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The federal judges who heard arguments Wednesday in the fight over access to the most commonly used abortion pill in the U.S. questioned the Biden administration's position that the drug mifepristone should remain widely available. The hearing at the 5th U.S. Circuit Court of Appeals in Louisiana included arguments from the Justice Department and drugmaker Danco Laboratories on one side and a group of doctors and medical professionals who oppose abortion on the other. The three-judge panel heard the case after the Supreme Court said the status quo on mifepristone's availability should remain in place while the appeals process plays out. (Gregorian and Junod, 5/17)

Judge Jennifer Walker Elrod focused on FDA decisions that allowed doctors to prescribe the drug and send the pill by mail without ever seeing the patient in person — a policy that began in 2021 as a pandemic accommodation and later became permanent. Referring to the practice as “the telemedicine situation” and the “mail business thing on the computer,” Elrod expressed skepticism that these remote options are safe. She asked Justice Department attorney Sarah Harrington how doctors can determine how far along a patient is in pregnancy or whether they may have an ectopic pregnancy without an in-person examination. (Ollstein and Gerstein, 5/17)

A federal appeals court judge on Wednesday questioned a lawyer for Danco, the manufacturer of the brand name abortion pill mifepristone, about whether Mother’s Day is “celebrating illness,” during oral arguments over the drug’s approval. Judge James Ho, an appointee of former President Trump, expressed doubts about the Food and Drug Administration’s (FDA) use of an expedited process to approve mifepristone more than 20 years ago. The accelerated approval process is typically reserved for medications used to treat serious or life-threatening illnesses. “Pregnancy is not a serious illness,” Ho said, later adding, “When we celebrated Mother’s Day, were we celebrating illness?” (Shapero, 5/17)

All three of the judges on the 5th U.S. Circuit Court of Appeals panel that will hear the Biden administration's appeal to keep the abortion pill mifepristone on the market are staunchly conservative, with a record of opposing abortion rights. Here is a look at their records. (Pierson and Thomsen, 5/17)

In 1988, France and China became the first countries to authorize the use of mifepristone. Thirty-five years later, at least 94 countries have approved the drug to some degree, according to Gynuity Health Projects, a reproductive health research organization that seeks to improve access to abortion. The group used World Health Organization data, government websites and its own research to track regulatory approval of the drug over time. (Berger and Klimentov, 5/17)

For a while, it was known as RU-486. It's called Mifeprex or mifepristone – but many know it as "the abortion pill." It is one of two drugs – along with misoprostol – that are used in more than half of abortions in the U.S. now. And it is the subject of a federal court case that could make it illegal. As attorneys gather in New Orleans this week at the 5th Circuit Court of Appeals to argue whether this medication should be removed from the market all over the country, NPR asked people to share their experiences with using mifepristone. More than 150 people responded. (Sullivan and Simmons-Duffin, 5/17)

South Carolina House members approved a controversial bill late Wednesday that would ban most abortions as early as six weeks into pregnancy, after having spent the last two days in contentious debate on the legislation. Lawmakers had been called back for a special session this week by Republican Gov. Henry McMaster to continue work on Senate Bill 474, known as the “Fetal Heartbeat and Protection from Abortion Act,” which bans most abortions after early cardiac activity can be detected in a fetus or embryo, which can commonly be detected as early as six weeks into pregnancy, before many women know they are pregnant. (Kashiwagi, 5/17)

Access to abortion is essentially locked down in Illinois. But Democrats are looking for ways to further protect the practice and its availability, including to outsiders who potentially face home-state penalties for seeking treatment here. Legislation approved by both houses of the General Assembly include requiring Illinois insurers to cover abortion-inducing drugs, penalizing crisis pregnancy centers if they distribute inaccurate information and requiring colleges to offer reduced-price emergency contraception on campus. (O'Connor, 5/17)

The evolving patchwork of access to abortion care is going through big changes this week, with the entire Southeast on the brink of imposing new limits. Bands of states restricting abortion access could soon extend the entire length of the country, depending on legislative action and pending court battles. (Wolf, 5/17)

