- Last week, a Ninth Circuit panel vacated its prior decision in the long-running Wit v. United Behavioral Health litigation and issued a new opinion. To recap the litigation’s history, Wit is an ERISA class action in which the plaintiffs challenged the propriety of guidelines that United Behavioral Health (UBH) previously consulted when determining the medical necessity of certain outpatient and residential mental health treatments. Following a ten-day bench trial, the district court found that the class members’ plans were required to provide coverage for all mental health treatments that are consistent with “generally accepted standards of care” (GASC). Read more here.
- The pandemic has kicked off an uninterrupted spike in telehealth utilization for mental health services and increased spending for those services. Such spending may inspire commercial health plans to cut back on the historically generous and flexible approach to telehealth rolled out to compensate for the lack of access due to the coronavirus pandemic. Read more here.
- As part of a $19 million settlement this spring with Glass’ parents, Colorado’s Clear Creek County this month joined a growing roster of U.S. communities that respond to nonviolent mental health crises with clinicians and EMTs or paramedics, instead of police. The initiatives have spread rapidly in recent years, particularly among the nation’s biggest cities. Data gathered by The Associated Press show at least 14 of the 20 most populous U.S. cities are hosting or starting such programs, sometimes called civilian, alternative or non-police response teams. Read more here.
- Yale University and a student group announced Friday that they’ve reached a settlement in a federal lawsuit that accused the Ivy League school of discriminating against students with mental health disabilities, including pressuring them to withdraw. Under the agreement, Yale will modify its policies regarding medical leaves of absence, including streamlining the reinstatement process for students who return to campus. The student group, which also represents alumni, had argued the process was onerous, discouraging students for decades from taking medical leave when they needed it most. Read more here.
- It’s been 10 months since the Food and Drug Administration first announced a nationwide shortage of Adderall — one of the most widely used medications for attention deficit hyperactivity disorder — and the supply strain could potentially worsen in the months ahead. While some supply issues have improved, many Americans are still struggling to find and fill prescriptions for the drug and other medications for ADHD that they often rely on to stay focused and complete daily tasks. Read more here.
- Anne Arundel County Public Schools filed a lawsuit against social media companies Meta, Google, ByteDance, and Snap Inc. for their roles in the youth mental health crisis. The district alleges that its social media platforms increase the mental health crisis for its 85,000 students and place an increasingly large burden on the school system to provide essential mental health resources. Anne Arundel County, and other districts across the country, say students have been significantly impacted by intense feelings of depression, anxiety, and body image issues, among others. Read more here.
- At the start of my inpatient career, six years ago, I embraced what I believed chaos theory identified as the butterfly effect: the notion that even the smallest of interventions can ultimately create a tsunami on the other side of the world. To me, that meant that even in the most complex of cases, every effort made to change how things are going for the child — clarifying that they meet criteria for a major depressive disorder, initiating a new therapy approach, helping them experience safety — counts for something. Read more here.
- A shooter opened fire at a Florida Dollar General store on Saturday, killing three people in what Jacksonville Sheriff T.K. Waters described as a racially motivated crime. All three victims are Black Americans. The shooter — a white male in his early 20s armed with a handgun and an AR-style rifle with swastikas painted on it — killed himself before authorities could apprehend him. The incident occurred after the shooter attempted to enter the campus of Edward Waters University, a historically Black university, but was refused entry. Sheriff Waters described writings left by the shooter outlining a “disgusting ideology of hate,” and the FBI is investigating the incident as a hate crime. Read more here.
- As students return to the classroom around the D.C. region this year, safety is top of mind. “As a principal, the first thing you think of every day is keeping the students safe. And the parents, when they send the students to school, they trust that you and the staff will keep everyone safe every day,” said Bull Run Middle School Principal Matthew Phythian. But this year, something else will also be watching. It's a new weapons detection system called Evolv that uses sensors and artificial intelligence to detect potentially dangerous weapons coming through the front door. Read more here.
The Opioid Crisis and Addiction Issues
- Fentanyl was involved in the vast majority of all teen overdose deaths – 84% – in 2021, and the problem has been growing. According to the Centers for Disease Control and Prevention, fentanyl-related adolescent overdose deaths nearly tripled from 2019 to 2021. And nearly a quarter of those deaths involved counterfeit pills that weren't prescribed by a doctor. Lauren Tanz, an epidemiologist who studies overdose prevention at the CDC, says a number of factors contributed to these alarming numbers. Read more here.
- Drugmaker Mallinckrodt (MNK.A) on Monday said the company and some of its units have filed for a second bankruptcy in 3 years in the U.S., with the newest restructuring plan set to reduce its debt by about $1.9 billion. The Ireland-based company initiated Chapter 11 proceedings after reaching a debt reduction deal that would cut $1 billion from the amount it owes to victims of the opioid crisis. The company is one of the largest manufacturers of opioids. It also makes generic and branded drugs such as Acthar Gel, which is used to treat multiple sclerosis and infantile spasms. Read more here.
- Gov. Jim Justice announced the appointment Monday of five people to the board of a private foundation that will distribute most of West Virginia’s $1 billion-plus in opioid lawsuit settlements. The governor’s choices still must be approved by the state Senate. The other six members of the committee were nominated by local governments throughout the state. Read more here.
- Anniversaries of trauma-causing events, like catastrophic hurricanes, have a way of resurfacing difficult emotions and throwing us off kilter, according to NOLA Ready, the city's emergency preparedness team. The phenomenon is called the "anniversary effect." It can make you feel restless, on edge and depressed. It can also cause trouble sleeping. Driving the news: Aug. 29 is the anniversary of Hurricanes Katrina and Ida, both of which devastated southeast Louisiana. Many residents are still rebuilding. Read more here.
