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POLITICO New York Health Care, presented by PhRMA: Medical marijuana problems; Legionella at Syracuse hospital

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

WILL THE MEDICAL MARIJUANA PROGRAM BE READY BY JANUARY? — With roughly three months until the state’s medical marijuana program is supposed to be fully operational, several companies awarded a license to grow and distribute the drug aren’t sure where they will locate some of their dispensaries, calling into question whether the program will be up and running by January, as Governor Andrew Cuomo promised. Five of the 20 dispensary locations, which the state sanctioned, have not been finalized yet by the local governing body, meaning that patients in large areas of the state could be left without access to the drug. While all five licensees may settle their dispensary locations by January, the uncertainty with just nine weeks until the new year feeds the worst fears of medical marijuana advocates, who never believed Cuomo understood their urgency. Read our story here:

COLUMBIA CARE SETTLES WITH RIVERHEAD — Columbia Care, one of the five companies the state has licensed to grow and distribute medical marijuana, has found a new site for its Long Island dispensary. The company will now have a dispensary at 1333 E. Main St. in Riverhead, about two miles east of Peconic Bay Medical Center, CEO Nicholas Vita said Friday. The company had originally proposed a dispensary a couple miles down the road, also in Riverhead. But that site, an old Blockbuster video store, sparked local concern because of its proximity to the high school, and the town board considered a moratorium on medical marijuana dispensaries. That is now off the table, Vita said, thanks to the new location, a medical office owned by a local oncologist, who also specializes in palliative care. Vita said he expects to have his program up and running by January, in line with state expectations.

HEAVEN FORBID — The Pope’s visit hurt the finances of Cooper University Health Care, according to its latest financial report. Cooper lost out on $4.5 million in projected outpatient revenue for the month of September, POLITICO New Jersey’s Katie Jennings reports. “The main story around patient service revenue is the significant fall off in volume leading up to the Pope Visit weekend,” the financial report said.

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LEGIONELLA IN THE HOSPITAL — Gov. Andrew Cuomo is deploying staff from the state Department of Health to St. Joseph’s Hospital Health Center in Syracuse after preliminary testing found traces of Legionella bacteria in the building’s water system. On Saturday morning, hospital officials said they had received preliminary test results indicating some of the hospital's water supply may contain the Legionella bacteria. As a precaution, the hospital halted the use of tap water for hand washing. [PRO]

NOW WE KNOW — Biologists at the University of Utah are using the arms of dead people to punch and slap dumbbells. Why? To see if our hands evolved so that men could fistfight each other for women. These researchers started with nine cadaver arms but ended up using only eight because one was too arthritic. They purchased the cadaver arms from the university's body donor program and from a private supply company. "We tested the hypothesis that a clenched fist protects the metacarpal [palm or hand] bones from injury [and fracture] by reducing the level of strain during striking," the study says. The research was funded by the National Science Foundation. And here’s an image to take with you: The cadaver hands were placed in those positions with fishing line tied to tendons of forearm muscles. Guitar-tuner knobs controlled tension on the fishing lines to adjust the hands. "Each one of these hands took about a week of work,” professor David Carrier, senior author of the study published in the Journal of Experimental Biology, said in a press release accompanying the article.

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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 **

FINANCES — Strong Memorial Hospital in Rochester reported an operating revenue of $1.45 billion in the 2015 fiscal year, up more than 8 percent since the 2014 fiscal year. The hospital reported a total operating expense increase of nearly 11 percent from $1.22 billion during the 2014 fiscal year to $1.35 billion, according to the recently released municipal secondary market financial disclosures. View the full disclosure here:

CBOs LEARN ABOUT DSRIP — Approximately 100 representatives from different Community Based Organizations were at Medgar Evans College on Thursday to learn more about the state’s Delivery System Reform Incentive Payment program. Community based organizations are supposed to be a key part of the reform but many are unaware what their role should be. The forum coordinators include the IM Foundation, The Commission on the Public's Health System, Brooklyn Perinatal Network, CAMBA, The Caribbean Women's Health Association, Arthur Ashe Institute for Urban Health, The US Census Information Center at Medgar Evers College and The Brooklyn- Queens-Long Island Area Health Education Center.

GRANT LAND — Montefiore Health System received a four-year, $6.9 million grant from the Center for Medicare and Medicaid Innovation to treat people with severe mental illness. The money will be used to create a Practice Transformation Network, which is a care management program focused on relapse prevention. Montefiore will partner with North Shore-LIJ.

PHARMA REPORT — The Wall Street Journal continues breaking Theranos news, reporting that Walgreens Boots Alliance Inc. won’t open any new blood-testing centers until the startup company resolves questions about its technology. “On Thursday, a team from the drugstore chain met with senior Theranos executives, including founder and Chief Executive Elizabeth Holmes, at the startup’s headquarters in Palo Alto, Calif. … Walgreens officials also were concerned after finding out in a follow-up article in the Journal that Theranos had stopped collecting tiny vials of blood drawn from finger pricks for all but one of its more than 240 tests. Walgreens officials also were unaware of the Food and Drug Administration’s surprise inspection of Theranos facilities in August and September.”

- PARKER — The Wall Street Journal digs into Valeant Pharmaceuticals International, a company whose stock plummeted after questions were raised about the accuracy of its revenue figures. “Around the Phoenix-area offices of mail-order pharmacy Philidor Rx Services LLC, employees said they often ran into a friendly colleague named Bijal Patel who tracked prescriptions. But when the employees got an email from the colleague, they say he used a different name: Parker, the alter ego of Spider-Man. … The use of alternative names by workers at Philidor is one of a number of new details emerging about the relationship between Valeant and the network of specialty pharmacies it uses to distribute drugs. The relationship is at the center of questions that investors have raised about the strength of the drug company’s operations and the disclosures of its business ties.”


