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POLITICO New York Health Care: Docs call for paid family leave; NYC moves to combat K2

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written by Dan Goldberg

DOCS PUSH FOR FAMILY LEAVE — A group of physicians, union leaders, and elected officials has sent a letter to Gov. Andrew Cuomo and Senate Majority Leader John Flanagan urging them to pass a paid family leave law in New York. The physicians argue that research has shown the importance of bonding with newborns, and that paid leave is an investment that will lead to better health outcomes in the future. Read their letter here:

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NEW CAMPAIGN — The de Blasio administration on Monday began its latest campaign to warn New Yorkers about the dangers of synthetic marijuana, with new advertisements in homeless shelters, at bus stops and on phone kiosks saying the drug is “zero percent marijuana and 100 percent dangerous.” The ads are also being mailed to the more than 9,000 licensed cigarette retailers in New York. The move follows new legislation that gives the city’s Department of Consumer Affairs authority to suspend and revoke cigarette licenses for retailers caught selling synthetic marijuana, also known as K2, AK-47, Spice and Scooby Snax, and comes after a series of highly publicized raids on more than 100 bodegas across the city. The hope is that increasing the risk of distributing the drug will increase the price per packet, which can currently be bought for as little as $2. Its cheapness is one of its chief attractions, and one reason it is preferred by so many living in homeless shelters, and in lower-income neighborhoods. Read my full story here:

QUOTE OF THE DAY: “I think when people hear the words synthetic marijuana they have some image of a guy in a white coat, following a protocol, putting together something in a laboratory. Don’t think about it like that,” said Dr. Mary Bassett, the city’s health commissioner. “Think about it as somebody hosing down leaves in some place where they have them spread out, and just hosing it down. A concoction of chemicals, many of which come from overseas where we have no idea what the regulatory oversight of these chemicals are.”

NOW WE KNOW — Are you a woman with an apple-shaped body? Well, you may be at risk for uncontrollable eating, according to a study from Drexel University, published in the American Journal of Clinical Nutrition. This study also found women with more fat in their midsection were less satisfied with their bodies. Want to know what an apple-shaped body looks like? This not-so-flattering chalk outline of the female form provided by Drexel helps, sort of.

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FIDELIS AND CONTRACEPTION — In an effort to help thousands of Health Republic customers who are on the verge of losing their insurance, the Cuomo administration announced last week it would automatically enroll those who do not pick their own plan with one of three insurers — MVP, Excellus BlueCross BlueShield and Fidelis Care. Fidelis, because of its size and the fact it is the only one of the three operating in New York City, will almost certainly be the insurer for the majority of people who do not choose a new plan by Nov. 30. Fidelis, while comparable in price to Health Republic, is different in one crucial way. The company, also known as the New York State Catholic Health Plan, does not cover many of the reproductive services which Health Republic covered, including abortion, sterilization and contraception coverage.

THE ROADMAP — First lady Chirlane McCray is scheduled to be at Bellevue this morning to discuss maternity and mental health, and a new initiative related to the much-hyped Mental Health Road map. Last week, Dr. Gary Belkin, an executive deputy commissioner at the city’s health department said the roadmap will come out in pieces over the next few weeks instead of all at once.

OPINIONS — The tabloids are teeing off on the unseen roadmap. First, the Daily News, in a blistering editorial, said the “white paper,” released last week outlining the scope of the problem was woefully inadequate. “New York suffers from widespread mental health troubles, Mayor de Blasio’s administration reported Thursday for purposes still to be determined. … The ills inventoried by de Blasio and McCray fall generally under the umbrella of a lack of happiness. Stunningly, they barely address conditions that are classified as serious mental illness, such as schizophrenia.”

...And then the Post published an op-ed calling the administration “clueless” and bemoaning McCray’s focus on everyone’s mental health as opposed to focusing specifically on severe mental illness. To be fair, that’s exactly what McCray says needs to be done so people such as her daughter have an easier time finding the help they need.

TB IN THE BRONX — New York City officials are investigating multiple cases of tuberculosis linked to a school in the Bronx, according to NBC news. “The Health Department said Monday all tuberculosis patients linked to PS 112 have been treated or are being treated. Health officials would not confirm the patients' connection to the school; multiple media outlets reported the patients are teachers at the school in Bronxwood.”

OMIG WEBINAR — The New York State Office of the Medicaid Inspector General posted a new webinar entitled “Mandatory Compliance Programs & Deficit Reduction Act of 2005.” See it here:

HAPPENING TODAY — The NYC Health + Hospitals is hosting a Music & Memory retreat at the Gouverneur Auditorium from 11:30 a.m.-1p.m. This is a program that brings customized music playlists to individuals with dementia or other cognitive loss while improving quality of life and reducing reliance on psychotropic medication. Learn more here:

DON’T DO THAT — Steven Rawlins, 58, a former Chief Financial Officer of two healthcare services companies based outside Nashville, Tennessee, was found guilty Monday of engaging in a scheme to defraud that yielded over $8 million, according to U.S. Attorney Preet Bharara. Rawlings was convicted of withdrawing company funds to pay personal expenses.

