health

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Once people realized that opioid drugs could cause addiction and deadly overdoses, they tried to use newer forms of opioids to treat the addiction to its parent. Morphine, about 10 times the strength of opium, was used to curb opium cravings in the early 19th century. Codeine, too, was touted as a nonaddictive drug for pain relief, as was heroin.

Those attempts were doomed to failure because all opioid drugs interact with the brain in the same way. They dock to a specific neural receptor, the mu-opioid receptor, which controls the effects of pleasure, pain relief and need.

Now scientists are trying to create opioid painkillers that give relief from pain without triggering the euphoria, dependence and life-threatening respiratory suppression that causes deadly overdoses.

J. Tyler Franklin

The secretary of Kentucky's Cabinet for Health and Family Services says officials will be making some changes to Gov. Matt Bevin's Medicaid proposal.

Vickie Yates Brown Glisson told the state Medicaid Oversight and Advisory Committee on Wednesday that officials are still reviewing the public comments submitted on the proposal. She said the comments were "thoughtful and very helpful." She did not detail what the changes might be.

Kentucky was one of 32 states that expanded its Medicaid program under the federal Affordable Care Act. More than 400,000 were covered under the expanded program, which Bevin says is too large for the state to afford.

Bevin's proposal would charge small premiums to able-bodied adults, and it would require them to have a job or volunteer for a charity in order to keep their benefits.

Aetna will pull out of the ten counties in Kentucky where it offers exchange coverage, starting in 2017.

The company said Monday that it lost $430 million since January 2014, when Kentucky and many other states started offering plans on their state exchanges.

The departure leaves Boone, Campbell, Owen and Kenton counties with only two exchange plans. The other affected counties are Fayette, Jefferson, Madison, Henry, Oldham and Trimble. Aetna will continue to offer small group and an off-exchange individual coverage for 2017.

Aetna spokesman Rohan Hutchings says the company will notify customers before open enrollment in November about their options. But they’re likely to lose some current benefits.

The departure means consumers will have fewer insurance choices. They may already face dramatically increased premiums.

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The battle continues to rage between drug companies that are trying to make as much money as possible and insurers trying to drive down drug prices. And consumers are squarely in the middle.

That's because, increasingly, prescription insurers are threatening to kick drugs off their lists of approved medications if the manufacturers won't give them big discounts.

CVS Caremark and Express Scripts, the biggest prescription insurers, released their 2017 lists of approved drugs this month, and each also has long lists of excluded medications. Some of the drugs newly excluded are prescribed to treat diabetes and hepatitis. The CVS list also excludes some cancer drugs, along with Proventil and Ventolin, commonly prescribed brands of asthma inhalers, while Express Scripts has dropped Orencia, a drug for rheumatoid arthritis.

St. Joseph London Hospital

A jury has determined that a hospital in London, Kentucky , and its parent company should pay $21.2 million to a Corbin man who received unnecessary heart procedures.

The Lexington Herald-Leader reports that the jury ruled this week that St. Joseph Health System and Catholic Health Initiatives were negligent, violated consumer-protection rules and took part in a conspiracy after performing heart procedures on Kevin Wells.

Wells alleged that the hospital performed the procedures to boost payments from health programs and insurance companies.

Wells' attorney, Hans Poppe, says a doctor at the hospital recommended Wells get a peacemaker, although other doctors would later say he didn't need one.

The hospital argued that the treatment Wells received was necessary.

Poppe says the defendants are likely to appeal.

Kentucky Reopens Medicaid Waiver Comment Period

Aug 9, 2016
LRC Public Information

Kentuckians who missed the chance to give input on proposed changes to state-run Medicaid now have until the end of the day on August 14 to comment.

Officials with the Kentucky Department for Medicaid Services say the comment period was reopened because of the high volume of remarks received after the original July 22 deadline.

“We got 30 percent of comments on the last day and even some after the deadline,” said Jean West, Cabinet for Health and Family Services communications director. “So we decided to extend it to accept the comments that came right after the deadline and allow any others.”

She said the state has not determined a date for submission of the revised waiver to the federal government. That will allow officials time to go through comments, she said.

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After the state expanded Medicaid under the Affordable Care Act in 2014, low-income Kentuckians made fewer trips to the emergency room, had less trouble paying medical bills, received a checkup and sought help for chronic conditions. That’s according to a new study released Monday from the Harvard Chan School of Public Health.

Researchers surveyed almost 3,000 low-income Kentuckians in 2013, 2014 and 2015. Participants were asked about their coverage and about their health habits, including if they skipped doses of medication, had a personal doctor or had any emergency room visits in the past year.

In 2013, prior to the Medicaid expansion, 46.3 percent of Kentuckians surveyed said they had a checkup in the past year. Of those surveyed in 2015, after the expansion, that number increased to almost 59.8 percent. There was also a big jump in the number of people who said they had a primary physician after the expansion – from 56.6 percent to 71.7 percent.

51fifty at the English language Wikipedia

For those working daily to treat addiction tied to the opioid epidemic in the Ohio Valley, resources have been limited. Beginning this week doctors will have a little more to work with.

The federal government will allow doctors to treat more patients with buprenorphine, a medication that can help ease people away from addiction.

While the science supports this treatment, some remain skeptical. Visits to three treatment centers in the region show the different approaches people in the recovery community are taking. In the fight against the addiction crisis, it appears there is no single silver bullet.

