year. That bill so far has no Republican support. (Levine, 9/3)

Lawmakers under pressure to address mass shootings could provide millions for research on gun violence, which would help fill a knowledge gap about policies that are most effective at reducing injuries and death, as Congress attempts to fund the government by Oct. 1. House Democrats have proposed $50 million to study gun violence, and academics say the government funding could ensure that the data collection infrastructure is adequate to support a broad��research enterprise. (Siddons, 9/4)

The gunman in a West Texas rampage that left seven dead obtained his AR-style rifle through a private sale, allowing him to evade a federal background check that blocked him from getting a gun in 2014 due to a “mental health issue,” a law enforcement official told The Associated Press. The official spoke to The Associated Press Tuesday on condition of anonymity because the person was not authorized to discuss an ongoing investigation. The person did not say when and where the private sale took place. (Weber, Bleiberg and Balsamo, 9/3)

A man who went on a deadly mass shooting spree across West Texas on Saturday was barred under federal law from owning or buying firearms because a court had previously determined he was mentally unfit, according to law-enforcement officials. Authorities on Tuesday were looking into whether the gunman, 36-year-old Seth Aaron Ator, bought the AR-15 style rifle used in the attack through a private sale, thus avoiding a background check, the officials said. The gunman had tried to buy a gun in January 2014 but failed because a nationwide criminal background check system flagged the mental health determination by a local court and prevented the purchase, according to the officials. (Frosch and Gurman, 9/4)

Leaders of the Missouri Black Caucus met with Gov. Mike Parson to talk about gun violence but left without much hope for stricter gun control. The topic was discussed Tuesday, but state Rep. Ashley Bland Manlove, D-Kansas City, said the governor did not see legislative interest in making changes. (Driscoll, 9/3)

Odessa Mayor David Turner spoke with David Brown of the Texas Standard on Tuesday, three days after a gunman killed seven people during a rampage in Odessa and Midland. This interview has been edited for length and clarity. (Brown and Fanning, 9/3)

Virginia Democrats are betting health care will help them take control of the state legislature in November, following their rout of Republicans two years ago that nearly eliminated the GOP’s hold on the Virginia statehouse. Democrats are already pouring tens of thousands of dollars into ads targeting the health care records of GOP incumbents in newly competitive races, hoping to capitalize on recently redrawn legislative districts seen as more favorable to Democrats. And new polling data says health care ranks high for potential voters. (Pradhan, 9/4)

Ohioans who purchase insurance on HealthCare.gov will likely save money in 2020, as the state is reporting an average premium decrease of 7.7% compared to last year, according to the Ohio Department of Insurance. It is the first decrease for Ohioans since the health insurance marketplace was unveiled seven years ago, and it could be more evidence that the controversial Affordable Care Act is working. (Hancock, 9/3)

Enroll Wyoming is a program that helps residents access health insurance options. Andrea Hixon, project team manager with the Department of Workforce Services, said the goal of the partnership is to connect job-seekers with resources to make an informed decision about health insurance coverage. (Wheeler, 9/3)

Kaiser Health News: Trump Promises ‘Phenomenal’ Health Plan. What Might That Mean?

While many Capitol Hill Republicans want to avoid a repeat of the Affordable Care Act repeal debate, President Donald Trump keeps promising a health plan that will be “phenomenal” and make the GOP “the party of health care.” Last month, Medicare chief Seema Verma said, “We’re actively engaged in conversations” on what to do. Earlier in August, Trump adviser Kellyanne Conway indicated an announcement might come this month. Behind the pronouncements lies a conundrum: whether to stray beyond efforts underway to improve the nation’s health care system — loosening insurance regulations, talking about drug prices, expanding tax-free health savings accounts — to develop an overarching plan. (Appleby, 9/4)

A U.S. judge on Tuesday rejected efforts by major drugmakers, pharmacies and distributors to dismiss claims that they caused the nation's opioid crisis, clearing the way for a scheduled landmark trial even as he pushes for a nationwide settlement. U.S. District Judge Dan Polster, who oversees roughly 2,000 opioid lawsuits by states, counties and cities, said the plaintiffs can try to prove that drugmakers' deceptive marketing of the painkillers caused a harmful, massive increase in supply that pharmacies and distributors did not do enough to stop. (Stempel, 9/3)

The ruling clears the way for J&J, Cardinal Health, Walgreens and other companies to face a federal court jury in Cleveland Oct. 21 on claims -- by more than 2,000 U.S. cities and counties – they fueled an opioid crisis that kills more than 100 Americans daily. The companies were seeking to throw out the municipalities’ civil-conspiracy claims and other allegations, but the judge refused. Based on the cities’ and counties evidence, “the court cannot conclude that no reasonable jury could find” opioid makers such as J&J and Teva Pharmaceutical Industries Ltd “entered into a conspiratorial agreement or malicious combination,” Polster wrote in a 10-page decision. (Feeley, 9/3)

