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POLITICO New York Health Care: City mental health care roadmap; Health Republic ripples

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written by Dan Goldberg

BIG NEWS ON HOMELESSNESS — The de Blasio administration will create 15,000 additional units of housing that will be paired with social-service support, an initiative estimated to cost about $3 billion, according to The Wall Street Journal. “The move comes as months of talks between Gov. Andrew Cuomo and the city on a joint program have failed to come to fruition.”

MCCRAY’S ROADMAP — The de Blasio administration announced Tuesday it will work with hospitals across New York City to increase the prevalence of prenatal and postpartum depression screenings. The announcement was billed as a part of first lady Chirlane McCray’s mental health roadmap, a document she promises will be "the most comprehensive municipal road map ever developed in the United States." But this initiative is not particularly comprehensive nor is it particularly new, and we will still have to wait a few weeks for the rest of the roadmap to find out some important details, such as how the city plans to expand services for all the newly diagnosed women who are being screened. Read my full story here:

...There is a commitment from Brooklyn’s Maimonides Medical Center and the city’s public hospital system to screen all women they see within two years time. Those two institutions account for about 25 percent of all births in the city. The Greater New York Hospital Association, a trade group that represents hospitals, committed to creating a learning network so that its members can work to increase screenings. They will have a steering committee said GNYHA president Ken Raske, which will assess the current level of activity and what resources are needed. Neither the de Blasio administration nor GNYHA know just how often screenings currently take place in New York City, but they aim to find out.

MAKE MENTAL HEALTH LIKE TOBACCO — New York City health commissioner Mary Bassett has an op-ed in The Guardian that says the city should be as aggressive in combating mental health problems, such as drug and alcohol addiction, as it was with combating smoking. “We learned from the fight against tobacco that public health responses require long-term investment, sustained attention, strong collaboration and ongoing political will in order to see results.”

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MORE FALLOUT FROM HEALTH REPUBLIC — Physicians across New York are owed tens of millions of dollars from Health Republic, the collapsing health insurance company that will shut down at the end of the month. The Medical Society of the State of New York, which advocates on behalf of physicians, reported that 8 percent of 800 respondents said they are owed at least $100,000 in unpaid insurance claims. Another 18 percent are owed at least $25,000. The Greater New York Hospital Association and the Healthcare Association of New York State, two groups that represent hospitals, say their members are owed more than $150 million in unpaid claims. Read my story here: [PRO]

WHAT’S NEXT — The Albany Business Review reports: “Some local brokers are helping businesses and individuals who are losing health insurance coverage because of the collapse of a nonprofit cooperative that was set up under the Affordable Care Act. But those brokers say some important questions have yet to be answered following the financial trouble at Health Republic Insurance of New York.”

NOW WE KNOW — Australian researchers looked into whether kangaroos produce less flatulence than cows. Adam Munn, from the University of Wollongong, is a scientists who measures gas that passes through animals. Writing in the Journal of Experimental Biology, he explains methane production is affected by the length of time that a meal takes to pass through an animal, and that food passes through well-fed kangaroos faster than through hungry animals. Turns out kangaroos produce about the same amount of methane as horses but less than cows.

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NEIGHBORHOOD PROFILES — The city’s health department released neighborhood profiles for Queens, detailing the health of all 14 community districts in the borough. Looks like the neighborhood I grew up in has nearly 1,200 psychiatric hospitalizations per 100,000 adults, the fifth highest rate in the city. You can see profiles for Queens, Brooklyn, Manhattan and Staten Island here:

REBRANDING — Mount Sinai Roosevelt will be renamed Mount Sinai West, the latest rebranding effort for a health system working to reposition itself in the New York health care market. This is the second time in two years Mount Sinai Health System has renamed its Tenth Avenue hospital, which it bought from Continuum Health Services in 2013. Geography is not incidental to the new name. With many residents still stung by the loss of St. Vincent's Hospital, this lets people know that Mount Sinai, which has its main campus on the Upper East Side, has a presence on the west side of Manhattan as well. [PRO]

CARECONNECT EXPANDS — North Shore-LIJ announced Tuesday its insurance product has reached a deal with Westchester Health Associates, further expanding its network in Westchester County. CareConnect, the only insurance plan offered on the New York exchange that is directly owned by a private health system, is planning to offer its products in Westchester this coming year. To be competitive with other insurers on the exchange, the company needs to grow its network. The move, which adds 130 physicians at 39 locations, follows a letter of intent signed in September between Westchester Health Associates and North Shore-LIJ, which brings the physician group into the North Shore-LIJ Clinical Integration Network IPA.

