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POLITICO New York Health Care, presented by PhRMA: James settles with state, not city; Assembly considers transitioning care

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 Dan Goldberg

JAMES SETTLES WITH STATE, NOT CITY — A little more than three months after she filed a federal class-action lawsuit against city and state child protective services agencies alleging mismanagement in foster care, Public Advocate Letitia James announced she had reached a settlement. Its terms include requiring the state’s Office of Children and Family Services to install a new monitor to oversee the Administration for Children's Services, a city agency it already oversees. The settlement may mark the newest chapter in an ongoing feud between Gov. Andrew Cuomo and Mayor Bill de Blasio. The city and ACS were left out of the settlement agreement entirely. In an important detail relegated to the last line in a press release issued Tuesday announcing the settlement, the Public Advocate's office revealed that her office is still, in fact, suing the city and ACS. A spokeswoman for James said that Cuomo’s office reached out to the public advocate immediately after she filed the lawsuit in early July, at the height of de Blasio’s feud with Cuomo.

TRANSITIONING CARE — An Assembly panel on Tuesday heard from both the Office for People with Developmental Disabilities as well as advocates for the developmentally disabled, about what can be done to facilitate the transformation from living on an Office for People with Developmental Disabilities campus to a community-based facility. In 2013, as part of a United States Supreme Court decision, OPWDD entered into a “transformation agreement” with the Centers of Medicare and Medicaid Services. Under the agreement, OPWDD committed to offer individuals who live on its campuses the ability to live in smaller, more personalized community-based living facilities. Read more here: [PRO]

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SIGNED — Mayor Bill de Blasio signed legislation Tuesday that will criminalize the sale and production of K2, a drug sold in bodegas and convenience stores that has ravaged the homeless populations in East Harlem for months, and has been directly responsible for at least one death. The legislation criminalizes the manufacture, possession with intent to sell and sale of the drug. Under the new laws, which take effect in 60 days, selling K2 is a misdemeanor that can carry punishments of up to a year in jail and $5,000 in fines. Another piece of legislation signed Tuesday will allow the city to revoke, suspend or refuse the lucrative cigarette licenses of any bodegas or dealers who are found to be selling synthetic marijuana. POLITICO New York’s Laura Nahmias has more:

NOW WE KNOW — Researchers atCornell University are able to gauge a woman’s weight by the food on her counter. The study, published in Health Education and Behavior, found women who had breakfast cereal sitting on their counter weighed 20 pounds more than those who did not. Those with soft drinks out were 24 to 26 pounds heavier. Those who had a fruit bowl weighed about 13 pounds less. The study looked at 200 kitchens. All were in Syracuse.

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** A message from PhRMA: In 2013 alone, the biopharmaceutical industry invested more than $553 million dollars in clinical trials in New York. Learn more about the economic impact of clinical trials in our communities at **

NURSES PROTEST — Members of a state nurses union are holding a "die-in" to protest the movement of oil trains through New York State. On Wednesday, hundreds of members of the New York State Nurses Association will protest at the Amtrak station in Saratoga Springs, where dozens of oil trains pass through each day on their way to the Port of Albany or further south. The union, which has almost 40,000 members, is trying to dramatize the threat posed by oil trains and is calling for legislation to make the transportation of crude oil safer. The protesters will be joined by labor and environmental groups, as well as Democratic Assembly members Patricia Fahey of Albany, Richard Gottfried of New York City and Phillip Steck of Albany.

MEDICAL MARIJUANA 101 — Physicians who would like to prescribe medical marijuana in New York State will be required to take a four-hour online course, the state's health department said Tuesday. The course, according to a press release from the agency, will include information on the pharmacology of marijuana, contraindications, adverse reactions, drug interactions, dosing, routes of administration, risks and benefits and abuse and dependence. The class will cost $249 and count for four 4 1/2 hours of Continuing Medical Education credits.

The course can be accessed here:

CASH INFUSION — The Syracuse Post-Standard reports: “The parent company of Oswego Hospital will receive $3 million in state and federal money to help stabilize its financial health. The federal Centers for Medicare and Medicaid Services has approved a state plan that will allow Oswego Health to get the money through the Vital Access Provider Program. That program provides operating assistance to financially distressed hospitals, nursing homes and other health facilities to help them redesign their health care delivery systems so they can achieve financial stability.”

IN CASE YOU MISSED — A Manhattan judge on Monday ruled that New York’s ban on assisted suicide is constitutional, according to the New York Post. “State civil judge Joan Kenney ruled that while she was sympathetic to the patients’ plight, the US Supreme Court has already found that New York state laws prohibiting assisted suicide are not a violation of civil rights.”

....J.J. Hanson, an aide to former governors Eliot Spitzer and David Paterson, is set to help lead the fight against a bill to legalize physician-assisted suicide in New York State, according to the Daily News. “Hanson, who last year was diagnosed with brain cancer, is now president of the Patients Rights Action Fund, a group opposing assisted suicide efforts nationally.”