OxyContin maker Purdue Pharma LP is preparing to seek bankruptcy protection before the end of the month if it does not reach a settlement with U.S. communities over widespread opioid litigation, three people familiar with the matter said, after some states balked at the company's $10 billion to $12 billion offer in August to end their lawsuits as part of a negotiated Chapter 11 case.�� On Friday, Purdue lawyers had documents prepared for a Chapter 11 filing at a moment’s notice, Reuters has learned. (Spector and DiNapoli, 9/3)

Insys Therapeutics Inc. is selling the fentanyl painkiller Subsys out of bankruptcy, unloading the opioid drug at the center of racketeering convictions against the drugmaker’s former top brass. (Scurria, 9/3)

New York City’s largest measles outbreak in nearly 30 years is over, city officials said Tuesday. The city spent over $6 million, deployed more than 500 staff and issued a mandatory vaccination order for people living and working in four Brooklyn neighborhoods. The outbreak of a highly contagious and potentially life-threatening disease was heavily concentrated in the ultra-Orthodox Jewish community, where misinformation about the safety and effectiveness of the measles, mumps and rubella vaccine has spread, officials said. (Sun, 9/3)

“Ending the measles outbreak required extensive collaboration with community organizations and Jewish leaders,” Mayor Bill de Blasio, a Democrat, said in a statement Tuesday. He urged people to get vaccinated, especially as school starts up again. City officials said 654 people have been diagnosed with measles since the outbreak began in October. The outbreak was concentrated in ultra-Orthodox Jewish communities in Brooklyn, including South Williamsburg and Midwood. It was the largest outbreak in the country and was part of the worst nationwide since 1992, according to the Centers for Disease Control and Prevention. (Honan, 9/3)

No new cases have been reported since mid-July, the city's health department said, but officials will continue keeping track and may add cases retrospectively as they are identified. The city also could see future measles cases emerge that are not associated with this outbreak. "Ending the measles outbreak required extensive collaboration with community organizations and Jewish leaders. They helped encourage vaccinations and achieve record immunization levels in parts of Brooklyn," New York City Mayor Bill de Blasio said in a written statement on Tuesday. (Howard, 9/3)

More than 15,500 people have received measles vaccines since the city issued the emergency order in April. While that order was lifted Tuesday, officials are still encouraging New Yorkers to get vaccinated if they are not, warning that the threat of measles is still present. (Hellmann, 9/3)

Jacquelynn Vance-Pauls, a real-estate lawyer in upstate New York, has a 14-year-old son with autism who was recently kicked out of his private special needs school. Her 9-year-old twins and her high-school senior are also on the verge of being expelled from their public schools. The children did not do anything wrong, nor are they sick. Instead, Ms. Vance-Pauls has resisted complying with a new state law, enacted amid a measles outbreak, that ended religious exemptions to vaccinations for children in all schools and child care centers. (Otterman, 9/4)

When Wisconsin children return to school this week, close to 50,000 of them will have waivers that exempt them from vaccines, leaving them vulnerable to measles at a time when the nation has experienced its largest outbreak in 27 years. Health officials across the U.S. have reported 1,215 cases of measles this year as of Aug. 22, the highest number since 1992, according to the Centers for Disease Control and Prevention. Measles had been declared eliminated in 2000. (Johnson, 9/3)

California's state Assembly approved legislation Tuesday designed to crack down on doctors who sell fraudulent medical exemptions for vaccinations. But Gov. Gavin Newsom's office said immediately after the vote that he will seek additional amendments affecting one of this legislative session's most hotly debated issues. The bill by Democratic Sen. Richard Pan of Sacramento would allow state public health officials to investigate doctors who grant more than five medical exemptions in a year and schools with vaccination rates of less than 95%. (Thompson, 9/3)

The state Assembly voted on short notice Tuesday to tighten rules for children to obtain medical exemptions from vaccinations required to attend school. The Assembly voted 47-17 to approve SB276, which would give the state Department of Public Health the authority to revoke new exemptions, under limited circumstances, if it determines the waivers aren’t medically necessary. (Gardiner, 9/3)

Newsom’s office said in a message posted on Twitter that the governor wants a few “technical — but important” revisions to state Senate Bill 276, which would tighten the state’s school immunization law. However, a brief description of the requested changes — which would be added to a separate bill — provided by the governor’s office indicates they would be fairly significant. Tuesday marked the second time Newsom has asked for the legislation to be watered down after he raised concerns in June that SB 276 would create an immunization bureaucracy that could interfere with doctor-patient relationships. (Gutierrez and Luna, 9/3)

“The governor believes it’s important to make these additional changes concurrently with the bill, so medical providers, parents and public health officials can be certain of the rules of the road once the bill becomes law,” the tweet continued. The proposal has been one of the most closely watched and hotly debated bills in Sacramento this year because it would authorize the California Department of Public Health to review vaccine medical exemptions that doctors issue for kids enrolling in school. (Wiley, 9/3)

