“[The Senate passed opioid epidemic legislation] doesn’t include everything all of us want to see but it has important new initiatives and it’s a step in the right direction, Congress is committing itself to actually putting politics aside." — Senator Rob Portman (R-Ohio)

A bipartisan group of senators is unveiling a draft measure to crack down on surprise medical bills, which they say have plagued patients with massive unexpected charges for care. The measure would prevent a health care provider that is outside of a patient’s insurance network from charging additional costs for emergency services to patients beyond the amount usually allowed under their insurance plan. The insurer, not the patient, would have to pay additional charges, which are limited under the proposal. (Peter Sullivan, The Hill)

The Senate on Monday overwhelmingly passed a bill that would let pharmacists inform consumers when it’s cheaper to buy a drug without insurance, as lawmakers inched closer to delivering the Trump administration a win — albeit a small one — in the effort to lower drug prices. So-called gag clauses prevent a pharmacist from telling consumers when their insurance co-pay is higher than the cash price for a drug. The administration has sought to outlaw the clauses, and its push to do so is one of the few ideas in its drug pricing plan to advance so far in Congress. (Nicholas Florko, STAT)

The Senate on Monday passed sweeping, bipartisan legislation aimed at combating the opioid epidemic through new research, treatment and help for families affected by addiction. The bill, which includes more than 70 provisions, passed the Senate with a 99—1 vote. Federal funding to combat the opioid epidemic has increased over the past few years, as the health crisis has worsened. The spending bill passed in March of this year included $4.7 billion to fight the health crisis, including $1 billion for grants for states. (Natalie Andrews, The Wall Street Journal)

The Trump administration is awarding more than $1 billion in grants to help states confront the opioid epidemic, with most of the money going to expand access to treatment and recovery services. Officials say more than $900 million comes from a grant program Congress approved this spring as part of a budget bill. Health and Human Services Secretary Alex Azar says his agency is following science in its response to the epidemic, stressing medication-assisted treatment strategies that have been shown to work. (Associated Press)

A federal court ruled this month that a Montana insurer is entitled to federal compensation for subsidy payments under the Affordable Care Act (ACA) that President Trump abruptly ended last October, a ruling that could reverberate through insurance markets and cost the government hundreds of millions of dollars. At issue are payments for so-called cost-sharing reductions, discounts that enhance the value of health insurance policies purchased from the ACA’s marketplaces by reducing deductibles, co-payments and other out-of-pocket costs for low-income consumers. Judge Elaine D. Kaplan of the United States Court of Federal Claims said this month that Mr. Trump’s actions violated a government promise to insurance companies participating in the health law. (Robert Pear, New York Times)

The U.S. Justice Department has approved the proposed $67 billion merger between health insurer Cigna Corp. and pharmacy benefit manager Express Scripts, the companies announced Monday. Cigna and Express Scripts still must secure certain state regulatory approvals to complete the deal, which was first announced in March, but the nod from the federal antitrust enforcers takes care of the biggest hurdle. The companies expect to close the deal by year-end. But many observers, including hospital groups, employers and other health plans, have criticized the deal and that of CVS Health and insurer Aetna's, which has not yet been cleared by the Justice Department, as profit-driven schemes unlikely to benefit consumers. (Shelby Livingston, Modern Healthcare)

Dominant hospital systems use an array of secret contract terms to protect their turf and block efforts to curb health care costs. As part of these deals, hospitals can demand insurers include them in every plan and discourage use of less-expensive rivals. Other terms allow hospitals to mask prices from consumers, limit audits of claims, add extra fees, and block efforts to exclude health care providers based on quality or cost. The U.S. spends more per capita on health care than any other developed nation and will soon spend close to 20 percent of its GDP on health. Americans aren’t buying more healthcare overall than other countries. What they are buying is increasingly expensive. (Anna Wilde Mathews, The Wall Street Journal)

The health venture led by Dr. Atul Gawande is working with a global consulting powerhouse to hone its strategy for improving care of chronically ill patients who account for the vast majority of medical costs, according to a person familiar with the arrangement. The partnership with Boston-based Monitor Group, the business consulting arm of Deloitte, signals a desire to deliver stepped-up services — enabled by data and modern technology — to frequent users of health care within Amazon, Berkshire Hathaway, and JPMorgan Chase, the companies that hired Gawande to rein in their 1.2 million employees’ health spending. (Casey Ross, STAT)

The Trump administration argues that imposing work requirements for Medicaid is an incentive that can help lift people out of poverty. But a test program in Arkansas shows how hard it is merely to inform people about new incentives, let alone get them to act. In the first month that it was possible for people to lose coverage for failing to comply, more than 4,300 people were kicked out of the program for the rest of the year. Thousands more are on track to lose health benefits in the coming months. (Margot Sanger-Katz, New York Times)

Virginia is gearing up to expand Medicaid eligibility to as many as 400,000 residents in January, but requirements that recipients work and pay premiums could lag two years behind, officials said this week. The gap has infuriated Republican state senators who opposed the expansion effort and viewed work requirements as making it slightly less objectionable. But the state’s director of medical services, Jennifer Lee, told lawmakers this week that the timetable is largely up to authorities in Washington who have to grant Virginia a waiver to impose restrictions on the federally funded Medicaid program.  (Gregory S. Schneider, Washington Post)

The Trump administration will review Alabama's proposal to require some Medicaid beneficiaries, including parents of young children, work to continue receiving benefits. The proposal would require beneficiaries work or complete other activities for 35 hours a week. Parents of children younger than six would have to work 20 hours a week. Those subject to the requirements would have 90 days after the program starts to comply or lose coverage, the state says. (Jessie Hellmann, The Hill)

Enrollment in Michigan's expanded Medicaid program boosted the finances of many low-income residents as well as their health care status, according to a University of Michigan study released Monday. Among more than 655,000 residents who gained health coverage after the legislature approved the Healthy Michigan Plan in April 2014, many have experienced fewer debt problems and other financial issues than before enrollment, according to the analysis of thousands of enrollees' financial records. The study found drops in unpaid debts, such as medical bills and overdrawn credit cards, as well as fewer bankruptcies and evictions after people enrolled in Healthy Michigan. (Karen Bouffard, The Detroit News)

With one in every 10 patients walking into state hospitals without insurance, the Alabama Hospital Association on Thursday launched a campaign to push for expansion of the state’s Medicaid program. Politicians in the Deep South have often opposed expansion, but the Alabama Hospital Association is urging citizens and policy makers to think of expansion as they would any other economic development investment, arguing it would benefit communities and the entire state health care system in addition to the estimated 300,000 people who would gain health care coverage (Kim Chandler, Associated Press)