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The Latest on a court hearings on a pharmaceutical companies lawsuit to stop Nevada from using their drugs for a lethal injection...Nevada's top doctor isn't licensed to practice medicine in the United States...Ihsan Azzam testified in Las Vegas...that he has a master's degree and worked for several years in environmental public health and epidemiology before being named chief state medical officer last May...Azzam says he practiced for several years as an obstetrics and gynecology physician in Africa before moving to the United States in the 1990s...That qualifies Azzam for the job under Nevada state law...Azzam testified that while he has no background in anesthesia or pain management, he says the doses of three drugs proposed for an inmate's lethal injection would be enough to kill a mammoth.

A judge ruled...that the Department of Corrections must reveal the name of the attending physician in the planned execution of Scott Dozier, but the name may be revealed only to the attorneys who represent the makers of drugs in the state’s lethal injection protocol...Assistant Solicitor General Jordan Smith, who represents the prison system, told District Judge Elizabeth Gonzalez that publicly revealing the name could lead to death threats...Todd Bice, an attorney for Alvogen Inc., which makes the sedative midazolam, said the company’s lawyers wanted to ensure that the doctor who is expected to oversee capital punishment is a licensed physician...Gonzalez is expected to hear further arguments...in the fight over the use of the three drugs in Nevada’s lethal injection cocktail.

Nevada is looking to save more than $18 million by transitioning the state’s health insurance exchange from healthcare.gov to its own platform under a newly approved contract...The Board of Examiners...approved contracts...that included a $24.4 million, five-year deal with GetInsured for the platform and a call center. The move will save the exchange $18.9 million through 2023 as costs rise to use healthcare.gov, said Heather Korbulic, executive director of the Silver State Health Insurance Exchange...The GOP tax law’s elimination of the individual mandate — a tax penalty for certain people without insurance intended to encourage healthy people to buy plans, which helps stabilize the marketplace — is expected to raise average premiums about 10 percent almost annually for a decade, according to a November 2017 Congressional Budget Office report...Korbulic said a state-run platform will not only save the state money but help protect Nevada from much of the uncertainty in the market as federal health care policies remain in flux. She has said moving away from healthcare.gov would give the exchange more data to understand demographics that are being reached and those that need more targeted resources

The Washoe County School District is poised to renew a contract...with Renown Hospital and its insurance arm to provide health care to teachers and other district employees, but the hospital’s biggest competitor, Saint Mary’s Regional Medical Center, is crying foul over the process, saying it can provide care more cost-effectively and wasn’t given a fair shot to prove it can do so...Saint Mary’s Health Network, which includes the hospital, other health-care facilities and networked providers, submitted a proposal to the school district earlier this summer for a comprehensive health plan that it says could have saved the district anywhere between $5.4 million and $15.9 million in 2019. But the school district rejected the proposal as “non-responsive” because the district had only requested information on hospital services, not a full health plan, adding in a letter that it only sent out the bid in the first place in response to “constant badgering and lobbying” by Saint Mary’s.

A doctor has been disciplined by Nevada state pharmacy regulators after he was accused of improperly looking up prescription records of the dead gunman in last October's mass shooting in Las Vegas...Attorney E. Brent Bryson said Thursday that Dr. Ivan Goldsmith has to pay $26,000 in fines and attorney fees but keeps his license to prescribe medicines if he completes a year of probation...Goldsmith was accused of improperly looking up gunman Stephen Paddock's patient profile and disclosing to the Las Vegas Review-Journal that Paddock had been prescribed diazepam, an anti-anxiety drug better known as Valium.