Dr. Bob Sears sits at a worn wooden desk near a cushioned exam table designed for pediatric patients. The room has only a few other trappings — small molds of a child’s foot and hand, hanging from a wall — that suggest the routines of childhood. And there is nothing to suggest the notoriety that trails in his wake. But this office is a hub in a nationwide movement that the medical establishment contends is a threat to public health. Sears’ practice caters to parents the public largely labels as anti-vaxxers, people who no longer trust the scientists, doctors or government representatives who say vaccines are safe and that the risk of disease is far greater than the chance of an adverse reaction. (Gutierrez, 9/3)

Hurricane Dorian, a Category 2 storm that's said to be headed toward the Florida coast, is the latest natural disaster to threaten U.S. hospitals. While hospitals previously struggled to keep paper records free from physical damage, more recently hospitals have struggled with maintaining EHR connectivity after power outages or sharing patient medical histories if a patient is displaced from their usual hospital. Here are four things to consider to maintain access to patient records during the storm. (Cohen, 9/3)

After battering the Bahamas as a Category 5 storm, a weaker but still destructive Hurricane Dorian is now marching toward the Southeastern U.S. with threats of strong winds and storm-surge flooding. For hospitals unlucky enough to be caught in its path, Dorian could also bring steep costs associated with disruptions in patient visits or facility damage. Of the investor-owned hospitals, Tenet Corp. and HCA Healthcare are most likely to be affected by the hurricane. (Livingston, 9/3)

Nineteen patients were airlifted from Marsh Harbour Healthcare Centre in the Abaco Islands, and rising floodwaters forced an evacuation of Rand Memorial Hospital, the main clinic in Freeport on Grand Bahama, according to early reports of Hurricane Dorian's impact on hospitals in the Bahamas. The Abacos and Grand Bahama bore the brunt of the Category 5 storm's prolonged punch to the area, which continued on Tuesday, though it has been downgraded to a Category 2 storm by the National Hurricane Center. (Fiore, 9/3)

More than 100 healthcare facilities have been evacuated in Florida, displacing thousands of patients and residents, as state officials remain wary of storm surge and flooding that Hurricane Dorian could bring on its path up the east coast. Dorian was downgraded Tuesday to a widening yet weakened Category 2 storm and now looks unlikely to unleash its full wrath on the state’s densely populated coastline. (Koh, 9/3)

Three major medical centers closed their doors and evacuated patients as Hurricane Dorian menaced the east coast of Florida and Palm Beach County. Good Samaritan Medical Center, which sits along the Intracoastal Waterway at 1309 N. Flagler Drive in West Palm Beach, transferred its 64 patients to Palm Beach Gardens Medical Center and St. Mary’s Medical Center. (Baitinger, 9/3)

With Hurricane Dorian moving toward Georgia, coastal medical facilities have swung into action.Nursing homes and assisted living facilities along the coast have begun evacuating residents to more inland locations. And hospitals are scaling back operations but plan to remain open as the storm approaches. (Miller, 9/3)

As Hurricane Dorian continues��churning toward��South Carolina, four��patients were evacuated Tuesday from��Lowcountry hospitals to��Prisma Health-Upstate. The patients are from Charleston-area hospitals and are in need of acute care, said��Dr. C. Wendell James III, chief clinical officer for the region of the former Greenville Health System.��James said other patients had been evacuated to other inland hospitals, including Prisma's Midlands affiliate, though he didn't know how many.��Last year during Hurricane Florence,��the hospital cared for 52 patients, he said. (Osby, 9/3)

Michigan on Wednesday will become the first state in the nation to ban flavored e-cigarettes, a step the governor said was needed to protect young people from the potentially harmful effects of vaping. Gov. Gretchen Whitmer (D), in an interview, said the state health department found youth vaping constituted a public health emergency, prompting her to take the action. “My number one priority is keeping our kids safe and protecting the health of the people of Michigan,” Whitmer said. (McGinley, 9/4)

A middle-age Oregonian died in July from severe lung disease after vaping cannabis, Oregon health officials said Tuesday. The death is the first in Oregon connected to electronic cigarettes. If confirmed by the federal government, it would be one of just two such deaths nationwide. The Centers for Disease Control announced the first-ever death linked to vaping about two weeks ago. (Zarkhin, 9/3)

Last month, the Illinois Department of Public Health announced the first such death amid a growing number of similar lung illnesses across the country. (Nedelman, 9/3)

So far, the patients have a few things in common. They suffered from respiratory symptoms, including coughing, shortness of breath, chest pain, and difficulty breathing. Some have gotten seriously ill, even winding up in intensive care units on oxygen support through ventilators or intubation. Most are in their late teens and 20s with no underlying health issues. Many cases also involved vaping THC-containing liquids (though it’s not clear whether that was from cannabis e-cigs or nicotine e-cigs), and the CDC singled out black market products as another potential commonality. (Belluz, 9/3)

