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POLITICO New York Health Care: Paying for props; Legionnaires' up in Buffalo

12/05/2016 10:00 AM EDT

Good morning! You are reading a complimentary synopsis of the POLITICO New York Pro Health Care newsletter. Pro subscribers receive a premium version of this newsletter, which includes an enhanced look-ahead and robust analysis of the health care news driving the day, weekdays at 5:45 a.m. Contact us here to learn more.

written by Dan Goldberg

WHAT HAPPENED AND WHY IT MATTERS: There's so much health policy news both in New York and around the nation that it can often be difficult to keep track. So, we're going to tell you some of last week's most important news and why we think it matters.

-TRUMP TRANSITION - The biggest news of the week was that President-elect Donald Trump has selected Rep. Tom Price to lead the Department of Health and Human Services and Seema Verma to head the Centers for Medicare and Medicaid Services. Why it matters: Price and Verma will be in charge of repealing and replacing Obamacare, reforming Medicaid, and possibly taking on Medicare. What we know is that Price favors reducing federal spending, high risk pools, tax credits based on age instead of income and repealing Medicaid expansion. His replacement plan is to the right of proposals by Speaker Paul Ryan, Sen. Orrin Hatch and Sen. Ted Cruz.

...Verma, on the other hand, has received high marks from Democrats, who praise her pragmatism. Jason Helgerson, New York State's Medicaid director, said he takes some "solace" because the head of the CMS has usually been Medicare focused. Verma has a wealth of experience in Medicaid and state-based reforms.

-ANOTHER KIND OF TRANSITION - Ram Raju, president of Health + Hospitals, is off to India, having turned over the leadership of the nation's largest public hospital system to Stanley Brezenoff, who turned 79 this weekend. Why it matters: Health + Hospitals is an important safety net for the city. Executives from the city's private hospitals will tell you in hushed tones that they count on Health + Hospitals to absorb the uninsured and underinsured patients who drag down the bottom line of any hospital or health system they frequent. Brezenoff is a placeholder, but he, and whoever follows, have a near-impossible task. The system faces a $2 billion deficit. And there aren't many ways to raise revenue or decrease expenses that are quick, effective and politically expedient.

-CHRONIC - Chronic pain will soon be added to the list of qualifying conditions for medical marijuana. Why it matters: New York State has five organizations registered to grow and sell medical marijuana. Because they are private companies, it is hard to know their financial strength but the early indicators aren't good. Earlier this year, I wrote about Bloomfield's struggles. ( ) The state is trying to help the program by expanding who can prescribe and who can qualify. The question is will that be enough, or will more drastic measures be needed?

-A NEW LOW - HIV diagnoses in New York City reached a new low. Why it matters: It is hard to overstate what this means. New York and the United States are one the cusp of ending the AIDS epidemic and turning HIV into a chronic, manageable disease.

-21ST CENTURY CURES - The House passed the largest, most consequential, most far-reaching health care bill since the Affordable Care Act. Why it matters: For starters, we just don't see much big bipartisan legislation move these days. (Remember, the ACA is so vulnerable because it received no Republican support.) The bill authorizes billions of dollars in funding for the National Institutes of Health. It preserves President Barack Obama's BRAIN initiatives and Vice President Joe Biden's cancer moonshot. It also folded in other legislation meant to improve the nation's fragmented mental health system.

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

NOW WE KNOW - Drinking fluids when sick may help. But everything should be done in moderation, according to a study in BMJ Case Reports. The study told of a 59-year-old woman who developed hyponatraemia, which occurs when sodium levels are too low, from drinking too much water to help her urinary tract infection. This patient was drinking several liters a day, trying to flush out her system.

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

SETTLED - Medrite Urgent Care agreed to pay a $100,000 fine to settle claims that it had been paying for positive reviews online, according to a press release from the state Attorney General's office.

MAKING ROUNDS - New York's own Dave Chokshi was appointed to the President's advisory group on prevention, health promotion, and integrative and public health. Chokshi is the chief population health officer of OneCity Health and senior assistant vice president at New York City Health + Hospitals.

LEGIONNAIRES' DISEASE INCREASE - The Buffalo News reports: "Niagara County's total number of confirmed Legionnaires' Disease cases this year is up to 37, but the county public health director said Friday that could be attributable to more testing for the disease."

A HOPEFUL TWEET - Erie County Executive Mark Poloncarz tweeted the projected number of opioid-related overdose deaths this year has been brought down.


-AT STAKE - STAT looks at what pharma companies stand to gain and lose when Republicans repeal and replace the Affordable Care Act.


-REPEAL AND DELAY - The latest strategy from Washington Republicans is to repeal the Affordable Care Act during their first month in power, but not have the repeal take effect until 2018 or 2019. ...What you need to know: There aren't many details yet but a repeal and delay tactic would likely destabilize the existing exchanges. Outside New York, the majority of counties have fewer than three insurers from which to choose. The entire state of New Jersey has only two insurers participating on the exchange. It doesn't take a whole lot to destabilize the market. Also, it seems like incentive for younger, healthier people to shop on the exchange is pretty weak. Expect prices to rise substantially if this plan takes effect. Finally remember we are roughly five months away from insurers setting 2018 rates and only 17 months away from 2019 rates.

-HEALTH CARE SPENDING TICKS UP - U.S. health care spending grew by 5.8 percent in 2015 compared to 5.3 percent the previous year, according to the Centers for Medicare and Medicaid Services.

-LOOMING PROBLEM - The Wall Street Journal reports: "A pair of small Pennsylvania insurers focused on long-term care could soon become one of the nation's costliest insurance failures ever, highlighting the widespread problems that have plagued the industry niche for more than a decade."

-WHAT YOU DON'T KNOW CAN KILL - The Courier-Post explains that Ancora psychiatric hospital isn't giving up data on how often patients are physically restrained.

-SAME AS IT EVER WAS - The New York Times looks at the frustrating world of flawed insurance directories.

-DON'T DO THAT - Becker's reports on a massive fraud allegedly perpetrated by the physicians, founders and investors at Forest Park Medical Center in Dallas.

-MESSING WITH TEXAS - Texas is becoming a hotbed of the anti-vaccine movement, according to an article in Science.

-SPEAKING OF VACCINE PROBLEMS - The New York Times has a story about how older Americans are skipping vaccines. "People once vigilant about vaccinating their children aren't nearly as careful about protecting themselves as they age, even though diseases like influenza, pneumonia and shingles (a.k.a. herpes zoster) are particularly dangerous for older people."

-READ THIS WITH TISSUES - The Boston Globe has a five-part series about a family's refusal to give up on their sick baby.

-EXAMINING HSA - Kaiser Health News examines Health Savings Accounts, arguing that they are far more helpful to people with money.

TODAY'S TIP - Comes from the Cleveland Clinic: "Research shows laughter is good for your blood vessels."


-CELIAC TROUBLE - Researchers from MassGeneral Hospital and Boston Children's Hospital say nearly one in five children with celiac disease weren't helped by a gluten-free diet. That same problem has been found in adults as well, according to a study in the Journal of Pediatric Gastroenterology and Nutrition.

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