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When he was diagnosed with two autoimmune diseases, Joel Hechler knew he’d be in for a battle. He didn’t realize maybe his toughest one would be with his insurance company.“I think they put the dollars ahead of a patient’s health,” Hechler said. “I don’t think they fully understand the impact the medicine will have on my long-term health and well-being."Hechler suffers from Crohn’s disease and ulcerative colitis, diseases that attack the lining of his digestive tract. Autoimmune conditions like his can’t be cured but, with the right medication, the symptoms can be controlled.  Finding the right medicine can be hard for those suffering from autoimmune diseases. Even if there are scores of drugs on the market, some patients might only respond to one. In Joel’s case, his doctor thought he’d have a better chance trying a drug called Remicade.“I received a letter from my insurance company that denied the Remicade on the basis that I have to try a different drug before I can get to Remicade," Hechler said.Hechler's insurance company, Premera Blue Cross, wouldn’t approve the drug his doctor prescribed because they wanted him to try a cheaper one first.It’s part of a program that health insurers nationwide use called step therapy, requiring that patients try less-costly drugs before “stepping up” to more expensive ones — even if doctors believes the cheaper drug won’t work.Dr. Larry Adler is president of Huron Gastro in Ypsilanti, Michigan and says he spends virtually every day battling insurance companies over step therapy drugs.“They have to fail this medicine first before they get the new drug,” Adler said. “That doesn’t make any sense.”Adler says it's common for patients to get sicker while waiting for step therapy to run its course.In Hechler's case, it took six weeks of fighting with his insurer to convince them that the cheaper drug wouldn’t be effective. As he was waiting, he was getting worse.“It got to the point where I had to be admitted to the hospital,” Hechler said. "I was very, very sick.”Step therapies are used by insurers to try to control skyrocketing prescription medicine costs, says Glen Perry, Director of Pharmacy Contracting and Sales for Blue Cross Blue Shield of Michigan.“These drugs can cost up to 0,000 per year. These are not cheap medications,” Perry said.“It seems like you’re telling patients that, in many cases, your insurer knows what’s best for you, rather than your doctor,” Jones said.“We are trying to provide the most cost effective and safe medication use,” Perry said, adding that when a doctor and insurer disagree over a drug, they can usually resolve the case within a few days without putting a patient at serious risk.“A delay of one or two days I don’t think is really going to make that much of a difference for the medical outcome of the patient," he said.But for many patients, like Phyllis Toole, the delay is longer than a few days.Phyllis suffers from rheumatoid arthritis, a condition where her body attacks her joints. When her doctor wanted to put her on Orencia, her insurance company HAP said she needed to first try a less expensive drug, Humira.But Phyllis’ doctor was worried about possible side effects and thought Humira could be risky.After battling for months, Phyllis says the whole thing made her feel more like a number than a patient. With her doctor and insurer in a standoff, she was forced to rely on samples of the drug she got from her doctor. HAP never approved her prescription.“They’re playing doctor, is what it feels like,” Toole said. “They’re saying this is what you can have for the symptoms you have. It may make you sicker, but this is what you can have.”HAP issued the following statement to Scripps station WXYZ in Detroit: 3800

WEST PALM BEACH, Fla. -- Two specially modified shotguns and ammunition were stolen from Palm Beach Zoo in the hours between late Wednesday and early Thursday.Head of Communications & Public Relations for Palm Beach Zoo, Naki Carter, says someone broke into the zoo and pried open a gun safe that stored the weapons.The shotguns were used by the zoo's "critical response team" in cases of emergency.The zoo is offering a ,000 reward for the return of the weapons.When asked if this was thought to be an "inside job", Carter had no comment.If the perpetrator(s) is caught with the weapons, which require a federal permit, they could face 10 years in prison and a fine.Carter says Palm Beach Zoo has increased security measures since the theft, but will not go into detail as to what those measures entail. 828

