Berwick served for a year-and-a-half as administrator of the Centers for Medicare and Medicaid Services under Obama, and since January has been meeting with voters and donors as he explored a potential campaign.

So far, Berwick has already raised roughly $223,220 toward a gubernatorial bid, including $100,000 of his own money put toward the campaign, and spent more than $47,827 as he has hired staff and begun to put together a team.

“We lead the nation — with hard work and a continued commitment to making our state better and taking care of the most vulnerable among us, we can ensure that tradition of leadership continues. As a doctor, an educator, an innovator and someone who has dedicated his professional career to making things work better and to helping people — I am ready to lead,” Berwick said in a statement released Monday afternoon.

Berwick said a formal campaign kickoff event and “traditional campaigning” will come later after Democrats “do everything they can to elect my friend Ed Markey to the United State Senate.”

Other Democrats mulling potential campaigns include state Treasurer Steven Grossman and Congressman Michael Capuano. Former Wellesley Selectman and health care executive Joseph Avellone has already announced his campaign for governor, and Evan Falchuk, an attorney who works for Best Doctors, is running as an independent.

Berwick’s evolving campaign resembles in one respect that of Elizabeth Warren in that both arrived on the scene in state politics by capitalizing on profiles they had built while working in Washington, D.C.

• Earlier: Berwick Says Government Can Be ‘Productive Force’

The decision by Harvard Pilgrim Health Care that takes effect Aug. 7 comes months after a deadly nationwide meningitis outbreak was traced to a Massachusetts compounding pharmacy.

Dr. Michael Sherman, the chief medical officer at Harvard Pilgrim, said the policy, which will apply to only adults, stems from a safety review after the meningitis outbreak traced to tainted steroids produced at New England Compounding Center in Framingham. Fifty-eight people died and hundreds were sickened.

Harvard Pilgrim will consider appeals on a case-by-case basis.

Harvard Pilgrim said 4,200 of its members over age 18 have filled a prescription for a compounded medication in the last six months.

The insurer’s review found that most of the claims it received from patients for compounded drugs were for medications that should not be covered by a health insurer, including cosmetic, anti-aging, weight loss and homeopathic remedies, Sherman told The Boston Globe.

“This is not about denying care,” he said. “It’s about eliminating costs that don’t add value.”

Harvard Pilgrim will continue to cover compounded drugs for those under age 18 because the company’s review found appropriate use of the drugs in children.

Compounded drugs are mixed for individual patients who need formulations or doses not widely available off the shelf.

Brian Rosman, research director at Health Care for All, a Boston patient advocacy organization, said he understands the concerns but believes Harvard Pilgrim’s approach is unwarranted.

“For those who need these drugs, to make them go through extra hoops seems to be unfair and makes no sense because it’s coverage they have paid for,” Rosman said.

Two Massachusetts pharmacist groups are urging Harvard Pilgrim to reconsider the policy, saying in a letter that a compounded medication is sometimes the only drug available for patients because of drug shortages.

Blue Cross Blue Shield of Massachusetts and Tufts Health Plan, the state’s largest and third largest health insurers, plan to continue covering compounded medications.

For more on Cellucci’s efforts and the latest on where ALS research stands, WBUR’s All Things Considered host Sacha Pfeiffer spoke with Cellucci’s neurologist, Dr. Robert Brown of UMass Memorial Medical Center, who also leads the medical school’s ALS research.

Sacha Pfeiffer: First, I’m sure it’s difficult when you lose any patient, but you clearly had a special connection with Cellucci given all of his work to support your research.

Robert Brown: That’s exactly right. It’s a sad loss, of course, for his family and for all of us who’ve come to know and admire Gov. Cellucci. But, of course, it’s also yet one more form of motivation to try to find an answer to this terrible disease.

For many people who looked in from the outside, it was very inspiring to see how Cellucci dedicated himself to raising money for ALS research even while he was battling the disease himself and, of course, ultimately lost that battle. How would you characterize what Cellucci did for this field, this research field?

I think what he did was very courageous. It was also very important, both in terms of raising awareness of the disease and in terms of the fundraising for the research itself. It was typical of him not to walk away from this, but in fact to tackle it head-on and turn what is a terrible and tragic diagnosis into a very positive path of action.

What kind of work did he do for you and for the field?

I think the main thing was to increase public awareness and then to put in place an effort to raise dollars for the research program, which will continue after his passing.

As a little primer in this disease, ALS stands for amyotrophic lateral sclerosis. Remind us what it is and what it does to the body.

