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POLITICO New York Health Care: Councilman chides de Blasio administration on health policy process; Empire gets new CEO

Dear readers: POLITICO New York Pro subscribers receive this email at 5:30 a.m. each weekday. If you'd like to receive it at that time, along with a customized real-time news feed of New York health care policy news throughout the day, please contact us at and we'll set you up for trial access.

written by Dan Goldberg

JOHNSON VS. ADMINISTRATION - A City Council hearing Wednesday on a relatively mundane piece of legislation became a forum for broader dissatisfaction over how the de Blasio administration communicates its health plans to certain members of the Council. On several of Mayor Bill de Blasio's signature programs, including TakeCare NYC, which aims to improve community health outcomes, the mayor's Direct Access plan, which provides health access to undocumented immigrants, and the Caring Neighborhood Initiative, the Council was left in the dark, health committee Chairman Corey Johnson said. Johnson said the administration pays lip service to working with the Council on many new health prerogatives but often brings members in after decisions are made, invites them to press conferences or asks for a supportive quote shortly before a press release is sent.

...The health committee held the hearing to discuss legislation that would create a new office responsible for coordinating the delivery of city health services. The measure would also create an interagency coordinating council to advise the director of that new office, who would be chosen by the mayor. The de Blasio administration opposes the legislation. Johnson tried to impress upon the administration that this wasn't a power grab. "We're not trying to strip you of your powers," Johnson said. "We're not trying to neuter the deputy mayor. We are saying there are better ways to do this. There are more comprehensive, thoughtful, strategic ways to do this, and that is through a specific office looking at these issues."

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MAKING ROUNDS — Crain’s reports: “Empire BlueCross BlueShield, the city’s largest health insurer by membership, has a new chief executive. Lawrence Schreiber, 52, will take over as CEO of Empire, a subsidiary of Indianapolis-based insurance giant Anthem, on Dec. 28. He replaces Brian Griffin, who was promoted in September to executive vice president and chief executive of Anthem’s commercial and specialty business—the company’s largest and most profitable business segment.” Read more here:

DON’T DO THAT — In 2013, Mendel Hagler, the executive director of Gouverneur Healthcare Services, part of the city's Health and Hospitals Corporation, resigned under circumstances that were later described as "not amicable." On Wednesday, the city's Conflict of Interest Board, announced he had been fined $6,000 for authorizing a 10 percent raise for his brother in 2008, and for using an HHC computer to send his resume and LinkedIn profile to executives at NYU Langone Medical center just weeks before his resignation took effect. Read the full report here:

OR THAT — Kyle and Krystle Steed were indicted on Wednesday, charged with stealing personal information from dozens of patients who came through the Lenox Hill emergency room. The couple allegedly made $300,000 in fraudulent purchases and attempted to make more than $1 million in additional purchases from Saks Fifth Avenue. Between Jan. 2014 and Feb. 2015 Kyle Steed stole the information and gave it to his wife who took over customer credit card accounts at Bank of America and American Express through a variety of methods, according to the indictment. Krystle is accused of circumventing security questions by claiming to be at a doctor’s office where she required immediate access to a credit card number to pay a bill; stating that she was doing holiday shopping with grandchildren and demanding that fraud prevention measures be lifted; becoming combative with customer service representatives and accusing them of biased treatment; and repeatedly placing calls inquiring about the same account in order to reach service representatives who were more susceptible to her methods.

HURRY UP AND WAIT -- WNYC reports: “The number of medical calls has steadily increased over the last twenty years, as the city’s population has grown and aged. It’s changed the nature of work for the fire department. But the agency has been too slow to integrate EMS, according to a report released Wednesday from the Citizens Budget Commission. … [I]t raises the question: How long should someone have to wait when the city says assistance is on the way?”

NEW TWITTER HANDLE — The city’s public hospital system, in the midst of a rebranding campaign, has changed its twitter handle to @NYCHealthSystem from @HHCnyc.

ACROSS THE RIVER: The New Jersey Senate Commerce Committee will take up the re-worked version of the “Out-of-Network” bill at a hearing today. The measure (S-20) aims to protect consumers from surprise and high-cost out-of-network medical bills. It outlines significant reforms to the health care billing process aimed at increasing transparency regarding in-network and out-of-network services. It also lays out an arbitration system for insurance carriers and health care providers to resolve billing disputes. POLITICO New Jersey’s Katie Jennings has more:

-POWER UP — Gov. Chris Christie signed legislation that will help health care facilities to choose from different options for distributed power generation, such as onsite generators or campus microgrids, to ensure that power remaIns on during storms or other emergencies. The facilities will be able to seek funding for the energy projects from the Energy Resilience Bank, a pool of capital managed by the Economic Development Authority.

PHARMA REPORT: Just how did Pfizer set the cost of its $8,950 per month breast cancer drug? The Wall Street Journal, in a really smart piece, explains: “Pfizer’s multistep pricing process shows drugmakers don’t just pick a lofty figure out of the air. At the same time, its process yielded a price that bore little relation to the drug industry’s oft-cited justification for its prices, the cost of research and development.”


