A new fight over health price transparency is playing out in an unusual copyright lawsuit over a hospital billing manual.

Why it matters: Hospitals have been required since 2021 to post prices for items and services in a consumer-friendly way, but patient advocates say the system is still opaque.

State of play: The fight surrounds efforts by the nonprofit PatientRightsAdvocate.org to make the contents of a widely used industry billing manual public, in the belief it's essential for patients and employers to understand what they're being charged.

• The American Hospital Association, which sells the manual and holds a copyright on it, is suing in the U.S. District Court for the Northern District of Illinois, arguing that it amounts to copyright infringement.

The manual contains standardized billing codes and instructions that hospitals and insurers use to process payments and essentially serves as the backbone of the modern billing system.

• The AHA has a copyright on the manual and leads a committee of health care stakeholders — including government payers — that updates it annually.
• The licensing agreement prohibits users from disseminating its content.

Before AHA began to standardize billing practices in the 1970s, each payer used its own codes and forms, which led to delayed payments, duplicative medical work and inefficiencies, per the hospital group's lawsuit.

• The federal government and many states have embraced the standardized system and require providers to use the instructions for medical billing.

Zoom in: Patient Rights Advocate argues that since government administrators are on the committee that updates the manual and it's part of federal and state electronic billing regulations, it can't be copyrighted.

• The advocacy group has asked the court to dismiss AHA's lawsuit.

The big picture: Health price transparency is becoming more important to consumers with the rise of high-deductible plans that require them to pay more out of pocket, said David Glaser, a lawyer at Fredrikson.

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Gas prices over $4 a gallon haven't dislodged health care as a top economic concern of voters, even among adults with health insurance, a new KFF tracking poll finds.

The big picture: Affordability of care is shaping up to be a big liability for Republicans heading into the midterms, with two-thirds (67%) saying they disapprove of President Trump's handling of health costs.

What they found: Nearly two-thirds of the public (64%) is at least somewhat worried about covering health expenses, including insurance and out-of-pocket costs for office visits and drugs.

• About the same share now worry about gas and transportation costs, which ranked at the bottom of household financial worries before the war with Iran.

Between the lines: Asked about possible changes to their health insurance, about half of respondents said "paying less out-of-pocket for health care" (46%) is most important, more than twice the share who said "eliminating prior authorization" (22%), which previously was the top friction point.

• On specific parts of Trump's health agenda, about 4 in 10 voters (41%) approved of the administration's handling of prescription drug costs.
• A similar share (42%) approve of the administration's increased efforts to crack down on health care fraud while 58% say they disapprove.

Majorities of voters said health care costs will have a "major impact" on their decision to vote (55%) and which party's candidate they support (61%).

Nebraska will be in the spotlight tomorrow as it becomes the first state to roll out Medicaid work requirements stemming from last year's GOP tax-and-spending law.

Why it matters: The May 1 effective date is more than a half year before the law's January 1 deadline, stoking concerns about the readiness of the state's verification systems and whether some people could lose coverage faster.

Driving the news: The state says it will first match about 70,000 enrollees affected by the rules with other data it has to see if participants are working or exempt, AP reported.

• Between 20,000 and 28,000 are expected to have to provide more information, plus an average of 3,000 to 4,000 new enrollees each month.
• Initially, they'll need to demonstrate they met the requirements in just one month of the previous 12, per AP. The time frame will shift to six months in 2027.

The new law requires states to condition Medicaid eligibility for able-bodied adults on working, volunteering or doing other qualifying activities for at least 80 hours per month.

• States will have to verify recipients' eligibility monthly and do redeterminations at least twice a year.

What we're watching: The technical requirements and compressed time frame for rolling out the rules could leave some states scrambling or applying for extensions.

"Getting CVS out of the monopoly business is good for patients, independent pharmacies and innovation! God bless Tennessee!!!"

🏛️ The Trump administration appealed a federal judge's ruling that blocked the planned overhaul of the federal childhood vaccine schedule. (NBC News)

🍼 Health Secretary Robert F. Kennedy Jr.'s search for heavy metals in baby formula came up mostly empty after large-scale testing by the FDA. (Bloomberg)

🥼 Mayo Clinic researchers say they developed an AI tool that can spot pancreatic cancer years before it's typically diagnosed. (KMSP)

🧠 An FDA-approved headset that delivers a shock is expanding psychiatry's tool kit beyond conventional depression treatments. (NYT)