This is a disease in which motor nerves in the brain and spinal cord degenerate over about a four- to five-year period, leading to complete paralysis. It starts insidiously — focal weakness somewhere — and then it spreads and ultimately weakens the diaphragm, which leads to death, usually by breathing failure.

And what makes this even more tragic is that this all happens while the mind stays sharp, typically?

Typically that’s the case, absolutely.

Where do things stand in terms of research and any hope of some day finding a cure or better treatments for this disease?

I think most of us who are deeply involved in the research are very upbeat about where the field is going. We now know of 30 different genes whose mutations can cause this disease, and each one provides a set of targets for therapy.

Am I correct that there are also more random causes of the disease, rather than inherited ones, and the causes haven’t been pinpointed?

You’re absolutely correct. Probably 90 percent of the time the cause is not thought to be a single gene defect. We don’t know what that cause or those causes are. It could be many genes acting in concert. It could be environmental poisons. We don’t know. And, of course, that defines a huge area for further research going forward.

Cellucci was diagnosed with this disease five years ago, and then after going public in early 2011 he made it clear he was going to devote himself to raising money for your research efforts. How much, ultimately, was he able to raise by the time he died?

He has created an endowment at UMass, which is just over $2 million and growing.

The goal, I believe, was $10 million. Has there been any disappointment in the amount raised so far?

Well, you know, these things are open-ended. And obviously one sets up provisional targets and tries to do the best one can.

Is there any hope that, with his death, one positive of that may be that it brings even renewed attention and reminds people that this is a battle we are far from winning and could bring more money in?

I think there’s no doubt that he himself and almost certainly his family, as well, would want that to be one outcome — which is to say that from this very, very sad ending there emerges a renewed effort to solve the problem once and for all.

Are there any particular challenges, would you say, to raising money for ALS?

One challenge has been that it is deemed an orphan disease, which is to say the number of people afflicted with it each year in aggregate is relatively small compared to, say, hypertension or diabetes. On the other hand, if you look at the number of people now alive in this country who will die of ALS, at least based on present projections, it’s hundreds of thousands. So I would submit that to call this an orphan disease is an actual definition that doesn’t really do justice to the full toll the disease takes.

Based on the time you spent with Cellucci, how would you describe his state of mind about his disease, particularly as it worsened?

I think he had, to an astonishing degree, always a very upbeat frame of mind, both in terms of addressing the reality — he was not delusional about it all — but in terms of saying, “Let’s do our best to turn this into a very positive situation and achieve something that’s lasting.” In a sense, to be slightly cliched about it, let’s make this another victory, not a loss.

The Berkshire Eagle reports that spraying could begin in some towns this month.

Chris Horton of the Berkshire County Mosquito Control Project says surveillance and treatment have increased so mosquito larvae can be killed in the Berkshires before they hatch. He says officials acted after last year’s positive testing of West Nile virus and the more severe mosquito-transmitted disease Eastern Equine Encephalitis,

Horton said his three-person team may treat 120 surveillance spots in Pittsfield.

Horton says public health concerns in the Berkshires followed 29 insects testing positive for the West Nile virus in 2012 and two others testing positive for Eastern Equine Encephalitis.

The Banfield Pet Hospital report found Bay State dogs live an average of 10.6 years. The lifespans are shorter in only four other states: Delaware (10.5), Louisiana (10.4), Alabama (10.2) and Mississippi (10.1).

Dr. Sandi Lefebvre, a veterinary research associate at Banfield, says the finding is a bit of a mystery, particularly since the lifespan for Massachusetts cats — 12.7 years — is on the high end.

Spaying and neutering provides some protection against disease and may serve as a marker for how well pet owners are taking care of their pets. But with 77 percent of dogs spayed or neutered, Massachusetts is above the nationwide average of 73 percent.

A high prevalence of heartworm infection helps to explain shorter lifespans in much of the South. But that’s not a serious problem in the Bay State.

“I had a look at all the other diseases that we evaluated, for arthritis and diabetes and heart disease, and Massachusetts was actually pretty decent,” Lefebvre says.

The short lifespan for dogs, she concludes, “can’t really be explained easily.”

One place where the state stood out: Canine obesity is a bigger problem here than nationwide.

Too many bacon strips under the breakfast table, perhaps.

Lefebvre says large sample sizes nationally — and in Massachusetts in particular — mean statistical error is probably not behind the surprisingly poor lifespan figure for Bay State dogs.

The Banfield study is based on euthanasia records.

A law approved by voters last November allows patients with medical conditions including cancer, HIV and Parkinson’s Disease to seek permission from their doctors to use marijuana. The law authorizes up to 35 dispensaries around the state that could begin to open late this year or early next.

