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Medicare open enrollment begins today: Patient costs to rise slightly in 2019. Medicare enrollees will be paying slightly more for their coverage in 2019, the Trump administration announced just ahead of the signup period that begins today. Medicare is divided into various parts according to the type of medical care it provides, and people who enroll can choose the traditional Medicare or can buy Medicare Advantage, which is run by private plans. Beneficiaries pay premiums for Medicare Part B, which covers care from doctors, hospitals, medical supplies, and certain home health services. The standard cost for 2019 will be $135.50 a month, a slight increase from the 2018 cost of $134 a month.  About 2 million Medicare enrollees won't pay the full premium because of their income. Annual deductibles, or the out-of-pocket amount that people pay before an insurer kicks in the rest, also will rise slightly to $185, from the $183 a month beneficiaries paid in 2018. The vast majority of those enrolled in Medicare Part A don't pay a premium but will pay deductibles toward a skilled nursing facility, home health services, and inpatient hospital care. That amount also will increase slightly next year, by $24, to $1,364.

Welcome to Philip Klein’s Daily on Healthcare, compiled by Washington Examiner Managing Editor Philip Klein (@philipaklein), Senior Healthcare Writer Kimberly Leonard (@LeonardKL) and Healthcare Reporter Robert King (@rking_19).  Email for tips, suggestions, calendar items and anything else. If a friend sent this to you and you’d like to sign up, click here. If signing up doesn’t work, shoot us an email and we’ll add you to our list.

AHIP touts Medicare Advantage plans. Matt Eyles, president and CEO of America’s Health Insurance Plans, praised Medicare Advantage at the group’s conference in Washington, D.C., on Monday, saying beneficiaries like the “value, choice, and personal sense of control” the program offers. The average premium will fall 6 percent among these plans, to $28 for 2019. They also are now expanding to cover adult day-care services and in-home services. The comments from Eyes came just a few days after a New York Times report on a report from the Inspector General at the Department of Health and Human Services finding that the plans have been improperly denying medical claims to patients and doctors. Few people appeal the claims, but those who do tend to be successful, the report found.

Azar to give drug pricing speech this afternoon. HHS Secretary Alex Azar is set to deliver an announcement on prescription drug prices at 4 p.m. at the National Academy of Medicine’s Annual President’s Forum. Politico reported on Friday that part of the announcement would be kicking off the rulemaking process on requiring drug companies to post their prices in ads, a policy that was part of the Trump administration’s blueprint published earlier this year. “While we cannot comment on pending regulations, the president’s ‘American Patients First’ blueprint to lower prescription drug prices and reduce out-of pocket costs clearly states that HHS is looking at options to require drug pricing transparency,” said Caitlin Oakley, HHS spokeswoman. “It should not come as a surprise that this would require rulemaking.”

Obamacare’s open enrollment starts in California today. California is getting a really big jump start on its 2019 open enrollment period by starting it today and running through January 15. This gives consumers more than 90 days sign up for health insurance under Covered California, the state-run Obamacare exchange. California has boosted its outreach and enrollment period after the federal enrollment period was cut by half for the 2018 open enrollment and enrollment funding for the states covered under was cut by 90 percent by the Trump administration. California last open enrollment devoted $100 million to outreach funding, compared to $10 million used by the Trump administration for which is used by residents in 38 states to buy Obamacare plans. But the state’s open enrollment for the 2018 coverage year dipped slightly by 2.5 percent. The 2019 open enrollment period for is expected to run from Nov. 1 to Dec. 15, the same period as last year.

FDA cracks down on illegally marketed vaping products. The Food and Drug Administration announced Friday it will investigate whether more than 40 vaping products are being illegally marketed. “Companies are on notice – the FDA will not allow the proliferation of e-cigarettes or other tobacco products potentially being marketed illegally and outside of the agency’s compliance policy, and we will take swift action when companies are skirting the law,” FDA Commissioner Scott Gottlieb said in a statement, adding that the increased crackdown stems from kids’ increased use of vapor products. The FDA sent letters to the 21 e-cigarette companies that could be going against FDA compliance, and asked for information about 40 products that could be in violation.

First flu season death was unvaccinated child in Florida. An unvaccinated child in Florida is the first person nationwide to die from the flu in the 2018-2019 season, the Florida Department of Health announced Monday. Officials reported the child was healthy until the time of illness and tested positive for Influenza B between Sept. 30 and Oct. 6. The state office did not share additional information about the victim nor the date of death, according to a local report. Last year's flu claimed 80,000 lives in the United States, the highest on record for one year.

Canadians linked to newly legal pot industry could be barred from US. More than 100 recreational marijuana stores are opening across Canada this week, introducing new opportunities for international business and tourism — and creating potential conflict with U.S. authorities as money and people flow across the border. Canada will be the second Western country to regulate recreational sales, after tiny Uruguay in South America, which sells pot only to its own citizens at pharmacies. Trump administration officials long anticipated the fulfillment of Prime Minister Justin Trudeau’s 2015 campaign pledge, but the precise U.S. response remains unclear when stores open Wednesday. “We need reform in federal law worse than we’ve ever needed it,” said Washington state defense attorney Douglas Hiatt, a marijuana reform advocate. “There is no reform movement anymore. [President] Trump has sucked all the oxygen out of the room.” Hiatt and other marijuana policy experts see major questions of U.S. policy toward Canada, involving criminal law, access to banking, and border crossings.

