The Star Tribune: Court Rules Against UnitedHealth Group On California Fines 
A California appeals court has ruled in favor of state regulators in their attempt to impose fines on a subsidiary of Minnetonka-based UnitedHealth Group related to more than 900,000 alleged violations of a California law on insurance claims. Dave Jones, the insurance commissioner in California, issued a statement Friday saying the court ruling this week paves the way for another court to affirm some $91 million in fines against PacifiCare, an insurance company that UnitedHealth Group acquired more than a decade ago. The deal substantially expanded the company's UnitedHealthcare health insurance business, which is now the nation's largest carrier. (Snowbeck, 9/21)

Ventura County Star: California Asked To Protect Patients In Dignity Hospital Merger
Worries about reproductive services, rising prices and cuts to health care access emerged in an Oxnard hearing Thursday on a proposed hospital mega-merger. Dignity Health, which operates 39 hospitals including St. John’s hospitals in Oxnard and Camarillo, plans to merge with the 101-hospital Catholic Health Initiatives system. The transaction would likely create the nation’s largest nonprofit hospital group. Health system leaders hope to complete the merger by the end of the year but first must gain the OK of California Attorney General Xavier Becerra. A decision is expected by Halloween. (Kisken, 9/21)

The Associated Press: Judge: California Child Can Take Cannabis Drug To School
A California kindergartner can keep bringing a cannabis-based drug used for emergency treatment of a rare form of epilepsy to her public school, a judge ruled Friday. The Santa Rosa Press-Democrat reported that a judge sided with the family of 5-year-old Brooke Adams. The Rincon Valley Union School District in Santa Rosa sought to ban the ointment from school grounds because it contains the active ingredient in marijuana. (9/22)

KQED: Santa Rosa Family Wins Fight For Daughter To Go To School — With Her Cannabis Meds
Brooke Adams was diagnosed with Dravet syndrome when she was just 3 months old. The rare and severe seizure disorder often causes developmental delays. Like a lot of kids with Dravet, Brooke didn’t respond to a long list of heavy-duty pharmaceutical drugs. Every time she had a seizure, her mother, Jana Adams, said, “we’d have to call 911 to have her ambulanced to the ER, to load her up with all kinds of drugs. Her longest one was three hours.” The rescue medication they tried — to stop her seizures once they started — would often slow her breathing so much she would have to be intubated. (Romney, 9/21)

San Francisco Chronicle: Federal, State Officials Probe Gilead’s Drug Marketing Practices
California insurance regulators and Alameda County prosecutors have subpoenaed Gilead Sciences for information regarding the Foster City drugmaker’s marketing practices and other services. The subpoenas, issued in October by the California Department of Insurance and the Alameda County district attorney’s office, were disclosed in a filing with the U.S. Securities and Exchange Commission in February. (Ho, 9/21)

The Wall Street Journal: U.S. Probes Drugmakers Over Free Services
Drug companies say the services, such as nurses and reimbursement assistance, help doctors and patients. But the practices, which have become more prevalent as drugmakers have introduced more complex and expensive drugs, are drawing scrutiny over whether they serve an illegal commercial purpose: inducing sales. (Loftus, 9/21)

Capital Public Radio/KXJZ: Maternal Mental Health Issues Affect One In Five New Moms. These California Bills Could Point Them To Treatment 
Bills on Gov. Jerry Brown’s desk could require some providers to screen moms for these disorders. Hospitals and other facilities offering deliveries would also have to educate staff about the issue. If left untreated, maternal mental health challenges such as depression, anxiety, obsessive compulsive disorder and post-traumatic stress can lead new moms to take their own lives, or in rare cases, their children’s lives. (Caiola, 9/21)

In other mental health news —

KPBS: San Diego County Adding Pyschiatric Beds To Serve Growing Mentally Ill Population
A new psychiatric unit is set to open in San Diego next week as part of the county’s plan to boost services for a growing number of people suffering from mental illness. The 67 long-term care beds will serve people who are too ill to live on their own. (Murphy, 9/24)

San Francisco Chronicle: Mentally Ill Cole Valley Man Needs Help. So Do His Neighbors 
With strict laws governing the conservation of mentally ill people, the usual routine has those who are violent or threatening cycle in and out of jail or in and out of hospitals with little opportunity for real improvement. And plenty of opportunity for frightening innocent people. State Sen. Scott Wiener’s bill to expand the definition of who can be conserved to include the drug-addicted has passed the Legislature and is on Gov. Jerry Brown’s desk, though it’s not clear it would apply in this case. (Knight, 9/21)

