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Political Cartoon: 'Made To Be Broken?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Made To Be Broken?'" by John Deering from "Strange Brew".

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THE NBA’S DR. POLKA

It's the perfect name
For a Cleveland physician:
Dr. Schickendantz

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Capitol Hill Watch

Apparent GOP Budget Deal Hits Snag

News outlets report that, on the eve of its unveiling, the agreement struck between House and Senate Republican negotiators appears to be stalled by Sen. Bob Corker, R-Tenn. According to coverage, the negotiated blueprint currently takes aim at President Barack Obama’s health law and would cut entitlement programs. However, a proposal by Rep. Paul Ryan, R-Wis., to turn Medicare into a voucher program was dropped.

Politico: GOP Budget Dodges Fights Over Entitlements, Defense
Forget about Paul Ryan’s Medicare privatization plan. The same with other entitlement reforms. And never mind offsetting defense spending increases. In almost every instance, sources describe a GOP budget deal in which political practicality beats out ideology as Republican leaders tack toward the party’s center now that they’re in control of both chambers. The final agreement was expected to be unveiled Monday evening until Sen. Bob Corker (R-Tenn.) announced he would not sign the deal without explanation. (Bade, 4/27)

Fox News: House, Senate GOP Budget Negotiations Hit Snag Over Paying For Defense Spending Boost
House and Senate GOP negotiators hit a snag in talks to construct a budget blueprint late Monday over a gimmick that would boost defense spending, but not have the extra dollars count against the federal deficit. ... Republicans plan to use the special filibuster-proof bill to wage an assault on Obama's Affordable Care Act rather than try to impose a variety of painful cuts to Medicare, Medicaid, food stamps, student loans, and other so-called mandatory programs over Obama's opposition. Obama is sure to veto any attempt to repeal the health law, too, but Republicans want to deliver such a measure to Obama anyway. The GOP plan is generally similar to cuts proposed by former Budget Committee Chairman Paul Ryan, R-Wis., — whose budget was largely endorsed by Mitt Romney as the duo formed the GOP presidential ticket in 2012 — with one significant difference. This year's compromise drops Ryan's plan to change Medicare into a voucher-like program for retirees joining the program in 2024. (4/28)

Politico: Bob Corker Puts Brakes On Budget Deal
Sen. Bob Corker is holding up a much-awaited GOP budget deal, barring Republican leadership and top budget negotiators Monday night from filing the agreement that was weeks in the making, his office confirmed to POLITICO. The Tennessee Republican’s office would not say why, but his refusal to sign on to the deal stops the agreement in its path for the time being. Corker’s vote is needed to advance the fiscal blueprint, which GOP leadership hopes to pass this week before the House goes on recess the first week of May. (Bade, 4/27)

The New York Times: Republicans In House And Senate Agree On A Budget
The deal would increase military spending and take aim at President Obama’s signature health care law. It would also cut education and entitlement programs, like Medicare, but negotiators dropped a proposal by Representative Paul D. Ryan, Republican of Wisconsin and a former chairman of the House Budget Committee, to turn Medicare into a largely private voucher program. Under the deal, Congress would use a procedural process known as reconciliation to repeal, or at least begin to undo, the Affordable Care Act. (Parker, 4/27)

Reuters: Republicans Reach Deal For Budget Plan, Target Obamacare
Passing a budget will allow Republicans the opportunity to use budget "reconciliation" procedures to dismantle "Obamacare" with only a simple majority vote in the Senate, rather than a near-impossible 60 vote margin that would require some Democratic support. As reported by Reuters last week, the compromise budget will exclude Representative Paul Ryan's longstanding proposals to convert the Medicare health program for seniors to a system of subsidies for largely private health insurance. (Lawder, 4/27)

Los Angeles Times: Democrats, Several Of Them Californians, Were 'Party Of No' In House Budget Fight
Republicans are usually cast as the "Party of No" in today's Congress. But it was Democrats like [Rep. Ami] Bera in competitive electoral environments who formed the largest bloc of "no" voters during last month's budget debate, the first opportunity lawmakers had this year to weigh in on the crucial taxing and spending battles ahead. A Republican proposal — cutting social safety-net programs, lowering tax rates and raising spending on defense — eventually passed along mostly party lines, 228 to 199, setting the stage for negotiations with the Senate. (Bierman, 4/27)

In other news from Capitol Hill -

The Wall Street Journal: Makers Of Baby Formula Press Their Case On WIC Program
Capitol Hill lawmakers will soon be wrestling over the future of one of the nation’s biggest food-assistance programs, and the makers of infant formula are among the unlikely players in the middle of the scrum. The law authorizing the $6 billion-a-year WIC program, which provides food vouchers to pregnant or postpartum women and their young children, is up for renewal this year. One of the largest formula makers has suggested the program’s eligibility should be tightened, noting that it has up to 20% more recipients than the government intended. Much like the government’s separate food-stamp program, WIC expanded during the recession—reaching a peak of 9.2 million participants in 2010—and has since contracted to about 8.3 million women and children. (Tracy, 4/27)

