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POLITICO New York Health Care: Budget deal -- Former assemblyman charged -- South Nassau finances

By Dan Goldberg | 04/10/2017 09:59 AM EDT

THE STATE BUDGET — We have a budget! Gov. Andrew Cuomo announced the deal in the 9 o'clock hour on Friday. It is the latest budget of Cuomo's tenure, arriving a week after the March 31 deadline, and it has frayed relations with lawmakers who described the negotiating process to a roller coaster ride. For a complete budget breakdown, read my colleague Jimmy Vielkind here and here.

WHAT ABOUT HEALTH CARE? — Here's a look at some of the health care items that did (and did not) make it into this year's final budget.

HOSPITALS — The state budget provides $500 million for the Health Care Facility Transformation Program. Hospitals and health systems love this pot of money because it can be used to help with mergers and retire debt. It helps small, struggling hospitals be acquired and helps large health systems become even larger. "These critically important funds will help to ensure that many financially struggling hospitals can continue to provide high-quality care to their communities," said Ken Raske, president of the Greater New York Hospital Association. "New York's hospital community applauds the Governor for once again demonstrating his deep commitment to the health and well-being of all New Yorkers."

... This is really important. Consolidation in the health care space worries a lot of people because it tends to increase costs and there is debate over whether it increases quality (as well as a debate over how to measure quality). Market forces are already driving consolidation, and Cuomo is putting his foot on the gas, spending billions of tax dollars over several years to encourage even more consolidation.

AMSNY — The Associated Medical Schools of New York received $20 million for medical school research. The budget also funds the creation of a scholarship for students underrepresented in medicine.

CDPAANYS — The Consumer Directed Personal Assistance Association of New York State was thrilled to see language in the final budget that requires the state health commissioner to authorize fiscal intermediaries before they can work with patients.

CRISIS INTERVENTION TEAMS — The budget adds $1.4 million to fund Crisis Intervention Teams and criminal justice diversion services, adding to previous investments of around $3 million.

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

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DIRECT CARE — As my colleague Josefa Velasquez reported last week, the budget also increases pay to direct care workers.

BUT NOT EVERYONE WILL WALK AWAY HAPPY — Cuomo, on New Year's Eve, vetoed legislation that would have created a new class of safety net hospitals and required the state to provide increased Medicaid reimbursement to those facilities that meet the new definition. The Assembly put it back in its one-house budget and the Senate changed the charity care formula so that safety-net hospitals would receive funds to cover 100 percent of the losses from Medicaid and uninsured patients. But neither idea made the final budget.

NO SSI INCREASE — The Assembly and Senate had wanted to increase the Supplemental Security Income rate but the proposal was not included in the final budget.

HOOSICK FALLS — There's no money in the state budget to help the upstate New York village whose water contamination crisis drew national attention and spurred a historic investment in water infrastructure. Read more here.

WHAT HAPPENED AND WHY IT MATTERS: There's so much health policy news 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.

PHARMA WINS BUT CUOMO SCORES POINTS, TOO — Gov. Andrew Cuomo's quest to rein in pharmaceutical spending appears to have hit a snag for the second consecutive year, as the policy proposals in the budget extender the governor offered on Monday were significantly watered down from the ambitious proposals he laid out earlier this year during his State of the State address. ... Why it matters: New York and states across the nation are spending a greater and greater amount of Medicaid dollars on prescription drugs. Either the pharmaceutical companies will have to slow the trend or the federal government will have to take action.

COULD CUOMO CALM EXECUTIVES? — Cuomo's administration may allow health insurance companies to provide information on how federal policy decisions could impact their rate requests, according to several health insurance companies, an effort to quell the uncertainty of executives after President Donald Trump promised that Obamacare would implode. ... Why it matters: Imagine knowing that a regulation, or even a tweet, could wreak havoc on the careful predictions you've spent months calculating. Anything Cuomo can do to reduce that uncertainty could help lower rates.

