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good morning. The Australian musician recently broke his hip while on tour and spent nearly two weeks in an American hospital. Other than the typical American medical expenses she received, her deployment was surprisingly heartwarming.
Inside the lucrative emergency room that will turn you away.
For decades in the United States, it has been illegal for emergency departments to turn away patients simply because they cannot pay. However, this only applies to hospitals that contract with Medicare. In a new investigation, STAT’s Tara Banau reveals how Nutex Health, a Houston-based system, exploited this loophole to enrich itself and its investors.
At one Nutex emergency room, a receptionist turned away an uninsured patient who arrived with obvious signs of a heart attack but was unable to pay up front. At another facility, a family of five discovered they had been charged $21,000 in premiums for a coronavirus vaccination that was advertised as free. And in recent years, nearly all of Nutex’s bills have been sent to the No-Surprise Act federal arbitration process, which is supposed to be a last resort.
This latest strategy is actually generating so much revenue that multiple investors are suing Nutex for its unsustainable reliance on arbitration. (Read Tara’s March article about how a Texas couple got rich through the same process, and Nutex is working with that company.) Read more about how this money grab impacts patients in Tara’s in-depth investigation.
Court blocks President Trump’s definition of ‘professional’
Last week, a federal judge in Washington, D.C., temporarily blocked new regulations that would limit the amount of federal loans available to students pursuing non-professional degrees, while significantly redefining what counts as a professional degree. Importantly, U.S. District Judge Beryl Howell did not rule on the legality of differentiated lending caps in general, but focused specifically on the Trump administration’s definition of professional degrees. This definition is likely to conflict with the way Congress defined it when it established the lending cap last summer, he said in his decision.
The rule is scheduled to go into effect on Wednesday, but will be suspended pending judicial review. Meanwhile, medical workers continue to resist. More than 500 nurses arrived at the Capitol on Thursday for a day of advocacy. One of their topics is the Nursing as a Profession Degree Act, which aims to change the field’s position within policy through legislation.
988 What’s next for LGBTQ+ services?
The Trump administration confirmed this month that services specifically for LGBTQ+ youth will return to the national suicide and crisis hotline by the end of the year. But it is unlikely to return to the way it was before. Officials also said they are working to ensure the service complies with last year’s executive order that sought to re-binary gender. And The Trevor Project, which previously answered more than half of the calls for the service, could be shut out of the revived line entirely.
This nonprofit appears to be excluded for technical reasons. The call for applications to manage the return of the LGBTQ+ “Press 3” line is limited to “currently active” members of the 988 network, the Associated Press reported Friday. The Trevor project is not active, but that’s only because the administration canceled the service in the first place.
It is still unclear exactly how LGBTQ+ services will change to comply with the executive order, whether in name only or in the actual counseling provided to young callers. LGBTQ+ advocates say any changes to 988 professional services could be worse than no services at all.
“If it comes back on trend and people start denying transgender identity, is it worth being there?” Aaron Almanza, executive director of the LGBT National Help Center, told me. “Because it does more harm than good.”
Death of a child after exposure to rabies
The Canadian Medical Association Journal published a heartbreaking report of an 11-year-old boy in Ontario who died from rabies. In 2024, one morning while his family was visiting a vacation home, a young boy woke up to find a bat nesting in his nose and mouth. He drove it away. His father caught a bat in a pot and released it. The boy’s family initially withheld medical treatment because he had no signs of abrasions or skin punctures.
Within three weeks, the boy began developing neurological symptoms. At first, doctors thought he had Bell’s palsy, a temporary paralysis of the facial muscles. She was later diagnosed with herpes gingivostomatitis, an infection of the lips and mouth. Doctors knew about the bat exposure and asked public health officials whether they should administer rabies post-exposure prophylaxis (PEP). However, given that the boy already had symptoms of rabies and that post-exposure precautions could actually be harmful once symptoms started to appear, it was decided not to use PEP.
Rabies is preventable if this therapy is administered quickly, but once symptoms develop, it is almost certainly fatal. The boy’s condition rapidly deteriorated and he died 17 days after being admitted to the hospital.
The authors said they agreed to share the boys’ story to raise awareness of the dangers of rabies, noting that encounters between bats and humans increase in summer. “Direct contact between humans and bats, even in the absence of visible bites or scratches, is an indication of PEP and should be discussed with public health officials,” they wrote. — Helen Branswell
The mysterious patient had pulmonary hypertension. What is it?
Last week, STAT’s Lizzie Lawrence reported on a mysterious patient with obesity, sleep apnea and pulmonary hypertension who was given a powerful weight loss drug that has not yet been approved by federal regulators. The White House said the patient: it’s not President Trump. However, this story caused a lot of interest and skepticism. As political influences play out, our colleague Elizabeth Cooney provides a helpful overview of pulmonary hypertension and how GLP-1 drugs can help treat it.
Depending on the type of pulmonary hypertension, “it can be very serious, life-threatening, life-altering, or it can be nothing at all,” cardiologist Paul Forfia told Liz. Read more about common symptoms and treatments.
what we are reading
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Could Massachusetts become the first state to delegalize marijuana? boston globe
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Support grows based on right to prosecute women who have abortions, New York Times
- Opinion: U.S.-China biotech crackdown could hurt the scientists America needs most, STAT
- Efforts to end vaccination requirement in schools hit wall in Florida, KFF Health News
- Opinion: Supreme Court decision on Roundup points to confusing difference between law and science, STAT
