Overnight Health Care: Push on 'surprise' medical bills hits new roadblocks | Dem asks FDA to investigate Juul's advertising claims | CDC chief expects drop in opioid deaths this year

Overnight Health Care: Push on 'surprise' medical bills hits new roadblocks | Dem asks FDA to investigate Juul's advertising claims | CDC chief expects drop in opioid deaths this year
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Welcome to Thursday's Overnight Health Care. 

Efforts to address surprise medical bills are facing a lobbying blitz from providers like hospitals and doctors who oppose legislation before Congress. Also today, authorities have found a contaminant in marijuana vaping products that is likely linked to a deadly disease. And a House Democrat wants FDA to investigate whether Juul is illegally marketing itself as a way to help people quit smoking.

We'll start with the latest on surprise billing..


Push on 'surprise' medical bills hits new roadblocks

Protecting patients from surprise medical bills was supposed to be one of Congress's few bipartisan accomplishments this year. But it's turning out to not be so easy. 

The push is hitting fierce opposition from doctor and hospital groups, and struggling with the bitterly divided politics on health care. 


"Big insurance companies want a one-size-fits-all approach that lets them decide what they'll pay doctors for your care," warns an ad launched by the group Physicians for Fair Coverage against the effort.

A separate group, called Doctor Patient Unity, which does not disclose its donors, has spent at least $10 million on ads opposing the effort, according to the Center for Responsive Politics. 

2020 angle: Democrats also could be wary of giving President TrumpDonald John TrumpDemocrats blast Trump for commuting Roger Stone: 'The most corrupt president in history' Trump confirms 2018 US cyberattack on Russian troll farm Trump tweets his support for Goya Foods amid boycott MORE a bipartisan health care victory when he is still attacking ObamaCare. 

Sen. Elizabeth WarrenElizabeth WarrenDemocrats blast Trump for commuting Roger Stone: 'The most corrupt president in history' Pharma pricing is a problem, but antitrust isn't the (only) solution The Hill's Campaign Report: Democratic Unity Taskforce unveils party platform recommendations MORE (D-Mass.), one of the party's top-tier candidates for president, voted against the surprise billing legislation in committee in June, saying that she could not vote for a bill that does not address "the administration's shameful sabotage of health coverage for millions of Americans."

Read more here


Investigators identify vitamin E in vaping products as common threat in lung illnesses

Federal and state investigators have identified a common chemical in marijuana vaping products taken from patients experiencing mysterious lung illnesses.

Vitamin E is not known to cause harm when ingested in a pill form as a vitamin supplement, but investigators said there could be dangers associated with inhaling it due to its "oil-like" properties.

The New York Department of Health said Thursday that vape products containing vitamin E have been linked to every patient who has submitted a product for testing to state health officials.

While nearly all cannabis vaping products tested positive for vitamin E, none of the nicotine-based products contained the chemical, New York officials said.

"As a result, vitamin E acetate is now a key focus of the Department's investigation of potential causes of vaping-associated pulmonary illnesses," the department said.

What can inhaling vitamin E do to your lungs? From the Washington Post: Vitamin E acetate is basically grease, said Michelle Francl, a chemistry professor at Bryn Mawr College. Its molecular structure means that "you have to heat it up pretty hot" for it to vaporize.

When that vapor cools down in the lungs, it returns to its original state at that temperature and pressure, she said, which means "it has now coated the inside of your lungs with that oil," she said.

Patients have reported a cough, shortness of break, chest pain, as well as nausea, vomiting, diarrhea, fatigue, fever and weight loss. 

Two patients have died in Illinois and Oregon. 

Read more here.


Health officials report second death in vaping illness in Oregon 

A second person has died from a severe respiratory illness after vaping. 

Oregon health officials said the individual, who died in July, had used a vaping device containing cannabis that was purchased from a dispensary before experiencing the illness. 

The patient's symptoms were consistent with the more than 200 similar cases of respiratory illnesses that have been reported in other states, officials said. 

"We don't yet know the exact cause of these illnesses -- whether they're caused by contaminants, ingredients in the liquid or something else, such as the device itself," said Dr. Ann Thomas of the Oregon Health Authority. 