Health Law Issues And Implementation

High Court Sends Health Law Contraception Challenge Back To Lower Court

The earlier appeals court decision predated the Supreme Court's June 2014 ruling that family-owned Hobby Lobby Stores Ltd could seek exemptions on religious grounds from the contraception provision of the health law. The 6th U.S. Court of Appeals in Cincinnati will now revisit its decision. Other news outlets examine how tax refunds were impacted by the health law and the continued need for outreach to Hispanics.

Reuters: U.S. Top Court Throws Out Obamacare Contraception Ruling
The U.S. Supreme Court on Monday revived religious objections by Catholic groups in Michigan and Tennessee to the Obamacare requirement for contraception coverage, throwing out a lower court decision favoring President Barack Obama's administration. The justices asked the Cincinnati-based 6th U.S. Circuit Court of Appeals to reconsider its decision that backed the Obama administration in light of the Supreme Court's June 2014 ruling that allowed certain privately owned corporations to seek exemptions from the provision. (Hurley, 4/27)

The Kansas City Star: Affordable Care Act Cut Tax Refunds $729, H&R Blocks Says
Two out of three taxpayers who got help from Uncle Sam to buy health insurance last year owed some of that money back come April 15, according to H&R Block Inc. The Kansas City-based tax preparation firm reported its customers’ experiences under the Affordable Care Act and the just completed tax season on Monday. (Davis, 4/27)

The Hill: Study: ObamaCare, Outreach Could Boost Hispanic Health Coverage
A new analysis points to expanding Medicaid under ObamaCare and improving outreach efforts as ways to lower the stubbornly high uninsured rate among Hispanics. Hispanics have long had higher uninsured rates. The Commonwealth Fund, a health research group, finds that ObamaCare is making a dent but that the rate remains high. (Sullivan, 4/27)

Florida Medicaid Expansion Fracas Continues

Also in the news, the latest on the Medicaid expansion debate in Ohio, Alaska and Louisiana, and an Obamacare public relations contract extension in Illinois.

Orlando Sentinel: Leaders Stuck On Health Care Fight
Lawmakers made no progress Monday in settling the war over health-care funding, as Friday's deadline for the end of the regular session loomed. The latest salvo in the battle came from Rep. Richard Corcoran, R-Land O'Lakes, who claimed that expanding Medicaid would actually kick thousands of Floridians off federal health insurance exchanges. "Six hundred nine thousand are the people … currently getting private insurance through the exchange,'' he said, citing figures provided by state health officials. "So those good people get kicked off so that we can get 607,000 Medicaid, that's my point. That's not a good deal." (Rohrer, 4/27)

Orlando Sentinel: Corcoran Defends Anti-Medicaid Expansion Position In Barrage Of Tweets
Rep. Richard Corcoran, R-Land O’Lakes, the fiercest opponent of Medicaid expansion in the House and the next in line to become House Speaker in 2016, defended his position in a series of tweets over the weekend. The burst of 140-character messages slammed hospitals as profit-hungry, blasted Medicaid as a broken system and asserted he was the one standing up for the “working poor” by denying them sub-par health care through Medicaid. “The entire fight is about paying hospitals more money. It has nothing to do with coverage or health care outcomes for the poor.” “Hospitals: ‘show me the money’ Hospitals on poor people: ‘let them eat Medicaid’" (Rohrer, 4/27)

Health News Florida: Gardiner: Send Full FHIX Plan To Feds
Florida Medicaid’s request that federal officials send the state $2.2 billion dollars to keep the Low Income Pool subsidies flowing to hospitals won’t work because a vital part is missing, Florida Senate President Andy Gardiner says. The missing link, he said, is the Florida Health Insurance Affordability Exchange, known as the FHIX. It is the Senate’s plan to cover up to 1 million of Florida’s low-income uninsured residents by accepting billions of dollars in Medicaid expansion money under the Affordable Care Act. (Gentry, 4/27)

Columbus Dispatch: Ohio House Wants To Take Medicaid Authority From Governor
Despite conservative grumblings, House Republicans last week supported the continuation of Gov. John Kasich’s Medicaid expansion. But it could be the last time the administration sets eligibility guidelines for the tax-funded health-insurance program. Before approving the House version of the state budget last week, Republican leaders added a provision giving the General Assembly authority to decide who qualifies for Medicaid, taking it away from the governor. (Candisky, 4/27)