The Washoe County School District Board of Trustees voted...to renew contracts with Renown Hospital and its insurance arm while also beginning the process of scouting out alternative options over the next year to address the long-term solvency issues of its health insurance fund...trustees voted unanimously to direct the superintendent to begin a competitive request for proposals process over the next year to explore other health-care options for employees and retirees as the district grapples with the rising costs of health care and an insurance fund balance that isn’t keeping up. They then voted to approve three-year contracts with Renown and Hometown Health...Saint Mary’s Health Network, which had held the longstanding contract to provide coverage to district employees, cried foul about the renewal process for the Renown and Hometown Health contracts this year, saying that it could provide health care more cost effectively but hadn’t been given a fair shot to prove to the district that it could do so. Amber Norris, director of business development and marketing for Saint Mary’s, said at the meeting that the request for proposal is “a move in the right direction” and that the health network looks forward to submitting its proposal...

The Washoe County school board may open bidding for the district’s multi-million-dollar healthcare contract, school officials confirmed...The contract has been a point of conflict between the district and local healthcare provider Saint Mary’s Medical Group, which has said it was unfairly excluded from the bidding process — potentially at the expense of the district’s employees...The current proposal being weighed by the school board is an exclusive 3-year contract with Renown Health and its insurance arm Hometown Health, the district’s current health care provider. That plan would raise the cost of health insurance premiums by 10 percent in 2019...It's unclear if the move to accept other healthcare proposals comes too late to curb potential premium increases for 2019.

Nevada officials have filed an emergency request with the state Supreme Court seeking to block a lower court’s decision to release the identity of the attending physician scheduled to oversee the delayed execution of Scott Raymond Dozier...In an emergency motion...the attorney general’s office, representing the Nevada Department of Corrections, is seeking to block a...decision by District Court Judge Elizabeth Gonzalez. The judge said the state must reveal the name of the physician set to oversee Dozier’s execution to attorneys representing one of the drug manufacturers whose product will be used in the execution...Although Gonzalez’s order would limit disclosure of the physician’s identity to the attorneys for drug manufacturer Alvogen, the state wrote in its emergency request that the attending physician would only oversee the execution “to the extent their anonymity is protected from disclosure” and that even a limited disclosure of individuals involved in the execution wasn’t relevant and would limit the state’s ability to carry out the execution...“The drug manufacturers should not be permitted to go on a fishing expedition for information that can be used to harass individuals who assist the State in carrying out lawful executions,” attorneys with the state wrote in the filing. “The intended effect is to scare people away from assisting the State. This tactic is well-documented and, unfortunately, has been effective in stopping executions.”

Las Vegas police and Clark County firefighters experienced numerous communication problems and failed to follow some protocols on the night of the Oct. 1 mass shooting...But the 61-page report also described the response to the attack — which left 58 concertgoers dead and more than 800 people injured — as “efficient” and “coordinated,” crediting the counter-terrorism training of Las Vegas police...The Federal Emergency Management Agency created the report with participation from the Metropolitan Police Department and the Clark County Fire Department. It took nearly a year to complete and includes 72 lessons learned.

The after-action report...makes no mention of confusion surrounding University Medical Center’s bed availability in the immediate aftermath of the...shooting...The report, commissioned with “the intent of distributing best practices and lessons learned for other communities around the country to better prepare for a mass casualty incident,” did not address communication issues surrounding the county-run hospital’s status. Nor does it mention the county-run hospital’s improper use of an “internal disaster” alert.

Nevada Medicaid approved a requirement that therapists receive prior approval before providing more than five therapy sessions to a patient...The new policy, which takes effect on Oct. 1, will require psychologists, therapists and other mental health providers to submit written documentation to the state’s third-party vendor demonstrating the medical necessity of treatment and receive prior approval to continue providing both talk therapy and neurotherapy services after five sessions with a patient. The final policy is a scaled back version of earlier proposals from Medicaid to require prior authorization before the first session or after three sessions, both which received significant pushback from the mental health community over the last few weeks...The policy will only apply to patients enrolled in Medicaid’s fee-for-service program, in which Nevada Medicaid reimburses individual providers for services rendered, and not those who are covered under Medicaid managed care, where the state pays an insurance company a flat fee to provide health services to a patient. About one in four of the 650,000 Nevadans on Medicaid are enrolled in the fee-for-service-program.