Smart, Affectionate & Youthful

First Edition: Sept. 9, 2022

Today’s early morning highlights from the major news organizations.

Hospitals Divert Primary Care Patients To Health Center ‘Look-Alikes’ To Boost Finances

A growing number of hospitals are outsourcing often-unprofitable outpatient services for their poorest patients by setting up independent, nonprofit organizations to provide primary care. Medicare and Medicaid pay these clinics, known as federally qualified health center look-alikes, significantly more than they would if the sites were owned by hospitals. (Galewitz, 9/9)

Many Preventive Medical Services Cost Patients Nothing. Will A Texas Court Decision Change That?

A federal judge’s ruling in Texas has thrown into question whether millions of insured Americans will continue to receive some preventive medical services, such as cancer screenings and drugs that protect people from HIV infection, without making a copayment. It’s the latest legal battle over the Affordable Care Act, and Wednesday’s ruling is almost certain to be appealed. (Appleby, 9/9)

Children In Northern California Learn To Cope With Wildfire Trauma

Maia and Mia Bravo stepped outside their house on a bright summer day and sensed danger. A hint of smoke from burning wood wafted through their dirt-and-grass yard anchored by native trees. Maia, 17, searched for the source as Mia, 14, reached for the garden hose, then turned on the spigot and doused the perimeter of the property with water. (de Marco, 9/9)

KHN’s ‘What The Health?’: Judge Takes Aim At The Affordable Care Act’s Preventive Care Benefits

The same federal judge in Texas who tried — unsuccessfully — to strike down the entire Affordable Care Act in 2018 has ruled that portions of the health law’s preventive care benefit package are unconstitutional. But it will be a long time, with many more court actions, before it becomes clear whether the decision will change how the law works. (9/8)

Detroit Free Press:
Michigan Supreme Court: Abortion Amendment Must Appear On Ballot

Tiny spaces and cries of gibberish are not enough to derail an effort to explicitly enshrine abortion rights in the Michigan Constitution, according to a ruling issued Thursday by the state’s highest court. The ruling, the court’s first dealing at all with abortion since the U.S. Supreme Court reversed the national constitutional right to an abortion afforded under Roe v. Wade, means Michiganders will have the chance to amend the state Constitution when they cast their ballots this fall. (Boucher, 9/8)

The Hill:
Michigan Supreme Court Puts Abortion Rights Question On Nov. Ballot 

The anti-abortion group opposing the effort argued that due to missing spaces and other formatting errors the text circulated to voters for their signatures was too confusing, making the petition invalid. The majority wrote that despite the typos, the meaning of the amendment was not changed. “Regardless of the existence or extent of the spacing, all of the words remain and they remain in the same order, and it is not disputed that they are printed in 8-point type. In this case, the meaning of the words has not changed by the alleged insufficient spacing between them,” the court ruled. (Weixel, 9/8)

The New York Times:
After Long Brawl, South Carolina Senate Approves More Abortion Restrictions 

The South Carolina Senate voted Thursday night to tighten abortion restrictions but failed to pass a total ban after a heated debate revealed the ongoing struggle among Republicans to define a cohesive post-Roe strategy. The chamber voted to gut a bill that would have prohibited abortion without exception for rape or incest, instead choosing to add more limits to the state’s existing law that bans abortion after six weeks. That law is temporarily blocked by the state Supreme Court because of ongoing litigation. (Sasani, 9/9)

Idaho Legislature Asks Judge To Reconsider Abortion Ruling

The Idaho Legislature has asked a federal judge to reconsider his decision blocking the state from enforcing a strict abortion ban in medical emergencies. In court documents filed Wednesday, attorneys for the Legislature said Senior U.S. District Judge B. Lynn Winmill incorrectly followed the guidance of President Joe Biden’s administration rather than using the standards set by Congress when he found that Idaho’s ban appeared to violate a federal law governing emergency health care services at Medicare-funded hospitals. (Boone, 9/8)

Ohio Capital Journal:
Judge Holds Off On Ohio Abortion Ban Decision

A Hamilton County judge said he needs more time to decide whether or not to put a pause on a six-week abortion ban in Ohio. Judge Christian Jenkins said in a Thursday hearing that he would not issue an opinion because the court still has questions about how the case moves forward. “The court would like to investigate the threshold issue of jurisdiction and the effect of the (state) supreme court still not having dismissed the case,” Jenkins said on Thursday. (Tebben, 9/9)

