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POLITICO New York Health Care, presented by the NYeC Gala & PATH Awards: DSRIP concerns; Silver's trial

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

DSRIP CONCERNS — Roughly seven months into the second year of the $7.3 billion Medicaid waiver, Performing Provider Systems had a chance to update the state on where they stood. The Albany Medical Center PPS said one of its challenges has been communication with the state’s Department of Health. Bethany Gilboard, the president and CEO of the Alliance for Better Care PPS, said the process they were using was an older “legacy system” that wasn’t collecting documentation of care as needed. Representatives of several PPSs also said one of their biggest hurdles is a shortage of primary care providers and behavioral health specialists. POLITICO New York’s Josefa Velasquez has more:

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

SILVER TRIAL — Sheldon Silver had sole discretion over whether to award funding to various groups from a little-known pot of money, federal prosecutors said Monday on the fourth day of his federal trial that hinges on whether the former state Assembly speaker was engaged in a quid-pro-quo with a Columbia University physician or whether it was simply business as usual at Albany. Read my story here:

...The New York Times reports: “On Monday, federal prosecutors in Mr. Silver’s corruption trial turned to a relatively obscure staff member on the Assembly Ways and Means Committee whose title seemed as bland as the job he held — deputy budget director for budget studies — to open a window into the seemingly impenetrable world of state finances that Mr. Silver controlled. The staff member, Victor E. Franco, in his second day of testimony at the trial in Manhattan, elaborated on the budgetary process, as prosecutors sought to illustrate that Mr. Silver controlled it all with little transparency or accountability, particularly on the Health Department grants that are the focus of the case.”

THE DOCTOR BEHIND IT ALL — Watching the start of former Assembly Speaker Sheldon Silver’s corruption trial last week, it was hard not to feel sorry for Dr. Robert Taub, a prominent physician who got sucked into one of Silver’s money-making schemes and is now paying dearly for that mistake. The bow-tie-wearing 79-year-old, holder of an endowed professorship at Columbia, dedicated his career to the good work of treating mesothelioma, a rare and deadly form of cancer caused by asbestos exposure. Now, he finds himself in a Manhattan criminal courtroom, confessing his role in a particularly ripe episode of Albany corruption – his reputation tarnished, his family humiliated and even his tenured job in jeopardy. Taub’s story is a powerful reminder that, just as surely as asbestos can poison the body, money can twist the soul. Make sure you read Bill Hammond’s column for POLITICO New York.

NOW WE KNOW — The New York Times writes about OpenBiome, which “has come up with a capsule containing fecal microbes that can be taken much like any other drug — poop in a pill.”

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

** A message from the New York eHealth Collaborative’s Gala & PATH Awards: Join 300 CEOs, C-level executives, and influencers from New York State health systems, health plans, large employers, and the public sector leading New York's healthcare transformation by reshaping it into a new, secure, digital system. The awards honor individuals and organizations who have contributed to the advancement of health IT in New York State. 2015 Honorees: Steven M. Safyer, MD, President & CEO, Montefiore Medical Center; and Jason Gorevic, CEO, Teladoc. Register today to join our exclusive community of healthcare leaders. November 18, 2015, at Capital, New York, NY. **

REBRANDING — The New York City Health and Hospitals Corporation is rebranding, changing its name to NYC Health + Hospital. The logo has been replaced with a more colorful orange and blue. The “new brand strategy” is intended to help HHC redefine itself and, more plainly, help the cash-strapped organization in its efforts to make more money. HHC is facing a more than $1 billion dollar deficit in the next several years. The rebranding also means that each of the 11 public hospitals in the city’s system and every long-term care center and community based health center run by HHC will also change their names. For example, Bellevue will now be known as NYC Health + Hospitals/Bellevue and Lincoln Medical and Mental Health Center will be known as NYC Health + Hospitals/Lincoln. Read more here:

Read the press release here:

SUPREME COURT WEIGHS SCHNEIDERMAN’S PURSUIT — The US Supreme Court is considering a request from Allergan to rule on whether drug companies can pull a medication from the market as generic competition looms in order to force patients to switch to new versions of the drug, according to Pharmalot’s Ed Silverman. “Allergan’s request follows a heated battle between the drug maker and New York Attorney General Eric Schneiderman over a tactic known variously as product-hopping or forced switching, which involves pushing consumers from one product to another. A federal appeals court earlier this year ruled that a switch Allergan had planned would harm consumers. … Schneiderman argued the tactic was “unethical and illegal” because patients would be forced to switch to the newer Namenda XR pill well before lower-cost generics are available for the older drug.