San Francisco Chronicle: SF’s New HIV Cases Hit Record Low, But Disparities Widening Among Groups
Aggressive efforts to end transmission of HIV are paying off in San Francisco, where public health officials are reporting record-low new cases, and the city is far outpacing national trends that show much narrower declines. But at both the local and national level, disparities among age, race and gender groups are becoming more pronounced. (Allday, 9/21)

In other public health news —

The San Diego Union-Tribune: Florida Inventor Pledges $25M To UC San Diego To Help Create School Of Public Health 
A Florida inventor who made a fortune developing protective eyewear is giving UC San Diego $25 million to battle public health problems ranging from substance abuse to the sort of deadly hepatitis A outbreak that hit the county last year. The gift from Herbert Wertheim of Miami represents seed money to create a school of public health, which is considered to be a missing piece at a campus that operates two major hospitals and separate schools of medicine and pharmaceutical science. (Robbins, 9/21)

Orange County Register: Flu Season Is Approaching; Here’s What You Need To Know 
This year’s flu season is just getting started. And experts are already beginning to worry.Last year was the worst flu season in more than a decade. There were 164 flu-related deaths last year in California, compared to 81 deaths the year before. The situation became so dire that some Southern California hospitals opened up flu triage tents in their parking lots to serve the high volume of patients. The dominant strain last year was Influenza A H3N2, which wasn’t new. But it is often associated with severe illness in young children and those 65 and older. (Bharath, 9/21)

The New York Times: Trump Administration Aims To Sharply Restrict New Green Cards For Those On Public Aid
Trump administration officials announced Saturday that immigrants who legally use public benefits like food assistance and Section 8 housing vouchers could be denied green cards under new rules aimed at keeping out people the administration deems a drain on the country. The move could force millions of poor immigrants who rely on public assistance for food and shelter to make a difficult choice between accepting financial help and seeking a green card to live and work legally in the United States. (Shear and Baumgaertner, 9/22)

Reuters: Trump Administration Moves To Restrict Immigrants Who Use Public Benefits
The proposed regulation from the Department of Homeland Security would expand immigration officers' ability to deny visas or legal permanent residency to aspiring immigrants if they have received a range of taxpayer-funded benefits to which they are legally entitled, such as Medicaid, the Medicare Part D low-income subsidy, Section 8 housing vouchers and the Supplemental Nutrition Assistance Program, which is commonly known as food stamps. U.S. immigration law has long required officials to exclude a person likely to become a "public charge" from permanent residence. (Torbati, 9/22)

The Associated Press: US Considers Limit On Green Cards For Immigrants On Benefits
The proposal "will clearly define long-standing law to ensure that those seeking to enter and remain in the United States either temporarily or permanently can support themselves financially and will not be reliant on public benefits," the department said. (9/23)

The Washington Post: Trump Administration Seeks To Limit Access To U.S. For Immigrants Who Use Or Are Likely To Use Public Assistance
The proposal will publish in the Federal Register in the coming weeks, according to DHS, triggering a 60-day public comment period. “After DHS carefully considers public comments received on the proposed rule, DHS plans to issue a final public charge rule that will include an effective date,” the agency said. DHS officials say they are anticipating court challenges to any change. While the proposal does not include tax credits and other health benefits that were under consideration in previous drafts, immigrant advocates have raised concerns that the rule change will force families to forgo help to avoid jeopardizing their immigration status. (Miroff, 9/22)

The Wall Street Journal: Trump Administration Targets Immigrants On Public Assistance
“Building on the traumatic separation of families at the border, the Trump administration has taken another cruel step,” Marielena Hincapié, executive director of the National Immigration Law Center, said Saturday in a statement. “This proposed rule change will similarly result in the separation of families and is just the latest assault on immigrant families.” The proposal would take into account immigrants’ current and past receipt of benefits above a certain threshold but wouldn’t go into effect until the rule is finalized. The rule will be published in the Federal Register in coming weeks. (Armour and Caldwell, 9/23)

The New York Times: Christine Blasey Ford Reaches Deal To Testify At Kavanaugh Hearing
The woman who has accused Judge Brett M. Kavanaugh of sexually assaulting her when they were teenagers has committed to testify before the Senate Judiciary Committee on Thursday, setting up a potentially explosive confrontation unlike any seen in decades with the future of the Supreme Court at stake. (Stolberg and Fandos, 9/23)