Ohio Capital Journal:
Ohio Docs Say New Abortion Law Has Them Working Against Oaths To Do No Harm  

A little more than two months into enforcement of Ohio’s harsh abortion restrictions, doctors are describing scenes of almost unimaginable anguish — and increased risks to women and girls who become pregnant. According to them, in all but the most dire medical emergencies, they and their patients have had to take up to 15 minutes with a bureaucratic process that some docs say is meant to shame women before allowing them to end pregnancies that pose a threat to their lives. Other women have partially delivered fetuses too undeveloped to survive only to see the delivery stall. In that condition, with the fetus partly out, they also have had to sign paperwork — and then wait for 24 hours, or for the fetus’s heart to stop. (Schladen, 9/7)

The Hill:
AMA Warns ‘Patient Health Is At Risk’ Post-Roe, Calls For ‘Clear Guidance’ On State Abortion Laws

The American Medical Association (AMA) and three other health organizations warned on Thursday that patients’ health is at risk in the aftermath of the Supreme Court overturning Roe v. Wade and called on state officials across the country to give “clear guidance” on the interpretation of their abortion laws. The AMA, American Pharmacists Association, American Society of Health-System Pharmacists and National Community Pharmacists Association said in a release that health care providers face a “confusing” legal landscape on abortion policies following the Dobbs v. Jackson Women’s Health Organization ruling, which struck down a federal protection for abortion. (Gans, 9/8)

Medical Groups Warn Of ‘Irreparable Harm’ To Patients In Confusing Post-Roe Era 

The AMA and other groups said Thursday they were deeply concerned about patients’ health, pointing to reports many women are unable to access medication and decisions that compound trauma for victims of sexual assault. “As physicians and pharmacists, we view patient wellbeing as paramount and are deeply troubled that continuity of care is being disrupted,” they said. “We call on state policymakers to ensure through guidance, law, or regulation that patient care is not disrupted and that physicians and pharmacists shall be free to continue to practice medicine and pharmacy without fear of professional sanction or liability.” (Visser, 9/9)

Biden Leans Into Abortion Rights In Speech To Democratic Activists

President Joe Biden escalated his attacks on Republicans over abortion rights in a speech to Democratic activists late Thursday, addressing the specifics of what he contends his opponents want: an expansion of abortion bans before many women know they’re pregnant, and an attempt to to pass a national ban, which he pledged to veto. Leaning into the Supreme Court’s overturning of abortion rights this summer, the president suggested there would be a surge of voter activity in the fall midterm elections pushing back against the high court’s decision. Biden reiterated that abortion could be just the start of Republican attempts to dial back rights, including contraception and same-sex marriage. (Olander and Cadelago, 9/8)

Houston Chronicle:
In Houston, VP Harris Urges People Of Faith To Defend Democracy

“As extremists work to take away the freedom of women to make decisions about their own bodies, faith leaders are taking a stand, knowing one does not have to abandon their faith or deeply held religious beliefs to agree that a woman should have the ability to make decisions about her own body, and not have her government tell her what to do,” Harris said. (McGuinness, 9/8)

DHS Issues Rule To Revise Trump’s ‘Public Charge’ Policy, Easing Access To Health Services For Immigrants

The Department of Homeland Security on Thursday issued a new rule to revise a Trump administration policy that effectively discouraged non-citizen immigrants from using government-funded health services. The new rule clarifies that DHS will not classify non-citizens as “public charges” — a classification that could result in them being denied green cards — based on their use of health-related benefits and government services. (Trang, 9/8)

Becker’s Hospital Review:
Duke Surgeons Perform World’s 1st Partial Heart Transplant

Cardiologists at Durham, N.C.-based Duke Health performed what is believed to be the world’s first partial heart transplant by fusing the arteries and valves from a freshly donated heart onto an existing heart, the system said in an email to Becker’s Sept. 8. The procedure was performed on a newborn with truncus arteriosus — a condition in which the two main heart arteries are fused together. Joseph Turek, MD, PhD, Duke’s chief of pediatric cardiac surgery, led the surgery team. (Gleeson, 9/8)

