Summary

The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to notify clinicians, public health officials, and potential travelers about a measles outbreak in Texas and New Mexico and offer guidance for prevention and monitoring. As of March 7, 2025, Texas and New Mexico have reported 208 confirmed cases associated with this outbreak (198 in Texas and 10 in New Mexico). As a part of this outbreak, two deaths have been reported: one in Texas and one in New Mexico. More cases are expected as this outbreak continues to expand rapidly.

With spring and summer travel season approaching in the United States, CDC emphasizes the important role that clinicians and public health officials play in preventing the spread of measles. They should be vigilant for cases of febrile rash illness that meet the measles case definition and share effective measles prevention strategies, including vaccination guidance for international travelers.

The risk for widespread measles in the United States remains low due to robust U.S. immunization and surveillance programs and outbreak response capacity supported by federal, state, tribal, local, and territorial health partners. Measles-mumps-rubella (MMR) vaccination remains the most important tool for preventing measles. To prevent measles infection and spread from imported cases, all U.S. residents should be up to date on their MMR vaccinations, especially before traveling internationally, regardless of the destination.

The Value of the 340B Program Case Study

Who is Johnson County Hospital?

Opened in 1958 as a county-owned hospital, Johnson County Hospital is an 18-bed critical access hospital based in Tecumseh, Neb., a rural community of 1,800 located in the Southeastern part of the state. It also operates rural health clinics in Tecumseh and neighboring Gage County. Recognizing the broader community’s unique needs — and looking for ways to amplify the hospital’s impact — hospital leaders made the decision to participate in the 340B Drug Pricing Program in 2012.

Since then, the 340B program has allowed Johnson County Hospital to purchase certain drugs from pharmaceutical companies at a discount and apply the savings to support community programs that it otherwise would not have the resources to implement. With a commitment and dedication to improving health care access and outcomes among some of Nebraska’s most rural residents, Johnson County Hospital is a textbook example of how the 340B program is working as Congress intended.

Who Does Johnson County Hospital Treat?

Johnson County Hospital is a lifeline for many Nebraskans, including those living in rural areas. The U.S. Census Bureau estimates the population of Johnson County was 5,200 in 2020, with a population density of just 14.1 per square mile — significantly less than the nationwide average of 93.8. While this creates a strong sense of community, it also means that care options are far less accessible than in urban areas. Statewide, over two-thirds of Nebraska counties are considered “medically underserved.” Without Johnson County Hospital, patients would be forced to travel anywhere between 45 miles and more than 100 miles away to receive care at the nearest advanced-care hospital.

“The 340B program allows us to do even more

for the community without tax dollars being used.”

Olivia Little

340B Director at Johnson County Hospital

What’s the Value of the 340B Program for Johnson County Hospital’s Community?

To strengthen the community’s access to care close to home, Johnson County Hospital has created many important programs with the support of 340B savings. Johnson County Hospital is proud to participate in the 340B program and openly and regularly reports on the benefits made possible through the program. In Fiscal Year 2023-24, Johnson County Hospital provided $831,000 in 340B benefits, including:

Robust Health Services in the Community — Home health is critical to meeting patients where they are, providing care in a safe, familiar environment, and helping patients manage chronic conditions to prevent them from getting worse and requiring more acute care. Johnson County Hospital’s home health department regularly provides free blood pressure checks at local restaurants and coffee shops. It also goes out into the community to provide low-cost toenail care.

Enhanced Transportation Options for Patients — Using 340B savings, hospital leaders recently launched a new interfacility ambulance service to benefit Johnson County Hospital and the surrounding hospitals throughout Southeast Nebraska. Instead of waiting several hours for an ambulance transfer service, patients can now use the in-house ambulance service option. To further ease transportation challenges, Johnson County Hospital used 340B savings to purchase a van that transports patients to and from medical appointments when the local on-demand, publicly funded bus is not running.

Breast Health — Recognizing the high proportion of local women with dense breast tissue, Johnson County Hospital invested in a 3D mammography upgrade through savings from the 340B program. Before this upgrade, one-third of women had to be referred to 3D imaging over an hour away, which can be a barrier for some and increase costs.

“For us, our focus is always on the patient

— we must stretch the dollars to serve the

community. Without the 340B benefit, a lot of

these vital services would not be possible.”

Olivia Little

340B Director at Johnson County Hospital

340B Hospitals Need Support

Since it was created in 1992, the 340B Drug Pricing Program has helped improve health care access for millions of Americans without using any taxpayer dollars — just as Congress intended. However, misguided policy proposals and continued unlawful restrictions by pharmaceutical manufacturers are threatening the future and accessibility of the 340B program.