Alaska News Miner: Walker Calls Legislature Back To Work
After 98 days in the regular session, the Legislature will be back at work this morning by order of Gov. Bill Walker. The special session proclamation delivered moments after the Senate gaveled out includes some of the governor’s top priorities that were left unfinished by the Legislature when it adjourned Monday night. That includes Medicaid expansion, a sexual abuse prevention program for K-12 students known as Erin’s Law and funding for the unfunded budget bills the Legislature passed Monday evening. (Buxton, 4/28)

The Associated Press: Hospitals Offer To Share In Cost Of La. Medicaid Expansion
As Louisiana struggles with budget troubles, private hospitals are offering lawmakers a way to draw down more federal health care dollars for patient care, but only if the money is used to expand coverage through the Medicaid program. Legislation filed by House leaders would let the state tap into a voter-backed plan that allows hospitals to pool their dollars and use that money to attract new federal Medicaid money to compensate them for their care for the poor. (DeSlatte, 4/27)

The Associated Press: State To Extend Get Covered Illinois PR Contract By 2 Months
Illinois Gov. Bruce Rauner's administration is negotiating a two-month contract extension with the public relations firm that's handled state promotion of insurance coverage under President Barack Obama's health care law. A $25.6 million contract with St. Louis-based FleishmanHillard to promote Get Covered Illinois expires Thursday. (4/28)

Medicaid

Tennessee Provides A Lens For Viewing Medicaid Managed Care's Access Issues, Challenges

As Tennessee and many other states move increasingly to managed care in their Medicaid programs, federal officials weigh new protections for enrollees. Elsewhere, about 40 percent of Connecticut babies are covered by Medicaid, the Office of the Inspector General finds shortcomings, fraud vulnerabilities in Colorado low income health insurance program, and N.J. Gov. Chris Christie's comments about the program's cost increases are examined.

Kaiser Health News: Medicaid’s Tension: Getting Corporate Giants To Do Right By The Needy
Lynda Douglas thought she had a deal with Tennessee. She would adopt and love a tiny, unwanted, profoundly disabled girl named Charla. The private insurance companies that run Tennessee’s Medicaid program would cover Charla’s health care. Douglas doesn’t think the state and its contractors have held up their end. In recent years she says she has fought battle after battle to secure essential care to control Charla’s seizures, protect her from choking and tube-feed and medicate her multiple times a day. (Hancock, 4/28)

CT Mirror/Trend: 40% Of Connecticut Babies Are Born On Medicaid
Four out of 10 babies born in Connecticut are covered by HUSKY, the state’s Medicaid program for low-income residents. But in some cities, that number is as high as three-quarters. Statewide, 458,674 people were covered by HUSKY A, the portion of the Medicaid program that covers children and their parents. Gov. Dannel P. Malloy’s budget proposal calls for lowering the income limit for parents in the program, a move that is estimated to cause 34,200 parents to lose HUSKY coverage. (Levin Becker and Chang, 4/28)

The Denver Post: OIG: Colorado's Flawed Medicaid System Open To Provider Fraud
Colorado paid more than 800,000 Medicaid claims that were missing required provider identifying numbers or had invalid numbers during 2011 and, until the system is updated in November 2016, the state is vulnerable to fraudulent provider claims, a federal investigation reports. The U.S. Department of Health and Human Services' Office of Inspector General found that the state agency administering Medicaid lacks sufficient internal controls to ensure claims it paid during fiscal year 2011 included required documentation — the national provider identifiers, or NPIs. It's a unique 10-digit number identifying health care providers and health plans. State officials countered that there is no evidence that fraud occurred. (Draper, 4/27)

The Washington Post's Fact Checker: Christie’s Claim That Medicaid Spending Has Grown ‘Over 800 Percent’ In 25 Years
Overhauling long-term entitlement programs has become a major talking point for [N.J. Gov. Chris] Christie, and it is expected to his centerpiece of his potential presidential campaign. Christie recently unveiled his plan to make sweeping changes to government spending and structure of entitlement programs, especially long-term programs such as Social Security, Medicare and Medicaid. Such programs have grown out of proportion and taken up too much of the federal budget and debt, according to Christie. ... While it is correct that Medicaid spending has grown disproportionately to the size of the economy, Christie’s numbers give a misleading impression of the magnitude. (Lee, 4/27)

Meanwhile, one outlet takes a look at news related to another government health care program: Medicare -

The New York Times: Obama Proposes That Medicare Be Given The Right To Negotiate The Cost Of Drugs
Embedded in President Obama’s budget request to Congress is a paradox. He proposes a major new initiative to develop drugs tailored to the genetic characteristics of individual patients, but he expresses deep concern about the costs of such specialty medicines for consumers and for the Medicare program. He has asked Congress to let Medicare officials negotiate prices with drug manufacturers — a practice explicitly forbidden by current law. (Pear, 4/27)

Marketplace

Aetna, Universal Health, Post Strong Profits

The quarterly shareholder reports by the insurer and the health care provider continue the good showing of health care companies since implementation of the health care law. In other news, the FDA orders Medtronic to halt production and distribution of one type of implanted drug pump.