- Air pollution is more dangerous to the health of the average person on planet Earth than smoking or alcohol, with the threat worsening in its global epicenter South Asia even as China quickly improves, a benchmark study showed Tuesday. Yet the level of funding set aside to confront the challenge is a fraction of the amount earmarked for fighting infectious diseases, said the research from the Energy Policy Institute at the University of Chicago, known as EPIC. Its annual Air Quality Life Index (AQLI) report showed that fine particulate air pollution — which comes from vehicle and industrial emissions, wildfires and more — remains the "greatest external threat to public health." Read more here.
- "Prescribing" fruits and vegetables to adults and children is associated with increased consumption of these foods and multiple health benefits, according to a new study. The analysis, published in the American Heart Association's peer-reviewed journal Circulation, looked at people at increased risk for cardiovascular disease who participated in produce prescription programs for an average of six months, and found they increased their consumption of fruits and vegetables. This shift was associated with improved body mass index, blood sugar and blood pressure levels, researchers found, as well as a decrease in food insecurity. Read more here.
State Bans on Gender-Affirming Care
- Two new laws restricting the access of transgender youth in Missouri to gender-affirming health care and school sports took effect Monday. One law bans minors from beginning puberty blockers and hormones and outlaws gender-affirming surgeries for youths. The other law requires student athletes from kindergarten through college to play on sports teams that align with their sex as assigned at birth. Republican Gov. Mike Parson signed the bills in June after he and other proponents of the laws pressured the GOP-led legislature to act during this year’s session. Both laws are set to expire in 2027. Read more here.
- One of Iowa’s largest cities repealed its ban on “conversion therapy” — the discredited practice of trying to change a person’s sexual orientation or gender identity through counseling — after a Christian organization threatened legal action, part of a deepening national movement to challenge protections for LGBTQ+ kids. The city council in Waterloo voted this week to remove its restrictions after Liberty Counsel warned in a letter June 30 that it would “take further action” if the city did not repeal the ordinance by August 1. It was enacted in May. Read more here.
- Unfortunately, the difficult search for a mental health provider trained to support LGBTQ people, regardless of age, is common. A study published earlier this summer found that less than 1 in 3 of the nation’s mental health facilities offers services targeted to LGBTQ clients, including coming out support, counseling on sexuality, and gender-affirming therapy. Researchers also learned there are fewer than 10 providers offering LGBTQ services for every 100,000 children across the nation. The findings confirm results of a 2022 national survey from The Trevor Project, in which 60% of LGBTQ youth respondents who sought mental health care in 2021 couldn’t get it. Read more here.
Medicaid Redetermination and Medicaid Expansion
- All across the US, hundreds of thousands of children are being kicked off of Medicaid, even though experts say the vast majority continue to qualify. They are among the more than 87 million people in Medicaid and several million more in the Children’s Health Insurance Program who are having their eligibility checked and are facing possible termination of coverage for the first time since the Covid-19 pandemic began. States regained the ability to start winnowing their Medicaid rolls of residents whom they deem no longer qualify on April 1, when a pandemic relief program expired. Read more here.
- Senate Finance Committee Chairman Ron Wyden (D-Ore.) and House Energy and Commerce Committee ranking member Frank Pallone Jr. (D-N.J.) have urged CMS to threaten to withhold funding from state Medicaid programs if they don’t undertake good-faith efforts to prevent procedural terminations. Most recently, the entire Texas Democratic delegation, led by Rep. Lloyd Doggett, sent a letter to CMS on Aug. 22 urging “swift intervention … to prevent the catastrophic loss of coverage occurring in Texas, which already has the disgraceful distinction of the most uninsured people in the country.” Read more here.
- With the state budget’s passage now two months late, North Carolina Gov. Roy Cooper’s administration announced Monday that it can’t start the implementation of Medicaid expansion to hundreds of thousands of low-income adults in the early fall as it had wanted. State Health and Human Services Secretary Kody Kinsley said that expansion won’t begin on Oct. 1, which in July he unveiled as the start date — provided that a budget law was enacted by Sept. 1. Read more here.
- Adults who are eligible for Medicaid but not enrolled in the program are more likely to delay care due to costs, according to an analysis published Tuesday by the Urban Institute. The survey found 21.4 percent of non-Medicaid enrolled individuals delay medical care due to the cost, compared to only 7.3 percent of enrollees and 9.5 percent of Medicaid-eligible individuals with private insurance. Eligible but unenrolled adults were less likely than Medicaid enrollees to have visited a doctor in the last year, 23.4 percent compared to 65.4 percent. Read more here.
- Depending on who you ask, the first-ever Medicare drug negotiations announced yesterday will either mean huge pocketbook relief for seniors or the demise of America's pharmaceutical industry — but the immediate impact will likely be relatively small, experts told Axios. Why it matters: There are still questions about how the Biden administration will arrive at what it thinks is a fair price for the drugs and how much of the savings from lower prices will ultimately be passed on to seniors. Read more here.
- The Biden administration says the 10 medicines selected for the first round of negotiations cost Medicare $50 billion in the last year. By the numbers: The blood thinner Eliquis, made by Bristol Myers Squibb and taken by 3.7 million Medicare enrollees, cost the federal government more than $16 billion between June 2022 and May 2023. That's more than double the next highest-cost drug, the diabetes medication Jardiance from Boehringer Ingelheim and Eli Lilly, and over six times higher than the three drugs rounding out the list. Read more here.
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