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POLITICO New York Health Care: Paying for marijuana; Weill Cornell, NYP start new company

Dear readers: POLITICO New York Pro subscribers receive this email at 5:30 a.m. each weekday. If you'd like to receive it at that time, 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 Josefa Velasquez

MEDICAL MARIJUANA INSURANCE COVERAGE — With about four months left before the state’s medical marijuana program is slated to become fully operational, many insurers say they have no plans to cover the Schedule I drug under their current policies. Excellus BlueCross BlueShield, one of Western New York’s largest insurers, only covers drugs approved by the federal Food and Drug Administration under its current policy, a spokesman told POLITICO New York. An Aetna spokesman echoed the sentiment, adding that the insurance company already covers Marinol, an FDA-approved drug that contains some of the same elements as marijuana and is used to treat nausea. Emblem Health, one of the state’s largest insurance providers, also has no plans to cover medical marijuana. Medicaid will not cover it, either. “It has been a major concern for patients and families,” said Julie Netherland, the deputy state director of the Drug Policy Alliance. “Some patients are going to simply be left behind because they’re not going to be able to afford the medicine.”

WEILL CORNELL, N.Y.-PRESBYTERIAN TEAM UP — Weill Cornell Medical College and New York-Presbyterian Hospital have started a new for-profit company, Lumendi, that will focus on developing and bringing to market new endoscopic tools for use during gastrointestinal surgeries. The company was created to test the Endolumeenal Surgical Platform, a disposable device that fits over an endoscope — the way a koozie fits over a can — and offers increased stability and control, according to a press release from Weill Cornell. The idea comes from the Minimally Invasive New Technologies (MINT) program, a group within Weill Cornell and New York-Presbyterian that works on developing and commercializing new medical devices.

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NOW WE KNOW — If you’re obese at 50 years old, you may be at an increased risk of developing Alzheimer’s at a younger age, according to a study in Molecular Psychiatry.

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GRANT LAND — The city's health department will receive $4.44 million from the Centers of Disease Control and Prevention to increase use of pre-exposure prophylaxis (PrEP), which helps prevent people from contracting HIV. The grant comes from a $185 million pot first announced in March, which funds local health departments working to combat HIV.

LEGISLATING HUMAN TRAFFICKING — StateAssemblyman Matthew Titone will introduce legislation that will require state contractors, municipalities and public authorities receiving state funds to craft policies that prevent human trafficking within their supply chains, according to a press release from the Staten Island Democrat's office. "Human trafficking is a despicable crime in which victims are exploited by vile predators," Titone said in the release. "Innocent people — mostly women and children — are taken advantage of, exploited and forced into deplorable situations."

SUNY’S NEW GENDER, SEXUAL IDENTITY POLICY — When SUNY students register for their spring classes later this fall, they will have more choices than male or female as their gender identifier. Students will be able to select one of seven options: man, woman, trans man, trans woman, genderqueer/gender-fluid, questioning or unsure or write-in an identity. Same goes for their sexual identity. Students can select straight, gay, lesbian, bisexual, pansexual, queer, questioning or unsure, or write-in an orientation not identified, under a new diversity policy the trustees of the State University of New York approved Thursday. The new policy will require diversity officials, plans and training at all SUNY campuses and will require that every campus develop a diversity and inclusion plan.

TROUBLE IN VALHALLA The Journal-News reports “Westchester Medical Center is seeking a new contractor to provide mental health care just three years after outsourcing the task to a Pennsylvania company. The move leaves the future of nearly 200 mental health workers uncertain.” Read more here:

HEALTH ACCELERATOR ADDS STARTUPS — The New York Digital Health Accelerator, a program run by the Partnership Fund for New York City, which aids early-stage and developing digital health companies, announced it would be taking on six new startups, including an app to help physicians track wound recovery, a tool that allows users to distribute and implement clinical care paths to a team of physicians or nurses and a tool that aggregates medical data and visualizes it. "With New York State's implementation of new payment models and care delivery mechanisms such as DSRIP, the NYDHA serves as an engine of innovation helping to provide the new tools and solutions healthcare professionals need to deliver better patient outcomes, reduce costs, and thrive in this new era of healthcare," David Whitlinger, executive director of the New York eHealth Collaborative, said in a statement.

PHARMA REPORT: Bloomberg Business reports: An analysis shows that attempts by drugmakers to raise prices on their prescription medications are being wiped out in negotiations with managers of drug insurance benefits, such as Express Scripts Holding Co. and CVS Health Corp.


