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Grady Health System’s proposal to cover more uninsured through a “waiver’’ has run into a major snag at the state’s Medicaid agency. The big problem is concern about the cost. (Miller, 8/5)

Five of Ohio's largest independent physician groups are collaborating to help family practices manage their costs and better compete with larger health care systems. The Ohio Independent Collaborative launched Wednesday. The president, Dr. Gary Pinta, says members will use it to purchases medical supplies in bulk, coordinate patient care and better negotiate payment contracts from insurers. (8/5)

Windham Hospital is facing significant job cuts and service reductions – needed changes, officials from its parent company say, to help the financially struggling hospital survive in a rapidly changing health care market. But the magnitude of the potential cuts has drawn concerns about access to care for residents of an area with significant poverty and poor health outcomes, where transportation options are limited and hospitals are farther apart than elsewhere in Connecticut. (Levin Becker, 8/6)

Desperate for a deal to save its beleaguered hospitals, Bay Area-based Daughters of Charity Health System was left at the altar this spring when California's Attorney General told its prospective new owner it must keep most of the hospitals open for at least 10 years. (Seipel, 8/5)

Rhode Island's health insurance exchange says it has stopped helping people enroll for coverage in person at its walk-in center because fewer people are seeking help. HealthSource RI announced Wednesday its walk-in center in Providence is now a drop-off location. People can deliver documents needed to enroll in coverage and make payments, but not get in-person help enrolling. (8/5)

The company contracted to conduct mental health screens of aspiring Baltimore police officers is under investigation by the city's inspector general and legal department over allegations that it rushed those evaluations, according to city officials and documents obtained by The Baltimore Sun. The investigation focuses on whether Lutherville-based Psychology Consultants Associated fulfilled the requirements of its $730,000, two-year contract with the city. PCA allegedly conducted evaluations of prospective police officers in as little as 15 minutes, instead of the hour required under the contract to clear them for service, officials said. (Rector, 8/5)

Local companies that pay for their employees' medical expenses, rather than buying private health insurance, will soon have another, non-traditional option in providing care to workers. Normally companies that self-insure hire a benefits administrator to manage a network of providers for employees. But a new program offered by Healthcare Interactive Inc., a health benefits technology firm, with Group Benefit Services Inc., an employee benefits administrator, would send workers to Greater Baltimore Medical Center, which now runs on the so-called patient-centered medical home model. (Cohn, 8/5)

An Arizona-based drug maker Insys Therapeutics has agreed to a $1.1 million settlement after Oregon Attorney General Ellen Rosenblum's office accused it of using deceptive marketing and improper payments to sell a powerful and addictive painkiller. (Budnick, 8/5)

A drugmaker's Oregon sales campaign used intended "kickbacks" and flirtation to persuade doctors to inappropriately overprescribe an addictive narcotic – including the promise of "tequila dates" with an attractive sales manager, state documents show. Earlier Wednesday a court settlement was entered in which Arizona-based drug maker Insys, agreed to a $1.1 million settlement after Oregon Attorney General Ellen Rosenblum's office accused it of using deceptive marketing and improper payments to doctors to sell Subsys®, a powerful opioid painkiller. (Budnick, 8/5)

Pharmacists in California and Oregon will soon be able to prescribe birth control to women right over the counter, encroaching on another medical service that was once the exclusive province of doctors. The two states will be the first in the country to allow pharmacists to prescribe contraceptives on their own, without a doctor’s prescription. California legislators passed their bill in 2013 and the law goes into effect Oct. 1. Oregon Gov. Kate Brown, a Democrat, signed her state’s bill July 6 and it takes effect Jan. 1. The two laws are part of a broader trend in states seeking efficiencies in health care as more residents become insured and doctors struggle with increased demands for their services. For instance, 21 states and the District of Columbia have given nurse practitioners the ability to practice without doctor supervision. (Evans, 8/5)

Gov. Terry Branstad has asked a judge to throw out a lawsuit challenging his authority to close two state mental hospitals. Branstad says the union leader and 24 Democratic legislators who filed the suit cannot show he exceeded his authority to manage the facilities and to veto money to keep them running. He also says the plaintiffs failed to demonstrate they were directly harmed by the action, so they have no grounds to sue. (Leys, 8/5)

Two Iowa chiropractors could face state sanctions for allegedly exaggerating their abilities to heal patients. The Iowa Board of Chiropractic has filed administrative charges against James P. Woods of Bettendorf and Jason James of Keokuk, according to documents released Wednesday. The licensing board said Woods “claimed to be able to ‘cure almost everything,’ including ear conditions, eye conditions, stroke, kidney stones, hernia, tremors, blindness and high blood pressure.” (Leys, 8/5)

State officials say they’ve crafted a plan that could improve health care for Washington’s poorest people. At a public forum Wednesday in Spokane, officials unveiled a five-year pilot program they said will curb the cost of treatment under Medicaid insurance, streamline primary care services, and reduce patient demand in emergency rooms, psychiatric hospitals and nursing facilities. With a waiver from the federal government, they hope to make sweeping reforms in Washington’s Medicaid program, which insures more than 1.7 million people – a quarter of the state’s population. (Sokol, 8/6)