Reuters: Health Insurer Aetna Raises Full-Year Profit Forecast
Aetna Inc, the third-largest U.S. health insurer, increased its forecast for full-year operating earnings after a stronger-than-expected profit in the first quarter. Aetna's members increased 122,000 from the fourth quarter and higher margins in its government and commercial business also boosted results in the latest quarter. ... Low hospital and medical use has helped keep claims down and profits up in the past few years, even as the U.S. healthcare system has undergone major reforms under the Affordable Care Act. (4/28)

The Wall Street Journal: Universal Health Posts Rise In Profit, Revenue
A wave of newly insured patients coupled with fewer uninsured patients and a higher rate of admissions drove Universal Health Services Inc.’s revenue and profit growth in the first quarter, the hospital operator said Monday. Shares, up 45% over the past 12 months, rose 2% in recent late trading to $123, just shy of a 52-week-high set Friday during regular trading. Like its industry peers, Universal Health—which operates medical, surgical and behavioral-health facilities—has benefited from an increase in insured patients under the Affordable Care Act. (Armental, 4/27)

Associated Press: FDA: Medtronic Must Stop Most Sales Of Synchromed Drug Pumps
The FDA has filed a court order against Medtronic that says the medical device giant must halt most production and distribution of its Synchromed II drug pumps, which are implanted devices used to treat patients with cancer, chronic pain and severe muscle spasms. Among other defects, some Synchromed pumps had to be recalled because they could lose battery power and fail, endangering patients. In other cases, the devices could cause patients to receive too much or too little medication. Medtronic generally did not recommend that patients have the devices removed, unless they were proven to be failing. (Perrone, 4/27)

Meanwhile, the board of drugmaker Mylan rejects a takeover bid by rival Teva and Massachusetts drugmakers defend the high costs of their products -

Bloomberg: Mylan Board Unanimously Rejects Takeover Bid As Too Low
Mylan NV’s board unanimously rejected a $40.1 billion takeover offer from Teva Pharmaceutical Industries Ltd., saying it’s too low and doesn’t address the difficulties of combining companies with different cultures. The board won’t consider talks to sell the company unless it gets an offer of significantly more than $100 a share, Mylan said in a statement Monday. Teva offered $82 a share in cash and stock for Mylan last week. ... Consumer advocates, pharmacists and other groups have expressed concern that a merger of Teva and Mylan would contribute to a trend of rising prices for generic drugs. Some 10 percent of generic drugs doubled in price between July 2013 and June 2014, and half of all generic drugs rose in price, according to an analysis of Centers for Medicare and Medicaid data cited by Senator Bernie Sanders, an independent from Vermont, and Representative Elijah Cummings, a Democrat from Maryland. (Harrison, 4/27)

Boston Globe: State’s Drug Makers Defend High Costs Of Medicines
[To] the heads of Massachusetts’ most prominent drug makers, the problem isn’t how much the public is paying for their drugs but rather that patients don’t fully understand what they get for their money. “One thing we haven’t done a good job at is telling the story,” Dr. Jeffrey Leiden, chief executive of Boston-based Vertex Pharmaceuticals, said Monday at a Boston conference on medical innovation hosted by the hospital giant Partners HealthCare. “We need to tell the story of the value of what we do in life sciences because that’s the inspiration for what we’re going to do in the future.” (McCluskey, 4/28)

Plugged-In Patients And Doctors Alter Traditional Power Dynamic

Online consultations, self-generated health data and easily accessible information is changing typical doctor-patient interactions, but there are still challenges. Also, a new study suggests ways to improve the negatives of weekend hospital stays.

The Washington Post: How Is The Doctor-Patient Relationship Changing? It’s Going Electronic.
Thanks to technology, Gary Sullivan enjoys a new kind of relationship with his doctor. If he wakes up with a routine health question, the 73-year-old retired engineer simply taps out a secure message into his doctor’s electronic health records system. His Kaiser Permanente physician will answer later that day, sparing Sullivan a visit to the clinic near his Littleton, Colo., home and giving his doctor time to see those with more urgent needs. (Levingston, 4/27)

The Fiscal Times: Why You Should Never Have Surgery on a Weekend
A new study presented on April 25th at the American Surgical Association has identified five resources that mitigate the so-called “weekend effect” of longer hospitals stays, higher mortality rates and readmissions. This study has special importance given the government’s performance requirements for both Obamacare and Medicare to reduce the readmission rate and increase the desirable outcome rate for hospital surgeries and other treatments. (Leo, 4/27)

Public Health And Education

FDA Calls For New Drug Labels To Explain Risks, Benefits For Pregnant Women

The government is also calling for reducing fluoride levels in water after children developed splotchy teeth, and the Journal of the American Medical Association interviews the new U.S. surgeon general.

