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POLITICO New York Health Care: Budget breakthrough; what the mayor didn't know

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written by Dan Goldberg

MEDICAID HURDLE CLEARED — Budget talks have cleared the Medicaid hurdle, Assembly Speaker Carl Heastie said Wednesday night, but a final resolution on a new spending plan remains out of grasp.

NOT SO SIMPLE — Earlier Wednesday, county executives pushed back against the notion they are responsible for waste in the state’s Medicaid program, pointing out that they have almost no control over how the program is run or how money is spent.

WRONG DIRECTION — Gov. Andrew Cuomo’s proposal to find $250 million in Medicaid “efficiencies” from all counties in the state would be “moving backwards,” the head of the Senate’s health committee said Wednesday. “If you’re going to make changes, you have to do it in a programed way. In a slow way,” Republican Sen. Kemp Hannon said on Public Radio’s Capitol Pressroom.

BOTTOM LINE — Medicaid is a $63 billion program paid for with county, state and federal dollars, and although the state’s share is considerably less, Cuomo’s call for $250 million in savings means this fight was over four-tenths of 1 percent of the program.

HEALTH-RELATED ITEMS — The Senate and Assembly released health care related budget items Wednesday night, signifying some relatively minor agreements between the Legislature and Gov. Andrew Cuomo.

... There is a $200 million health care facility transformation fund, which supports projects that replace inefficient and outdated facilities as part of a merger, consolidation or acquisition. At least $30 million must be used for community based providers.

...Advocates for those suffering from traumatic brain injuries will be heartened to learn the suite of services offered to them under managed care plans must be similar to those offered under fee-for-service Medicaid.

...The state will require prior authorization for anyone seeking more than four opioid prescriptions in a 30-day period, except for patients in hospice, or those with cancer, sickle cell or any other disease designated by the health commissioner.

...The state is also amending the new e-prescribe law, which took effect this week, so that physicians who write fewer than 25 prescriptions in a year may still use paper and pen.

...Read the budget language here:

NEGOTIATING PAID FAMILY LEAVE — State lawmakers are discussing the possibility of extending the qualifying period for an employee-funded paid family leave program, two people familiar with the budget negotiations told POLITICO New York on Wednesday.

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

DIDN’T TELL THE MAYOR — The city's law department felt U.S. Attorney Preet Bharara's request for millions of documents relating to the city's public housing authority was a routine matter and therefore did not inform Mayor Bill de Blasio, who said he only learned about the inquiry through news reports. In fact, a law department spokesman said, the mayor and the public only found out because the city's health department, worried it might be violating patients' privacy rights by complying with the U.S. attorney's requests, asked for a court order before turning over the necessary documents.”

NOW WE KNOW — Women who believe their partner wants them to be perfect tend to have a poor self image, according to psychologists at the University of Kent.

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

MUST READ — NBC’S investigative team reports that the Cuomo administration has given $850 million to more than 600 nursing homes, even though federal regulators have found quality of care at more than two-thirds of the facilities to be below average or much below average.

HOOSICK’S WATER IS SAFE — The water in Hoosick Falls is once again safe to drink, the state Department of Health said Wednesday, months after residents in the upstate village were warned consumption could be dangerous because of a toxic chemical in the public water supply.

FINANCES — Montefiore Medical Center reported an operating gain of $1.5 million in 2015, significantly less than the $40 million gain it reported in 2014. Operating revenue, according to the health system's most recent financial report increased to $3.7 billion, a year-over-year increase of about $210 million. But expenses increased $250 million, thanks in large part to an increase in capital investment.

NEW CEO — Mary LaRowe has been named the CEO of Brooks Memorial Hospital in Dunkirk. LaRowe previously worked for the Healthcare Association of New York State, Westfield Memorial Hospital, United Memorial Medical Center in Batavia and the state Department of Health. Earlier this month, Brooks Memorial announced its intention to affiliate with Buffalo-based Kaleida Health.

MAKING ROUNDS — Leena Gandhi, an assistant professor of medical oncology at Harvard, is NYU Langone Medical Center's new director of thoracic medical oncology, according to a press release from Langone. The center has been recruiting some big names of late as it works to bolster its reputation for cancer care. Read more here:

PHARMA REPORT: The Wall Street Journal reports: “Pfizer Inc. and Allergan PLC on Wednesday said federal regulators are seeking more information on their pending merger deal, a so-called inversion that would create the world’s biggest drugmaker and move one of the top names in corporate America to a foreign country.”


-ABORTION PILL There was a lot of attention paid to what Donald Trump said and then retracted regarding punishing women who have abortions were they to become illegal. But the real big news came out of the Food and Drug Administration, which relaxed restrictions on a pill that induces abortion, a move that is expected to expand access to the procedure, according to the New York Times.

...My colleague, Dan Diamond, points out that the pro-life movement likely would have contested this development were the abortion debate not hijacked by Trump.

-HIV ORGAN TRANSPLANT — The Associated Press reports: “Surgeons in Baltimore for the first time have transplanted organs between an HIV-positive donor and HIV-positive recipients, a long-awaited new option for patients with the AIDS virus whose kidneys or livers also are failing.”

-HORRIBLE — The owner of a North Texas medical company regularly directed nurses to give hospice patients overdoses of drugs such as morphine to speed up their deaths and maximize profits, an FBI agent wrote in an affidavit for a search warrant obtained by NBC 5.

-ANALYSIS OF PARALYSIS — STAT looks at some remarkable breakthroughs in the science of curing paralysis. “The history of paralysis research is littered with overhyped promises and false hopes. But many physicians and patient advocates say [this] work is one of the first approaches that may actually help large numbers of patients in the near future, particularly those with fairly recent injuries.”

ZIKA PROGRESS — The federal government will allow the use of a test for screening donated blood in areas with active Zika transmission. The announcement comes about six weeks after FDA guidance called for the halt of blood collection in affected areas like Puerto Rico until such a screening test was available. The announcement: More here:

TODAY'S TIP — Comes from the Community Healthcare Network: “April is Foot Health Awareness Month. To keep your feet healthy, dry your feet and between your toes after you shower to help prevent infections. Then use a good lotion to moisturize.”


-TAKING ADVANTAGE — New Jersey enacted a paid family leave program in 2009, but many low-income workers aren’t taking advantage of it, according to a Columbia University report released Wednesday. The state’s Family Leave Insurance program, which is funded by a payroll tax and administered by the Department of Labor and Workforce Development, offers six weeks of cash benefits to low-income workers after the birth of a child or to care for an ill family member.

MISSED A ROUNDUP? Get caught up here: 3/29, 3/28, 3/25, 3/24, 3/23

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