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POLITICO New York Health Care: Risk Adjustment problems; Teva angst

07/05/2016 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

RISKY BUSINESS - The CEO of CareConnect, the insurance company started by Northwell Health, says he needs the Cuomo administration to take extraordinary action if his company is to remain solvent. "The small group is just completely bizarre," CareConnect CEO Alan Murray said. "It makes no sense at all." The Cuomo administration appears to agree, and last week, DFS Commissioner Maria Vullo wrote to Sylvia Burwell, the U.S. Secretary of Health and Human Services, saying she is "concerned that the Risk Adjustment program has created inappropriately disparate impacts among health insurance issuers in New York and unintended consequences." Read my story here:

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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

NOW WE KNOW - There is a genetic mutation in yeast that could ruin sake, according to scientists at Hiroshima University, who worked with the Japanese government, the National Institute of Brewing, the Asahi Sake Brewing Company, the Brewing Society of Japan, The University of Tokyo, The University of Pennsylvania, and Iwate University.

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ENDORSEMENT - DC 37 on Friday endorsed Jamaal Bailey for state Senate in September's Democratic primary. Bailey is vying to replace Ruth Hassell-Thompson, who left the Senate earlier this year to take a job with the Cuomo administration. The district takes in Mount Vernon and parts of the Bronx. Bailey announced his candidacy less than a week after Hassell-Thompson's announcement, and picked up the early backing of Assembly Speaker Carl Heastie, for whom he worked. The New York State Nurses Association endorsed Bailey last Thursday.

MILESTONE - July 3 marked the 35th anniversary of the The New York Times' first article on AIDS. The headline, "Rare Cancer Seen in 41 Homosexuals," began a decade of misinformation. The full statement is here:

OPINION - The New York Times editorial board commended the U.S. Supreme Court's decision not to consider Home Care Association of America v. Weil.

ACROSS THE RIVER: The state Department of Health on Friday released the revised charity care payment distribution to hospitals for Fiscal Year 2017 to reflect an additional $50 million in cuts included in the budget. POLITICO New Jersey's Katie Jennings has more:

PHARMA REPORT: Gilead Sciences increased the list prices for six of its drugs on the Friday before a long holiday weekend. STAT reports:

-BATTLE FOR THE BRANDS - The New York Times examines the angst being caused by Teva Pharmaceuticals, the world's largest drug maker, desire to join the Pharmaceutical Research and Manufacturers of America, known as PhRMA, the powerful trade association for producers of brand-name medicines.

INSURANCE REPORT: Bloomberg reports: "Aetna Inc., the health insurer, is preparing to sell assets worth several billion dollars as it seeks to quell regulatory concerns over its proposed $37 billion takeover of smaller rival Humana Inc., according to people familiar with the matter."


-THE SHADOW DOCTORS - The New Yorker's piece on what it's like to try and practice medicine in Syria is as haunting a tale as you can expect to find in a piece of nonfiction.

-ZIKA - The New York Times says sex may account for more transmission of the Zika virus than was previously thought.

-AGENT ORANGE - Check out Charles Ornstein's latest on Agent Orange. "The Veterans Administration will conduct its first nationwide survey of Vietnam veterans in more than three decades and request an outside panel of experts to continue its work studying the health effects of Agent Orange on veterans, their children and their grandchildren."

-DON'T DO THAT - The Food and Drug Administration is warning people to stay from a sexual enhancement product subtly titled My Steel Woody.

-OBAMACARE SUIT TOSSED - The D.C. Circuit Court threw out a lawsuit stemming from West Virginia, according to The Incidental Economist.

-OVERREACH - POLITICO reports: "The Obama administration overstepped its authority by essentially prohibiting "fixed indemnity" health insurance plans from being sold, the U.S. Court of Appeals in D.C. confirmed in a ruling." Read the ruling here:

-CALIFORNIA SMART - The East Bay Times reports that some families are leaving California to avoid complying with its strict new vaccination law.

-FINAL ANSWER - The CMS issued a final rule expanding the number of organizations allowed to access Medicare and private claims data before selling it to providers and employers. Read the rule here:

TODAY'S TIP - Comes from the Mayo Clinic: "Golfers: Tee up some common sense with these tips."


-TOO SOON TO KNOW - Carl Zimmer explains that epigenetics may not hold all the answers despite early signs of promise. Three prominent researchers recently outlined their skepticism in detail in the journal PLoS Genetics.

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