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POLITICO New York Health Care, presented by The Healthcare Education Project: Why Durst cut off his leg; the one-house budgets

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 newyork@politicopro.com and we'll set you up for trial access.

written by Dan Goldberg

MONDAY MORNING’S MUST READ — In the litany of misfortunes to befall Douglas Durst — his mother’s violent death, an allegedly murderous older brother who stalked him — Durst’s bum leg might seem trivial. But the leg caused the real estate developer so much pain over so many years that last summer, he had it removed. Seven months later, Durst, 71, agreed to talk at length about his elective amputation, but only so he wouldn't have to talk about it any more. http://politi.co/1TE5BcQ

THE ONE HOUSE BUDGETS — The Assembly and Senate released their one-house budgets over the weekend and we picked apart some of the highlights. We’ll have more coverage in the coming days, so stay tuned.

-The Senate's budget keeps Cuomo's proposals to remove $485 million in funding for the City University of New York and to shift the growth of New York City's Medicaid program back to the city government, which will have a $180 million impact in the coming fiscal year and will increase in future years. POLITICO New York’s Jimmy Vielkind breaks it all down here: http://politi.co/1RGnbHj


-MINIMUM WAGE FUNDING — Amid concerns from the health care sector about the repercussions of a proposed $15 minimum wage, the Democratic-dominated Assembly’s one-house budget would create a $200 million reserve fund to help health care providers afford the increase. POLITICO New York’s Josefa Velasquez has more: http://politi.co/24Xktqy

-MEDICAL MARIJUANA — The Assembly's one-house budget would significantly expand the state's nascent medical marijuana program. The Assembly calls for doubling the number of dispensaries — from four to eight — that a registered organization may operate. The Assembly also would require the state health commissioner to double — from five to 10 — the number of registered organizations by Jan. 1, 2017.

-FQHCs — The Senate's and Assembly's one-house budgets include $54.4 million for federally qualified health centers to fill the gap left in funding after the state "inadvertently allowed" a program that brought in federal funds to sunset. The money would go toward the Diagnostic and Treatment Center Uncompensated Care Pool, which reimburses roughly 200 clinics throughout the state for the care they provide to undocumented immigrants and those who have little or no ability to pay.

-PAID FAMILY LEAVE — Despite concerns among some members of their conference, Republican senators included paid family leave in the one-house budget resolution they unveiled early Saturday morning. POLITICO New York’s Josefa Velasquez has more: http://politi.co/1RGmRIv

-MEDICAL MALPRACTICE — In their one-house budget proposals released on Saturday, both the state Senate and the Assembly rejected Gov. Andrew Cuomo's proposal to cut the state’s Excess Medical Malpractice program. Cuomo's budget proposes cutting the program, which provides subsidized malpractice insurance, by $25 million — a cut physicians said could be particularly painful to specialists upstate. Read more here: http://politi.co/1Ucqj2h

-SPOUSAL REFUSAL — Both the state Senate's and Assembly's one-house budget proposals reject Gov. Andrew Cuomo's effort to end New York's spousal refusal program. If lawmakers succeed in defending the program, it would mark the 26th consecutive year a governor has tried to cut the program, and the Legislature has kept it in place. Spousal refusal allows one spouse to protect assets by refusing to pay for long-term home care for a sick spouse, who is then enrolled in Medicaid.

-INSURANCE FOR IMMIGRANTS — The New York Assembly's one-house budget extends the state's Essential Plan to immigrants who are not yet citizens. That would cost New York $10.3 million, according to a report from the Community Service Society, which advocates on behalf of immigrants and low-income New Yorkers. The plan would offer state subsidized health insurance to more than 5,000 immigrants who have legal status under President Barack Obama's Deferred Action for Childhood Arrivals program, known as DACA. These DACA immigrants are already entitled to Medicaid but once their income increases above $16,243, they lose their health insurance benefits and are not entitled to partake in the Affordable Care Act. Extending the Essential Plan would offer low-cost health insurance to this group until they earned 200 percent of the federal poverty level, or $23,670 for a single person. The plan is not in the Senate's one-house budget, nor was it included in Gov. Andrew Cuomo's executive budget.

-MEDICARE PART C — The Senate's and Assembly's one-house budgets rejected Gov. Andrew Cuomo's proposal to cap Medicare Part C cost-sharing limits. The move would have saved the state $11.45 million this year.

-NO GUARANTY FUND — Neither the Assembly or the Senate created a guaranty fund, which providers had requested following the collapse of Health Republic Insurance of New York. The Senate did, however, propose eliminating prior approval, the means by which the Department of Financial Services can approve or change premiums.