Read more here.


In other vaping news.. 

House Dem accuses Juul of illegally advertising as a way to quit smoking

A House Democrat on Thursday accused e-cigarette company Juul of making false and misleading advertising claims and called on the Food and Drug Administration to investigate.

Rep. Raja KrishnamoorthiSubramanian (Raja) Raja KrishnamoorthiMilley confirms soldiers deployed to DC amid unrest were given bayonets Democrats seek information on Treasury's administration of 'opportunity zone' program Biden campaign rips 'outrageous' Trump comments on coronavirus testing MORE (D-Ill.) said Juul has been marketing itself as a tool to help people quit smoking, claiming its pods are safer and healthier than traditional cigarettes. 

Krishnamoorthi, chairman of the Oversight and Reform Subcommittee on Economic and Consumer Policy, launched his own investigation into Juul earlier this summer. The subcommittee in July held a two-day hearing into the company's marketing and health claims.

In a 53-page letter to acting FDA Commissioner Ned Sharpless, Krishnamoorthi 

called the testimony during the hearing "extremely concerning" and urged Sharpless to take action "to protect the American public from the fraudulent and unapproved medical claims made by" Juul.

"Your predecessor, Scott Gottlieb ... pointed to Juul as a primary cause of the epidemic," Krishnamoorthi wrote. "Testimony from our hearing supports that conclusion."

Krishnamoorthi said Juul co-founder James Monsees and the company's Chief Administrative Officer Ashley Gould made multiple unproven claims under oath that Juul is safer and healthier than traditional cigarettes. He said the two also made numerous references that Juul is a device that could help people quit smoking.

Context: Juul wants its device to be considered by FDA as a tobacco product, which has a much lower regulatory bar than a smoking cessation product. FDA says it has never approved an e-cigarette as a smoking cessation device.

Stay tuned: An FDA spokesman said the agency will respond directly to Krishnamoorthi about his concerns, but added that Juul's marketing activities are part of the FDA's broader investigation, and the agency will share more "early next week." 

Read more here


CDC director: US on pace for 5 percent drop in opioid deaths this year

Centers for Disease Control and Prevention (CDC) Director Robert Redfield on Thursday said the number of opioid-related deaths this year is likely to decline 5 percent compared to 2018.

"We are making progress," Redfield said at the National Health Research Forum. "This year it looks like overdose deaths are down by 5 percent, but we've got a long way to go."

Last year marked the first decrease in drug overdose deaths since 1990, The New York Times reported, with a 4.1 percent decline from 2017 according to the most recent CDC data.

Redfield praised the Trump administration's recent $1.8 billion dollar grant to combat the opioid epidemic and called it a "whole-of-government priority."

"We don't need to wait for the perfect solution to the challenges that we have with opioid and drug use disorder. We need to embrace science [and] bring it into the field," he said.

Redfield added that the CDC intended to "improve surveillance" in identifying and predicting potential areas of crisis in the opioid epidemic, which he called "the outbreak of our time."

Of note: While Democrats and public health experts have amped up their calls for the CDC to study gun violence, Redfield didn't raise the topic. 

In a later panel, Dr. David Skorton, president and CEO of the Association of American Medical Colleges, said: "I just have to take the stage to say this: that gun violence is an epidemic in our country. It's time we treat it like an epidemic and a public health crisis."


What we're reading

The problem of medical debt, and the wonky fight behind Bernie SandersBernie SandersTrump glosses over virus surge during Florida trip The Hill's Coronavirus Report: Fauci says focus should be on pausing reopenings rather than reverting to shutdowns; WHO director pleads for international unity in pandemic response Ex-Sanders aide says Biden unity task forces need to go farther MORE's plan to eliminate it, explained (Vox.com

Texas doctor Stephen M. Hahn is a top contender to head FDA (The Wall Street Journal)


State by state

How Kansas' GOP leaders kept thousands from getting health insurance (Kaiser Health News

A bipartisan effort: States pass record number of laws to reel in drug prices (Kaiser Health News