State and federal health investigators are focusing on illicit THC compounds as they search for the cause of a rash of vaping-related respiratory illnesses that struck teens and young adults this summer. Health officials have interviewed eight of 15 patients in Minnesota who have been hospitalized for severe respiratory illnesses with confirmed links to vaping. All inhaled THC, the psychoactive compound in marijuana that creates a sensation of being high, said Richard Danila, epidemiology program manager for the Minnesota Department of Health. (Olson, 9/3)

Summit County Public Health warned people Tuesday to stop using any vape or e-cigarette devices amid a rise in cases of severe respiratory illness among teenagers and young adults who reported vaping e-cigarette or marijuana devices prior to hospitalization. Between Thursday and Tuesday, 298 patients across 25 states, including Ohio, were hospitalized with severe pulmonary illness after vaping tobacco products or dabbing marijuana oils, extracts or concentrates, SCPH said in a news release. (Goist, 9/3)

Stamina may trump strength for improving metabolic health, according to an interesting and provocative new study of the molecular effects of different aspects of fitness. The study, which was published in August in JAMA Network Open, finds that people’s aerobic endurance — or lack of it — can influence their metabolisms more potently than their muscular weakness or might, a result with implications for anyone wondering which types of exercise could be most beneficial for health. (Reynolds, 9/4)

Psychedelic substances are gaining legitimacy as a treatment for mental illnesses, prompting a handful of entrepreneurs and venture-capital investors to look for business opportunities in the nascent sector. Still, veteran health-care investors say it is too early to jump into the market given the legal ramifications. Psilocybin, found in “magic mushrooms,” has been decriminalized in countries including the Netherlands and Portugal, but remains illegal under U.S. federal law. “We would not invest in something where we were also betting that the illegality would change,” said Bryan Roberts, a partner at Venrock Associates, one of the U.S.’s oldest venture-capital firms. “But we would absolutely invest in something that was utilizing some novel understanding of biology and generating new research into drug development.” (Mack, 9/3)

Recalls of Losartan for a carcinogen impurity have been numerous since July 2018. But that’s not why Sandoz recalled about 636,000 bottles of Losartan Postassium and cholesterol medicine Ezetimibe last week. The exact problem, as stated in the U.S. Consumer Product Safety Commision recall notice: “The prescription drug packaging is not child resistant as required by the Poison Prevention Packaging Act, posing a poisoning risk if swallowed by children.” (Neal, 9/3)

Brace yourself, lovers of diet sodas and sugary drinks. It's more bad news and yet another reason to consider ditching your favorite soda or soft drink. A new study followed more than 450,000 people from 10 European countries for up to 19 years and found those who drank two or more glasses of any type of soda a day had a higher risk of dying from any cause of death than people who drank less than a glass each month. None of the people had cancer, diabetes, heart disease or stroke before their participation. (LaMotte, 9/4)

An extreme case of “fussy eating” caused blindness in a United Kingdom teenager, according to a report published Monday in the Annals of Internal Medicine. When Denize Atan, the study’s lead author, met the 17-year-old boy at Bristol Eye Hospital, his eyesight had been deteriorating for two years. But what shocked her most was “how long the patient’s eating behaviour had persisted,” Atan wrote in an email Tuesday to The Washington Post. “By the time I first met him, he had followed the same diet for [approximately seven] years.” (Paul, 9/3)

Getting your protein from plants instead of animals could prolong your life, a new study suggests. Researchers prospectively followed 70,696 Japanese men and women, average age 55, for an average of 18 years. All had completed detailed health and diet questionnaires, and none had a history of cancer or cardiovascular disease at the start. There were 12,381 deaths over the period. (Bakalar, 9/3)

That lack of tree cover can make a neighborhood hotter, and a joint investigation by NPR and the University of Maryland's Howard Center for Investigative Journalism found just that: Low-income areas in dozens of major U.S. cities are more likely to be hotter than their wealthier counterparts, and those areas are disproportionately communities of color. (Anderson, Eckert and McMinn, 9/4)

A federal judge has put a hold on Missouri’s eight-week abortion ban, but has left other provisions of the controversial law intact. The parts of the law that prohibit abortions because of race, sex or Down syndrome diagnosis and updated requirements to pre-abortion counseling went into effect last week. Doctors say those new regulations victimize patients and compromise doctors’ medical ethics.��(Fentem, 9/3)

When Jessy Rosales was a sophomore at the University of California-Riverside, she had a boyfriend and was taking birth control pills. Then, out of nowhere, she started feeling sick. “I just thought it was the stomach flu,” she said. “It turns out I was pregnant.”Rosales was sure she was not ready to have a baby. She wanted a medication abortion that would involve taking one pill at a health clinic, and a second one at home a day or two later to induce a miscarriage. (Dembosky, 8/30)

Sen. Sherrod Brown worries that nearly 100,000 Ohio women could lose health care as Planned Parenthood loses federal funding. However, the group’s leaders say they are using existing funding to continue providing reproductive care, cancer screenings and all other services.How long the organization can continue to operate without taxpayer funding is the big question. (Candisky, 9/3)