-A GOING CONCERN — POLITICO New York’s Addy Baird explains why children’s advocates are concerned over a proposal in Gov. Andrew Cuomo’s budget that would change how children are screened for developmental delays. http://politi.co/1nETqhR

SHARE ME: Like this newsletter? Please tell a friend to sign up. Give them this link: http://politi.co/1gMLiJV

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

CUOMO HEADS TO HOOSICK FALLS — Gov. Andrew Cuomo made his first visit to Hoosick Falls on Sunday, about 100 days after the polluted town water supply became one of the most serious public health crises his administration has experienced.


...The state Department of Health has been aware that there were dangerous levels of PFOA in the water in the municipal water supply for Hoosick Falls since at least 2014, and that it was above the recommended federal level of 400 parts per trillion put in place in 2009. Yet the state DOH didn't warn residents against using the water until December 2015, after the federal Environmental Protection Agency issued a warning not to drink the water. When asked if he had stayed away because of criticism, Cuomo pointed to the support of the elected and state officials that his office picked to stand with him at the podium and said their support was an indication that locals were happy with the response of his administration to the crisis. “Every situation that deals with an emergency is always criticized, always criticized,” he said. “Some snarky reporter always finds something to criticize. I think it’s in the job description.” http://politi.co/24YKUwd

SODIUM SUIT — The New York City health department is urging an appellate court to reject an appeal by a restaurant trade association to delay and ultimately overturn the Board of Health’s new sodium rule. The delay, they said, is instead causing a public health harm by denying people the opportunity to know which menu items at certain restaurants have more sodium than the U.S. dietary guidelines recommend for a single day. Read my full analysis here: http://politi.co/1RGmttD


...Read the city’s papers here: http://politi.co/21qKFp0

...Health Commissioner Dr. Mary Bassett wrote an op-ed on Friday defending the sodium warning. http://bit.ly/1Mgz5WJ

THE RACE — Discredited theories of racial and genetic inferiority have, in medicine at least, morphed into a subtler but no less disturbing ideology that views poor health in black and Hispanic communities as the result of bad choices, said New York City health commissioner Dr. Mary Bassett. In the wake of the Black Lives Matter movement, Bassett has become increasingly vocal about the role racism plays in health outcomes. Read my story here: http://politi.co/1RGmBJL

BUDGET HEARINGS — As city health officials explained their mental health budget in a mostly placid City Council hearing Friday, the de Blasio administration — which has added $62 million in its preliminary budget to help realize the first lady's mental health roadmap ThriveNYC — took a victory lap of sorts. The plan has been largely praised by the Council and the public, though there were some concerns over administering contracts and whether there is enough funding to achieve the administration's ambitious goals. http://politi.co/1nETyOv

** 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: www.nyguarantyfund.org **

NOW WE KNOW — Have you ever wondered about the sexual habits of Quebecers? Well, for those of you have, you’re not alone. Christian Joyal and Julie Carpentier, researchers at the Institut Philippe-Pinel de Montréal and the Institut universitaire en santé mentale de Montréal, set out to determine how kinky Quebec is. Of the 1,040 adults interviewed, more than a quarter were into frotteurism and 19 percent had tried masochism. http://bit.ly/1TEaEdx

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 dgoldberg@politico.com.

KLEIN’S HERBALIFE BILL — State Sen. Jeff Klein introduced legislation Friday requiring companies that sell products through independent agents to report to the state the details of their sales and what percentage the agents keep. The legislation, which does not yet have an Assembly sponsor, requires companies like Herbalife to file with the Department of Law the total number of agents, contractors or distributors the company has in the state; total sales; and the average income earned by agents, contractors or distributors. Read the bill here: http://bit.ly/1XiN2sO

...Last October, The Albany Times-Union reported that Klein — as well as Public Advocate Letitia James and Councilwoman Julissa Ferreras-Copeland, who have also attacked Herbalife’s credibility — was tied to the MirRam group, paid by Ackman to discredit Herbalife.

Klein dismissed that story, calling it “utter nonsense.” “I think it was the best example of horrible, hatchet job journalism,” Klein said.

MUMPS — The Department of Health on Saturday announced it is investigating cases of mumps at SUNY Buffalo. SUNY Buffalo has identified two cases of mumps and four suspected cases among students.

MEDICAL MARIJUANA — Assemblyman Richard Gottfried has introduced four bills to expand the state’s medical marijuana laws, according to Crain’s. http://bit.ly/1TE6DFR

CORRECTION — On Friday, we wrote Dr. Ann Errichetti is leaving St. 's Hospital for Presence Health in Buffalo. Presence Health is in Chicago.

OMIG NEWS — The office of the Medicaid inspector general on Friday imposed corporate integrity agreements on a chain of nursing homes in the mid-Hudson Valley for delaying discharges. View the CIA here: http://on.ny.gov/1Xj3bi9

BILL TRACKER — School districts would be required to test drinking water for lead, according to a bill proposed by Assemblywoman Donna Lupardo.

