First Edition: July 22, 2014

Today's headlines include a report about how anger over narrow networks is bubbling up.

Kaiser Health News: Medicare Testing Payment Options That Could End Observation Care Penalties
Reporting for Kaiser Health News, Susan Jaffe writes: "Medicare officials have allowed patients at dozens of hospitals participating in pilot projects across the country to be exempted from the controversial requirement that limits nursing home coverage to seniors admitted to a hospital for at least three days. The idea behind these experiments is to find out whether new payment arrangements with the hospitals and other health care providers that drop the three-day rule can reduce costs or keep them the same while improving the quality of care. They are conducted under a provision of the Affordable Care Act that created the Center for Medicare and Medicaid Innovations to develop ways of improving Medicare" (Jaffe, 7/22). Read the story, which also appeared in the Washington Post.

Kaiser Health News: Insuring Your Health: Arkansas Weighs Plan To Make Some Medicaid Enrollees Fund Savings Accounts
Kaiser Health News' consumer columnist Michelle Andrews writes: "If all goes according to plan, next year many Arkansas Medicaid beneficiaries will be required to make monthly contributions to so-called Health Independence Accounts. Those that don't may have to pay more of the cost of their medical services, and in some cases may be refused services" (Andrews, 7/22). Read the story.

Politico: Obamacare: Anger Over Narrow Networks
Anger over limited choice of doctors and hospitals in Obamacare plans is prompting some states to require broader networks -; and boiling up as yet another election year headache for the health law. Americans for Prosperity is hitting on these "narrow networks" against Democrats such as Sen. Jeanne Shaheen of New Hampshire, whose GOP opponent Scott Brown has made the health law a centerpiece of his campaign to unseat her. And Republicans have highlighted access challenges as another broken promise from a president who assured Americans they could keep their doctor (Norman, 7/ 22).

The Associated Press: Judge Tosses Wisconsin Senator's Health Care Suit
A federal judge on Monday dismissed a U.S. senator's lawsuit challenging a requirement that congressional members and their staffs to obtain government-subsidized health insurance through small business exchanges, saying the senator had no grounds to sue (7/21).

Politico: Judge Tosses Sen. Ron Johnson's Obamacare Lawsuit
A federal judge said Monday that Sen. Ron Johnson (R-Wis.) cannot challenge the Obamacare policy that lawmakers and their staff obtain health insurance through the exchanges. The ruling could prove ominous for House Republicans as they prepare to file suit against the Obama administration, also against Obamacare. That suit would focus on a different issue, the president's delay of the employer mandate (Haberkorn, 7/21).

Politico: Progress On VA Reform Deal
Members of a committee tasked with reforming the Department of Veterans Affairs have moved slightly closer toward closing a deal, even as Senate Majority Leader Harry Reid predicted the committee's failure. Sen. Bernie Sanders (I-Vt.), a co-chairman of the House and Senate VA conference committee, said Monday the panel's 14 Senate-members have agreed to offset portions of the reform legislation. The Congressional Budget Office has estimated overhauling the agency could cost around $30 million (French, 7/21).

The Associated Press: GOP Seeks Jolt To Senate Race Against Dem Franken
Mike McFadden leaned his sturdy frame over the front counter of the Shady Drive Inn as the owner aired the same frustrations with political gridlock that some of her regular customers grumble about. Then she asked the Senate candidate point-blank: "What party are you affiliated with?" McFadden tiptoed into the answer: "Well, I'm an American first," he said. "But I'm a Republican." … So McFadden is embracing a lot of ideas that many fellow Republicans are fighting fervently to kill. He supports an immigration overhaul with a path to citizenship. He says President Barack Obama's health care law must go, but he wants a replacement that replicates some of its goals (7/21).

The Washington Post: In Virginia's 10th Congressional District, GOP Struggles To Woo Minority Voters
With the GOP's most conservative voices opposing immigration reform and the federal health-care law -; issues of great importance to Latinos and Asians -; Republicans acknowledge the challenges they face in appealing to those groups. Their goal, at least initially, is to chip away at Democratic dominance (Schwartzman, 7/20).

