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POLITICO New York Health Care, presented by the NYeC Gala & PATH Awards: MetroPlus to pick up HR customers; Cuomo signs marijuana legislation

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 newyork@politicopro.com and we'll set you up for trial access.

written by Dan Goldberg

METROPLUS TO THE RESCUE — New York City's public hospital system is offering to cover Memorial Sloan-Kettering Cancer Center patients who live in the city and are set to lose their health insurance because of the collapse of the nation's largest co-op. The demise of Health Republic Insurance of New York has created tumult for hundreds of thousands of New Yorkers and headaches for the state's other insurance companies. One of the most pressing concerns is the fate of the roughly 200 patients receiving treatment at Sloan-Kettering, which contracted with no other insurer offered on the state's health exchange. The de Blasio administration on Wednesday announced an agreement with the renowned cancer center that allows patients who are losing their Health Republic coverage at the end of this month to continue to receive coverage for care for as long as they require treatment if they enroll in MetroPlus, the insurance offered by New York City Health + Hospitals (formerly known as the city Health and Hospitals Corporation). Read my story here: http://politi.co/1NLAfxF

...The agreement means Sloan-Kettering will accept MetroPlus insurance for 114 New York City patients, but it does not cover the approximately 135 Sloan-Kettering patients living outside New York City, where MetroPlus does not offer insurance.

‘DIRE SITUATION’ Health Republic Insurance of New York owes hospitals at least $140 million, according to the Greater New York Hospital Association, which surveyed its members. That figure doesn't include hospitals that don't belong to GNYHA, or other providers like rehabilitation facilities and independent physicians. GNYHA president Ken Raske told his members the figures present a "dire situation." "[S]everal hospitals have reported Health Republic receivables of more than $10 million," Raske wrote. Read more here: http://politi.co/1WNDf28

SHARE ME: Like this newsletter? Please tell a friend to sign up. Give them this link: http://politi.co/1gMLiJV

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

CUOMO SIGNS MEDICAL MARIJUANA BILLS — Gov. Andrew Cuomo signed long-anticipated legislation Wednesday to expedite the state’s medical marijuana program for people with serious medical conditions, ahead of the program's January 2016 start date. The two bills would require the state’s Department of Health to create an “expedited pathway to certify patients for medical marijuana use if a patient's serious condition is progressive and degenerative, or if delaying the certified use of medical marijuana would pose a serious risk to a patient's life or health.” POLITICO New York’s Josefa Velasquez has more: http://politi.co/1MXZ8Ho

DECISION WAS A TOSS UP — The head of the Assembly’s health committee and one of the lead sponsors of legislation legalizing medical marijuana for people with debilitating illnesses said that, as he saw it, Cuomo’s decision to sign an expedited medical marijuana bill Wednesday could have gone either way. Cuomo had a tepid response to medical marijuana at the end of 2014's session, as lawmakers pushed to legalize the use of the drug. The governor advocated for a more stringent version of the legislation, the so-called Compassionate Care Act, which he said offered “balance.” He signed that into law in July, 2014. It’s still unclear if the medical marijuana program will be up-and-running by the Jan. 2016 start date that was set by Cuomo and the Department of Health. http://politi.co/1MXYPwm

...Quick question: Where is this medical expedited marijuana going to come from?

NOW WE KNOW — The New York Times, writing about a study in Annals of Internal Medicine, says beer bellies are dangerous. http://nyti.ms/1WNDytG

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 dgoldberg@politico.com.

** 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. **

FLU SUIT — A group of mothers from Manhattan and Brooklyn “filed a lawsuit Monday claiming unelected city health officials overstepped their bounds in December 2013 when they decided all children between the ages of 6 months and 5 years must get an annual influenza vaccination to attend city-regulated daycares and preschools,” according to the Daily News. http://nydn.us/1WNGiYi

GRANT LAND — A Washington D.C.- based nonprofit awarded a Montefiore Health System research team $14 million to study ways to treat hepatitis C among injectable drug users. The Patient-Centered Outcomes Research Institute-funded study will later examine why some patients develop resistance to conventional hepatitis C therapies. Hep-C is most often spread by sharing needles, and nearly 3 million Americans are thought to have the virus, which can destroy the liver. The study will be conducted in conjunction with John Hopkins Bloomberg School of Public Health, Warren Alpert Medical School of Brown University, Harvard Medical School, University of Cincinnati College of Medicine, University of Washington School of Medicine, University of California, San Francisco, University of New Mexico Health Sciences Center, and The New York City Department of Health and Mental Hygiene.