A former executive of the Anti-Defamation League was named the director of a new office that will work to stem the surge in hate crimes in New York City, including two over Labor Day weekend at Rockaway Beach, city officials said Tuesday. Deborah Lauter will helm the Office for the Prevention of Hate Crimes, a new agency that Mayor Bill de Blasio created as the city has seen a rise in hate-crime complaints this year, many of them anti-Semitic incidents. (Honan and Chapman, 9/3)

Researchers at Cincinnati Children's Hospital Medical Center say an initiative that involved identifying "hot spots" for social needs among children living in neighborhoods with high rates of morbidity and poverty could be a potential model for health systems across the country. Results of a new study published Tuesday in Health Affairs showed the medical center reduced the number of days children spent in the hospital by 20% for patients living in two low-income neighborhoods that were studied over a three-year period. (Johnson, 9/3)

A St. Joseph’s Hospital nurse is suing her former employer over unsafe workplace conditions, which include allegations of “dangerously" low staffing levels in the emergency room. A lawsuit filed in Hillsborough County circuit court claims that Marie David, a Pinellas County resident, worked as a registered nurse for BayCare, the operator of 15 hospitals around Tampa Bay, for more than 10 years including the last five years at St. Joseph’s in Tampa. (Griffin, 9/3)

The standoff between North Carolina’s state government power brokers over the state budget and Medicaid expansion has claimed a victim: the planned roll-out this fall of Medicaid managed care. N.C. Department of Health and Human Services Sec. Mandy Cohen announced Tuesday morning she was pushing back the Nov. 1 start date of Medicaid managed care, given the uncertainty caused by the lack of a state budget more than 60 days into the fiscal year that started on July 1. (Ovaska-Few and Hoban, 9/4)

New York City physicians have long observed a higher-than-average use of the emergency department by the homeless. What was less understood is how visits to the emergency room are connected to first-time shelter use. In a new study to be published Tuesday, researchers found that 39.3% of first-time adult shelter users visited the emergency department for treatment or were hospitalized in the year before the shelter entry. In the year after departing a shelter, 43.4% of first-time shelter users went to the emergency department or were hospitalized. (West, 9/3)

As Hahnemann University Hospital closes, some state lawmakers representing the Philadelphia region have put on their advocacy hats. But the state senators, about a dozen of them, upset a labor union representing some of the 2,500 workers losing their jobs as a result of the Center City institution’s closure. (Brubaker, 9/4)

Portland’s troubled mental health hospital has a new leader, according to operator Legacy Health. Melissa Eckstein will take over as president of Unity Center for Behavioral Health on Sept. 30. She replaces Chris Farentinos, who served as director of behavioral health services for Legacy since 2013. ...Farentinos presided over the opening of Unity, which was supposed to offer a humane alternative to hospital emergency rooms for people in mental health crisis. However, patients and staff at the center immediately reported dangerous conditions. (Harbarger, 9/3)

Attorneys representing foster children in Kansas have filed a motion to amend their ongoing class-action lawsuit, insisting even more vulnerable kids in the state are being harmed. Since the suit was filed in November, children still bounce from placement to placement and are subjected to “night-to-night” stays, only compounding the instability they feel, according to court records filed late Friday. Children in state custody also continue to be deprived of the mental health treatment they need, attorneys said. (Bauer, Thomas and Shorman, 9/3)

Governor Chris Sununu signed two bills Tuesday banning the use of some products that contain harmful PFAS chemicals. The industrial compounds have been linked to a wide array of health problems. (Ropeik, 9/3)

A recent study by the University of Iowa found many rural Iowans may not be receiving care that meets an accrediting group’s standards. The study found that 40 percent of rural Iowans diagnosed with breast, lung and colorectal cancers were being treated in hospitals not accredited by the Commission on Cancer. (Krebs, 9/3)

About 1,000 health care workers protested in Oakland Monday to show Kaiser Permanente they’re serious about a potential strike in October, after negotiations for a new contract stalled. Kaiser Permanente employees and their families rallied at Mosswood Park in Oakland and then marched to Kaiser’s Oakland Medical Center. (Klivans, 9/3)

Sylvia Colt-Lacayo is 18, fresh-faced and hopeful, as she beams confidence from her power wheelchair. Her long dark hair is soft and carefully tended, and her wide brown eyes are bright. A degenerative neuromuscular disease, similar to muscular dystrophy, has left her with weak, underdeveloped muscles throughout her body, and her legs are unable to support any weight. Each time she needs to get in or out of her wheelchair — to leave bed in the morning, use the bathroom, take a shower, change clothes — she needs assistance. (Gold, 9/3)