MAKING ROUNDS — Kathryn Ruscitto, the president and CEO of St. Joseph's Hospital Health Center, announced she will retire at the end of this year, according to the Syracuse Post-Standard. http://bit.ly/1Mgzpof

THE ETHICIST — Arthur Caplan, a medical ethicist at NYU Langone, says the Canadian couple who treated their son’s meningitis with maple syrup should be found guilty of neglect. http://onforb.es/1TE9rms

GRANT LAND — Fourteen community organizations will receive grants to improve access to mental health care through the Connections to Care program, part of ThriveNYC, which is First Lady Chirlane McCray’s signature mental health program, the de Blasio administration announced Friday.

...The U.S. Department of Health and Human Services awarded nearly $7.3 million to 21 health centers in New York to combat the opioid epidemic. See the awardees here: http://1.usa.gov/1XiONGD

...The University at Buffalo has been awarded two SUNY grants worth $2.6 million to hire senior faculty members to grow the school’s research expertise in biomedical engineering, energy and the environment. http://bit.ly/1RVp3i1

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. http://bit.ly/215xkrf


...I will be moderating the first panel and want to know what you think I should ask and/or discuss. Email me at
dgoldberg@politico.com

ACROSS THE RIVER: Senate President Stephen Sweeney sent letters to health insurance CEOs on Friday asking them to provide information about balance sheets and profit margins from 2005 to 2015. Last week, Sweeney sent a similar letter to hospital and health system CEOs. Read the letter here: http://politi.co/229hNny

-FINANCES — Horizon Blue Cross Blue Shield of New Jersey, the largest private insurer in the state, posted net income of $101.3 million in 2015, according to POLITICO’s analysis of the company’s most recent filings with the National Association of Insurance Commissioners. That's a decrease of around $46 million from the previous year. POLITICO New Jersey’s Katie Jennings has more: http://politi.co/1nETQF5

PHARMA REPORT: The Wall Street Journal reports: “The U.S. Food and Drug Administration on Friday approved Pfizer Inc.’s Xalkori for treatment of a rare form of advanced non-small-cell lung cancer, making it the first therapy for the condition.” http://on.wsj.com/1MgxTTe

WHAT WE’RE READING:

-MISSED OBAMACARE GOAL — Roughly 8.8 million people were fully enrolled in Obamacare exchange plans at the end of 2015. The Obama administration had wanted 9.1 million people nationwide to be actively enrolled in Obamacare plans and paying their premiums at the end of the year, according to POLITICO.

-THE LION’S SHARE — Forbes reports that the majority of new Medicaid business went to five insurers. “Of the more than $115 billion ‘in total Medicaid premiums written’ in 2014, the first year broader coverage was available under the health law, nearly half were administered by Anthem, Centene, Molina,UnitedHealth Group UNH and Wellcare Health Plans.” http://onforb.es/1MgCrZI

-THE STATES RESPOND — The New York Times examines different state reactions to the opioid epidemic. “On Thursday, Massachusetts lawmakers passed a bill expected to be signed next week that would sharply restrict the number of pain pills a doctor can prescribe after surgery or an injury to a seven-day supply. Officials in Vermont and Maine are considering similar actions, and governors across the country are set to meet this summer to develop a broad approach that could reduce the use of painkillers like OxyContin, Percocet and Vicodin.” http://nyti.ms/1MgyioD

-DON’T DO THAT — Nestlé USA is initiating a voluntary recall of a limited number of DiGiorno, Lean Cuisine, and Stouffer’s products because they contain pieces of glass. http://bit.ly/1MgAJHO

TODAY'S TIP — Comes from the Community Healthcare Network, which reminds us that “three in 10 New Yorkers over 50 are not up to date with colon cancer screening. Colon cancer prevention month is the perfect time to get up to date. Call your doctor.” http://www.chnnyc.org/find-us

STUDY THIS:

-LOST AN HOUR — Jennifer Henderson, a clinical assistant professor in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, says people who already have sleep problems will be most impacted by the time change. She said, “for most people, the symptoms will be annoying but short-lived,” which is good to know since we’re kind of all committed to doing this once a year. http://bit.ly/1TEbkj9

-LOSING THE RACE — Hispanic women who identify as white are healthier than those who do not, according to an article in Research on Aging. http://bit.ly/24XkXwZ

-WAY TO GO — Researchers at NYU School of Medicine found that anticoagulants, such as warfarin, are more likely to cause intracranial bleeding than previously reported in clinical trials. http://bit.ly/24XlX49

** 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: www.nyguarantyfund.org **

MISSED A ROUNDUP? Get caught up here: 3/11, 3/10, 3/9, 3/8, 3/7

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