“Hi, James”

In a Louisville halfway house for inmates and parolees, a group of men gathered to offer support to one another as they work through addiction in a Narcotics Anonymous meeting.

Bevin Delays Applying For Medicaid Waiver

Aug 2, 2016
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Gov. Matt Bevin is delaying submitting changes to the state’s Medicaid program, which his administration had intended to submit to the federal government by Monday.

Adam Meier, Bevin’s deputy chief of staff for policy, said the extension is due to the large number of comments the state received regarding the proposal.

Under Bevin’s proposed plan, some recipients would have co-pays for doctor visits, basic dental and vision benefits would be eliminated for able-bodied adults, and beneficiaries who earn above the federal poverty line would pay monthly premiums. Those who don’t pay premiums would have co-pays.

In addition, beneficiaries would be required to accrue funds to earn dental and vision benefits by participating in activities such as community service or job-training.

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Ever wanted to find the cheapest price for a surgery but had no luck accessing information?

There’s a plan to change that in Kentucky, and it’s currently under consideration by the administration of Gov. Matt Bevin, which must give the green light to build a health care cost comparison website for the state.

This week, Kentucky earned an F on the 2016 Report Card on State Price Transparency Laws, an annual report released by the independent health policy organizations Health Care Incentives Improvement Institute and Catalyst for Payment Reform.

Kentucky’s main offense? Not having the database or a consumer website.

“Do you think it’s OK that a mom and her husband will have to pay an excess of $2,000 based on random selection of hospitals to deliver their baby?” said Francois de Brantes, executive director of the Health Care Incentives Improvement Institute.

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Senate Majority Leader Mitch McConnell says a new federal law can begin to turn the tide of drug fatalities in Kentucky and nationwide. 

The Comprehensive Addiction and Recovery Act, or CARA, sets up a federal grant program to help combat heroin and prescription drug abuse.  The law seeks to improve prevention and treatment resources, and provide more first responders with anti-overdose drugs. 

Flanked by law enforcement in Bowling Green on Wednesday, McConnell said CARA will give local agencies the funds to help addicts while prosecuting drug dealers.

"For the people who are using, it's obviously a sickness and they must be cured," remarked McConnell.  "These guys have a lot of sympathy for those people, but they have no sympathy, I assume, for the people making it possible for this addiction to be fed."

While not every area of Kentucky has a heroin problem, most of the state is experiencing prescription drug abuse, as well as crystal meth and synthetic drugs.  Statewide, more than 1,200 people died last year from drug overdoses.

Zika Infection Confirmed in Kentucky Infant

Jul 23, 2016
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Public health officials in Lexington say the Zika virus has been confirmed in an infant born to a woman who traveled during pregnancy to an area where the virus is circulating.

According to news media reports, test results from the Centers for Disease Control and Prevention indicate the infant was exposed to the virus in the womb. Health officials say neither mother nor child is capable of spreading the virus to others or to mosquitoes in the area.

The Lexington-Fayette County Health Department says even though the infant's mother never described symptoms of illness, antibodies against Zika found in her infant suggest maternal infection during an early stage of pregnancy.

Health officials say the infant doesn't have obvious physical abnormalities, but close follow-up and testing is recommended.

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New students will soon be starting college, and at some Kentucky colleges, that means getting vaccinated. The Kentucky Immunization Coalition — a public private partnership — launched a campaign Monday to convince students and parents that not doing so puts the entire student population at risk for an outbreak.

Three universities in the state require immunizations: The University of Kentucky, Kentucky State University and the University of Louisville. Tracy Kielman, director of the Kentucky Immunization Coalition, says although elementary through high school students in Kentucky are required to be vaccinated, that does not extend to college.

“Hopefully this will push them to do it on their own,” Kielman says.

Rebecca Schimmel

Miners in Kentucky, Ohio, and West Virginia who helped keep the country’s lights on are worried that their retirement benefits could go dark as a result of a wave of bankruptcies in the coal industry. They hope Congress will approve a bill called the Miner’s Protection Act to shore up the pensions and health benefits promised to union miners.

The bill has been bottled up in the Senate’s Finance Committee but Hill sources say Senate leaders have promised a committee vote before Congress breaks for the summer on July 15.

Joe Holland has been with the United Mine Workers of America for four decades. He worked 10 years as an underground miner for Peabody Energy in Muhlenberg County, in western Kentucky. Born in a company-owned house, Holland is a fourth generation coal miner. His grandmother kept two pictures on the mantle; Jesus and the UMWA’s legendary leader John L. Lewis.“Without Christ y’know they thought they was going to hell, and without John L. Lewis they was going to starve to death,” Holland said.

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The House on Friday passed sweeping legislation — endorsed by Democrats and Republicans — that would flood states with money for opioid and heroin addiction treatment programs.

The White House earlier this week called for $1.2 billion to fund a bill that would include programs to train police officers to administer a drug overdose antidote, expand childcare for mothers in residential treatment, and allow physicians to prescribe more people a drug that treats addiction. The House version of the measure only included $131 million.

But Al Guida, a mental health and substance abuse lobbyist in Washington, said that number is still the biggest chunk of funding for substance abuse treatment in decades.

“That’s probably the largest single commitment to expanding addiction treatment in a generation,” he said.

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