ABC11 Raleigh-Durham:
NC Newborn Becomes World’s First Partial Heart Transplant Recipient At Duke Health 

The scarring on baby Owen Monroe’s chest is a reminder to his parents of the leap of faith they took. He doesn’t know it yet, but he’s the world’s first person to ever successfully receive a partial heart transplant. “He was basically already in heart failure right out the gate,” said Tayler Monroe, Owens’s mother. He was born with a condition called truncus arteriosus, where his two main heart arteries were fused together. Doctors say he wouldn’t survive the wait for a full heart transplant. His parents reside in Leland and traveled to Duke Hospital for the procedure. (Davis, 9/8)

FDA Warns Of Potential Clip Lock Issue With Abbott’s Heart Valve Repair Device 

The U.S. Food and Drug Administration on Thursday alerted healthcare providers about a potential clip lock issue with Abbott Laboratories’ MitraClip device used to stop heart valve leakage. The medical device treats mitral regurgitation, a condition in which the mitral valve of the heart does not close properly, causing blood leakage that can lead to stroke, heart attack or even death. MitraClip was first approved in 2013. (9/8)

USA Today:
US Reaches 1 Million Organ Transplant Milestone, As Advances Continue

Friday, the United States is expected to pass another milestone: 1 million solid-organ transplants. Most have been kidneys, followed by livers, hearts and lungs. “To have the ability and the science and the technology to transplant an organ from one person to another so that person has another chance to live is nothing short of a miracle,” said Barry Massa, president of the Association of Organ Procurement Organizations. “Without the generosity of people who said yes to being a donor … none of this would have been accomplished.” (Weintraub, 9/9)

The New York Times:
Breast Implants May Be Linked To Additional Cancers, F.D.A. Warns 

The Food and Drug Administration on Thursday warned women who have breast implants or are considering getting them that certain cancers may develop in scar tissue forming around the implants. The malignancies seem to be rare, but they have been linked to implants of all types, including those with textured and smooth surfaces, and those filled with saline or silicone. (Rabin, 9/8)

The Hill:
FDA Issues Safety Alert Over Reports Of Cancer In Scar Tissue Around Breast Implants 

The Food and Drug Administration (FDA) issued a warning for doctors and patients on Thursday after it received reports of people with breast implants being diagnosed with multiple types of cancer. Binita Ashar, the director of the Office of Surgical and Infection Control Devices in the agency’s Center for Devices and Radiological Health, said in a release that the FDA received reports of squamous cell carcinoma and various lymphomas in the capsule or scar tissue near the implants. (Gans, 9/8)

Los Angeles Times:
L.A. County Investigating Death Of Resident Diagnosed With MPX

Los Angeles County health officials are investigating the death of a person diagnosed with MPX to see whether the viral illness was a primary cause of mortality. An autopsy still needs to be conducted, and “it does take time for those results to come back. So it may be as soon as a few days, or it may take a few weeks,” according to Dr. Rita Singhal, chief medical officer for the county’s Department of Public Health. (Lin II, Money and Toohey, 9/8)

Study Raises Questions On Dose-Sparing Monkeypox Vaccine Approach 

Late last week a notable group of Dutch researchers published a preprint study on the neutralizing antibodies produced by two subcutaneous doses of Bavarian Nordic’s monkeypox vaccine, Jynneos (MVA), and it indicated the dose-sparing strategy might not yield a very strong immune response. (Soucheray, 9/8)

US May Expand Monkeypox Vaccine Eligibility To Men With HIV

U.S. officials are considering broadening recommendations for who gets vaccinated against monkeypox, possibly to include many men with HIV or those recently diagnosed with other sexually transmitted diseases. Driving the discussion is a study released Thursday showing that a higher-than-expected share of monkeypox infections are in people with other sexually transmitted infections. (Stobbe, 9/8)