At least two residential care facilities in San Francisco that provide long-term care for 26 vulnerable people — some elderly, others formerly homeless — plan to shut their doors in the next few months, the latest in a spate of board-and-care closures around the city. Officials with both facilities say they’ve been socked by the rising costs of doing business in San Francisco and a stagnant state reimbursement rate to run the homes. (Thadani, 9/3)

Pareto Health Inc., a Philadelphia company that organizes health coverage for groups of businesses that pay medical bills directly, announced Wednesday that it had received an investment of more than $80 million from Great Hill Partners, a Boston private equity firm. Pareto, founded in 2011 by Swarthmore College graduate Andrew Cavenagh, has 800 employers with 100,000 enrolled employees as customers and expects to triple in size in the next three years as employers continue looking for ways to trim the cost of providing health insurance benefits. (Brubaker, 9/4)

In his office at Pfizer’s 42nd Street headquarters in Manhattan, Chief Scientific Officer Mikael Dolsten keeps a chessboard. Dolsten has played since he was a boy in Sweden, but this board has a special provenance: It was a gift from former Pfizer (PFE) CEO Jeff Kindler, after Dolsten delivered to his boss the unwelcome message, in 2009, that the turnaround of the drug giant’s research laboratories would be anything but rapid. “I told him that, look, it’s not just one investment, it is like playing chess,’’ Dolsten recalled. “You need to have a picture of the entire opening game, win the middle game, and be really good in the end game. And it’s a marathon, Jeff, I told him.” Kindler left the meeting unhappy, but a few days later he appeared in Dolsten’s office with the chess set and his own words of wisdom: “Mikael, Pfizer needs a real chess player.” (Herper, 9/4)

Top pharmaceutical CEOs have targeted a small group of Republican senators with roughly $200,000 in campaign donations in the past year, according to a STAT review of campaign finance disclosures. The focus on Congress comes as drug executives are holding back on donations to presidential candidates. No major industry executive has contributed to a Democratic presidential contender or President Trump’s reelection campaign, according to the review. Only one — David Ricks, the CEO of the Indiana-based drugmaker Eli Lilly — has given to a committee associated with Vice President Mike Pence, who once served as Indiana’s governor. (Facher, 9/3)

In a rare but important display of congressional bipartisanship, Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.) have co-sponsored the Prescription Drug Pricing Reduction Act, which includes a meaningful solution to the crisis created by runaway drug price increases.��The act would put a cap on drug price increases in Medicare Part D by requiring drug manufacturers to rebate 100% of any price increase that exceeds the rate of inflation. (Alfred Engelberg, 8/29)

The most important question, when comparing one pharmaceutical company to another, is this: Which is doing the best job bringing new medicines to market? It’s also one of the hardest to answer. No one measure will give a clear picture of how well a pharmaceutical company is doing at research, especially since victory and defeat in the drug business can come down to random chance and dumb luck. (Herper, 9/4)

Eight months ago, Gov. Gavin Newsom released a plan to lower the state’s prescription drug costs. The central idea: By consolidating the market power of state agencies into one statewide pool, California could gain greater leverage to negotiate with drugmakers. In late August, the administration took a first step toward making the proposal a reality. (Ho, 9/1)

The pharmaceutical industry is now the most poorly regarded industry in the U.S., ranking last among industries that are measured in the latest Gallup poll. Americans are more than twice as likely to rate drug makers negatively as positively — 58% versus 27%, to be exact. Just 15% held a neutral view, yielding an overall score of negative 31. Even the federal government fared better. (Silverman, 9/3)

The number is the lowest of any entities Gallup polled, including the federal government, at minus 27 points, the advertising industry at minus 1, the legal field at plus five, and airlines at plus 19. The public’s favorability toward the pharmaceutical industry is at its lowest point since Gallup began polling the question in 2001. Just four years ago, the industry had a net positive rating of 4 points, but that has plummeted in the years since then. (Sullivan, 9/3)

The measures are part of a flurry of legislation states are adopting to slow runaway drug costs, which are stretching state budgets and patients’ wallets. While debate continues in Washington, without resolution, nearly three dozen states have passed drug-pricing laws in 2019 alone. (Dayal McCluskey, 8/27)

De’Shonae Moody was rushed to an urgent care center where medical staff told the 14-year-old she had abnormally high blood sugar. By the time she arrived at the hospital, her blood glucose levels were at 800 milligrams per deciliter. That’s nearly eight times outside what’s considered normal and bad enough she could have gone into a coma. (Rago, 8/25)

Bayer said it hired Johnson & Johnson executive Marianne De Backer to manage acquisitions and licensing deals at its drugs unit, as the German drugmaker turns to outside sources to boost its development pipeline. De Backer will take the role of Head of Business Development & Licensing at Bayer's pharmaceuticals division, joining from rival J&J, where she lead business development activities across different therapeutic areas and regions. (9/3)