ACROSS THE RIVER — A bill that would require the licensing of people who act as lactation
consultants, or those who consult with mothers about breastfeeding issues, advanced out of New Jersey Assembly’s Women and Children Committee on Monday. The measure, which is sponsored by Assemblywoman Pamela Lampitt, the committee chair, would create the state Board of Lactation Consultants. Several practicing lactation consultants said they have had difficulty being reimbursed for their work by insurance companies and Medicaid, and they anticipate a more formal licensing process could improve access to services, particularly for low-income women.

PHARMA REPORT: The Food and Drug Administration said Monday that certain lab tests “may have caused or have caused” actual harm to patients by producing erroneous results, according to The Wall Street Journal. “At issue are so-called lab-developed tests, or LDTs, which are produced and performed within a single hospital or corporate laboratory. Such tests are often done on tissue samples sent in from outside doctors and hospitals. They are distinct from standard diagnostic equipment and products that are sold to doctors’ offices, hospitals or other labs.”


-CMS DELAYS BUNDLED PAYMENT RULE Modern Healthcare reports: “The CMS on Monday finalized a rule that will require hospitals in 67 geographic areas, including Los Angeles and New York City, to participate in a test of bundled payments for hip and knee replacements. The agency scaled back the initiative from its original plan which included 800 hospitals in 75 locations throughout the U.S. It also delayed the start date of the model to April 1, 2016. It was supposed to start at the beginning of next year.”

...POLITICO ADDS “[CMS]It scaled back how many hospitals will be required to participate and offered a more gradual phase-in of the part of the program that requires hospitals to pay back CMS if they spend too much. The program will pay hundreds of hospitals a set price for each case to encourage them to better coordinate and streamline the patient's experience. The bundle will include surgery and 90 days of follow-up care. Hip and knee surgeries, the most common inpatient surgery for Medicare, can vary drastically in quality and cost across the country.”

-TREND SETTING — USA Today writes that more physicians are moving to a direct pay, or concierge model. That’s where for a flat fee the doctor is at your service. It will be interesting to see how widespread this becomes and what impact it has on insurance risk pools.

-THE CO-OP CATASTROPHE — The National Journal says given congressional inaction, it shouldn’t surprise us that co-ops are failing. “How a pro­gram that hun­dreds of thou­sands are de­pend­ing on for their in­sur­ance could be left to with­er while Con­gress did noth­ing to fix it — or re­place it with something more pal­at­able to the cur­rent ma­jor­ity — is, in part, the fa­mil­i­ar story of the Af­ford­able Care Act, in which dis­agree­ment over the law as a whole strangles any at­tempts to im­prove its parts.”

-THE NOMINEE — Robert Califf is expected to face a largely friendly crowd at a Senate HELP committee hearing on his nomination to lead the FDA today. POLITICO reports he is expected to field questions on drug pricing, even though the agency's responsibility is to ensure pharmaceuticals are safe and work as advertised, not that they're cost effective. “In the Senate, he'll have the support of home-state Sen. Richard Burr of North Carolina, who will introduce the former Duke researcher in a show of support from a Republican who is influential on health care. Burr told POLITICO last week that he's not worried about accusations from critics who say Califf is too closely tied to the drug industry. ‘Find somebody that's a medical professional that you couldn't make that accusation against — I'm not sure that you could find one,’ Burr said.”

...The New York Times editorial board highlights Califf's past ties with the industry and says his "task is to show that he will be able to guard the public interest and resist industry pressures."

-GRANT LAND — Atlantic Philanthropies is giving $177 million to establish a brain health institute. The institute will be jointly based at the University of California, San Francisco’s Memory and Aging Center and at Trinity College Dublin, in Ireland, according to The Wall Street Journal.

-IN CASE YOU MISSED — STAT News goes behind the scenes of how hospitals in Paris dealt with the aftermath of Friday's attacks:

TODAY'S TIP — Comes from the state’s health department: “Do you warm your car up on cold mornings? Never warm it up inside the garage. Prevent CO poisoning and death.”


-DIRTY DRUG — Researchers from Weill Cornell Medicine, writing in The Journal of General Physiology, explain one possible reason why a drug becomes “dirty,” meaning it hits a larger number of targets. They looked at the beneficial, and toxic, effects of the most popular of the multi-target, antiarrhythmic drugs, amiodarone. They explain that amiodarone affects the lipid bilayer — an outside envelope of the cell where membrane proteins reside, which in turn can affect the proteins themselves, according to a press release accompanying the article.

“If you were in the business of bringing new drugs to market, a drug like amiodarone, which takes this promiscuous approach, looks pretty scary,” senior author Dr. Olaf Andersen, a professor of physiology and biophysics at Weill Cornell Medicine and director of the Tri-Institutional M.D.-Ph.D. Program, said in a press release accompanying the article. “But when you have a system that is as complicated as the one that regulates rhythm in the heart, it may actually be advantageous to have a number of different targets.”

-BRAND V. GENERIC — Aaron Carroll discuses a new study that found brand name placebos are more effective than generic placebos in The Incidental Economist:

MISSED A ROUNDUP? Get caught up here: 11/16, 11/13, 11/12, 11/11, 11/10

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