ACROSS THE RIVER — East Orange General Hospital has filed for Chapter 11 bankruptcy in U.S. District Court in Newark, complicating the hospital's purchase by a California-based for-profit hospital chain. Tuesday’s filing comes after the state approved the hospital's sale to Prospect Medical Holdings last month following a review process of a year-and-a-half. POLITICO New Jersey’s Katie Jennings has more. http://politi.co/1MXZwph

PHARMA REPORT: The New York Times reports: “The nation’s largest pharmacy benefit manager has stopped doing business with a specialty pharmacy used by the drug maker Horizon Pharma, in a sign of a further crackdown on the use mail-order dispensaries to help lift sales of expensive drugs. The benefit manager, Express Scripts, sent an immediate termination letter to Linden Care, a specialty pharmacy in Woodbury, N.Y., on Monday. Linden Care in turn sued Express Scripts in Federal District Court in Albany on Tuesday, asking the court to reverse the termination. A spokesman for Express Scripts said the pharmacy benefit manager was taking action against ‘captive’ pharmacies that seem to be aimed at pushing a single manufacturer’s products. He said Linden Care seemed to dispense mostly products made by Horizon Pharma.” http://nyti.ms/1SiJfcG

WHAT WE’RE READING:

-STANDING IN THE WAY OF HELPING VETERANS — Robert McDonald, the U.S. Secretary for Veterans Affairs, says his biggest obstacle in leading the second-largest federal agency has been politicians in Congress, according to The Washington Post. “As he tries to repair a sprawling agency beset by poor morale, growing caseloads, a shortage of medical staff and a crisis last year over manipulated waiting lists to paper over delays in health care, the retired chief executive of Procter & Gamble has felt bipartisan criticism. ‘I’m used to people being on the same team,’ the secretary said. ‘If you really care, you help with the transformation efforts. You don’t just throw rocks.’” http://wapo.st/1SiJ2WT

-TOO MUCH OF A GOOD THING — The Boston Globe’s STAT project reports there is a possibility that receiving the flu vaccine year after year may reduce its effectiveness. “The evidence, which is confounding some researchers, suggests that getting flu shots repeatedly can gradually reduce the effectiveness of the vaccines under some circumstances. That finding is worrying public health officials in the US, who have been urging everyone to get a flu shot each year — and who still believe an annual vaccination is better than skipping the vaccines altogether.” http://bit.ly/1NLxyfm

-WHY DOES HARVARD KEEP TOENAILS? — STAT also explains why Harvard is hanging on to toenails. “Harvard’s basement biorepository contains 3.5 million samples of blood, plasma, and urine from a nearly four-decade old research project known as the Nurses’ Health Study.

But it’s the toenail clippings from more than 100,000 people — and a similar number of snips of hair from cut-off ponytails — that hold special promise for scientists. A blood sample only reflects what’s going on in your body in the very moment the blood is drawn. But hair and toenails harbor hormones and trace elements like arsenic and selenium, so scientists can analyze them to get an average of the levels in your body over several months.” http://bit.ly/1NLxL2i

TODAY'S TIP — Comes from the state’s health department, which reminds us “build supply kits as a family and make sure all family members know where your home kit is stored.” http://1.usa.gov/1WNEe2i

STUDY THIS:

-BARRIER FOR VETERANS REMAINS — University at Buffalo researchers surveyed nursing and social work graduate students, and found that future clinicians are not taught about military culture in the classroom. Their findings, published in the Journal of Military and Veteran Health, show clinicians and veterans were often unable to form a relationship because students had difficulties relating to or understanding their experiences. That held true even if the graduate student had a military background. The key proved to be combat experience. http://bit.ly/1WNExKw

-NARROW NETWORK — Ed Silverman reports: “Just 16 percent of the so-called silver exchange plans in 2015 cover all 10 of the most widely used HIV drug regimens. These also cost patients less than $100 per month per regimen, according to Avalere Health, a consulting firm that ran the analysis.” http://bit.ly/1WNoxbv

** 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. **

MISSED A ROUNDUP? Get caught up here: 11/11, 11/10, 11/9, 11/6, 11/5

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