For example, a growing number of drug companies are implementing restrictions on contract pharmacies and increasing administrative requirements, which make it harder for hospitals like Johnson County Hospital to participate in the 340B program. It also makes it more difficult for independent rural retail pharmacies to keep their doors open, which could force members of the local community to travel many miles to get the medicines they need.

From coast to coast, Americans need the federal government to protect the 340B Drug Pricing Program so that patients can maintain access to high-quality, affordable care. Leaders in Washington must act to protect the program for the patients and communities it was established to help.

The Nebraska Medicine Fred & Pamela Buffett Cancer Center – Kearney opened on Dec. 16, advancing cancer care in central Nebraska and beyond. The 54,000-square-foot, $52 million facility represents more than just a new building – it embodies a commitment to making advanced cancer treatment accessible to all Nebraskans.

Comprehensive cancer services under one roof

The new center offers integrated cancer care services, including:

Medical oncology and hematology

Radiation oncology

Infusion therapy

On-site laboratory and pharmacy

Genetic counseling

Survivorship programs

Nutrition classes

Community conference room

Healing arts garden

Resource center

Bringing care to patients

For William Lo, MD, PhD, a radiation oncologist who trained at Harvard Medical School and Washington University in St. Louis and joined Nebraska Medicine in June 2024, the new facility represents an opportunity to address a critical health care gap in rural America.

“We believe that we should be reaching out to the patients, and we should be bringing the care to them instead of the other way around,” Dr. Lo says. “This center will allow us to do that – to really bring the care to patients instead of them having to travel for hours and hours.”

The difference in patient outcomes can be dramatic when care is readily accessible. Dr. Lo recalls treating a patient in Omaha who needed urgent care for brain metastases. “Imagine a similar patient who could not get to Omaha. The patient could have died from not having access to the treatment. There is urgency to some of these treatments, and not having access to a cancer center near you – it’s very easy to predict what the outcome would be.”

Excellence in rural health care

Fred & Pamela Buffett Cancer Center – Kearney builds upon the expertise of Heartland Hematology and Oncology, led by Cynthia Lewis, MD, and Nick Hartl, MD, who have served the Kearney community for two decades.

With the opening of the new facility, patients have access to additional resources, including:

Multidisciplinary tumor boards.

A wider range of advanced cancer treatments.

Connection to Nebraska’s only National Cancer Institute-designated cancer center for possible clinical trial enrollment.

Dr. Lo emphasizes that patients in Kearney can receive the same level of care available in Omaha. Radiation oncology will be delivered with the same technology used at Fred & Pamela Buffett Cancer Center – Nebraska Medical Center, ensuring consistent treatment quality.

A vision for rural health care’s future

For Dr. Lo, choosing to practice in Kearney aligns with his passion for improving rural health care access. His decision to join Nebraska Medicine after completing his residency was influenced by the opportunity to make a difference in Central Nebraska.

“Everyone should be able to receive the same level of care, and if anything, we should be able to bring state-of-the-art care, clinical trials and the best technology to rural Nebraska,” Dr. Lo says.

Dr. Lo’s vision extends beyond traditional cancer care. He sees technology and innovation as pivotal in expanding access to rural communities.

With a PhD in engineering from the Harvard-MIT Health Sciences and Technology program, in Cambridge, Massachusetts, Dr. Lo envisions advancements in radiation therapy equipment that could increase its mobility, allowing cancer treatment technology to be transported across the state.

“Many years ago, you wouldn’t have imagined you could put a PET CT or PET MRI on a truck, but now that technology is available,” Dr. Lo says. “I always think something is impossible only because you haven’t tried it yet.”

Looking ahead

The center’s opening is just the beginning. Plans for future expansion are already in place, with space dedicated to additional radiation equipment and services. Dr. Lo sees the Kearney facility as a model for rural health care delivery across America.

“With the construction of this new cancer center, hopefully, we can set an example for the rest of America and even the rest of the world at some point,” Dr. Lo says. “We can tell people that there is a way to advance rural medicine by proactively setting up centers like this to bring cancer care to these patients.”

As the Fred & Pamela Buffett Cancer Center – Kearney serves its first patients, it sets the standard for the future of rural medicine. And for patients and families in Central Nebraska and beyond who are facing cancer, this means spending less time traveling and more time focusing on what matters most – getting better.