The Chicago Tribune: FDA To Require New Information For Prescribing Medications During Pregnancy
For years, cautious mothers-to-be and their obstetricians thought "just say no" was the most prudent approach to any medication more potent than a cough drop. But abandoning treatment for chronic health conditions — such as depression, asthma or diabetes — can sometimes affect the baby more than taking a medication while pregnant, experts said. To help doctors and patients weigh the risks and benefits of taking medications during pregnancy and breast-feeding, the Food and Drug Administration in June will require a new labeling system for prescription drugs. (Rubin, 4/27)

JAMA: Being “Nimble and Flexible” Is New Surgeon General’s Goal
As “America’s doctor,” [new Surgeon General Vivek] Murthy’s job is to communicate “the best available scientific information to the public regarding ways to improve personal health and the health of the nation,” according to his official biography. He also oversees the 6700 uniformed health officers of the USPHS. Murthy ... was narrowly confirmed in December, more than a year after President Obama nominated him. His nomination was strongly opposed by the National Rifle Association because he supported gun-control laws and by Republicans who questioned whether he was qualified for the job and criticized his political ties to Obama. Two days before his ceremonial swearing in on April 23, JAMA spoke with Murthy at his office. (Rubin, 4/27)

State Watch

Georgia's Second-Largest Hospital To Settle Medicare Fraud Case For $20 Million

The Macon-based Medical Center of Central Georgia was alleged to have billed Medicare for "medically unnecessary" services that were more costly than the ones the hospital should have performed.

Georgia Health News: Macon Hospital To Pay $20 Million In Billing Case
A Macon hospital has agreed to pay $20 million to settle allegations that it violated the False Claims Act by overcharging Medicare on patient admissions. The U.S. Attorney’s Office in the Northern District of Georgia said that from 2004 to 2008, the Medical Center of Central Georgia billed Medicare for inpatient services when the billing should have been for less costly outpatient or observation services. (Miller, 4/27)

The Atlanta-Journal Constitution: Georgia Hospital To Pay $20 Million To Settle False Claims Case
The Macon-based Medical Center of Central Georgia, the second largest hospital in the state, will pay $20 million to settle allegations that it violated the False Claims Act by billing Medicare for more expensive inpatient services instead of less costly outpatient or observation services, the U.S. attorney’s office said. Federal authorities allege that from 2004 to 2008 the hospital “knowingly” charged Medicare for “medically unnecessary inpatient admissions when the care provided should have been billed as less costly outpatient or observation services. (Markiewicz, 4/27)

The Associated Press: Ga. Hospital Agrees To $20M False Billing Settlement
Federal prosecutors say a central Georgia hospital system has agreed to a multimillion dollar settlement to resolve allegations of fraudulent Medicare billing. Authorities say the Medical Center of Central Georgia has agreed to pay $20 million to settle claims that it billed Medicare for services that were more expensive than what the hospital should have been billing for between 2004 and 2008. (4/27)

State Highlights: Penn. Officials Press For Arbitration To Settle Disputes Between UPMC, Highmark; Florida Lawmakers OK New Senior Care Regs

News outlets cover health care issues in Pennsylvania, Florida, New Mexico, Connecticut, Hawaii, North Carolina, Texas, Illinois, Maryland, Wisconsin, Minnesota, D.C., Massachusetts and Oregon.

The Associated Press: Penn. Governor, Attorney General Seek UPMC, Highmark Arbitration
Gov. Tom Wolf and the state attorney general want the Commonwealth Court to force the University of Pittsburgh Medical Center and rival Highmark Inc. into arbitration to settle lingering disputes. A court filing was announced Monday after UPMC said it was canceling its Medicare contract with rival Highmark, which could cause about 180,000 seniors in western Pennsylvania to lose in-network access to UPMC hospitals and doctors next year. (4/27)

The Miami Herald: Florida Legislators Pass New Regulations To Senior Care Homes
After trying for four years to improve conditions at the state’s assisted living facilities, the Florida Senate on Wednesday sent to the governor a proposal to improve enforcement and oversight at the homes that serve more than 86,000 senior residents. But critics warned that while HB 1001/SB 382 increases some oversight at the 3,027 ALFs in Florida, the measure also reduces the number of monitoring visits for homes with good reputations, leaving seniors vulnerable when homes falter. (Klas, 4/27)