-SHAMEFUL — The American Academy of Pediatrics is now recommending physicians screen children for food insecurity. "It is important that everyone knows how to screen so that at every available opportunity they can do it," said Dr. Sarah Jane Schwarzenberg, lead author of the new policy statement. "We can't tell just by looking who is food insecure or not -- they look just like you and me.” Food insecurity — the stress of not knowing on a given day whether there will be enough food to eat — affects 20 percent of U.S. children. That’s 16 million kids. In New York City, it’s 25 percent of children, according to the Coalition Against Hunger.

-HOW THE TRIPLE WHAMMY UNDID THE TRIPLE AIM — Health Affairs takes a deep look at why Dartmouth-Hitchcock Health System, one of the best, pulled out of the Pioneer ACO program. Three problems: 1) Flawed risk-adjustment methodology. 2) A moving target: “The relative slowdown of cost growth in the US during this time period allowed organizations that had a history of providing excess care to generate a higher percentage of cost savings while concurrently generating unachievable targets for ACOs that operate in historically low-cost environments.”3) Identical incentives regardless of baseline performance. In other words, it gets really hard to lower costs when a system is already performing well.

-TWO SURGERIES AT ONCE — The Boston Globe examines the practice of surgeons performing two complicated surgeries at once, shuttling between two different operating rooms. “In medicine it is called concurrent surgery, and the practice is hardly unique to Wood or MGH. It is allowed in some form at many prestigious hospitals, limited or banned at many others. Hospitals that permit double-booking consider it an efficient way to deploy the talents of their most in-demand specialists while reducing wasted operating room time. For patients, however, it can come as an unsettling surprise — especially when things go wrong.”

-ROMNEY’S CONFLICTING STATEMENTS ON OBAMACARE — See if you can follow this: In 2012, Mitt Romney, running for President, said Obamacare was a bad law and he’d repeal and replace. It was different than Romneycare, the Massachusetts program he established, he said. On Friday, in an obituary for Staples founder Thomas Stemberg, Romney credits him with sparking the plan to provide near-universal health care. "Without Tom pushing it, I don't think we would have had Romneycare," Romney told the Boston Globe. "Without Romneycare, I don't think we would have Obamacare. So, without Tom a lot of people wouldn't have health insurance." The obit:

...Lest, that sound like an implicit endorsement
of a law that provides people with health insurance, Romney took to Facebook to write: “Getting people health insurance is a good thing, and that’s what Tom Stemberg fought for. I oppose Obamacare and believe it has failed. It drove up premiums, took insurance away from people who were promised otherwise, and usurped state programs. As I said in the campaign, I'd repeal it and replace it with state-crafted plans.”

-STUDENT PRIVACY — Charles Ornstein is out with the latest in his year long series on patient privacy. This time he focuses on students. “The story explains how university students have less privacy for their campus health records than they would have if they sought care off campus. Schools say they are trying to seek the right balance between privacy and safety, but some say student records aren’t protected enough.”

-SHORT READ — A sex scandal lands Prime Healthcare in hot water.

TODAY'S TIP — Comes from Johns Hopkins Medicine, which reminds us to “stay calm and cool, for the sake of your heart.”


-HOW WE DOING? — Lindsay Kelly, who works in the Office of Health Insurance Programs, published an article in JAMDA that examined the impact of Certified Home Health Agencies on aging-in-place trends in New York State.

-PREGNANCY WEIGHT — Researchers at Columbia University’s Mailman School of Public Health found that mothers with excessive weight gain during pregnancy weighed more and had greater body fat seven years after delivery, even if they began pregnancy at a normal weight or slightly overweight. That means, according to a press release from the university and a corresponding article in the American Journal of Clinical Nutrition, that gestational weight can have long term consequences. The study looked at data from 302 African–American or Dominican mothers enrolled in the Columbia Center for Children’s Environmental Health Mothers and Newborns Study in Northern Manhattan and the South Bronx from 1998 to 2013. Before pregnancy, 5 percent of the African–American and Dominican women studied were underweight, 53 percent were normal weight, 20 percent of overweight, and 22 percent were obese. Nearly two-thirds gained more weight than recommended during their pregnancy. Among mothers who were not obese before pregnancy, mothers with excessive weight gain had a nearly 400 percent increased risk of obesity seven years after giving birth, according to the release. And the effects were more pronounced on the women with a lower pre-pregnancy Body Mass Index.

-CELL SCIENCE — Researchers at Weill Cornell Medicine and SUNY Downstate Medical Center discovered how diseased cells produce proteins that help them thrive in the body. According to a press release from WCM, the ribosomes of diseased cells do not bind to the caps of messenger RNA, or mRNA. They latch on to a different part of the mRNA. These mRNA subsets often contain instructions for making proteins that are important for diseased cells to survive and multiply. Think cancer. Their work appears in Cell. “Our team has uncovered a pathway through which cap-independent translation can be turned on and off, raising the possibility that diseased cells might use this mechanism to regulate the translation of specific mRNAs that are important for survival or proliferation,” senior author Dr. Samie Jaffrey, a professor of pharmacology at Weill Cornell Medicine, said in a press release accompanying the article. “This discovery has important clinical ramifications, because it identifies a novel pathway that can potentially be targeted therapeutically.” If scientists can turn off the alteration in the nucleotides they might block the progression of certain diseases.

** 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: 10/23, 10/22, 10/21, 10/20, 10/19

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