Swiss drugmakers Novartis and Lonza separately deepened their push into so-called biosimilars, betting cheaper copies of name-brand drugs will make headway among cost-conscious insurers and governments. Novartis's Sandoz generics unit, among the biggest biosimilars makers, on Tuesday agreed to license from Poland's Polpharma Biologics a version of Biogen's decade-old Tysabri for multiple sclerosis. This is the fifth proposed biosimilar licensed by Sandoz in nine months. (Miller, 9/3)

Biotechnology startups usually are acquired for a combination of upfront cash and future success-based payments. That isn’t the case in Vertex Pharmaceuticals Inc.’s $950 million deal to buy startup Semma Therapeutics Inc. (Gormley, 9/3)

Vertex Pharmaceuticals announced Tuesday that it plans to acquire an ambitious startup for $950 million, betting the company’s early-stage science could lead to a functional cure for type 1 diabetes. The Boston company is buying Semma Therapeutics, a nearby firm turning stem cells into insulin factories. Based on the work of Harvard University stem cell scientist Douglas Melton, Semma’s approach involves turning moldable stem cells into beta cells, the insulin-producing machinery that is mistakenly attacked by the immune system in type 1 diabetes. (Garde, 9/3)

It is hard to discern the true state of drug regulation from the outside, but two recent decisions by the Food and Drug Administration — to approve one drug but reject another — offer a rare glimpse into that world. Exondys 51 and Vyondys 53, both developed by Sarepta Therapeutics (SRPT), are intended to treat a severe form of muscular dystrophy, though in different subgroups of patients. Exondys 51 gained FDA approval in 2016 amid great controversy. Agency officials were divided because evidence of the treatment’s benefits was especially thin. Its approval came with a condition requiring Sarepta to carry out a post-approval clinical trial to confirm the drug’s effectiveness. (Matthew Herder, 9/3)

While there are no easy answers, the Drug Enforcement Agency (DEA) database and our��recent research��forthcoming at��Social Science and Medicine��indicates that there is value in tracking and monitoring banned medicines with detailed nationally representative databases. Perhaps targeted monitoring using anti-counterfeiting technologies will also help, and so will naming and shaming firms using insights from behavioral economics. Another answer might be in setting up a global body that harmonizes enforcement standards across rich and poor countries, as research from��Amir Attaran and his coauthors��has indicated. (Chirantan Chatterjee, 8/28)

AB824 is legislation that would bar companies from settling patent disputes for generic medicines by using economic “pay-for-delay” agreements with the proprietary drug’s manufacturer. These agreements are between drug makers and generic companies, and they extend the amount of time the drug maker has to provide the sole offering of a drug on the marketplace. (Wendye Robbins, 8/29)

Like many people starting out in the biotech industry, I wanted to make an impact on people’s lives by developing life-changing therapies. But I’ve become disappointed by what I believe are too many companies pushing mediocre and me-too drugs, also known as copycat drugs, into clinical development where they will likely fail. Clinical trials are more than a way to test new therapies. They offer very sick people hope and a chance for more time with their loved ones. Lately, the drug development process has turned into an exercise in me-tooism — at patients’ expense. It’s time to shift the focus back to those who matter most. (Gail McIntyre, 9/4)

Take Hong Kong protests, add a dash of Brexit and then stir in the death of brick-and-mortar shopping. It’s hardly surprising that a savvy investor would want to bail from its stake in A.S. Watson Group, a retailer based in the former British colony with a big U.K. footprint.��These latest geopolitical flash points have been cited for Temasek Holdings Pte’s��decision to table the sale of its $3 billion interest in A.S. Watson,��Bloomberg reporters Manuel Baigorri, Joyce Koh and Vinicy Chan wrote Wednesday. (Nisha Gopalan, 9/4)

CVS Caremark is saving money on drug costs by kicking specific products with high inflation off their formularies. The pharmacy benefit manager (PBM) launched its��program for “hyperinflation” drug removals in 2017 in which it will take drugs��off��its template��formulary��if they have far cheaper equivalents and their high prices aren’t backed by quality metrics.��So far, they've identified five drugs to remove as the default option for docs. (Paige Minemyer, 8/29)

According to new state data released by AARP Nebraska, 31% of Nebraskan adults have stopped taking a prescription drug because of rising costs. Americans currently pay at least twice what people in other developed countries pay for the same medicine, and AARP Nebraska is urging its members to lean on the state's congressional delegation. Bob Lassen, AARP Nebraska executive council volunteer, says as drug prices continue to rise, Americans are being forced to make difficult decisions. (Eric Galatas, 9/3)

For decades, big drug companies have raised drug prices while thousands of people in Delaware are struggling to make ends meet. Between 2012 and 2017, the average annual cost of brand name prescription drug treatment in our state has increased 58%, while the annual income for Delawareans increased only about 9 percent. Prescription drugs don’t work if patients can’t afford them. That’s why Congress needs to pass the Prescription Drug Pricing Reduction Act. It’s time. (Lucretia Young, 9/2)