With California hospitals dealing with an extreme number of patients, nurses are terrified of what’s next.It comes as California hits 2 million infections just 44 days after reaching 1 million. Hospitals in California have been pushed to the brink, and it’s expected to get worse as people travel and gather for Christmas and New Year’s.The state is urgently searching for 3,000 temporary medical workers to meet the demand, focusing on nurses trained in critical care. Hospitals are also confronting the shortage by trying to free up staff any way they can, including postponing certain medical procedures.The state has also temporarily loosened some restrictions. Typically, California requires one nurse for every two ICU patients. Regulators have temporarily relaxed that requirement to one nurse for every three ICU patients.The state has sent more than 600 temporary healthcare workers to hard-hit counties from the National Guard, the California Health Corps, and other partnerships, but officials are still looking for more.State officials have even started reaching out to other countries like Australia and Taiwan to get much-needed medical workers.Elected leaders and health officials across the U.S. are asking people to stay home for the holidays while also trying to show the public that the COVID-19 vaccines trickling out to health care workers and nursing home residents are safe.The Associated Press contributed to this report. 1453

While there are still questions about whether trick-or-treating will happen in 2020 and how neighborhoods will make it possible, there is no question Americans like their Halloween candy.Sales of Halloween candy and chocolate at grocery stores are up 17 percent over 2019 so far this season, according to the National Confectioners Association. Total sales, including online purchases, is up 13 percent year-over-year.The National Confectioners Association, NCA, represents manufacturers and suppliers of sweet treats, gum, mints and chocolates.Their research showed chocolate is driving the increase. Halloween chocolate sales are up 25 percent over 2019 so far. The NCA released data over the summer showing chocolate was the treat of choice of Americans during the pandemic, with sales increasing five percent March through August over the same time period in 2019. Sales of premium chocolate during that time was up 12 percent year-over-year. Ferrara Candy, which makes Sweetarts, Nerds, Brach’s Candy Corn, Gobstoppers and more, said Halloween sales bring in about .5 billion in sales. In an interview with Axios, CEO Todd Siwak said their company learned a lot from the drop in sales for Easter. This was also the time many stores were closing because of lockdowns to stop the spread of the coronavirus. Even as shopping has picked up a little, they have made some changes.“As the frequency in-store is reduced by the shopper, so fewer trips but bigger baskets, we wanted to make sure we were there presenting the opportunity to consumers,” Siwak said. He added Ferrara Candy created more individually-wrapped confections and got product to stores earlier to extend the selling season.There are still about three weeks until Halloween, and the industry expects sales to increase. Siwak says about 60 percent of the sales for Halloween candy happen in the last few weeks before the holiday.The NCA data also suggested Americans are getting more excited for Halloween in 2020. They found 80 percent believe they will find creative and safe ways to celebrate this year. The response was just 63 percent in July. 2125

When legendary singer Aretha Franklin died, she did not have a will or trust. Her four sons have filed a document listing themselves as interested parties, reports say.Franklin died last week from advanced pancreatic cancer. She was 76.In addition to her sons' filing, Franklin's niece has asked the court to appoint her as a personal representative of the estate, the Detroit Free Press reported. It said under Michigan law, if an unmarried person dies without a will, his or her assets are divided equally among any children.Franklin's lawyer has represented her in entertainment matters for nearly three decades, and told the paper that he constantly asked her to do a trust, but she never got around to it."I was after her for a number of years to do a trust," Los Angeles attorney Don Wilson told the paper. "It would have expedited things and kept them out of probate and kept things private."Wilson is Franklin's attorney in copyright matters, song publishing and record deals, and will be consulted on estate planning purposes. He said while he doesn't have a dollar figure on the value of her assets, the lack of a will means the finances will become public in Oakland County Probate Court."I just hope (Franklin's estate) doesn't end up getting so hotly contested," Wilson said. "Any time they don't leave a trust or will, there always ends up being a fight."CNN has reached out to Wilson for more details.Franklin's funeral will be held on August 31 in Detroit, with the service for family and friends planned for 10 a.m. ET the same day.Public viewings will be held August 28 and 29 from 9 a.m. to 9 p.m. at the Charles H. Wright Museum of African American History in Detroit.Franklin will be entombed at Woodlawn Cemetery in Detroit.The-CNN-Wire 1767