Michigan companies will be prohibited from firing or otherwise retaliating against workers for receiving an abortion under a bill signed Wednesday by Democratic Gov. Gretchen Whitmer that amends the state’s civil rights law. Michigan’s Elliott-Larsen Civil Rights Act had previously only protected individuals against employment discrimination if the abortion was to “save the life of the mother.” Legislation signed Wednesday will extend those protections to anyone who terminates a pregnancy, regardless of reasoning. (Cappelletti, 5/17)

California officials have agreed to pay $1.4 million in legal fees for churches that pushed back against a state mandate that abortions be covered in health insurance plans. Attorneys with the nonprofit Alliance Defending Freedom (ADF) successfully resolved two lawsuits dating back to 2015 and 2016 involving four churches that objected to the abortion-coverage mandate, the nonprofit legal organization announced last week. (Brown, 5/17)

Almost a year since the landmark Supreme Court ruling that allowed states to ban abortion, confusion and fear reign as clinicians confront the risks of criminal charges amid evolving rules and uneven enforcement of laws that sometimes contradict each other. “We have chaos, and we just have to live with the chaos,” said Harvard Law School professor and former Maine Attorney General James Tierney (D). “Physicians and hospitals are very nervous. They don’t know what to do.” The legal cases that ensue will take years to litigate, and the underlying uncertainty isn't likely to abate until the high court weighs in again. (Hartnett, 5/17)

Former President Trump on Wednesday took credit for bringing about the end of Roe v. Wade and the restrictive abortion laws that have passed in the year since the Supreme Court struck down the landmark decision. Trump, in a post on Truth Social, said he “was able to kill Roe v. Wade, much to the ‘shock’ of everyone,” and put the anti-abortion movement in a “strong negotiating position.” “Without me there would be no 6 weeks, 10 weeks, 15 weeks, or whatever is finally agreed to,” he wrote. “Without me the pro Life movement would have just kept losing. Thank you President TRUMP!!!” (Samuels, 5/17)

A free fertility app used to track ovulation shared users' health information with other companies, including Google and China-based marketing and analytics firms, the Federal Trade Commission said Wednesday in announcing a $200,000 settlement. (Chasan, 5/17)

Pharmacy benefit managers would be subject to new transparency rules under legislation that cleared a key House subcommittee on Wednesday. The Transparent PRICE Act of 2023, which received a unanimous vote in the the House Energy and Commerce Committee's Health Subcommittee, would require PBMs to annually provide employers with detailed data on prescription drug spending, including acquisition costs, out-of-pocket spending, formulary placement rationale and aggregate rebate information. The bill also would order the Government Accountability Office to report on group health plan pharmacy networks, including those owned by health insurance companies. (Nzanga, 5/17)

The Federal Trade Commission is widening its probe into pharmacy benefit managers and their impact on drug pricing by looking into a pair of group purchasing organizations that are owned by these industry middlemen, but are not well understood outside the industry. By seeking documents from Zinc Health Services and Ascent Health Services, the agency is attempting to unravel what critics complain is an opaque set of business practices and relationships. Pharmacy benefit managers are linchpins in the pharmaceutical pricing system, and are under increased scrutiny for allegedly driving up consumer costs. (Silverman, 5/17)

A key House panel on Wednesday advanced several health care bills on Wednesday, including its first step toward a controversial effort to equalize Medicare payments between hospitals and physician offices. The Energy and Commerce health subcommittee passed a provision that would ensure Medicare pays the same amount to doctors who administer drugs whether they’re given in a hospital or a physician’s practice. (Cohrs, 5/17)

Senators warned the country’s largest Medicare Advantage insurers at a hearing on Wednesday that they must abide by Medicare’s coverage rules and cannot rely on algorithms to deny care that patients need. Congress is ramping up its oversight, too. Lawmakers in both parties have asked UnitedHealth Group, Humana, and CVS Health’s Aetna for internal documents that “will show how decisions are made to grant or deny access to care, including how they are using [artificial intelligence],” said Sen. Richard Blumenthal, the top Democrat on a subcommittee with the power to investigate government affairs, during the hearing. (Herman and Ross, 5/17)