The New Yorker: Senate Democrats Investigate A New Allegation Of Sexual Misconduct, From The Supreme Court Nominee Brett Kavanaugh’s College Years, By His Yale Classmate Deborah Ramirez
As Senate Republicans press for a swift vote to confirm Brett Kavanaugh, President Trump’s nominee to the Supreme Court, Senate Democrats are investigating a new allegation of sexual misconduct against Kavanaugh. The claim dates to the 1983-84 academic school year, when Kavanaugh was a freshman at Yale University. The offices of at least four Democratic senators have received information about the allegation, and at least two have begun investigating it. Senior Republican staffers also learned of the allegation last week and, in conversations with The New Yorker, expressed concern about its potential impact on Kavanaugh’s nomination. Soon after, Senate Republicans issued renewed calls to accelerate the timing of a committee vote. The Democratic Senate offices reviewing the allegations believe that they merit further investigation. “This is another serious, credible, and disturbing allegation against Brett Kavanaugh. It should be fully investigated,” Senator Mazie Hirono, of Hawaii, said. An aide in one of the other Senate offices added, “These allegations seem credible, and we’re taking them very seriously. If established, they’re clearly disqualifying.” (Farrow and Mayer, 9/23)

The Wall Street Journal: Kavanaugh Hearing Set As Accuser Commits To Testifying
On Sunday evening, Sen. Dianne Feinstein of California, the committee’s top Democrat, asked for an immediate postponement of the hearing after new allegations surfaced in an article in the New Yorker. Deborah Ramirez, a college classmate of Judge Kavanaugh, told the magazine that she remembered that Judge Kavanaugh had exposed himself to her at a drunken party when they were at Yale University. Judge Kavanaugh said in a statement Sunday that the alleged incident didn’t happen, and the White House said it stood by the nominee. Judge Kavanaugh said, “This is a smear, plain and simple.” (Peterson, Bykowicz and Nicholas, 9/24)

The Washington Post: Senate Judiciary Panel’s Top Democrat Calls For Delay In Kavanaugh Hearing After New Allegation
In her letter, Feinstein asked “that the newest allegations of sexual misconduct be referred to the FBI for investigation, and that you join our request for the White House to direct the FBI to investigate the allegations of Christine Blasey Ford as well as these new claims.” (Demirjian, Gardner and Kim, 9/23)

Bloomberg: 2018 Democrats Candidates Embrace Obamacare
Democrats used to run away from President Obama’s signature health care law. This year, defending Obamacare from Republican attempts to overturn it is central to the party’s efforts to take back Congress. Democratic candidates are running ads and campaigning on shoring up the Affordable Care Act, not just in reliably blue states, but in traditionally Republican strongholds. Though they might not use the word “Obamacare” itself, Democrats warn against GOP legislation and lawsuits that seek repeal or would block the law’s most popular elements.It’s a far cry from 2010, where fury over Obamacare fueled a Tea Party wave that cost Democrats the House and, four years later, the Senate as well. (Sullivan, 9/20)

CQ: It's Baaaccck! Health Care Law Again Front And Center In Midterms
For months, polls have shown that health care is a top issue for Democratic voters and candidates are leaning into that. A poll conducted in August by the nonpartisan Kaiser Family Foundation, which has closely tracked how health care is playing into the 2018 campaign, found that 27 percent of registered voters said health care was the most important issue for candidates to talk about, trailing only corruption in Washington. In recent campaign cycles, Democrats were on defense on the issue, facing protests and criticism for enacting the 2010 health law as voters blamed them for all of their health care concerns, says Ian Russell, a congressional strategist at Beacon Media who previously worked for the Democratic Congressional Campaign Committee. (McIntire, 9/24)

The New York Times Fact Checker: Trump Claims To Protect Pre-Existing Health Conditions. That’s Not What The Government Says.
The Justice Department told a federal court in June that it would no longer defend provisions in the Affordable Care Act that protect patients with pre-existing medical conditions. In a brief responding to a lawsuit filed by Texas and 19 other states, the Justice Department called the individual mandate — which requires most Americans to buy insurance or face financial penalties — unconstitutional. Government lawyers argued that protections for pre-existing conditions and other medical issues cannot be separated from the individual mandate, and should also be overturned. (Qiu, 9/21)

And this month a judge handed what could be an expensive defeat to the government over cost-sharing subsidies —