FATE OF OBAMACARE UP FOR GRABS — The disintegration of the latest Obamacare repeal bid in the House has thrown the health law's fate back to a divided circle of White House advisers wrestling with whether to pay out key subsidies — or cut them off and blow up the health law. ... Why it matters: This is simple. If the Trump administration doesn't pay the subsidies, Obamacare is dead.

GOTTLIEB — Dr. Scott Gottlieb, Trump's pick to lead the Food and Drug Administration, had his confirmation hearing Wednesday and by all accounts served himself well. He will almost certainly be confirmed. ... Why it matters: The FDA is obviously one of the most critical agencies regulating health care in this country.

IT'S DEFINITELY NOT HEAVEN, IT'S IOWA — Aetna and Wellmark both announced they will pull out of the Iowa insurance market. ... Why it matters: From Iowa Public Radio: "Iowa has only two insurers providing individual policies." ... Why it matters even if you don't live in Iowa: The more places with few choices, the stronger case Republicans can make to repeal and replace.

NOW WE KNOW — Lego action figures are no match for sound waves, a Brigham Young professor explains in this video.

FORMER ASSEMBLYMAN CHARGED WITH CHEATING MEDICAID — Former state Assemblyman Alec Brook-Krasny is facing five criminal charges for his role in an alleged scheme to overprescribe opioid and defraud Medicaid and Medicare, authorities said. Read more here.

FINANCES — South Nassau Communities Hospital, the Long Island hospital that is attracting interest from at least two of the state's largest health systems, saw its finances bounce back in 2016 ... Both Mount Sinai and Northwell have expressed interest. Read the report here.

WHERE HAVE I HEARD THAT BEFORE? Paul Massey, a Republican candidate for mayor, said that when it comes to metzitzah b'peh, he'd like to have more dialogue. He also said he heard good things about a model being used in Rockland County. Read more here.

... If this sounds familiar, it's because that's what Bill de Blasio said when he was running for mayor in 2013.

IS DOH DEFRAUDING THE COURT? Salon reports that a federal judge in Brooklyn has accused state officials of secretly trying to subvert a court order to improve care for thousands of mentally ill residents. Read the story here.

COMING LATER THIS WEEK — The primary Care Development Center is hosting a panel discussion at 5:30 p.m. Thursday on Long Island. Learn more here.



REPORTS OF DEATH ARE GREATLY EXAGGERATED — The New York Times reports: "In contrast to the dire pronouncements from President Trump and other Republicans, the demise of the individual insurance market seems greatly exaggerated, according to a new financial analysis released Friday."

HOW WASHINGTON'S FAVORITE CANCER FIGHTER HELPS HIMSELF — High-flying billionaire, doctor, and cancer-fighting entrepreneur Patrick Soon-Shiong has been a public fixture over the past year ... The public role has complemented his business activities, in which he has sought to place himself at the vanguard of cancer-fighting and health IT innovators. Yet his firms appear to have one crucial helper: his philanthropies, which have contributed millions of dollars to his for-profits and not-for-profits in an array of deals, loans, and fees. Read more from POLITICO's Darius Tahir here.

GLUTEN FREE DINING HALLS — The New York Times reports: "Out with pizza, in with poke bowls. That's the new culinary strategy at Kent State and Cornell University, which this school year rolled out the first certified gluten-free dining halls."

A MEDICAL REFUGEE CRISIS — Reuters reports: "For many patients suffering from life-threatening diseases in the Gaza Strip, treatment in neighboring Israel or the occupied West Bank is a much sought-after option."

GET THIS — Some people are going to a hospital just for the food.

TODAY'S TIP — Comes from the Cleveland Clinic: "Are you putting on extra 'wine weight' from your nightly glass (or two)? Avoid it with these tips."


DEEP BRAIN STIMULATION — Deep brain stimulation may help patients with Tourettes' Syndrome, according to a study from NYU Langone published in the Journal of Neurosurgery. Read more here.

INFECTIOUS — An asymptomatic infection may play a role in facilitating celiac disease, according to a study in Perspective.

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