PHARMA REPORT — The New York Times looks at how drug companies are sidestepping barriers to pricing. “Use of specialty pharmacies seems to have become a new way of trying to keep the health system paying for high-priced drugs.”


-ANOTHER ONE BITES THE DUST — Dartmouth Hitchcock Health System will exit the Pioneer ACO program because the financial penalties and performance goals are unsustainable, Modern Healthcare reports. The Centers for Medicare and Medicaid Services started with 32 Pioneer ACOs in 2012. We’re down to 18.

-THE OTHER SIDE OF THE ARGUMENT — I’ve written a lot about economists who support the so-called Cadillac Tax, the 40 percent excise tax on expensive health insurance plans. The tax, which does not take effect until 2018, is under fire from both political parties and may not survive the next administration. That, for the most part, is because of political considerations.’s Sarah Kliff reports on two economists making an economic case for why we should repeal the tax. They say the problem with suggesting that higher deductibles and co-pays will lead to a reduction in unnecessary care is that people aren’t smart enough to know what is necessary and what is extraneous. So, people will end up skipping needed medical care and become sicker.

-WHERE PHARMA IS STILL KING — Pharma companies have been making a lot of enemies lately because of drug prices. Everyone from Hillary Clinton to Marco Rubio says something must be done. But one place where the pharma agenda is alive and well is Capitol Hill, according to ProPublica. “Legislation is advancing that would speed up the FDA’s approval process for medications and medical devices, offering a rare example of how major initiatives can get traction even in today’s gridlocked Washington. … But the enthusiasts have left a small band of critics warning that bipartisan consensus does not necessarily affirm the bill’s worth. Far from showing that Washington can still get big things done, they say, it shows how a lobby can blow past skeptics if the pot of resources is sweet enough. They maintain that the bill, which easily passed the House in July and has a counterpart soon to be introduced in the Senate, hasn’t received the scrutiny that such sweeping legislation deserves.”

-FEWER MAMMOGRAMS RECOMMENDED The American Cancer Society issued new guidelines on Tuesday calling for women, who do not have heightened risk of breast cancer, to start having mammograms at 45 rather than 40. The organization also said women should get one once a year until 54, then every other for as long as they are healthy and expected to live another 10 years.

...Curious what readers, especially female readers, think of these new guidelines. (Feel free to email responses.) It will be interesting to see if they are heeded by doctors and patients or if people will, for a while, at least, err on the side of caution. If there is a reduction in mammograms, it could reduce costs both because there are fewer tests and fewer false positives. Of course, early detection could be lost as well.

-SYPHILIS IN THE MILITARY — Syphilis among the armed forces has increased 41 percent since 2010.

TODAY'S TIP — Comes from the state’s health department, which reminds us “you can’t feel bones getting thinner. Osteoporosis is a silent disease. Know when to get a Bone Mineral Density test.”


-EASE UP ON X-RAYS — Researchers from Mount Sinai Beth Israel are recommending a restrictive approach to ordering chest x-rays, according to an article in Chest. "A restrictive approach to ordering chest x-rays in the ICU appears to be a safe practice," Dr. Jason Filopei, Mount Sinai Beth Israel physician and lead researcher, said in a press release accompanying the article. "We believe it will lead to a significant saving of hospital resources."

-ALSO, EASE UP ON THE CATHETERS — Researchers from Maimonides Medical Center decreased the use of indwelling urinary catheters in patients from 92.3 percent to just 15 percent. "An intensive educational program with daily focus on appropriateness of IUC use can dramatically reduce use of ICUs in a MICU setting and can reduce catheter-associated urinary tract infections," Drs. Pavan Irukulla and Yizhak Kupfer, Maimonides Medical Center lead researchers, said in a press release accompanying the article.

-SECOND THAT EMOTION — Researchers from Stony Brook Cancer Center found 43 percent of patients undergoing low-dose computed tomography screening experience elevated stress before screening, and one-third experienced continued stress even after they were told they were cancer free, according to an article in Chest.

-THE HOLOCAUST AND GRATITUDE — Researchers at the University of Southern California are mapping gratitude in the brain using testimony from Holocaust survivors whose lives were saved. Participants in the study were shown documentaries on the Holocaust, Nazism and persecution. Then they were then told the real stories of people who were saved while an MRI mapped their brain. The researchers found that when the brain feels gratitude, it activates areas responsible for feelings of reward, moral cognition, subjective value judgments, fairness, economic decision-making and self-reference.

** A message from PhRMA: Every day in New York, countless people fight life-threatening diseases. Their bravery inspires countless researchers and scientists across the country in their quest to develop medicines that help patients live longer, healthier lives. Here in New York, the biopharmaceutical industry has invested more than $553 million during the 2,476 clinical trials that took place in 2013 alone. Each step brings us closer to a cure. To learn more, please visit **

MISSED A ROUNDUP? Get caught up here: 10/20, 10/19, 10/16, 10/15, 10/14

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