The New York Times: Ruling On Health Care Subsidies Could Prove Costly For Government
A federal court ruled this month that a Montana insurer is entitled to federal compensation for subsidy payments under the Affordable Care Act that President Trump abruptly ended last October, a ruling that could reverberate through insurance markets and cost the government hundreds of millions of dollars. At issue are payments for so-called cost-sharing reductions, discounts that enhance the value of health insurance policies purchased from the Affordable Care Act’s marketplaces by reducing deductibles, co-payments and other out-of-pocket costs for low-income consumers. President Trump ended the payments in October, one of a series of executive actions intended to undo President Barack Obama’s signature domestic achievement. (Pear, 9/22)

Politico: Republicans Cast Opioid Bill As Their Health Care Achievement
Endangered Republicans are running ads defending their achievements on health care — but it’s opioids they are boasting about, not the toxic fight about Obamacare and pre-existing conditions. GOP incumbents in Kentucky, Michigan, New York and Pennsylvania have run advertising recently focused on their efforts to bolster access to treatment, prevent overdoses and stamp out lethal synthetic painkillers like fentanyl. The conservative American Action Network has chipped in $5 million worth of digital and television ads in battleground districts, touting the GOP's commitment to fighting the epidemic. (Demko and Ehley, 9/22)

The Associated Press: Groups Say Medicare Discounts Threatened In Opioids Bill
Consumer and health care groups are scrambling to block what they say is a move by the pharmaceutical industry to commandeer must-pass opioids epidemic legislation as a vehicle for rolling back drugmaker discounts to Medicare beneficiaries with high prescription costs. Republicans said Friday nothing has been decided in behind-the-scenes discussions. But Henry Connelly, a spokesman for House Democratic Leader Nancy Pelosi, called the effort a "Republican attempt to hijack a bipartisan effort on opioids funding to ram through a multibillion-dollar handout to Big Pharma." (9/21)

In other national health care news —

The Washington Post: Trump Administration Diverts Nearly A Half-Billion Dollars To Migrant Children In Custody
Federal health officials are reshuffling nearly a half-billion dollars this year to cover the expense of sheltering a record number of migrant children in the department’s custody, according to government documents and officials. In a recent letter to several members of Congress, Health and Human Services Secretary Alex Azar said the department is moving “up to $266 million” to house children from other countries who are on their own, diverting money originally intended for biomedical research, HIV/AIDS services and other health-care purposes. (Goldstein and Moore, 9/21)

The New York Times: The Couple Who Helped Decode Dyslexia
By now, Sally and Bennett Shaywitz might have retired to a life of grandchild-doting and Mediterranean-cruising. Instead, the Shaywitzes — experts in dyslexia at Yale who have been married to each other for 55 years — remain as focused as ever on a research endeavor they began 35 years ago. Sally, 76, and Bennett, 79, both academic physicians, run the Yale Center for Dyslexia and Creativity. (Hafner, 9/21)

The New York Times: Tiny Device Is A ‘Huge Advance’ For Treatment Of Severe Heart Failure
Almost two million Americans have severe heart failure, and for them even mundane tasks can be extraordinarily difficult. With blood flow impeded throughout their bodies, patients may become breathless simply walking across a room or up stairs. Some must sleep sitting up to avoid gasping for air. Drugs may help to control the symptoms, but the disease takes a relentless course, and most people with severe heart failure do not have long to live. Until now, there has been little doctors can do. (Kolata, 9/23)

Stat: Can Building A Better Research Mouse Open The Black Box Of Alzheimer’s? 
Drug development for Alzheimer’s disease has been a series of disappointments, with only faint glimmers of hope from pharmaceutical companies or academic labs. What causes the disease is still hotly debated, with the amyloid hypothesis losing believers after each new trial failure. But before those drugs targeting amyloid plaques or tau tangles failed in human trials, they generally succeeded in preclinical studies — specifically, ones done with mice. Right now, about 160 mouse models for Alzheimer’s exist. But none is particularly good, experts say. (Sheridan, 9/24)

Los Angeles Times: Cornell Researcher Who Studied What We Eat And Why Will Step Down After Six Studies Are Retracted
A Cornell University professor whose attention-getting studies reported that guests at Super Bowl parties consumed more calories when served snacks from larger bowls and that couch potatoes ate nearly twice as much when watching an action-packed movie than when viewing a PBS talk show will step down from the university at the end of the academic year. Brian Wansink, the longtime director of Cornell’s Food and Brand Lab, submitted his resignation this week after a year-long review concluded that he committed academic misconduct, according to a statement from the university’s provost. (Kaplan, 9/21)