“The program will be self-sustaining through fees on registered marijuana dispensaries and patients,” said Cheryl Bartlett, acting commissioner of the state Department of Public Health, in a statement announcing the proposed fees.

The medical marijuana law is designed to be revenue neutral, meaning that the fees collected should be enough to offset the state’s administrative costs in regulating the program.

Applicants for dispensaries would pay a $1,500 fee when they initially apply for a license, followed by a $30,000 fee if they reach the later phase of the licensing process. Both fees would be non-refundable.

Once a dispensary is licensed, it would be required to pay an annual $50,000 fee for a certificate of registration and renewal, along with $500 yearly registration fee for each of its agents.

Individuals who are qualified for medical marijuana would pay the $50 annual fee to remain in the program. Patients who are granted permission to cultivate marijuana at home because they are unable to get to a dispensary would be charged an additional $100 fee.

Patients can seek a waiver from the fees if they prove a financial hardship. There would be no fees charged to personal caregivers.

“The proposed patient registration fees are in line with other states and will be affordable,” Bartlett said.

The state is not setting the price patients would have to pay for the marijuana itself, with the dispensaries being given discretion to set those prices.

A public hearing on the fee structure was scheduled for June 14.

Earlier this month, the state Public Health Council gave final approval to a wide range of other regulations covering medical marijuana.

The rules allow patients to receive a 60-day supply of 10 ounces of marijuana, though doctors could recommend that some acutely ill patients receive more.

The regulations require proof of a bona fide doctor-patient relationship before a doctor can recommend marijuana, and also require that dispensaries ensure the safety of the drug by testing for pesticides, mold and mildew.

• Related: Despite Lack Of Dispensaries, One Doctor Already Recommending Medical Marijuana

While medical marijuana remains illegal under federal law, the drug has been legal under state law since January, after voters approved it in a ballot measure last November.

But even before formal regulations were in place, and without any registered dispensaries in the state, one doctor from Northampton had begun writing marijuana recommendations for her patients.

Dr. Jill Griffin says she was not immediately sold on marijuana’s medicinal use, seeing it as an excuse for people to legally get high. After the law passed, she says patients started asking her about the drug. At first she disregarded those questions. But then she says she decided to take a chance by writing one recommendation for an elderly cancer patient.

“She was able to eat and get up and go out and go shopping,” Griffin said. “And prior to that, she had really been housebound.”

After that initial success, Griffin says she did more research, and decided to open her small office exclusively for medical marijuana. For $200, she meets with patients, examines their medical records, and decides if they’re eligible. The law states that a patient must have a “debilitating medical condition,” such as cancer, Parkinson’s disease or HIV. But under new regulations that go into effect Friday, a doctor can determine “other” debilitating conditions that could respond to the drug. Griffin says that’s where most of her patients fall.

“Most common is chronic pain, and amongst the chronic pain is low back pain,” she said.

Part of the reason she’s chosen to open her office, she says, is the hesitance of many primary care doctors to recommend marijuana to patients. And though Griffin says many of her patients are new to her, she maintains the required relationship with them through follow-up calls and visits.

Alan Berkenwald, a physician at Cooley Dickinson Hospital, says he was initially open to the idea of medical pot, but now he’s skeptical due to the lack of scientific research.

“My fear is that our rush to embrace medical marijuana now, well in advance of thought-out studies, is an example of that phenomenon where we’re embracing a cultural belief and trying to squeeze it into a medical application well before the data supports it,” he said.

Berkenwald says he’s particularly concerned about the open-ended ability of doctors to decide what conditions qualify. But Griffin says she is careful to sift out patients who may be trying to get a recommendation just to get high.

“There are certain qualities and characteristics of those diseases that a patient should be able to explain to you, and if that’s not there, they can’t qualify,” Griffin said.

She says she’s turned away several patients but approves over 90 percent who come to her office. And she has prescribed the drug to patients with conditions that some may find dubious. Tim, one of Griffin’s patients who declined to give his last name, was given a prescription for attention deficit disorder and insomnia. He says he’s now concerned about access to the drug he’s been prescribed.

“You can’t get it if you don’t have the avenue to get it, and plus there’s so many places that are not doing the right thing,” he said. “So they may be adding certain chemicals or pesticides, which you definitely don’t want.”

Tim won’t say how he currently gets marijuana. Up to 35 marijuana dispensaries can open in the state, but none will likely open until the end of the year. Griffin says she’s worried about the current legal gray area for her patients.

“What I tell my patients is, you could go into a known area where people purchase marijuana, and you can legally buy the marijuana if you take your letter with you, and you can buy it, but the person selling it to you can be arrested,” Griffin said.