WHO ARE THE UNINSURED? — Census data showed the number of uninsured residents is much higher in some pockets of Queens, Brooklyn and the Bronx where the percentages of residents who are foreign-born is high. In neighborhoods like Sunnyside, Jackson Heights and Elmhurst/Corona in Queens, rates of uninsured hovered around 22 percent, the census data showed. In Flushing, 18.9 percent of residents are uninsured. See the full analysis here:

DE BLASIO CALLS FOR ZADROGA PASSAGE —Mayor Bill de Blasio and members of New York’s congressional delegation are calling on House Speaker Paul Ryan to convince the Republican House majority to permanently extend the 2010 Zadroga Act, the law that provides compensation for first responders who became ill after the September 11, 2001 terror attacks. The chair of the House judiciary committee, Rep. Bob Goodlatte, introduced his own reauthorization bill several weeks ago that has been roundly criticized by members of the New York delegation. Goodlatte’s bill would significantly modify the Zadroga plan — extending it by five years instead of permanently reauthorizing it, and cutting compensation payments for victims by as much as 60 percent. POLITICO New York’s Laura Nahmias has more:

FAXTON’S BACK — The Utica Observer-Dispatch reports: “Faxton St. Luke’s Healthcare is back in the good graces of the Centers for Medicare & Medicaid Services following a Jan. 12 report that found multiple violations in the hospital’s emergency department.”

COMING SOON — YIMBY reports: “Staten Island-based Mzx Group Inc. has filed applications for a seven-story, 13,182 square-foot ambulatory, diagnostic and healthcare treatment facility at 867 53rd Street, in eastern Sunset Park.”

NORTH SHORE-LIJ AFFILIATION — North Shore-LIJ signed an agreement Monday for a clinical affiliation with ENT and Allergy Associates to focus on pediatric ear, nose and throat care.

ACROSS THE RIVER — A Superior Court judge in Middlesex County denied a request from Saint ’s University Hospital to issue a temporary restraining order designed to stop Horizon Blue Cross Blue Shield of New Jersey from implementing its OMNIA tiered health plans. Read more here:

-BANNED — Gov. Chris Christie signed a ban on the sale of powdered alcohol products, or Palcohol, into law on Monday.

-BACK TO WHERE WE STARTED — Saint Michael’s Medical Center in Newark announced on Monday evening that Prime Healthcare Services is the successful bidder in the hospital’s bankruptcy auction. The California-based for-profit’s final offer was more than $62.2 million. Saint Michael’s owes $228.8 million in outstanding state-backed bonds. Prime first entered into an asset purchase agreement with Saint Michael’s in 2013. The state’s review of the sale has held up the process for almost three years now. The hospital declared bankruptcy in August, hoping to speed up the sale to Prime. Instead, other interested parties appeared, including Prospect Medical Holdings, the other bidder in the auction. But Prime won the bid, so we’re kind of back where we started, waiting for the state. POLITICO New Jersey’s Katie Jennings has more:

PHARMA REPORT: President Barack Obama said he is looking "at every idea out there" to reduce drug costs, from negotiating drug prices in Medicare and Medicaid to figuring out how to prevent companies from jacking up prices of older drugs, according to POLITICO. Obama also spoke of the role of government-backed research in developing new drugs. "We essentially subsidize the development of a lot of these new drugs. And that is why prices oftentimes are cheaper in other countries," Obama said.

-NO ON INVERSION — POLITICO reports: “Rep. Mark Pocan (D-Wis.) introduced two bills [Monday] intended to prevent corporations from ‘inverting’ to reduce their tax bills. Pfizer Inc.'s pursuit of a merger with Allergan PLC in recent days has brought renewed congressional scrutiny to the practice of moving a company's tax headquarters abroad through a merger.