The Washington Post: The Wealth Gap Is Growing, But Poor Women See One Improvement: Healthier Newborns
Something extraordinary is happening to poor pregnant women such as Verret: They're giving birth to healthier babies. While other economic and health disparities have widened, giving way to huge national debates about inequality, pregnant women at the lowest rung of the nation's economic ladder are bucking that trend. They have narrowed the gap with wealthier women in the health of their babies (Goldfarb, 7/20).

The Wall Street Journal: Doctors Upset Over Skill Reviews
The medical community is embroiled in a bitter debate about what board-certified physicians should be required to do to prove that their knowledge and skills are up-to-date. Besides holding a state medical license, about 75% of U.S. doctors are certified by 24 privately run boards, signifying that they have mastered their area of specialty, in fields ranging from internal medicine to orthopedics. The specialty boards require their physicians to pass rigorous exams, generally every 10 years, to stay certified (Beck, 7/21).

The Wall Street Journal's Pharmalot: FDA Spars With Recalcitrant Compounding Pharmacy, Again
For the third time in 15 months, the FDA is warning health care providers and consumers not to use drugs that were made by a Dallas compounder because the medicines may be contaminated. And the ongoing struggle between the agency and NuVision Pharmacy underscores the difficulties that beset the pharmaceutical supply chain despite a recently passed law designed to bolster safety (Silverman, 7/21).

NPR: What The Odds Fail To Capture When A Health Crisis Hits
How well do we understand and act on probabilities that something will happen? A 30 percent chance of this or an 80 percent chance of that? As it turns out, making decisions based on the odds can be an extremely difficult thing to do, even for people who study the science of how we make decisions (Siegel and Hsu, 7/21).

The Associated Press: Widow: Jury Sent Tobacco Company A $23B Message
A Florida widow awarded $23.6 billion in the death of her chain-smoking husband on Monday called the massive verdict a message to Big Tobacco, even though she likely won't see much if any of the money. The punitive damages -; $23,623,718,906.62, to be precise -; almost certainly will be significantly reduced on appeal, if not thrown out entirely, legal experts and industry analysts said. In another major tobacco trial, a $28 billion verdict in a 2002 case in Los Angeles turned into $28 million after appeals (7/21).

Los Angeles Times: Amid Whooping Cough Epidemic, LAUSD Offers Free Vaccines
Starting middle school comes with a whole host of worries -- going to a new school, picking electives, making friends -- but coming down with whooping cough doesn't need to be one of them. For incoming 7th grade students in the Los Angeles Unified School District, proof of a TDaP booster shot is mandatory before school starts Aug. 12. L.A. Unified will host a number clinics, listed below, to help make sure students receive a booster shot free of charge (Hayden, 7/21).

The New York Times: Hospital Agrees To Pay $190 Million Over Recording Of Pelvic Exams
The doctor wore an unusual pen around his neck. It was really a concealed camera, and for years he secretly recorded women at some of their most private moments, during pelvic exams. On Monday, Johns Hopkins Hospital agreed to pay $190 million to more than 7,000 women for the gross violation of doctor-patient trust in what experts said was one of the largest medical malpractice cases of its kind. Dr. Nikita A. Levy, a gynecologist and obstetrician for Johns Hopkins Community Medicine in Baltimore, was fired in February 2013 after a female colleague reported her suspicions of his penlike device. Ten days later, he committed suicide (Gabriel, 7/21).

The Wall Street Journal: Johns Hopkins Agrees To $190 Million Exam-Photos Settlement
The investigation found no evidence that Dr. Levy had shared the images. No criminal charges were filed against the 54-year-old doctor, who committed suicide during the investigation by wrapping a plastic bag around his head and pumping it with helium, the Associated Press said (Levitz, 7/21).