Once a patient does get their hands on the drug they’re allowed to have up to 10 ounces every 60 days. Berkenwald says that’s far too much for one person, and could result in patients selling off their excess pot — a practice known as diversion.

“History has shown this happens,” he said. “You don’t control the prescriptive narcotics, they get diverted. Why would we not think that this would happen to marijuana, which has a high street value?”

Berkenwald says he hopes to see stronger regulations, limiting its use to patients with serious and terminal conditions. Griffin says for now she’s trying to stay cautious in her practice. She hopes to see more clarification in the law and qualifying conditions, particularly because marijuana is still illegal according to the federal government.

“I don’t want to put my license at risk,” she said. “I want to have a great practice with wonderful people, and I do have wonderful patients, but that’s a little bit scary.”

Plenty of questions remain about how medical marijuana will be used and enforced in the state, but unless lawmakers make future changes to the law, the current regulations are here to stay.

The sides were stuck on staffing levels, with nurses demanding more of them be on duty at a time, which they said ensures patient safety and care.

“The three-year contract provides for significant improvements in staffing levels on all floors with limits on nurses’ patient assignments we sought to ensure safe patient care,” said Margaret McLoughlin, chairwoman of the local bargaining unit of the Massachusetts Nurses Association.

The contract, which still must be ratified by union membership, sets an average patient-to-nurse ratio of 5-to-1, she told The Telegram & Gazette of Worcester. A ratification vote will be scheduled within a few days.

University Campus nurses received the same pension deal as Memorial Campus nurses, and got raises of 1 percent per year.

“Together with the MNA, we have reached an agreement that meets the objectives of the Medical Center and is also in the best interests of our nurses, and most importantly, the patients and the families in the communities we serve,” Dr. Eric Dickson, president and chief executive officer of UMass Memorial Health Care, said in a statement.

The agreement came after 18 months of negotiations.

The nurses’ union thanked U.S. Rep. James McGovern, who had urged the sides to get back to the bargaining table.

The hospital had said it was prepared for a strike and had hired temporary nurses.

Union officials representing 1,100 nurses spent four hours negotiating Monday, and no negotiation sessions are planned before a strike scheduled to start at 6 a.m. Thursday.

“We are disappointed by management’s refusal to negotiate a settlement to this contract, yet we are committed to standing up for patients and our union rights,” said Margaret McLaughlin, a nurse and co-chairwoman of the University Campus bargaining unit.

Hospital management expressed disappointment but say the hospital has spent $4 million to hire temporary nurses.

Nurses who work at the Memorial and Hahnemann campuses reached a contract agreement last week and are not planning to strike.

UMass Memorial Health Care President and CEO Eric Dickson said in a statement that the University Campus bargaining unit came in with a proposal that “far exceeded the agreed-upon terms” of the Memorial-Hahnemann package accepted Friday.

“As the Medical Center has repeatedly informed the MNA, it has already incurred significant costs to prepare for the threatened strike,” Dickson said.

The Telegram & Gazette reported that the union and hospital management are at an impasse over staffing levels, especially at night. Nurses want the hospital to set a patient-to-nurse ratio of 5-to-1. The Massachusetts Nurses Association says it’s now 7-to-1.

Nurses and administrators also disagree on pensions, vacation time and other issues.

UMass Memorial says University Campus will be “fully operational” during the strike.

But one FDA-approved study upcoming from a Cambridge firm is attracting a lot of attention because it marks a major milestone in spinal cord injury research.

‘Scaffold’ Study

Four floors up at One Kendall Square here in Cambridge, in the labs and machine-shop-like rooms of InVivo Therapeutics Corp., CEO Frank Reynolds hopes to shake up the world of spinal cord injury research.

“This is our chemistry lab,” he said while giving me a tour. “So all of our chemical engineering is done here. Our hydrogels and scaffolds are all made right in here. So we invent, discover and make right here.”

One of the products InVivo makes is a tiny, sponge-like device called a “scaffold.” The company has received FDA approval for a safety study of the scaffold. The study will be small scale — just five patients. But it’s a big deal for another reason. It will be the first time a device to treat spinal cord injury will be studied in humans.

The study subjects will undergo surgery to have the scaffold inserted directly into their spinal cords. The biodegradable scaffold is meant to do its work in six weeks and then dissolve.

“If you visually picture a cigarette filter, you know, cigarette filters are very light,” Reynolds explained. “They’re a little airy. It’s shaped like that, because the spinal cord is round. It’s a cylinder.”

More on the scaffold in a minute. But first, a look at the deep — and sometimes mixed — emotions surrounding the research.