President Joe Biden on Wednesday left the door open to expanding some work requirements as part of a debt ceiling deal, committing only to opposing new restrictions that affect health care programs. “I’m not going to accept any work requirements that’s going to impact on medical health needs of people,” he said, before adding that “it’s possible” a deal could expand work rules for other federal programs. (Cancryn and Daniels, 5/17)

The Veterans Affairs Department has renegotiated its agreement with Oracle Cerner to hold the electronic health record company more accountable, the VA said on Thursday. The new contract has been restructured from a single, five-year term to five, individual one-year terms, said Dr. Neil Evans, acting director of the VA's Electronic Health Record Modernization Integration Office, in an email. Evans said the new agreement “dramatically increases VA’s ability to hold Oracle Cerner accountable across a variety of key areas.” (Turner, 5/17)

Five percent of Tricare users who previously received automatic prescription refills by mail didn't renew their drugs under a new policy requiring them to confirm the orders, according to the Defense Health Agency. Those patients either disenrolled or didn't consent to renew their prescription between January and the end of March, which was the first three months of the new refill policy, DHA spokesperson Peter Graves told Military.com by email. (Miller, 5/17)

Drug overdose deaths in the United States plateaued in 2022 but still topped 100,000 — stark proof that the nation remains in the throes of a staggering crisis killing hundreds of Americans daily. According to provisional data released Wednesday by the Centers for Disease Control and Prevention, at least 105,452 people succumbed to overdoses in 2022, a number poised to increase because of the lag time in reporting deaths by state agencies. The CDC is estimating that number could top 109,000. The death count mirrors 2021, when drugs such as illicit fentanyl, cocaine and methamphetamine killed more than 107,000 people — a record high for the nation. (Ovalle, 5/17)

“The fact that it does seem to be flattening out, at least at a national level, is encouraging,” said Katherine Keyes, a Columbia University epidemiology professor whose research focuses on drug use. “But these numbers are still extraordinarily high. We shouldn’t suggest the crisis is in any way over.” (Stobbe, 5/17)

Walgreens has agreed to pay $230 million to San Francisco for its role in the city’s opioid epidemic following last year’s landmark trial that found the pharmacy chain liable for not performing proper screenings. ... The case was the first of its kind in the region and the first to include defendants along the pharmaceutical supply chain, including drug manufacturing, distributors and pharmacies. (Burky, 5/17)

As California faces a fentanyl overdose crisis, lawmakers are proposing tackling the crisis from two different angles: treatment and punishment. While policy proposals focused on treatment for drug overdoses and addiction have been sailing through the Legislature, ones that would increase punishments for drug dealing have been watered down or stalled. (Bollag, 5/17)

Up to one in three people diagnosed with rheumatoid arthritis could be at risk of long-term opioid use, a new study suggests. Academics warned that people diagnosed with rheumatic and musculoskeletal conditions (RMD) are “vulnerable” to long-term use of the strong pain relief medicines. (Pickover, 5/17)

Buprenorphine, an important drug in fighting the opioid crisis, has long been closely monitored over concerns it would be abused. But a first-of-its-kind government oversight report released Thursday finds Medicare recipients rarely misuse the drug, which is considered an underused tool to treat opioid addiction and stem overdose deaths. Less than 1% of Medicare recipients potentially misused or diverted the opioid-substitute medication in 2021, according to the report from U.S. Department of Health and Human Services inspector general investigators. (Alltucker, 5/18)

Advanced money-laundering techniques and clandestine precursor imports combine to stoke the opioid crisis – can the US stem the flow? (Doherty, 5/18)