HAPPENING TOMORROW — The Ryan Community Health Network will address questions associated with the costs of using Pre-Exposure Prophylaxis. Panelists include: Demetre Daskalakis, the city health department’s assistant commissioner for the Bureau of HIV/AIDS Prevention and Control, Carrie Davis, chief programs and policy officer at The LGBT Community Center, and Victor Hogue, care technician at the Ryan/Chelsea-Clinton Community Health Center. The event takes place at The LGBT Community Center, 208 W. 13th Street from 6:00 p.m. - 8:00 p.m.

MAKING ROUNDS — Dr. Wafaa El-Sadr is the inaugural recipient of an endowed professorship in global health at the Mailman School of Public Health. El-Sadr will be the Dr. Mathilde Krim-amfAR Chair of Global Health. El-Sadr is the professor of Epidemiology and director of ICAP and an internationally recognized leader in prevention and care of people with HIV/AIDS globally. Read more here:

ACROSS THE RIVER — A Morris County couple who owned a mobile diagnostic testing company pleaded guilty to a $4.3 million Medicare fraud scheme, U.S. Attorney Paul Fishman announced. Nita and Kirtish Patel, owners of Biosound Medical Services Inc. and Heart Solutions, would send a mobile unit to physicians’ offices to conduct testing to diagnose heart defects, blood clots and other medical conditions. The company was supposed to send the diagnostic tests to a licensed physician to interpret the results; however, the Patels fraudulently interpreted the reports and forged physician signatures. More than half of the diagnostic reports generated by the company between 2008 and 2014 were never reviewed by a licensed physician.

PHARMA REPORT: The female viagra isn’t selling so well, STAT News reports. “After two weeks of availability, a total of 80 prescriptions were filled for Addyi through October 30, according to IMS Health, the market research firm.“

...Forbes’ Matt Herper tweets: “It's awfully early to draw any conclusions based on Rx data when prescribers need to be certified. Just saying.”


-PRIVACY NOT INCLUDED — Charles Ornstein’s latest explains how the federal privacy law known as HIPAA doesn’t cover home paternity tests, fitness trackers or health apps. “The true extent of the problem is unclear because many companies don’t know when the health information they store has been accessed inappropriately, experts say. A range of potentially sensitive data is at risk, including medical diagnoses, disease markers in a person’s genes and children’s paternity.‘When you publicly make available your genetic information, you essentially are signing a waiver to your past and future medical records,’ said Erin Murphy, a professor at New York University School of Law.”

-JUST SAY NO — The American Medical Association called for a ban on drug advertising to consumers, citing it as a chief cause for the rise in prescription drug prices, according to POLITICO New Jersey’s Katie Jennings. The United States and New Zealand are the only countries that allow direct-to-consumer advertising on drugs.

— Republican Lamar Alexander, chair of the Senate’s HELP committee, and ranking member Patty Murray gave Robert Califf, President Obama’s nominee to head the Food and Drug Administration, their endorsement in the opening minutes of Tuesday’s confirmation hearing. Senator Bernie Sanders was one of the few to criticize Califf.

...POLITICO says: “The committee will probably OK him next month but we don't yet know when the full Senate will vote. We also remind you that Sen. Ben Sasse has pledged to block all HHS nominees until he's satisfied with the administration's answers on the meltdown of Obamacare co-ops.”

-MESS LAB — The U.S. Department of Justice has charged USPlabs and four of its executives with misrepresenting their weight-loss products. "Unfortunately, many of these products are not what they purport to be or cannot do what they claim to do," said Principal Deputy Assistant Attorney General Benjamin Mizer, who announced a nationwide sweep against other bad actors in the industry.