‘Incremental Improvements’ Sought

Dr. Eric Woodard, InVivo’s chief medical officer, will perform the delicate spinal cord surgeries on the study subjects.

“There’s excitement, but at the same time an equal amount of caution,” Woodard said. “We want to do this right. There’s a tremendous amount of concern for safety. If you’ve lost so much function, obviously there’s an enormous importance attached to maintaining what you’ve got left and not creating more of a problem due to the treatment itself.”

Woodard, who is also the chief of neurosurgery at New England Baptist Hospital in Boston, is very careful to not raise the hopes of people with complete spinal cord injury — which means they have a total absence of function below the level of the wound. For example, Woodard does not talk of people walking again. And he does not utter the word “cure.”

“‘Cure’ is certainly not a scientific term; it’s an emotional term,” he said. “And the enormous complexity of spinal cord injury really requires that any use of the word ‘cure’ has to be used in a very careful manner. We’re looking to make small, incremental improvements.”

Incremental improvements like restoring someone’s grip, or tricep function, so the person can support himself or herself on their elbows and transfer in and out of a wheelchair.

“Even very small improvements in neurologic function can be very, very significant to people’s lives,” Woodard said.

The study will involve patients who’ve been paralyzed for just a matter of days, or a couple of weeks.

Woodard will implant the scaffold directly into the wound in the spinal cord, the goal being to stop the injury in its tracks and stabilize the area. Without treatment, the spinal tissue gets progressively more inflamed for about three weeks after injury, causing further damage.

“The whole idea is to get in there and provide something for the cells that haven’t scarred yet, that haven’t received that signal yet, and give those cells something to cling onto,” Reynolds said. “And then by giving that tissue something to grab onto, it can survive and thrive.”

And that might mean maintaining, or regaining, function.

InVivo’s History, And The First Human Tests

Reynolds’ motivation stems from personal experience. He was paralyzed for eight days in 1992 as a result of accidental nerve damage during spinal surgery.

“I ended up living in my parents’ living room in a medical bed for about five months,” he said, “and went through the typical, you could say, horror that people go through.”

He says it took six years of extensive physical therapy and living in a body brace for him to recover.

Several years later, he happened to meet MIT chemical engineer Bob Langer, who had decades earlier developed a polymer material as a support in tissue engineering. Researchers had studied the use of that material in rodent spinal cords. Further collaboration led to the founding of InVivo Therapeutics, which has refined the technology.

The company’s scientists have seen widespread success with the spinal cord scaffold in monkeys paralyzed in the lab, and they hope that will translate to humans.

“In my opinion, it’s like Neil Armstrong’s first step on the Moon for neuroscience, you know?” Reynolds said. “We’re getting in there, we’re getting our first swing.”

Dr. Woodard points out that lab monkeys don’t have the same kind of contusion in their spinal cords as the human study subjects, who will have suffered from things like crashes and shootings. That’s because of humane considerations for the animals and the need to create an injury that can be replicated.

But if researchers are successful in their early studies of the device, their goal is to one day implant the scaffold carrying medications and stem cells — possibly sparking regeneration in the spinal cords of people who’ve been paralyzed for some time.

Watching, But Not ‘Waiting For A Cure’

People like David Estrada, of West Roxbury.

“Will I ever run again or regain what’s, you know, ‘normal function’? I don’t know,” he said.

Estrada says either way, he’ll be fine. He’s adjusted to life as a paraplegic in the 18 years since the motorcycle accident that paralyzed him.

But three days a week, he comes to Spaulding Rehabilitation Hospital here in Cambridge, straps himself into a rowing machine, and sticks electrodes to his legs to get them powering the machine.

“And so I’m literally pressing a button to contract my quadriceps to row out and pull on the rowing handle,” Estrada explained, “and then I release the button to come back in, and it contracts my hamstrings.”

Estrada says he does the exercise to improve his circulation and help prevent bone fractures. But it’s also to build muscle and bone strength in his previously atrophied legs because of the possibility he might one day benefit from new spinal cord therapies — like the ones InVivo is developing.

“If it happens, it’s great,” he said. “If it doesn’t happen, I’m not going to be completely depressed.”

Estrada says he has a good quality of life. But he will be following InVivo’s studies closely.

“It’s great that the research is there,” he said. “I am very proactive and advocate for a cure. But myself personally, and this is what I tell other patients is, live day to day. You can’t rest your laurels on just sitting around and waiting for a cure.”

InVivo is working to identify hospitals in Boston and central Pennsylvania that will conduct the research with them. They’re also setting up a system to identify new spinal cord injury patients to enroll in this first-of-its kind study.