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POLITICO New York Health Care, presented by New York's Hospitals and Doctors: Medicaid matters; Cuomo on breast cancer

06/13/2016 10:00 AM EDT

Good morning! You are receiving the complimentary synopsis of the POLITICO New York Pro Health Care newsletter. Pro subscribers are receiving an enhanced version of this newsletter at 5:45 a.m. each weekday, which includes a look-ahead and robust analysis of health care policy news driving the day. If you would like the Pro version of this newsletter, along with customized real-time insights on New York health care, please contact us here and we will set you up with trial access. Thank you for reading!

written by Dan Goldberg

MEDICAID MATTERS - New York's Medicaid program spent $17.738 billion in the 2016 fiscal year that ended March 31, according to the most recently released Medicaid Global Spending Cap Report. That's $3 million below the $17.741 billion spending cap imposed by the Cuomo administration, the fifth consecutive year state spending has come in under the cap. Throughout the 2016 fiscal year, state officials had said they were going to come very close to the cap, and as recently as February, the program remained slightly over budget. Some of that has to do with forces beyond the state's control, such as a recent court ruling requiring overtime to be paid at time-and-one-half. At the end of March, there were 6.2 million Medicaid recipients. Of those, 58 percent reside in New York City. Read the full report here:

SHARE ME: Like this newsletter? Please tell a friend to sign up. Give them this link:

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

** A message from New York's Hospitals and Doctors: New York is home to many of the world's finest doctors and hospitals, but they spend billions annually on medical malpractice costs-by far the nation's highest. Let's make sure Albany doesn't make things worse by passing bills that will raise those costs even higher and damage patient care. Learn more at **

BREAST CANCER - Gov. Andrew Cuomo on Sunday announced plans to introduce new legislation this week, in the waning days of the legislative session, to make it easier for women to get mammograms and breast cancer screenings.

NOW WE KNOW - Students at the University of Leicester spent seven years studying which superhero is the best. It's Superman because of his 'Super Flare' attack and possession of high density muscle tissue.

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

STAFFING FIGHT - As the final week of the legislative session begins, the New York State Nurses Association, the state's largest nurses union, is lining up support for its top legislative priority - mandatory staffing ratios that would require a set number of nurses on each floor.

PRIORITIES - Two nonprofit organizations that focus on drug education issued a statement of priorities on Friday for addressing New York's heroin and opioid crisis, on the heels of the release of a report from Gov. Andrew Cuomo's heroin and opioid task force. Read the full memo here:

PASSED - The Associated Press reports: "New York lawmakers have passed a bill to require that hospitals post statements explaining patient protections against surprise medical bills and patients' right to designate a caregiver to receive instructions about post-discharge care."

ASSEMBLY PASSES MENTAL HEALTH BILL - The Assembly on Thursday passed bill that clarifies state education law, calling on school districts to ensure health education programs include mental health and the relationship between mental and physical health in health education.

MAKING ROUNDS - Columbia University Medical Center has dedicated a new facility on its Washington Heights campus in honor of the Vagelos family, the university announced Friday.

...Dr. Alan Astrow recently joined New York Methodist Hospital as chief of hematology and medical oncology. Astrow comes to New York Methodist from Maimonides Medical Center. He is a graduate of the Yale School of Medicine, and he completed his residency in internal medicine at Boston City Hospital and his fellowship in hematology/oncology at New York University Medical Center.

GRANT LAND - Nine community-based organizations each received $25,000 awards on Saturday, money that will be used to improve neighborhood health in East Harlem.

PHARMA REPORT: More amazing reporting from John Carreyrou who says Walgreen Co. has ended its alliance with Theranos.

-PRICE SPIKE- During the past six months, Mylan, one of the world's largest purveyors of generic medicines, raised prices more than 20 percent on two dozen products. And Mylan also boosted prices by more that 100 percent on seven other products, according STAT's Ed Silverman.

-BOUGHT AND SOLD - The Associated Press reports: "Drugmaker Merck & Co. is buying Afferent Pharmaceuticals, a privately held biotechnology company developing a chronic cough medication."


-UNDOCUMENTED AND OBAMACARE - California Gov. Jerry Brown signed legislation that could make California the first state to allow undocumented immigrants to purchase Obamacare coverage.

-KICKING THE HABIT - The New York Times has a long piece on St. Joseph's (Paterson) plan to avoid prescribing opioids in the Emergency Room. It is really interesting what this hospital is doing and certainly worth a read. I do wonder though how many of these patients receive opioids when they are admitted to the hospital or referred to a specialty physician.

TODAY'S TIP - Comes from Montefiore: "Read safety labels on kids' toys - it could save a life."


-HORSE CANCER - Researchers at the Baker Institute for Animal Health at Cornell's College of Veterinary Medicine say genetic differences in the immune system of horses explain why some get sarcoid skin cancer and some do not, according to an article in the International Journal of Cancer.