HIV, Earlier STIs Common In US Monkeypox Patients

Surveillance data from eight US jurisdictions found a high prevalence of HIV and other sexually transmitted infections (STIs) among people with monkeypox, a research team based at the Centers for Disease Control and Prevention (CDC) reported today. In other developments, scientists from Europe today reported finding viable monkeypox viruses in anal and urethral samples from monkeypox patients, adding more evidence for a sexual transmission route, and the US government took more steps to expand testing and explore the efficacy of different vaccination strategies. (Schnirring, 9/8)

NBC News:
‘Don’t Wait’ To Get The New Covid Shot, White House Says

“We want Americans to know that the vaccine is here and that they shouldn’t wait” to get it, a senior administration official told NBC News on Thursday. The plans urge schools across the United States to hold at least one vaccination clinic before Thanksgiving, as well as university-led vaccination campaigns this fall. (Edwards, 9/8)

Doubling Up On Covid, Flu Shots May Have Downside, Experts Say

Earlier this week, Anthony Fauci, President Biden’s chief medical adviser, put it bluntly: “Get your updated Covid-19 shot as soon as you are eligible.” For many people over the age of 12, that would be right now. There’s just one problem with the advice. It’s still early to get a flu shot. (Branswell, 9/9)

San Francisco Chronicle:
U.S. Dedicates $300 Million To Next-Generation Tests

The White House has allocated $300 million for the accelerated development of next-generation coronavirus tests, the National Institutes of Health announced Thursday. Two new funding opportunities are available for diagnostic test manufacturers as part of the incentive program. The first opportunity is to develop accessible over-the-counter tests that can be used by people with disabilities, while the second seeks to improve the performance of over-the-counter tests to ensure ease of use. (Vaziri and Buchmann, 9/8)

Covid Is Here To Stay, But The White House Response Team Is Eyeing Its Endgame 

The pandemic may not be over. But there’s a growing sense among officials inside the White House that their days on the front lines of the Covid fight may be numbered. Even as it braces for a perilous winter, the Biden administration is planning a restructuring of its approach to major elements of the coronavirus response — a gradual shift that some administration officials now speculate could begin the phaseout of the White House Covid team as soon as the middle of next year. (Cancryn, 9/8)

New Omicron Subvariant Mutation Tied To Kids’ Neurologic Complications

Researchers in Taiwan have discovered a new mutation in the SARS-CoV-2 Omicron BA.2.3.7 subvariant that they suggest may be responsible for severe neurologic complications observed in young children on the island. Their study was published yesterday in the International Journal of Infectious Diseases. …Whole-genome sequencing revealed that all viruses were Omicron BA.2.3.7 and that they had a previously unidentified K97E mutation on the spike protein that differed from other BA.2.3.7 strains. (9/8)

Lawsuit Contests Montana Vaccine Mandate Ban On Tribal Land

A federal lawsuit in Montana seeks to block a state agency from enforcing on tribal lands a legislative prohibition against COVID-19 vaccine mandates. The Glacier County Regional Port Authority filed the complaint Tuesday in U.S. District Court in Great Falls. The litigation comes after Montana Labor and Industry Department officials determined the port authority discriminated against an unvaccinated person who attempted to attend one of its meetings, in Browning. (9/8)

The Hechinger Report:
For Head Start, Masks And Vaccine Mandates Are Still In Place—For Now

For much of the country, this school year started with Covid restrictions in the past: No more masking, vaccine mandates, social distancing requirements or testing regulations. But for many Head Start programs, federal requirements remain in force, complicating operations. Under a federal rule announced almost a year ago, Head Start centers must require vaccines for staff and masks for anyone 2 years or older, according to the Department of Health and Human Services, which oversees the program. The federally-funded preschool system collectively serves nearly 750,000 children from low-income families. (Gilreath, 9/7)

Mississippi’s Only Burn Center To Close Oct. 14 

Mississippi’s only burn center will close Oct. 14, hospital officials said Thursday. The JMS Burn and Reconstruction Center, located at Merit Health Central in South Jackson, includes 13 burn intensive care patient rooms, 20 burn step down unit patient rooms and a 12-room outpatient clinic. The center cares for both adult and pediatric burn patients on an inpatient and outpatient basis. … “The COVID-19 pandemic and the challenging staffing and recruitment environment have made it increasingly difficult for us to recruit the breadth of specialists needed to maintain the burn program, which is the primary reason why we’ve made the difficult decision to close.” (9/8)