The amount of misery and abuse suffered by hospital patients, and the workers who cared for them, jumped significantly during the COVID-19 pandemic, new data from the Massachusetts health department show. From patients who developed severely damaged skin, known as pressure ulcers, which often appear while bed-ridden for hours without being moved, to caregivers and security officers being assaulted by patients, the numbers paint a sobering picture of the heavy toll exacted by the pandemic on the state’s health care system and the people in it. (Lazar, 5/17)

An analysis of DNA from more than 24,000 people who had COVID-19 and required treatment in intensive care has yielded more than a dozen new genetic links to the risk of developing extreme illness from the disease. The study, which was published on 17 May in Nature1 and has more than 2,000 authors, highlights the role of the immune system in fueling the later stages of particularly severe COVID-19. The results could one day contribute to the development of therapies for COVID-19 — and potentially other diseases that cause acute respiratory distress or sepsis. (Ledford, 5/17)

Covid-19’s devastating toll is often measured by hospitalizations and deaths, but the effects of the pandemic run far deeper and wider. (Gale, 5/17)

�������ýҕ�l Health News: A Covid Test Medicare Scam May Be A Trial Run For Further Fraud 

Medicare coverage for at-home covid-19 tests ended last week, but the scams spawned by the temporary pandemic benefit could have lingering consequences for seniors. Medicare advocates around the country who track fraud noticed an eleventh-hour rise in complaints from beneficiaries who received tests — sometimes by the dozen — that they never requested. It’s a signal that someone may have been using, and could continue to use, seniors’ Medicare information to improperly bill the federal government. (Jaffe, 5/18)

An independent advisory committee to the Food and Drug Administration will decide Thursday whether to recommend an RSV vaccine for infants. (Bendix, 5/17)

Could the vaccine be available this winter, and how can people access it? Can this vaccine be used for young children who are also vulnerable to RSV? CNN Medical Analyst Dr. Leana Wen answers your questions. (Hetter, 5/18)

State and federal health officials are warning U.S. residents to cancel planned surgeries in a Mexico border city after five people from Texas who got procedures there came back and developed suspected cases of fungal meningitis. One of them died, officials said. The five people who became ill traveled to Matamoros, across the border from Brownsville, for surgical procedures that included the use of an epidural, an anesthetic injected near the spinal column, the Texas Department of State Health Services said Tuesday. Four remain hospitalized, and one of them later died. (5/18)

Leading heart health organizations are urging schools and parents to teach young children life-saving skills such as how to call 911 and how to administer CPR. On Wednesday, the American Heart Association, the European Resuscitation Council and the International Liaison Committee on Resuscitation published a scientific statement in the journal Circulation that details evidence showing schoolchildren as young as 4 know how to call for help in a medical emergency and that, by age 10 to 12, children can administer effective chest compressions when performing cardiopulmonary resuscitation, better known as CPR. (Howard, 5/17)

They don't call it the "death cap" mushroom without good reason. It's one of the most poisonous mushrooms in the world. Eating only half a cap can shut down your liver – and if you don't get medical attention fast enough, that shroom just might turn out to be your last meal. Mushroom poisonings are tough to track reliably, but some scientists estimate that they cause about 10,000 illnesses and 100 deaths a year globally. Until now, effective treatments for death cap poisonings were few and far between with no proven antidote available. (Barnhart, 5/17)

Exercise is, without question, good for our hearts. But can we potentially get too much of a good thing? A growing body of science, including a new report of the health of almost 1,000 longtime runners, cyclists, swimmers and triathletes, finds that years of heavy endurance training and competition may contribute to an increased chance of developing atrial fibrillation, especially in men. (Reynolds, 5/17)

Now a co-founder and strategic partner at Plezi Nutrition, a maker of sweetened beverages for kids ages 6 and up, Michelle Obama says she’s offering a lower-sugar alternative to steer them away from sugary drinks. ... But Plezi’s first product is a flavored juice drink blend that, under the very standards Obama championed, could not be served in US schools. (Shanker, 5/17)