The "Corporate Fair Share Tax Act" would curb so-called earnings stripping - moving profits abroad by loading up a U.S. subsidiary with tax-deductible debt - by limiting the available deduction. The deduction would be restricted to corporations in which the U.S. entity's share of interest is proportionate to its share of the multinational group's profits. The change would yield $49 billion in revenue over 10 years, according to a Treasury estimate of a similar restriction included in President Obama's fiscal year 2015 budget. The "Putting America First Corporate Tax Act" would eliminate deferral of taxation on foreign profits.


-PAGING DICK GOTTFRIED — Colorado voters put a single-payer health system on the November 2016 ballot. The New York Assembly passed a single payer law earlier this year but it did not move in the Senate.

-TOO SWEET — The Food and Drug Administration is considering a recommended cap on sugar for the first time, according to The New York Times. “The goal is for Americans to limit added sugar to no more than 10 percent of daily calories, according to the proposed guidelines. For someone older than 3, that means eating no more than 12.5 teaspoons, or 50 grams, of it a day. That’s about the same amount of sugar found in a can of Coke, but for most people, giving up sugary soft drinks will not be enough to meet the recommendations.”

-WHAT WE’RE MISSING — There has been a lot made of the recent study that found white, middle-aged Americans are dying at an unprecedented clip, and substance abuse is a leading culprit. Dan Diamond, for, reminds us that in 2013, CMS began deleting substance use disorder data from the files they share with researchers. “After researchers Austin Frakt and Nicholas Bagley broke the story, CMS said it was a matter of patient privacy and, citing a long-overlooked 1987 rule, concluded that researchers needed to start obtaining individual consent. It's hard to underscore how big a change this was at the time. First, it's impractical for researchers to get individual consent for millions of records. Second, it was a reversal of how Medicare and Medicaid health care claims data had been used for decades. Frakt and Bagley have spent months using their not-insignificant platforms at the New York Times and New England Journal of Medicine to advocate for a fix. Bagley even took a crack at writing a statute that Congress could just drop into a bigger bill. But so far nothing has changed.

-AND WHAT WE’RE NOT DOING ABOUT IT — Bill Gardner writes about how the National Institutes of Health has cut funding for the study of the very problems killing these Americans.

TODAY'S TIP — Comes from the Community Healthcare Network’s Director of Nutritional Services Maegan Ratliff: “To avoid overeating this Thanksgiving make sure you don’t skip breakfast, and load your Thanksgiving plate up with protein and vegetables.”


-HEART HELP — Researchers at Mount Sinai found group therapy helped improve healthy behavior in people with cardiovascular risk factors, according to a study in the Journal of American College of Cardiology. “Peer group support is a proven strategy for addressing substance abuse, eating disorders and chronic illness,” Dr. Valentin Fuster, director of Mount Sinai Heart and physician-in-chief of The Mount Sinai Hospital, said in a press release accompanying the article. “We now have proof that peer group support also helps improve healthy behaviors in people who are at a higher risk for cardiovascular issues and has a significantly positive impact on smoking cessation.”

-WHY PREMIUMS WON’T COME DOWN — Austin Frakt, in The Incidental Economist, explains why premiums are unlikely to come down even as hospitals pay for less uncompensated care because coverage has expanded. “Now, as coverage expands, this does suggest a reduction in premiums, but only if other support for uncompensated care isn’t withdrawn. Guess what? It is. Don’t expect coverage expansion to pay a dividend to premium payers if it’s, in a sense, already paying it to the government through lower support for uncompensated care.”

** A message from the New York eHealth Collaborative’s Gala & PATH Awards: Join 300 CEOs, C-level executives, and influencers from New York State health systems, health plans, large employers, and the public sector leading New York's healthcare transformation by reshaping it into a new, secure, digital system. The awards honor individuals and organizations who have contributed to the advancement of health IT in New York State. 2015 Honorees: Steven M. Safyer, MD, President & CEO, Montefiore Medical Center; and Jason Gorevic, CEO, Teladoc. Register today to join our exclusive community of healthcare leaders. November 18, 2015, at Capital, New York, NY. **

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