Midday Tuesday, Doug McMillon, Walmart’s chief executive, sent me a surprise email. He shared a series of policies the company was about to make public about combating gun violence since the mass shooting that killed 22 people at one of his El Paso stores last month. Mr. McMillon’s email was a reply of sorts to an open letter I had written to him, along with the outcry he heard from scores of Americans, calling on him to use his leverage as the leader of the country’s largest retailer to create a model for more responsible gun-selling practices. (Andrew Ross Sorkin, 9/3)

There is a smell to blood. It’s the iron in it. Once you smell it, you can never get it out of your memory. Other things will remind you of it —��innocent things, like a rusty pipe. In a scene of violence, like a mass shooting, there are other smells mixed in with the blood. Bodies have emptied out, either because they were shredded by bullets or because that’s what happens with shock��and death. If you talk to men and women who have been in war zones, many of whom have post-traumatic stress disorder, they will tell you that certain smells are triggers. (Patti Davis, 9/3)

What if there was a mass shooting in the United States not once or twice or four or six times monthly, but every single day, a big one, the kind that electrifies social media and squats for days on Page 1 — would that be enough to move Senate Majority Leader Mitch McConnell from his insistent inertia on gun safety? Would any volume of bloodshed convince the Kentucky Republican that Congress faces a moral imperative to act? Thirty-eight people were slain in three such shootings in August — in Dayton, Ohio, and El Paso, as well as West Texas — and still Senate Republicans and President Trump refuse to act. (9/3)

The 7th U.S. Circuit Court of Appeals in Chicago has affirmed the right of local governments to impose reasonable gun restrictions. This is in line with Supreme Court precedent that says gun control isn’t inherently unconstitutional. Put simply, those who buy into the Nation Rifle Association’s dogma that gun ownership cannot be restricted in any way are flat-out wrong. This latest case again supports the argument being made by St. Louis officials to Missouri leaders: Local governments need the authority to impose their own restrictions based on their own circumstances, and nothing in the Constitution inherently prevents that. In St. Louis’ case, those circumstances include the shooting deaths of more than a dozen children so far this year. (9/3)

Many people, including health professionals, have assumed that e-cigarettes are safer than traditional cigarettes because they use heated liquid vapor (hence the term “vaping”) rather than burning tobacco leaves in a process that has been proved to be carcinogenic. But “safer” doesn’t mean “risk-free.” A troubling increase of acute lung disease among e-cigarette users across 25 states is making the sobering point that there is still a lot we don’t know about the health implications of vaping. (9/4)

The Trump administration has proposed a change in the way the federal government measures poverty. On the surface, this proposal may appear to be an innocuous, technical adjustment. It’s not. Instead, this change would dramatically reduce the number of people who qualify for vital basic assistance programs, including Medicaid, children’s health care and food assistance. To understand what is happening, it helps to remember how the official poverty measure was first created. (Sen. Bob Casey and Indivar Dutta-Gupta, 9/4)

Huge settlements by drug-making giants Johnson & Johnson and OxyContin-maker Purdue Pharma will total billions of dollars when all is said and done.But whatever the amount, the families and friends of those who slipped into the maw of the opioid epidemic that has ravaged the nation will find little solace in the payouts. The more than 400,000 dead since 2000 will stay dead, and more than likely the deep-pocketed corporations will recover and have the whole matter in their rear-view mirrors. When an Oklahoma judge last week ordered a $572 million judgment against Johnson & Johnson, the company’s stock actually rose a bit the following day. (9/2)

Much of the medical progress in the past half-century has involved expensive, high-tech diagnostic tests and therapies. But it would be a mistake to gainsay the value of inexpensive, low-tech innovations. Consider the problem of falls, which are both a cause and effect of declining health in the elderly. They are the leading cause of injury-related visits to U.S. emergency rooms and of accidental deaths for Americans over 65. Preventing falls or reducing their impact would help millions of people and moderate health-care costs significantly. (Henry I. Miller and Shiv Sharma, 9/3)

Imagine your aunt has developed diabetes and you want her to get better. Medical science suggests that medicine might help, but you decide that the better strategy is to lock your aunt in a room and force her to eat only lettuce — even though she hates vegetables. No medication, no discussion of other options.Does this seem absurd? Illegal? It’s both of those, and no medical professional would advise it. But we are doing more or less the same to people who use drugs. (Leo Beletsky and Denise Tomasini-Joshi, 9/3)

The Constitution delegates no “abortion power” to the federal government and thus the regulation of abortions is clearly part of the residuary sovereignty of the states concerning the lives and liberties of the people. (William J. Watkins, Jr., 9/3)

As children throughout Massachusetts head back to school, they should be focused on learning — not whether they will get the measles. This week, we are filing a bill called the Community Immunity Act to protect children’s health by reducing the threat of preventable diseases. The Community Immunity Act will fix serious flaws in the state’s existing public health systems for immunizations and exemptions, with the goal of safeguarding not just the health of our youth, but also the health of their families, their teachers, our seniors, and everyone in the Commonwealth. (Becca Rausch and Paul Donato, 9/4)