Global temperatures are likely to soar to record highs over the next five years, driven by human-caused warming and a climate pattern known as El Niño, forecasters at the World Meteorological Organization said on Wednesday. ... “This will have far-reaching repercussions for health, food security, water management and the environment,” said Petteri Taalas, the secretary general of the meteorological organization. “We need to be prepared.” (Plumer, 5/17)

Florida Governor Ron DeSantis on Wednesday signed into law a bill that bans gender-affirming medical care such as puberty blockers or hormone therapy for transgender youth, and also enacts obstacles for adults to access treatment. (Trotta, 5/17)

Over the opposition of Democrats and the loud protests at the Capitol this month, the Texas Legislature voted on Wednesday to approve a bill banning hormone and puberty blocking treatments, as well as surgeries for transgender children. The state is poised to become the largest state to ban transition medical care for minors. The final version of the bill included a limited exemption for those transgender children who were already receiving medical treatment before the bill’s passage, though it also required those patients to “wean” themselves off the medications over an unspecified period of time. (Montgomery and Goodman, 5/17)

A hospital that serves more than 14,500 patients in rural northern Maine would have shut its doors in 2023 had significant changes not improved its financial situation, according to the CEO. Northern Maine Medical Center CEO Jeff Zewe said that a group commissioned by the hospital to study its finances told the board that if it kept up standard operating procedure, the hospital would not survive beyond Christmas of 2023. The comment was made during a Wednesday press conference held at the hospital. (Potila, 5/17)

Minnesota settled its lawsuit against e-cigarette maker Juul Labs and tobacco giant Altria for $60.5 million, Attorney General Keith Ellison announced Wednesday, saying the total is significantly higher per capita than any other state that sued Juul over youth vaping and marketing practices. The state’s lawsuit was the first and still the only one of thousands of cases nationwide against the e-cigarette maker to reach trial. It settled just ahead of closing arguments last month, but the terms had to be kept confidential for 30 days until the formal papers were filed publicly with the court. (Karnowski, 5/17)

The Supreme Court declined to immediately block Illinois’s assault weapons and high-capacity magazine bans, leaving them in place, for now. A gun rights group and gun shop owner asked the justices to pause the law’s enforcement by intervening in the case ahead of an appeals court’s final ruling. The lawsuit also challenges an ordinance in Naperville, Ill., that bans the sale of assault rifles. (Schonfeld, 5/17)

�������ýҕ�l Health News: Thousands Face Medicaid Whiplash In South Dakota And North Carolina 

Until recently, Jonathon Murray relied on Medicaid to pay for treatments for multiple health conditions, including chronic insomnia. Murray, a 20-year-old restaurant worker from the college town of Brookings, South Dakota, said that without his medication, he would stay awake for several nights in a row. “I’d probably not be able to work that much because I’d be tired but couldn’t fall asleep,” he said. (Zionts, 5/18)

The U.S. health regulator's staff reviewers on Wednesday raised a string of concerns with Intercept Pharmaceuticals' treatment for a type of fatty liver disease, sending the drugmaker's shares plunging 22%. The U.S. Food and Drug Administration's reviewers flagged increased risk of diabetes and liver injury from using the oral tablets, called obeticholic acid (OCA), for the treatment of nonalcoholic steatohepatitis (NASH). (Roy, 5/17)

Apple Inc. unveiled an array of new features to make its products more accessible to users who suffer from cognitive, visual and speech impairments. In a news release Wednesday, Apple said its new features which include Assistive Access, Live Speech, Personal Voice and Point and Speak, will “draw on advances in hardware and software,” including ensuring user privacy and expanding on the company’s “long-standing commitment to making products for everyone.” (Oshin, 5/17)

Riyaz Bashir was frustrated with the tools he had to treat blood clots in the lungs. So the Temple University Hospital cardiologist invented a new device to treat the nation’s third leading cardiovascular cause of death. Last month, the Food and Drug Administration approved his invention. Bashir believes the device is a significant milestone in the treatment of pulmonary embolism, which occurs when a blood clot gets stuck in one of the arteries in the lung. Blood then can’t reach the oxygen it needs to carry to the heart, brain and the rest of the body. (Gutman, 5/17)