Deal Reached With Strikers At 4 Pennsylvania Nursing Homes

Workers at four Pennsylvania nursing homes reached a tentative contract agreement Thursday, nearly a week after going on strike over pay and staffing, the workers’ union said. Terms of the deal with Comprehensive Healthcare were not disclosed pending a ratification vote. Workers could be back on the job as early as Saturday, according to SEIU Healthcare Pennsylvania. (9/8)

The Wall Street Journal:
Judge Voices Skepticism Of Justice Department’s Antitrust Challenge To UnitedHealth Acquisition

A federal judge grilled the Justice Department on Thursday over its antitrust claims that UnitedHealth Group Inc.’s $13 billion acquisition of health-technology firm Change Healthcare Inc. would suppress competition and limit innovation in health insurance markets. During closing arguments, U.S. District Judge Carl J. Nichols questioned the department’s arguments that he should block the deal because it would limit competition for technology used in claims processing and would give UnitedHealth access to sensitive industry data that it could use to harm competitors. (Mulvaney, 9/8)

Modern Healthcare:
Healthcare Leaders Facing Dozens Of Cyberattacks Annually: Survey

Healthcare leaders say it can cost more than $4 million for an organization to recover from a single cyberattack, according to a new survey. A poll of more than 600 healthcare information-technology and security professionals found 89% of organizations surveyed had experienced at least one cyberattack in the past year. Within that group, organizations on average had 43 attempted cyberattacks during that time period, according to the poll published Thursday by research firm Ponemon. (Kim Cohen, 9/8)

Modern Healthcare:
Medicare Fraud In Telehealth Stays Low In Pandemic’s First Year

Federal officials found few instances of fraud in Medicare billing practices for telehealth services during the first year of the COVID-19 pandemic. There were 1,714 providers out of approximately 742,000 whose billing was deemed “high risk” for Medicare, according to a report released this month by the U.S. Department of Health and Human Services’ Office of Inspector General. (Hudson, 9/8)

Regulators Try To Stop Unlawful Nursing Home Debt Collection 

Nursing homes and debt collectors are flouting a law that prohibits them from requiring friends and family of care home residents to shoulder the costs of the facilities, according to a federal report issued Thursday. The Consumer Financial Protection Bureau said friends and family members have had to declare bankruptcy, had their wages garnished and their homes repossessed after signing unenforceable contracts called “admission agreements” with nursing facilities. As a result, they have been held liable as third parties for their loved ones’ nursing home stays. (Hussein, 9/8)

Illinois Governor Calls For Changes After “Awful” Reports Of Abuse At Developmental Center 

Illinois Gov. J.B. Pritzker called patient abuses at the Choate Mental Health and Developmental Center in rural Anna “awful” and “deeply concerning,” and he said the future of the facility depends on correcting poor conditions. Pritzker’s comments at a news conference on Tuesday came on the heels of articles published Friday by Capitol News Illinois, Lee Enterprises and ProPublica outlining a history of egregious patient abuses and other employee misconduct at Choate. (Hundsdorfer, Parker and Moore, 9/6)

The Washington Post:
D.C. Heroin Overdoses Plunge As Fentanyl Use Soars

For decades, it brought fleeting euphoria and permanent loss. It was the basis of commerce in neighborhoods that had lost their foothold in America’s economy and a poison that destroyed those same neighborhoods block by block. It was an addictive salve for the lives it had broken. Now heroin, synonymous with illicit drug use in Mid-Atlantic cities since the 1960s, is close to vanishing from the streets of the nation’s capital. (Jamison, 9/8)

Insurer Off Hook For Opioid Lawsuits Against Drug Distributor – Ohio Top Court 

Mutual insurance company Acuity does not have to cover a former drug distribution company’s legal costs in 22 lawsuits by cities and counties that have been hard-hit by the opioid epidemic, the Ohio Supreme Court has held. Reversing an appellate court’s ruling, the top court held that Acuity had no duty to defend Masters Pharmaceutical Inc because the local jurisdictions were suing for their own economic losses, not for “damages because of bodily injury” as defined in Acuity’s insurance policies for the company between 2010 and 2018. (Grzincic, 9/8)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.