The Associated Press: N.M. State Senator Wants Answers From Mental Health Care Officials
A key Democratic state senator is asking Republican Gov. Susana Martinez's administration for answers as a mental health provider prepares to pull out of southern New Mexico. Senate President Pro Tem Mary Kay Papen said she's concerned about the thousands of people who currently receive care from Arizona-based La Frontera. The provider is set to stop services June 1. (Jolly, 4/27)

The CT Mirror: Budget Panel Would Blow By Spending Cap To Restore Social Service, Education Funds
The [Connecticut] legislature’s Democrat-controlled budget-writing panel recommended adding $514 million in spending to Gov. Dannel P. Malloy’s plan for next fiscal year — and embraced a radical new interpretation of the constitutional spending cap — primarily to bolster human services and education. ... Under the committee’s plan, no parents or pregnant women would lose eligibility for Medicaid — Malloy’s plan would lower eligibility, affecting an estimated 34,200 people — and state funding of Medicaid payments to health care providers would be cut by $8 million over two years, compared to $90 million under the governor’s plan. (Phaneuf, Becker and Thomas, 4/27)

The Charlotte Observer: Carolinas HealthCare, UnitedHealthcare Forge New Deal
Carolinas HealthCare System and UnitedHealthcare have forged a new contract that keeps the hospital system’s Charlotte-area patients and physicians on the insurance provider’s coverage plans – nearly two months after negotiations soured and resulted in their decade-long contract expiring. The new contract ensures that services will continue for enrollees in UnitedHealthcare’s employer-sponsored and Medicare plans who seek care at Charlotte-area Carolinas HealthCare System hospitals and doctors offices, according to a joint news release. (McFadden, 4/27)

Dallas Morning News: Senate Votes To Enlarge Management Board Of Dallas County Hospital District
The board of managers for the Dallas County Hospital District would be expanded from seven to 11 members under legislation passed by the Senate on Monday. Sen. Royce West, D-Dallas, author of the measure, said it incorporates recommendations from a governance advisor to Parkland Hospital officials in 2013. The report from the advisor noted that similar health boards typically have between nine and 17 members to operate most effectively. “Increasing the size would provide stronger expertise, experience, and perspectives in the boardroom,” according to the report. (Stutz, 4/27)

The Baltimore Sun: Hackers Get Access To Patient Information At Saint Agnes Health Care
Saint Agnes Health Care Inc. has informed about 25,000 people about an email phishing incident that breached protected health information. Hackers who targeted employees' email accounts gained access to patient protected information including names, date of birth, general medical record numbers insurance information, limited clinical information and in four cases Social Security numbers. (Mirabella, 4/27)

The Chicago Tribune: Chicago Counseling Centers Asks For $1M To Halt Closure
News that Community Counseling Centers of Chicago plans to close at the end of May prompted concern Monday from other mental health service providers worried about serving so many more people — especially at a time of dwindling resources and increasing need. The 42-year-old agency — one of the largest providers of mental health services in the Chicago area — serves more than 10,000 clients a year at four locations, primarily on the city's North and West sides. In a letter sent to nine state lawmakers last week, the agency asked for an additional $1 million to continue operations. Without the funding, "we will be required to immediately shut our doors," the letter said. (Rubin, 4/27)

Milwaukee Journal Sentinel: Program Streamlines Health Care For Foster Children
Not long ago, when doctors were assigned to provide primary care for foster children, they would spend hours on the phone trying to find specialists willing to provide other medical needs, such as mental health or dental care. Thomasien Malsch, manager at three Milwaukee-area Children's Hospital of Wisconsin clinics, said her team would put in at least 20 calls at times to find specialists willing to take the children on. That frustrating process has eased considerably with the establishment of Care4Kids, a private-public partnership between Children's and the state departments of Children and Families and Health Services. In the program, which has been in place for slightly more than a year, Children's creates a "medical home team" through Medicaid for foster children. (Gebelhoff, 4/27)

Minnesota Public Radio: Data Show Big Drop In Hennepin County Opiate Deaths
Deaths tied to heroin or prescription opiates in Hennepin County fell more than 20 percent last year while they rose slightly in Ramsey County, data released Monday show. Hennepin County saw deaths fall to 102 in 2014, significantly better than the 132 deaths recorded in 2013, said Carol Falkowski, an expert on Minnesota drug trends who analyzed the data. Officials say the county's efforts to get the anti-overdose drug naloxone in the hands of first responders may have made a difference. (Collins, 4/27)

The Associated Press: State Costs Soar To $7M As Bird Flu Outbreak Worsens
Gov. Mark Dayton and state officials approved a monthlong extension to a peacetime state of emergency Monday to battle bird flu, acknowledging they still don't know the full scope of an outbreak that has wiped out about a fifth of the turkey population in the nation's largest turkey-producing state. The deadly virus is spreading in Minnesota by the day. Its toll more than doubled in the last week -- 55 turkey farms had been hit as of Monday, costing farmers more than 3 million birds. (4/27)