-COMMON LINK - There is a common theme for patients who do not respond to immunotherapy treatments for tumor, according to research from NYU Langone Medical Center. Those who do not respond to the tumor infiltrating lymphocytes share changes in mechanisms that switch genes on or off in those cells, and this "gene dysregulation" causes immune T cells to turn back to an immature state, making the cells less effective against metastatic melanoma.

-WATCHING HIV - Researchers at the Icahn School of Medicine at Mount Sinai, writing in Cell Reports, studied HIV-infected immune cells in mice and found how they can latch onto an uninfected sister cell to directly transmit newly minted viral particles, according to a press release from Sinai.

-THINK OF THE CHILDREN - Children who experience psychological trauma, particularly abuse and domestic violence, are more likely to experiment with drugs in adolescence, according to a study from Columbia University's Mailman School of Public Health published in the Journal of the American Academy of Child and Adolescent Psychiatry.

MISSED A ROUNDUP? Get caught up here:

** A message from New York's Hospitals and Doctors: Everyone agrees: New York's hospitals and doctors deliver world-class patient care. But out-of-control medical malpractice costs that are by far the nation's highest are stark proof of a deeply flawed system. Let's make sure Albany doesn't make things worse with harmful, misguided legislation. Join us in urging the New York State Legislature to reject any bills that would raise medical malpractice costs even higher and weaken the ability of doctors and hospitals to deliver high-quality care. **

To view online:

Stories from POLITICO Pro

Both sides in mandatory staffing fight line up support during session's final week Back

By Dan Goldberg | 06/13/2016 05:27 AM EDT

As the final week of the legislative session begins, the New York State Nurses Association, the state's largest nurses' union, is lining up support for its top legislative priority - mandatory staffing ratios that would require a set number of nurses on each floor.

Letters of support are coming from the New York Professional Nurses Union, District Council 9, New York State United Teachers, the New York State Laborers' Union and others.

"By establishing safe nurse-to-patient standards, this legislation will reduce the number of medical errors, provide lower costs for hospitals and nursing homes, and provide better overall patient outcomes due to increased patient safety," read one letter from Metro New York Health Care for All, which was sent last week to Gov. Andrew Cuomo, Assembly Speaker Carl Heastie and Senate Majority Leader John Flanagan.

But an equally ardent group of opponents, who say the staffing law would be too burdensome and too expensive, is also galvanizing support.

Catskill Regional Medical Center in Sullivan County, where Assembly sponsor Aileen Gunther once worked, released a statement saying the bill "will have a negative impact on the health of this community."

"Overstaffing the nursing department will prevent the organization from providing state of the art care and in some instances prevent us from continuing programs currently supporting the patients in this county," Gerard Galarneau, the medical center's CEO, said in a statement. "I consider Aileen Gunther a true friend. Much of the reason that Catskill Regional Medical Center is successful is because of her leadership in our county. She served CRMC tirelessly not only as a legislator but a staff nurse. I believe she wants the best for healthcare in this state. However, speaking for Sullivan County, these mandatory ratios would end the only hospital in a county in desperate need of better health."

The bill, which is not expected to pass the Republican-controlled State Senate, still could pass the Democrat-dominated Assembly.

While both supporters and opponents agree the bill is not likely to become law this year, these campaigns are as much, if not more, about what might happen in 2017 as they are about the final week of this year's session.

Supporters believe that if Democrats retake the Senate next year, they could pass a similar bill, and a victory this year in the Assembly would provide needed momentum. It would also provide a bit of a morale boost after the union failed to advance legislation during previous sessions and failed to negotiate any mandatory ratios during its most recent round of contract negotiations.

Opponents want to make sure that if the bill does pass the Assembly, it remains nothing more than a symbolic vote.

Last week, a new group calling itself the Coalition for Affordable and Safe Care sent letters to every state legislator, arguing the bill, which proponents call the Safe Staffing law, would "impose arbitrary, inflexible, and unnecessary nurse staffing ratios on every hospital and nursing home in New York."

The bill would require set ratios based on the unit. For example, the union wants one nurse for every patient in operating rooms, procedure rooms and one for each mother and child after delivery, one nurse for every two patients in the ICU and post-anasthesia units, and one nurse for every three patients in the pediatric unit and emergency department.

The bill would also impose mandatory ratios for nursing homes, causing concern among long term care advocates.

"Appropriate staffing plays an important role in quality outcomes, but research confirms that an arbitrary ratio does not ensure quality outcomes," according to an issue brief from LeadingAge New York, which represents more than 600 nursing homes, senior housing, adult care facilities, continuing care retirement communities, assisted living and community service providers. "Determining the right level of patient care is complicated and must be determined on an individual basis."

See the CRMC letter here:

See the Metro New York Health Care for All letter here:


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