- RANKED — Infant mortality rates in the United States have fallen to their lowest levels, according to The New York Times. “[A]fter a recent peak in 2005, rates have been declining, down by 13 percent through 2013. In a report released by the Centers for Disease Control and Prevention on Wednesday, the rate declined again in 2014, down by 2.3 percent to a new low of 582.1 infant deaths per 100,000 live births, from 596.1 the year before.” That’s good but we’re still probably not in the top-30, and we’re behind countries such as Slovenia.

-BETTER BABIES — Arthur Caplan, director of the division of medical ethics at the NYU Langone Medical Center, looks at CRISPR, the genetic tool that has scientists and ethicists dreaming of a world where babies will be genetically modified — either to prevent disease or to design a more perfect child. “There is no reason to waste time arguing about whether humans should be genetically engineered. As justifiable as some of the ethical concerns may be, there are simply too many benefits to be gained from preventing hereditary diseases. Those seeking to limit genetic engineering to such efforts would be better off devoting their energies to explaining why eugenics is wrong, rather than attempting to stop the march of progress toward healing the sick and eliminating awful disorders.”

-NOT THE ONION — Martin Shkreli, the so-called “pharma bro,” who raised the price of a life-saving drug, from $13.50 a pill to $750, purchased the Wu-Tang Clan’s latest album for $2 million. The reason it is so pricey? The clan made only one, and it cannot be sold commercially, according to Bloomberg news. Read more of this crazy story here:

-OBAMACARE NUMBERS — More than 800,000 people chose plans on during the fifth week of open enrollment, according to the Centers for Medicare and Medicaid Services. The agency cited heightened interest ahead of the Dec. 15 deadline to enroll in plans for the new year. serves states on the federal exchange. New York, which set up its own exchange, has not yet released enrollment data.

-MORE TROUBLE FOR CO-OPS — POLITICO reports: “Community Health Options is cutting off individual enrollment on Dec. 15 because of financial difficulties. The nonprofit health plan seeded with Obamacare loans, however, will continue to sign up small group customers for 2016 coverage.”

-A DRUG TO END DRUG ADDICTION - The Boston Globe profiles Vivitrol, which block opioid receptors so drug addicts can receive no pleasure from getting high. The injection works for 28 days. “Barnstable County started offering Vivitrol to inmates in 2012, among the first jail operators in the country to do so. Since then, jails and prisons throughout Massachusetts, and about 100 others nationally, have embraced Vivitrol as a new tool to keep people off of drugs and out of prison.”

-A HOUSE DIVIDED — Congressional Republicans are divided over whether to attach provisions delaying the Affordable Care Act's Cadillac tax to their two-year backup plan for reviving the so-called tax extenders, according to POLITICO. “While a top House Republican is pushing to add the delay, a senior Senate Republican says Democrats must offer a major concession for that chamber to go along. The Senate voted overwhelmingly just last week to kill the Cadillac tax, as part of a doomed Republican measure designed to dismantle Obamacare. Ninety senators supported an amendment to strike the tax, including nearly every Republican.

But the Senate's deputy Republican leader said today Democrats would still have to give his side something significant in exchange for agreeing to delay the tax as part of the two-year extender bill. ‘That's a major Democrat ask, so there needs to be something proportionate in terms of achievement on our side,’ said Sen. John Cornyn. ‘We're for tax cuts, but this is something that organized labor and other parts of the Democratic base hate, and they did it anyway, and so now they're starting to get the pushback. So I'm just saying that it's good leverage for some other things that we need.’"

TODAY'S TIP — Comes from the Cleveland Clinic: “Don’t let a full bladder ruin your sleep! 5 tips.”


-STAYING ON TARGET — Researchers from several centers including the Icahn School of Medicine, published a study in Cell Host & Microbe that explains how scientists tapped into publically available large-scale ‘Omics’ databases to identify new targets to treat influenza. “Our work illustrates how the computational analysis of large datasets from multiple independent studies can reveal novel host factors and networks involved in virus replication as potential targets for therapeutic intervention,” Dr. Adolfo Garcia-Sastre, director of the Global Health and Emerging Pathogens Institute at the Icahn School of Medicine, said in a press release accompanying the article. “’Big data’ is no longer merely a catchphrase – it is a real tool to help scientists address the world’s most serious public health threats.”

-WHAT A TOOL — An article in Cell Host & Microbe explains how a tool developed by scientists at the Icahn School of Medicine may develop new therapies that rely on microRNA. “We developed a tool based on a poxvirus gene that allows us to manipulate microRNA populations in any tissue or cell type we desire,” Dr. Benjamin tenOever, the Fishberg Professor of Microbiology at the Icahn School of Medicine, said in a press release accompanying the article.

MISSED A ROUNDUP? Get caught up here: 12/9, 12/8, 12/7, 12/4, 12/3

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