Dallas Morning News: Dallas Fire-Rescue Program Helps Reduce 911 Calls By Frequent EMS Users
The number of 911 calls in Dallas has swollen by more than 17 percent during the last five years, Dallas Fire-Rescue officials said Monday. ... officials believe they have effectively treated a harmful symptom of the problem: EMS “frequent fliers” — people who call 911 several times a month for maladies real and imagined. Many of the callers are indigent and rely on the emergency services for their basic health care needs, such as managing their medications or diabetes-related problems, officials said. Assistant Chief Norman Seals said the Mobile Community Healthcare Program, which treated its first patient a year ago, has successfully helped cut the amount of calls from some of those frequent fliers from more than two a month to almost none a month. ... paramedics regularly visit the patients at their homes to teach them to care for themselves — and to use the 911 system properly. (Hallman, 4/28)

The Texas Tribune: Lawmakers Look To Ban Abortion From Health Plans
Health insurers could be prohibited from offering Texans plans covering abortions under a proposal by Republican state Sen. Larry Taylor of Friendswood that passed a Senate committee Monday. Under Senate Bill 575, private health insurance plans and those offered through the federal Affordable Care Act’s marketplace could only provide coverage for abortions in cases of medical emergencies. Women seeking coverage for what Taylor calls “elective” abortions would be required to purchase supplemental health insurance plans. (Ura, 4/27)

Boston Globe: Governor Baker Shining Spotlight On Sexual Assault
Governor Charlie Baker signed an executive order on Monday reestablishing a council that brings advocates against sexual assault and domestic violence together with law enforcement and government officials. The council’s aim is to improve prevention, enhance existing support services, and hold perpetrators accountable. The group will also help implement the state’s new domestic violence laws. The 30-member Governor’s Council on Sexual Assault and Domestic Violence was established by former governor Paul Cellucci’s administration, in which Baker served. (Johnson, 4/27)

The Oregonian: Oregon Gets A- For Work To Reduce Kids' Cavities
Oregon is among three states leading the nation in their dental sealant programs for low-income children, according to a report card released Friday by the Pew Charitable Trusts. Oregon earned 11 out of 11 possible points for its efforts to reduce children's tooth decay as of 2014 but received an A- rather than an A because Medicaid managed care organizations do not yet reimburse the statewide sealant program, the report said. In 2012, the state received a B. (Wang, 4/27)

Editorials And Opinions

Viewpoints: Can New Medicare Pay Improve Quality?; Kyle Bass' Patent Challenges

A selection of opinions on health care from around the country.

Dallas Morning News: Congress Makes An Amicable Repeal Of Medicare Formula
Under the new law, doctors treating Medicare patients will get half a percent raises for each of the next five years. Most physicians are expected to use the time to transition to a payment model moving from fee-for-service to one that rewards value over volume in care delivery. Between 2020 and 2025, the amount they’re paid will be tied to performance. ... [Rep. Michael] Burgess is less enthusiastic than the president about moving physicians away from traditional fee-for-service payments, and made sure the law keeps that option available. “It’s impossible to know at this point, but of those who select an alternative payment model, where you are paying for value over volume, there may be savings,” he said. “To date, the data are not all that encouraging.” (Jim Landers, 4/27)

Boston Globe: Patent Crusade Benefits Whom?
Is it possible that an aggressive hedge fund manager could be out to make the world a better place for patients who depend on crazy-expensive medication to battle serious illnesses? Don’t be ridiculous. The hedge fund manager in question is Kyle Bass of Hayman Capital Management in Dallas. Bass has been making waves lately by challenging the patents that drug and biotech companies hold for some of their most important and lucrative medicines. ... So how does that work? Bass doesn’t talk about it (I got only an e-mailed copy of his company’s statement on the subject) but stock analysts who follow the drug industry believe Hayman Capital attempts to drive the company’s stock price down with the patent challenge and profit on that decline. (Steven Syre, 4/28)

The New York Times' The Upshot: Federal Push For Privacy Hampers Addiction Research And Care
Researchers who want to study Medicare or Medicaid patients with substance-use disorders — and illnesses disproportionately affecting them like H.I.V. and hepatitis C — are, at best, working with biased data. At worst, they’re flying blind. That’s because agencies within the Department of Health and Human Services, without public notice and because of patient privacy concerns, decided in 2013 to remove researchers’ access to certain types of Medicare and Medicaid data. (Austin Frakt, 4/27)

Bloomberg: Obamacare, Assessed
No single statistic can cover all of [the federal health law's] many aspects. But there are some data sources than can shed some light. It’s helpful to step back from the day-to-day partisan battle and recall the sweeping goals of the law: to give more people health insurance while reshaping a medical system that spends more and delivers less than that of any other wealthy country. (Alex Wayne, 4/27)