-STRANGE BEDFELLOWS — SEIU, which funds the Fight for $15 movements, endorsed Hillary Clinton for President. The endorsement comes only days after Clinton reaffirmed her opposition to a $15 federal hourly minimum wage.

-IMPROPER PAYMENTS — Approximately 10 percent of Medicare and Medicaid provider payments in the 2015 fiscal year were improperly documented, according to a report from the Department of Health and Human Services. In the Medicare fee-for-service program, the improper payment rate was 12.1 percent. That was lower than 2014, but higher than the prior three years. For Medicaid, the improper payment rate was 9.8 percent. That was higher than in any of the four previous years. Read the report here:

-THE OBAMACARE TRAP — Robert Pozen explains how the Affordable Care Act could doom some small businesses that choose to self-insure. “A doomsday scenario is not far-fetched. Say an employee at a small company is diagnosed with some obscure but deadly type of cancer. He needs intensive therapy for two or three years at a cost of millions of dollars. The stop-loss insurer may pay for his care for one year but then get out of the contract as soon as possible. No other reinsurer will take on the policy, so the employer gets stuck with the bill. And for many small companies, a bill like that would be financially devastating.

-OPINION — Norman J. Ornstein, a resident scholar at the American Enterprise Institute, writes in The New York Times how his son suffered a psychotic break and ultimately died. The tragedy is in service of his support for a bill before congress that “provides incentives to fund expanded treatment, called assisted outpatient treatment, or A.O.T., only for those with a long history and pattern of proving a danger to themselves or others. The specifics of A.O.T. vary by state, but judges can order patients to undergo treatment while they live in the community instead of in prison or a hospital.”

-START UP NEWS — Doug Williams, who left Biogen in July, is now the founding CEO of Codiak Biosciences, a Cambridge, Mass.-based startup. The company announced it has raised $80 million in committed venture capital spread over two installments, according to Forbes. “This company aspires to be the first mover in using exosome biology to develop drugs. Exosomes are tiny vesicles secreted by all cells, and present in the blood and other bodily fluids. Since being discovered in the early 1980s, many scientists believed their role was just to dispose of cellular trash, such as chewed up pieces of DNA and RNA. More recently, scientists have learned that certain cancer-cell derived exosomes carry specific proteins on the surface that act like big red flags that are distinct to the cancer, and can be detected with standard lab tools. Not only that, exosomes can carry drug payloads, in the form of messenger RNA molecules, microRNAs, antibody fragments, or even whole antibodies to a specific site, Williams said. Taken together, it raises the possibility of targeted drug delivery to certain cells, or tissues. Diagnostics are another potential application.”

-SOCIAL IMPACT — Modern Healthcare reports: “Vital Healthcare Capital announced a $30 million loan fund that will target capital needs of organizations that care for low-income and vulnerable patients. The fund is the second for New York-based Vital Healthcare Capital, a not-for-profit that launched last year with a $10 million loan to the Commonwealth Care Alliance in Massachusetts. The new fund is financed by foundations, banks and an insurer and will initially make loans to 10 to 20 organizations.”

TODAY'S TIP — Comes from NYU Langone’s Dr. Phillip Tierno who offers tips to avoid sickness when you’re on a cruise.


-GOLDEN WINDOW — Researchers from The City College of New York proved that deep imaging of the brain is possible using light at wavelength 1600-1880nm (nanometer). They explain this is the "Golden Window" for imaging, according to an article in the Journal of Biophotonics.

-NOT LOOKING — The New York Times reports: “Fewer men are being screened for prostate cancer, and fewer early-stage cases are being detected, according to two studies published Tuesday in The Journal of the American Medical Association. The number of cases has dropped not because the disease is becoming less common but because there is less effort to find it, the researchers said. The declines in both screening and incidence ‘could have significant public health implications,’ the authors of one of the studies wrote, but they added that it was too soon to tell whether the changes would affect death rates from the disease.”

MISSED A ROUNDUP? Get caught up here: 11/17, 11/16, 11/13, 11/12, 11/11

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