On Wednesday, U.S. District Court Judge Edward J. Davila ordered Elizabeth Holmes to report to prison no later than 2 p.m. on May 30. The order comes a day after the U.S. Court of Appeals for the 9th Circuit denied Holmes’s request to remain out of prison as she appeals her conviction. (Lerman and Mark, 5/17)

The United Kingdom has reported an unusual increase in myocarditis infections and two deaths in babies who had enterovirus infections, the World Health Organization (WHO) said yesterday. In early April, the UK notified the WHO about an increase in severe myocarditis in infants in Wales. Fifteen cases consistent with neonatal sepsis in babies 28 days old and younger were reported from Wales and Southwest England from June 2022 and March 2023. Polymerase chain reaction (PCR) testing in nine patients confirmed either coxsackie B3 or coxsackie B4. As of April, three patients were hospitalized, four were receiving outpatient care, and two died. (Schnirring, 5/17)

A new study based on wastewater samples collected in Poznan, Poland, last year shows considerably more mpox DNA than expected based on area cases and hospitalizations, suggesting the virus has been underestimated in central Europe. The study appears in the International Journal of Infectious Diseases. (Soucheray, 5/16)

In a study published today in JAMA Network Open, US researchers report that a newly developed algorithm demonstrated high sensitivity in detecting antibiotic allergic-type reactions in patients receiving antibiotic prophylaxis (prevention) for cardiac implantable electronic device (CIED) procedures. (Dall, 5/17)

A new nationwide French study comparing outcomes for patients in the intensive care unit (ICU) for either influenza or COVID-19 due to acute respiratory failure shows that COVID-19 patients had a longer hospital stay and a 69% higher mortality rate than ICU patients with influenza. The study was published yesterday in the Journal of Infection. (Soucheray, 5/17)

Regular aerobic exercise is linked to a significantly lower risk of death from flu or pneumonia, according to US national data published yesterday in the British Journal of Sports Medicine. The study was based on 577,909 adults who had taken part in the US nationally representative National Health Interview Survey (NHIS) between 1998 and 2018. (Soucheray, 5/17)

The Food and Drug Administration just approved fezolinetant (Veozah) for moderate to severe hot flashes associated with menopause. Physicians call hot flashes and night sweats vasomotor symptoms, a term that has been shortened to VMS and was rebranded by Astellas Pharma as part of a pre-launch marketing campaign aimed at consumers and health care providers to “educate” them about VMS and resurrect 20th century myths about menopause. (Patricia Bencivenga and Adriane Fugh-Berman, 5/17)

Measles was declared eliminated in the United States in 2000, and the credit goes to parents who, year after year, brought their children to get measles, mumps and rubella vaccinations. When enough children are vaccinated, say 90 percent or more in a school or community, they reach herd immunity, and the highly contagious measles virus has nowhere to go. (5/17)

North Carolina’s Republican lawmakers overrode a veto by Democratic Governor Roy Cooper last night, enacting a ban on most abortions after 12 weeks of gestation. The ban will take effect in July. (David A. Graham, 5/17)

Millions of patients and their caregivers breathed a collective sigh of relief when drugmaker Eli Lilly recently announced its new experimental Alzheimer’s medication appears to slow cognitive decline by 35%. The Food and Drug Administration could approve the new treatment, donanemab, as soon as this year. (Tomas Philipson, 5/18)

Millions of Americans in the past few years have run into this experience: filing a health-care insurance claim that once might have been paid immediately but instead is just as quickly denied. (Rosenthal, 5/17)

Former president Donald Trump has been hammering Ron DeSantis over his past votes to significantly change Social Security and Medicare. The Florida governor and former congressman has attempted to wave away the attacks, but there’s a better way to counter Trump’s charges: Appeal to both GOP conservatives and populists by targeting entitlement benefits to those in need. (Henry Olsen, 5/17)