Tampa Bay Times: Why The Florida House Opposes Medicaid Expansion
We oppose expanding Medicaid because it is a broken system with poor health outcomes, high inflation, unseverable federal strings, and no incentive for personal responsibility for those who are able to provide for themselves. Under current law, Florida provides for our most vulnerable: low-income children, pregnant women, the elderly and disabled people. ... Those who claim we should expand Medicaid to get Florida's money back should note that we already receive over $15 billion more each year than we send to Washington. It's deficit spending. The national debt burden today is $145,000 per household. Medicaid expansion would not be financed with the hard-earned dollars we have already sent to Washington — it would be financed by mortgaging our children's and grandchildren's future. (Florida House Speaker Steve Crisafulli, 4/28)

Modern Healthcare: Rating A Politician's Claim That Medicaid Kills
One of Florida's most powerful Republicans reportedly is using the results of a narrow study focusing on surgical outcomes to insinuate that extending Medicaid to more Americans increases their chances of dying. Rep. Richard Corcoran is leading the battle in Florida to block a bill approved by the GOP-led state Senate to expand Medicaid to low-income adults. ... when his constituents email him about the expansion issue, PolitiFact Florida reported, Corcoran sends this reply: "The largest national study, conducted by the University of Virginia, found that Medicaid patients were 97% more likely to die than those with private insurance." PolitiFact Florida rated Corcoran's statement to his constituents as “mostly false.” “Mostly false” seems charitable. (Harris Meyer, 4/27)

Tampa Bay Times: This Is A Pivotal Time For Tallahassee Lawmakers
The Senate sees the budget as inseparable from the questions of whether to expand Medicaid and how to help hospitals, who face the loss of a federal program that helps pay for the cost of treating the poor. The House views the budget and those health care questions as completely separate, which suggests that the House would never agree to an extended or special session where Medicaid expansion is on the agenda. ... Something's got to give. It will. It always does in Tallahassee, because time is running out. (Steve Bousquet, 4/27)

Alaska Dispatch News: When You Do The Homework, Medicaid Expansion Makes Sense For Alaska
As a guest on the Glen Biegel show during my campaign for lieutenant governor, I was surprised by the certainty and conviction of callers that described Medicaid expansion as “welfare” and thought that improving health care for 40,000 Alaskans was somehow “taking away their dignity.” My dad’s top logging salary was $26,000 a year and he spent a considerable sum of money on catastrophic high-deductible insurance. Health care shouldn’t be treated as a luxury item that is not deserved by Alaskans that work hard but don’t make a lot of money. We will actually be honoring the dignity of our neighbors when we improve the quality of life and the health of 40,000 Alaskans. (Bob Williams, 4/27)

The Philadelphia Inquirer: How Obamacare Is Helping Fix A Problem With Mammograms In Bucks County
There’s a big problem with mammograms in Bucks County. Four out of every ten women who should be getting a yearly mammogram aren’t. They’re forgoing a chance to detect a serious health problem early on, when it’s easier to take care of and recover from. The Affordable Care Act (aka Obamacare) helped bring this problem to the attention of hospitals there. Now they are working together, through their long-standing participation in the Bucks County Health Improvement Partnership, to do something about it. (Andy Carter, 4/27)

Boston Globe: A United Front In The Opioid Battle
Last month, one North Shore community was rattled by the news of six heroin overdoses, three of those resulting in death, in just 48 hours. Sadly, this is just more evidence indicating that we are in the midst of an opioid epidemic. The numbers are staggering. Figures that will be released Tuesday estimate there were 1,008 deaths from opioid overdoses in the Bay State in 2014, a 33 percent jump from 2012. Opioids kill more people in Massachusetts than car accidents and guns combined. ... The prescription opioid and heroin epidemic requires coordinated and comprehensive action from federal, state, and local leaders. It requires multi-faceted efforts in the area of prevention, intervention, treatment, and recovery — and a dedicated focus on public awareness and education. (U.S. Secretary of Health and Human Services Sylvia M. Burwell, Mass. Gov. Charlie Baker and Mass. Secretary of Health and Human Services Marylou Sudders, 4/28)

Richmond Times-Dispatch: The Scientific Consensus On Guns
I decided to determine objectively, through polling, whether there was scientific consensus on firearms. What I found won’t please the National Rifle Association. ... it’s possible to find researchers who side with the NRA in believing that guns make our society safer, rather than more dangerous. As I’ve shown, however, they’re in the minority. Scientific consensus isn’t always right, but it’s our best guide to understanding the world. Can reporters please stop pretending that scientists, like politicians, are evenly divided on guns? We’re not. (David Hemenway, 4/27)