The use of medical marijuana dates to ancient civilizations, though historians are undecided about whether the first medical use of cannabis was in China, where the plant is indigenous. [1]

Archaeologists unearthed traces of cannabis with high levels of THC (the main psychoactive component of cannabis) in wooden bowls dating to 500 bce in the Jirzankal Cemetery in China, marking the earliest instance of marijuana use found to date. This particular use of marijuana was more likely for a religious rite than medicinal purposes, though religion and medicine were not necessarily kept separate. Such use was described by Greek historian Herodotus: “The Scythians then take the seed of this hemp and, crawling in under the mats, throw it on the red-hot stones, where it smolders and sends forth such fumes that no Greek vapor-bath could surpass it. The Scythians howl in their joy at the vapor-bath.” [2][3][4]

What do you think? Should Recreational Marijuana Be Legal? Explore the ProCon debate

The mythological Chinese Emperor Shennong’s pharmacopoeia, Treatise on Medicine (which itself has disputed dates–2737 bce or 1ce and unknown authorship), included marijuana as a treatment for “malaria, constipation, rheumatic pains, ‘absentmindedness’ and ‘female disorders.’” [5][6]

From China, marijuana was introduced to Iran and Anatolia by the Scythians and then spread to India, Greece, Egypt, and throughout Africa. Evidence suggests Arab physicians used marijuana for pain, inflammation, and epileptic seizures, while in India marijuana was used for fevers, sexually transmitted infections (STIs), headaches, sleep, dysentery, digestion, and appetite inducement. In Rome, Emperor Nero’s private physician, Dioscorides, used the plant to treat pain in ears. Marijuana was similarly used in Africa, as evidenced by the Egyptian Ebers papyrus (circa 1550 bce), for fever, pain, infected toenails, and uterine cramps. Other Egyptian papyruses include cannabis as treatment for eye infections (perhaps glaucoma), cholera, menstrual ailments, headaches, schistosomiasis, fever, and colorectal cancer. [1][4][7][8][9][10]

The Moors brought marijuana to Spain during the 8th-century occupation. The Spanish, in turn, took marijuana to the Americas where it was mainly used as a cash crop for producing hemp fiber. Medical use followed quickly, with Mexicans using the drug for gonorrhea, menstrual ailments, pain, and toothaches. [10][11][12][13]

Robert Burton’s The Anatomy of Melancholy (1621) heralded the arrival of marijuana in medieval Europe by suggesting that cannabis be used to treat depression. Thereafter marijuana was recommended for inflammation (New English Dispensatory, 1764) and coughs, STIs, and incontinence (Edinburgh New Dispensary, 1794). [1]

Medical use of marijuana did not gain much popularity in the United Kingdom until W.B. O’Shaughnessy, an Irish professor at the Medical College of Calcutta, India, tested the indigenous Cannabis indica on animals and children after seeing how Indians used marijuana in medicine. O’Shaughnessy reported in 1839 that cannabis was safe and used marijuana to treat rabies, cholera, delirium from alcohol withdrawal, pain, rheumatism, epilepsy, tetanus, and as a muscle relaxer. He deemed marijuana “an anticonvulsant remedy of the greatest value” and brought the drug with him when he returned to England in 1842. [1][7]

The Provincial Medical and Surgical Journal (now the British Medical Journal) put medical cannabis on the front page in 1843, prompting popularity and regular use of the drug as a painkiller, with even Queen Victoria reportedly being prescribed marijuana postpartum and for premenstrual syndrome (PMS) by her private physician J.R. Reynolds. A tincture of marijuana, frequently added to tea, was used commonly in Victorian England. The 1894 Indian Hemp Drugs Commission stated marijuana was not harmful if used in moderation and could be particularly helpful in treating malaria. [7][14]

In 1860, American doctor R.R. M’Meens, crediting W.B. O’Shaughnessy, extolled the virtues of marijuana to treat “tetanus, neuralgia, dysmenorrhea (painful menstruation), convulsions, the pain of rheumatism and childbirth, asthma, postpartum psychosis, gonorrhea, and chronic bronchitis” as well as the drug’s use for sleep-inducement and appetite stimulation. Other American doctors prescribed marijuana for restlessness, anxiety, “senile insomnia,” neuralgia, migraines, depression, gastric ulcers, morphine addiction, and asthma, and as a topical anesthetic. [1]

However, the arrival of marijuana wasn’t lauded by everyone. Mark Stewart, a member of the UK Parliament, complained in 1891 that “the lunatic asylums of India are filled with ganja smokers.” Along with negative associations with mental illness, marijuana was also attacked with racist political commentary. In the United States, the Federal Bureau of Narcotics (FBN) Commissioner Harry Anslinger claimed there were “100,000 total marijuana smokers in the U.S., and most are Negroes, Hispanics, Filipinos and entertainers. Their Satanic music, jazz and swing result from marijuana use. This marijuana causes white women to seek sexual relations with Negroes, entertainers and any others.” Additionally, the agency was concerned that “marihuana leads to pacifism and communist brainwashing.” [1][7][13][15] [16]