Hurricane Michael’s death toll rises to 18, hundreds of thousands without power. Hurricane Michael has claimed at least 18 lives as of Sunday afternoon, a figure that could very well rise as search and rescue teams clear debris and look for survivors. Michael's path was immense, impacting residents from Florida to Virginia. Four days after Michael made landfall Wednesday, a victim was found in Virginia, increasing the death toll to 18. Roughly 190,000 Floridians lost power and many are still waiting on supplies from support crews. Some managed to seek help by using blown-down tree logs to spell "HELP" on the ground. Florida officials ordered the evacuation of roughly 3,000 inmates in the wake of the storm, because the prisons had been damaged. As of Sunday, 435,000 people are still without power due to Michael across several states, according to CNN. Al Cathey, the mayor of Mexico Beach, Fla., near where the powerful Category 4 storm made landfall, estimated that some 250 residents tried to wait out the storm. While he remains confident that these holdouts are safe, as search-and-rescue crews have already surveyed the worst-hit areas, Cathey did admit, "If we lose only one life, to me that's going to be a miracle."

Wisconsin gubernatorial candidate calls for excessive fines on drugmakers that raise prices too much. Democratic Wisconsin gubernatorial candidate Tony Evers said he would create a state board that would have the authority to impose fines on egregious drug price hikes, according to a report in the Milwaukee Journal-Sentinel. Evers, who is running against Republican incumbent Scott Walker, would make the state’s prescription drug program also cover flu shots and allow it to import drugs from Canada, the newspaper added. If Evers is elected and he creates the board, it would be the latest state to tackle high drug prices. Maryland passed an anti-gouging law last year that banned egregious price hikes on certain generic and off-brand products. It is one of the strictest in the nation.  

Medicaid expansion leads to lower unmet health needs, watchdog says. Expanding Medicaid led to fewer people reporting unmet healthcare problems like not being able to afford prescription drugs, according to a report from the federal watchdog Government Accountability Office. The agency looked at survey results as of Dec. 2017 from 31 states and the District of Columbia that expanded Medicaid under Obamacare. The GAO looked at 2016 estimates from the National Health Interview Survey of low-income adults in states that did and did not expand Medicaid. The estimates showed that “low-income adults in expansion states were more likely to report having a usual place of care to go to when sick or needing advice about their health and receiving selected healthcare services compared with those in non-expansion states. There were 20 percent of low-income adults in non-expansion states who reported a financial barrier to getting care, compared to nine percent in expansion states.

AHIP presses for changes to privacy law that weren’t made in final opioids bill. AHIP pressed for Congress to take up changes to a patient privacy law that were left out of a final package of legislation that Congress passed to combat the opioid epidemic. AHIP said in a statement on Monday that it commended the legislation but pointed out that privacy rules “should be modernized.” The insurance lobby referenced a federal law called 42 CFR Part 2, which oversees the sharing of patient records for people that are seeking addiction treatment. Advocates for changing the law say that the regulations are outdated and hinders access to a patient’s entire medical record that includes whether they suffer from an opioid addiction, according to the Partnership to Amend 42 CFR Part 2, which includes the American Hospital Association and the National Alliance on Mental Illness. But the American Medical Association opposed the measure, concerned about loosening restrictions on patient confidentiality.


The Hill Vulnerable Republicans throw ‘Hail Mary’ on pre-existing conditions

Axios The main issue with prescription drug transparency

STAT News Harvard and Brigham and Women’s Hospital call for retraction of more than 30 papers on stem cell research

Roll Call Three states get ready to vote on abortion

NBC News Healthcare disappears from some campaign ads

Reuters Hip and knee surgeons to use Apple watch to monitor patients

Associated Press New strategy: Democrats go all in on healthcare in the midterms


House and Senate in recess until after the Nov. 6 midterm elections.

MONDAY | Oct. 15

Medicare open enrollment begins.

Oct. 14-18. America’s Health Insurance Plans conference on Medicare, Medicaid, and dual eligibles. Agenda.

Oct. 14-17. New Orleans. Employee Benefits Conference. Details.

Oct. 15-16. Marriott Wardman Park. Rare Diseases and Orphan Products Breakthrough Summit. Agenda.

10 a.m. 1775 Massachusetts Ave. NW. Brookings event on “Crafting public policy to address the nation’s opioid epidemic.” Details.

4:15 p.m. 2101 Constitution Ave. NW. National Academies of Sciences, Engineering, and Medicine Affordable Drugs Forum. Details.

TUESDAY | Oct. 16

8:45 a.m. UnitedHealth Group third quarter earnings. Details.

1:30 p.m. Alliance for Health Policy webinar on “Potential Midterm Election Implications for Healthcare.” Details.

FRIDAY | Oct. 18

Noon. G-50 Dirksen. Alliance for Health Policy event on “Flexibility and Innovation in Medicaid.” Details.