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Outside groups prepare to fight Trump drug pricing proposal. Outside groups involved with fighting HIV, epilepsy, and serious mental illness are prepared to battle the Trump administration on a plan to change Medicare Part D, the portion of the program that covers prescription drugs. The administration has proposed making changes to what are known as the “six protected classes” of drugs, which allow certain patients with serious health conditions to receive any drug that their doctor determines is best to treat them. Under the administration’s plan, aimed at reducing drug spending, insurance companies would be able to require that doctors try certain less expensive drugs first, or require doctors to check with an insurance company before they issue a prescription. The organizations, which receive some funding from drug companies, said such a move would harm patients, even risking their lives, because insurance companies could even discontinue a medication that patients are already finding effective. The organizations, which have banded together to form the Partnership for Part D Access, are lobbying members of Congress to have them undo the proposal if it should become a final rule. If that doesn’t work, they signalled in a meeting with reporters Wednesday that they were prepared to sue. “Patients and their families should not be paws in this fight,” said Andrew Sperling, director of legislative and policy advocacy at the National Alliance on Mental Illness. “We are going to continue to push back on the Trump administration on this.” Medicare patients who require the medicines are not only 65 and older, but many of them are younger and qualify for Medicare because their health condition meets the program’s provisions for people with disabilities. The Trump administration finished collecting comments on the proposal Jan. 25.

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Family of Arizona man declared brain dead seeks to move him to maintain care. David Ruiz made one thing clear to his family in recent years: If he ever became totally reliant on machines to keep him alive, they were not to disconnect him. “We had this conversation at length over and over, the entire family,” said his mother, Patricia Adames. “He said, ‘Don’t ever take me off.’ He was adamant. He said, ‘I know I’m going to be alive in there.'” Only a couple of years later, she’s standing beside her son at a Catholic hospital in Tucson, Ariz., where doctors have declared him brain dead, advocating for Ruiz to receive long-term care. Ruiz’s family is open to transferring him wherever he can get care, but has focused on New Jersey because it has a 1991 law that says death cannot be declared “in violation of individual’s religious beliefs.” Read the full story.

CMS to let Medicare Advantage reimburse meals. Medicare Advantage enrollees will have the option to choose plans that provide home-delivered meals or transportation for non-medical needs under a plan released Wednesday by the Center for Medicare and Medicaid Services. The agency is also urging the plans under Medicare Advantage, meaning those administered by private insurers, to offer better benefits for patients who have chronic pain or are receiving treatment for addiction. “CMS is committed to modernizing Medicare and our top priority is to ensure that seniors have more choices and affordable options in receiving their Medicare benefits,” CMS Administrator Seema Verma said in a statement. “Medicare Advantage enrollment is at an all-time high as more and more seniors are choosing to enroll in private Medicare health and drug plans, and we need to maximize competition by providing plans the flexibility to meet patients’ needs.”

E&C Dems scrutinize drug companies over insulin price hikes. Energy and Commerce Chairman Frank Pallone, D-N.J., and Diana DeGette, D-Colo., who chairs the Oversight and Investigations subcommittee sent a letter Wednesday to drug manufacturers Eli Lilly, Novo Nordisk, and Sanofi asking what was causing price hikes in insulin, a drug that millions of patients with diabetes rely on. The companies are the only ones who make the drug, which has seen price hikes in recent years. More and more stories are emerging about people with diabetes rationing insulin because they are unable to keep up with costs, a practice that puts their health and lives at risk. The focus on insulin in particular featured heavily during drug pricing hearings on the Hill. The Democratic lawmakers said in their letter that they want the companies to explain price increases, to demonstrate the precise profits associated with insulin, and to lay out what changes they have made to their products in the last decade.

E&C sets hearing on Obamacare case. The House Energy and Commerce Committee is poised to hammer Republicans and the Trump administration again on their efforts to repeal Obamacare. Its Health subcommittee, chaired by Rep. Anna Eshoo, is holding a hearing Feb. 6 titled “Texas v. U.S.: The Republican Lawsuit and Its Impacts on Americans with Pre-Existing Conditions.” The hearing will focus on the case to declare Obamacare unconstitutional that is being appealed to the Fifth Circuit. “If this disastrous district court ruling stands on appeal, the American healthcare system will be upended, premiums and out-of-pocket costs will skyrocket, and insurance companies will once again be able to discriminate against Americans with pre-existing conditions,” Eshoo and Pallone said in a statement. “This hearing will be an important opportunity to hear directly from patient advocates, as well as policy and legal experts on the devastating toll this ideological court decision will have on millions of Americans’ lives.”

Virginia governor Ralph Northam describes circumstances in which mother and doctor can decide whether to let infant live after birth.  Virginia Democratic Gov. Ralph Northam said Wednesday that Democratic Del. Kathy Tran’s controversial comments about a proposed bill to roll back restrictions on third-trimester abortions were “really blown out of proportion.” In an interview with WTOP on Wednesday, Northam defended the bill, which Tran acknowledged on Monday would let a woman who was dilated and about to give birth receive a third-trimester abortion. “We want the government to not be involved in these types of decisions… When we talk about third-trimester abortions, these are done with the consent of obviously the mother, with the consent of the physician — more than one physician, by the way — and it’s done in cases where there may be severe deformities. There may be a fetus that’s nonviable. If a mother is in labor, I can tell you exactly what would happen. The infant would be delivered. The infant would be kept comfortable. The infant would be resuscitated if that’s what the mother and the family desired, and then a discussion would ensue between the physicians and the mother.”

Study: Firearm injuries cost nearly $1 billion annually between 2010-2015. The average annual cost of inpatient hospitalizations for firearm injuries was more than $900 million between 2010 and 2015, according to a new study. The new study was released by Stanford University School of Medicine researchers this month and also shows that short-term hospital re-admissions for gun injuries alone cost $86 million a year from 2010 through 2015. A big chunk of the cost was put on the government, the study found. Of a total $5.47 billion in costs, Medicaid contributed $2.1 billion, and Medicare provided $389 million. Private insurance and self-paying patients each accounted for about $1.1 billion.

Covered California enrollment stays steady. Enrollment in the Obamacare exchange in California remained about the same this year as where it was last year, finishing at roughly 1.5 million, according to Covered California. Many of those who were enrolled were renewals from last year, and the state blamed actions for by the Trump administration for the decrease of new enrollees, which it estimates fell by 23.7 percent. “Covered California’s overall enrollment has held steady, but recent actions at the federal level appear to be causing large drops in enrollment that will lead to more uninsured and higher premiums for all Californians,” Peter Lee, Covered California executive director, said in a statement. “The federal removal of the individual mandate penalty appears to have had a substantial impact on the number of new consumers signing up for coverage.” Democratic Gov. Gavin Newsom, who was sworn in earlier this year, is asking the legislature to institute a fine on the uninsured, which was zeroed out at the federal level beginning this year. He has also proposed funding subsidies for more people, which would lower how much consumers pay and potentially bring in more middle-income people. Lee said in a statement that the latest enrollment figures underscored the need for both policies.

RUNDOWN

The Hill VA unveils proposal to expand private health care for veterans

Propublica OxyContin maker explored expansion into “attractive” anti-addiction market

Axios The quiet, steady rise of employer health coverage

The News & Observer The legislative session ends ‘when we get Medicaid expansion,’ says an aide to Gov. Cooper

MedPage Today Trial: Smoking cessation rate double with e-cigs vs nicotine replacement

Stateline Opioid money has helped, but states want more