By the 1890s, marijuana was falling out of favor among doctors, and U.S. states were working to ban marijuana because of the drug’s association with Mexican immigrants. Massachusetts led the charge, passing a ban on the drug in 1911. [7][10]

The FBN, which would merge with other departments to form what is now the Drug Enforcement Administration (DEA), worked to pass the Marihuana Tax Act of 1937. While the law only taxed marijuana, it effectively banned the drug as well as industrial hemp. The Marihuana Tax Act survived until 1969 when it was declared unconstitutional. However, President Richard Nixon would reinstate the marijuana ban in 1970 with the Controlled Substances Act, which classified cannabis as a Schedule 1 drug (“drugs with no currently accepted medical use and a high potential for abuse”), beginning Nixon’s “War on Drugs” and effectively ending medical research on the drug. [7][10][16][37]

In the United Kingdom, the Misuse of Drugs Act was passed in 1971, declaring marijuana to have “no known or limited medical use.” The law now classifies marijuana as a Class B drug, which are considered less dangerous than Class A drugs including cocaine, ecstasy, and crystal meth. Class B drugs include amphetamines, barbiturates, and ketamine, along with marijuana. The possession of any Class B drug carries a penalty of up to 5 years in prison. [7][17] [18]

While the American federal war on drugs would continue, U.S. states began legalizing medical marijuana in the 1990s. California was the first to legalize cannabis for medical use in 1996, quickly followed by Alaska, Oregon, and Washington state in 1998, and Maine in 1999. By Dec. 2022, 37 states and DC had legalized medical marijuana, leaving only 13 states where medical marijuana is illegal: Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Nebraska, North Carolina, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. [19]

While states were legalizing medical marijuana, some of the earliest adopting states also began legalizing recreational, or adult-use, marijuana. Colorado and Washington legalized this in 2012—19 other states and D.C. had done so by December 2022. Only states with legal medical marijuana have thus far legalized adult-use marijuana. [20]

An Apr. 2021 Pew Research Center poll found that 91 percent of Americans believed marijuana should be legal for medical use (60 percent for medical and recreational legalization; and 31 percent for only medical legalization). Only 8 percent believed marijuana should not be legal for any reason, and 1 percent did not answer the question. Support for marijuana legalization has steadily increased over the years. [21]

OMAHA, Neb. (WOWT) – Access to affordable healthcare continues to impact communities across the country.

For people insured through Medicare, changes might be coming your way. One doctor is speaking out against proposed cuts.

Dr. Bruce Scott, president of the American Medical Association, said if you’re having trouble getting into your doctor’s office recently, you’re probably not alone.

“Practices like mine are struggling to even survive,” Scott said.

Scott said Medicare insurance reimbursements have been cut 29% since 2001.

“Can you even imagine getting paid 30% less to provide the same care today or do the same job today that you were getting paid 20 plus years ago,” Scott said.

The impact is widespread: both rural and urban patients are feeling the cuts. According to the Centers for Medicare & Medicaid Services, monthly premiums are going up $3.00 in Nebraska in the new year.

Earlier this year, Great Plains Regional Health announced they are discontinuing Medicare Advantage Plans. The group is a leading provider in rural parts of Nebraska.

Scott said many other rural Americans will also have to travel further now to see a provider who will accept their payments.

“It takes eight to 10 years to train a new doctor and yet, for some physicians, another year of cuts may be the last year they can survive,” Scott said.

The American Medical Association is calling on congress now. Congressman Don Bacon is among those who agree that the cuts should stop.

“You have to put food on the table and to ask doctors to do healthcare and nurses in the hospital, the whole ecosystem, and you do it under what it costs, it doesn’t work,” Bacon said.

Scott said he hopes a decision about the cuts can be made in the new year.

“I think that spending money to secure the care for our senior citizens who have paid into Medicare their entire life anticipating that it would be there for them when they needed care in the future, is worth the expenditure,” Scott said.

As the new head of the Department of Government Efficiency, Elon Musk is calling for two trillion dollars in cuts, which could include slashing the federal workforce.

Oklahoma Representative Stephanie Bice said there’s a different pool they could pull from to get that number.

“Medicare, Medicaid, is where we should be looking at trying to find efficiencies,” Bice said.

In an interview on NBC’s Meet the Press, President-Elect Donald Trump said he would not touch Medicare.

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