-THE ARGUMENT AGAINST COST SHIFTING — Austin Frakt explains why the cost shifting argument, mentioned in Ezekiel Emanuel’s op-ed on drug prices, is wrong. Emanuel believes that if Medicare paid less for drugs, the pharma companies might raise prices on commercial insurers to make up the difference. But here’s a little Socratic method to explain why that might not be the case: Are drug manufacturers profit maximizing organizations? Of Course.

Well, if they could profitably raise prices to commercial market payers after government ones pay less, why didn’t they raise those prices before? It suggests they left money on the table.

-POINTING FINGERS — POLITICO’s Paul Demko reports on Thursday’s House Judiciary subcommittee hearing on consolidation in health care. Neither providers nor insurers could agree on which aspect of the consolidation was more alarming. [PRO]

-OPEN FOR BUSINESS — The Center for Medicare and Medicaid Services opened up its databases to researchers and entrepreneurs as part of a study to create products or tools they intend to sell or with which they plan to conduct research. But there are some conditions. CMS must approve of a research protocol under the existing research request process, an additional review to check whether the product or analysis could exploit beneficiaries or create fraud or abuse in CMS programs and a requirement that researchers access data through the CMS Virtual Research Data Center.

-SANDERS PLAN — Vermont Sen. Bernie Sanders, who is seeking the Democratic presidential nomination, introduced legislation Thursday aimed at fighting soaring prescription drug costs. His plan would make it easier to import prescription drugs from Canada and allow Medicare to negotiate lower drug costs for seniors, as Medicaid and Veterans Affairs both do.

-THE NEW DOCTOR, PATIENT DYNAMIC — The Associated Press looks at the new relationship between patients and the emerging alternatives to primary care physicians, like retail clinics and telemedicine. “The shift began more than a decade ago and has accelerated in recent years, the result of technology and competition creating more convenient options for care that does not require an in-person doctor visit. Insurance reforms have also contributed by pushing patients to shop around for the best price.These changes have helped make basic care more accessible to patients and lowered the cost per visit for many consumers. But the new options also make the doctor-patient bond seem like a throwback to another era.”

-IN CASE YOU MISSED — Anesthesiologists will be the first specialists no longer required to be recertified every 10 years. “Beginning next year, the American Board of Anesthesiology instead will offer its 50,000 ‘board-certified’ members the opportunity to show their mastery — and brush up if they fall short — through weekly online quizzes that they can take at will, coupled with educational material.”

-PREVENTING FOOD HAZARDS — The Food and Drug Administration finalized two rules mandating that food companies identify possible food safety hazards and actively take steps to reduce the risks rather than acting on them after someone gets sick.

...The move comes a little too late. The Centers for Disease Control and Prevention said a second person died after eating cucumbers contaminated from salmonella poona. The number of cases has increased to 341 people in 30 states (including four in New York). The outbreak is linked to a “slicer” of cucumbers imported from Mexico. The cucumbers are dark in color and typically sold in bulk displays at supermarket without wrapping.

TODAY'S TIP Comes from the Department of Health and Human Services. Yesterday was World Suicide Prevention Day, here are suicide warning signs to look out for.


-CATCHING ALZHEIMER’S — Scientists in the United Kingdom found that Alzheimer’s disease may be transmitted from one person to another during certain medical procedures. The study, published in the journal Nature, looked into eight people who were given growth hormone injections as children and found that Alzheimer’s can be transmitted when infected tissues or surgical instruments are passed between people. But before you start kicking your ill family member out of the house, scientists stress that the study is in its preliminary stages and that it is, in no way, a contagious disease.

-HEAD BANGERS — Simple sideline vision testing is 86 percent effective in detecting concussions, a review of 15 previous studies done by researchers at the the NYU Langone Concussion Center found. The study, published in the journal Concussion, found a timed vision test that asks participants to rapidly read numbers off of cards can detect whether there is a possible sports-caused concussion. When coupled with balance and cognition assessments, the testing battery was able to detect 100 percent of concussions that occurred amongst athletes.

-A SMOKEY FOUNTAIN OF YOUTH — Researchers at UCLA discovered a set of genetic markers in long-lived smokers that may allow them to better withstand and diminish the effects of environmental damage from stressors. The study, published in the Journals of Gerontology, Series A: Biological Sciences & Medical Sciences, found that smokers who were 80 or older had similar physiological functions a non-smokers in their age group. The Washington Post has more:

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