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POLITICO New York Health Care, presented by The Healthcare Education Project: Medicaid spending tops $400 million for hep C; MVP posts solid financials

Dear readers: POLITICO New York Pro subscribers receive an enhanced version of this email at 5:30 a.m. each weekday. If you'd like to receive it, 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

HARVONI, TRUVADA TOP MEDICAID SPENDING — New York State spent at least $107 million on hepatitis C drugs during the third quarter of 2015, accounting for roughly 10 percent of all Medicaid drug spending. That takes the total spent on hepatitis C drugs to more than $400 million through the first nine months of last year, emphasizing just how much strain the disease and a few other blockbuster drugs are putting on the state's insurance program for low-income residents. Read my full story here:

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AND MAKE SURE YOU FOLLOW Josefa and me on Twitter @J__Velasquez & @DanCGoldberg. And for all New Jersey health news, check out @katiedjennings

FINANCES — Empire HealthChoice Assurance, a licensee of Blue Cross Blue Shield Association, reported a net underwriting gain of more than $38 million in 2015 compared to 2014, according to annual financial statements filed with the Department of Financial Services.

...MVP Health Care reported a net underwriting loss in 2015, but it appears that the Capital Region insurer has turned a corner. View their financial disclosure here:

...Aetna, the country’s third-largest health insurer, lost members in New York between 2014 and 2015 and reported a higher net underwriting loss than the previous year, its annual financial statement with the Department of Financial Services shows. Read Aetna’s financial statement here:

** A message from The Healthcare Education Project: What’s a Health Insurance Guaranty Fund? It protects you if your health insurance plan goes broke. New York’s the only state without one.

Tell Albany we need a Health Insurance Guaranty Fund to ensure that families keep their coverage and healthcare providers aren’t left with massive unpaid bills. Visit: **

NOW WE KNOW — Psychologists from the University of Otago, Warwick Business School, and University of California, San Diego, have tried to explain why Johnny Depp is better looking than you. Sort of.

WE'D LOVE TO HEAR FROM YOU: This roundup is for you, so please tell us how we can make it even better. Send tips, news, ideas, calendar items, releases, promotions, job postings, birthdays, congratulations, criticisms and corrections to

LEAD SCREENING — The New York State Joint Task Force on Social and Emotional Development has recommended that child health care providers in primary care practices screen all children for lead poisoning as part of routine screens for developmental delays and disabilities. The recommendation is part of the suggestion that providers conduct a “full clinical assessment to rule out medical/neurological abnormalities, general development, and screen for lead, anemia, hearing, and vision.” The proposed guidelines were presented to the Early Intervention Coordinating Council last week. The recommendation of the task force, made up of members of the EICC as well as of the Early Childhood Advisory Council, comes in the wake of lead poisoning in Flint, Michigan and renewed concerns about the effects of lead, which can cause developmental delays and learning disabilities in children.

CHECK THIS OUT — The Manhattan Institute is hosting a conference March 23 on hospital consolidation and competition in New York State. Distinguished health care experts, from academia, business, and nonprofits, will examine various tools that policymakers can use to deliver better outcomes across New York’s vast health care ecosystem, including regulatory reforms to boost competition, better state and federal antitrust oversight, and value-based purchasing strategies.

...I’ll be moderating the first panel and want to know what you think I should ask and/or discuss. Email me at

PAY ATTENTION TO THIS — Retail clinics increase the cost of health care, according to a Health Affairs study reported on by The New York Times. “Researchers concluded that the clinics led to slightly higher spending because people used them for minor medical conditions they would typically have treated on their own.”

...That’s an argument likely to be repeated as Albany tries again to regulate retail clinics.

ACROSS THE RIVER: The debate over tiered health insurance networks and how best to regulate them, ignited by the rollout of Horizon Blue Cross Blue Shield’s OMNIA plans last fall, has exposed a rift among some of the state’s senior Democratic senators and Senate president Stephen Sweeney.

PHARMA REPORT: The Wall Street Journal continues to own the Theranos story. The latest: “A federal inspection report said a Theranos Inc. laboratory ran an important blood test on 81 patients in a six-month period despite erratic results from quality-control checks meant to ensure the test’s accuracy, people familiar with the report said. The report hasn’t been publicly released but is far more detailed than the letter that summarized the results of last fall’s inspection of the Newark, Calif., lab by the federal Centers for Medicare and Medicaid Services and was sent to Theranos in late January, these people said.”


-SMART TAKE — Yevgeniy Feyman writes about how we’ve oversimplified our health care debate, and that’s not doing any good. “Worse still, perhaps more than any other policy area, we’ve turned health care into a meme free-for-all. Maybe this has to do with the two most persistent meta-memes: health care before Obamacare was “free-market,” and universal health care in France, Sweden, or the U.K. is all peaches and cream, and that’s why ‘everyone else is doing better than us.’ Neither are true.”

-A NEW HOPE — Aaron Carroll explains why we are facing drug-resistant bacteria and why we might not want to despair just yet.

-MEDICAL MARIJUANA — Noting that he was embarrassed and angry that no child has received help under Florida’s 2014 medical marijuana law, state Sen. Rob Bradley said the time has come for the state to make sure low THC marijuana is available for those who need it. The bill will be sent to Gov. Rick Scott for review. POLITICO Florida’s Christine Sexton has more:

-NURSING WARS — The Wall Street Journal writes about the fight among four year colleges over who should be allowed to educate nurses.

TODAY'S TIP — Comes from the state health department, which reminds us, “Falls are not an inevitable part of the aging process. Resources for providers to help patients reduce falls.”


-FOLLOW THE MONEY — Researchers from Weill Cornell Medicine looked at how much time and money physicians in four specialties — family care, general practice, cardiology and orthopedics — spent reporting quality measures.

-MINORITY REPORT — There may not be a devil sitting on your shoulder but there is a region of the brain where bad intentions originate, according to researchers from NYU Langone Medical Center who published their findings in Nature Neuroscience.

-WHAT DOESN’T WORK — Researchers at Columbia University’s Mailman School of Public Health, working with the White House Social and Behavioral Sciences Team, the Massachusetts Institute of Technology, and the Centers for Medicare and Medicaid Services (CMS), sent letters to the top prescribers of addictive substances like opioids and amphetamines. The letters, which were informative, appeared to have no substantive effect on the doctors’ behavior, according to an article in Health Affairs.

** A message from The Healthcare Education Project: What’s a Health Insurance Guaranty Fund? It protects patients and healthcare providers if a health insurance plan goes broke. 49 states have one. New York is the only state that doesn’t. The recent failure of Health Republic left consumers scrambling for new coverage, and hospitals and doctors statewide are still owed hundreds of millions for care they already provided. We need a Guaranty Fund to protect patients and healthcare providers before it’s too late.

The New York State Legislature should create a Health Insurance Guaranty Fund to ensure that families keep their coverage and healthcare providers aren’t left with massive unpaid bills. To learn more, visit: **

MISSED A ROUNDUP? Get caught up here: 3/7, 3/4, 3/3, 3/2, 3/1

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