Capital Health Care: No waiver money for LICH; no rush on fracking study

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Dan Goldberg

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Welcome to Capital Health Care, an early-morning email full of scoops and storylines that will inform the daily conversation in New York among health-industry insiders and high-information consumers. Sign up for our morning newsletters here.

WAIVE GOODBYE –- Health Commissioner Nirav Shah said Monday that LICH would not be eligible for any Medicaid waiver funding that could come New York's way. That makes sense because the feds want to use that money to reduce unnecessary in-patient admissions by 25 percent over five years. LICH has too few patients at the moment to qualify for that type of arrangement. But Shah's testimony departs from what Cuomo has been saying over the last few weeks as he has publicly called on the federal government to approve the waiver to save Brooklyn hospitals. Cuomo specifically cited LICH both during his budget address and during a press conference with de Blasio.

BASIC PLAN COMPLICATIONS –- Shah told the legislators that he would love to implement the basic health insurance plan, a provision of the ACA that provides greater options for poor New Yorkers including legal immigrants who are not yet citizens. The problem, he said, is the feds haven't released any guidelines. The basic health option could bring New York $300 million in budget savings, Shah said.

NOW WE KNOW –- Want to live happily ever after? Talk about movies. New Research from the University of Rochester found that discussing five movies about relationships during a month could cut in half the three-year divorce rate for newlyweds. The study published in the Journal of Consulting and Clinical Psychology found movie talk could be just as effective as other more intensive therapist-led methods—reducing the divorce or separation rate from 24 percent to 11 percent after three years.



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TAKEN TO TASK –- State Sen. Diane Savino and Assemblyman Richard Gottfried, sponsors of a medical marijuana bill, took turns lambasting Cuomo's medical marijuana plan. Shah told the committee that his department was establishing a research program to study the efficacy of medical marijuana. Savino said the state does not need more research. The state needs a regulatory framework that would allow a legal grow program. “If you want to do research,” she said, “pull out the EZ-pass and go to New Jersey or Connecticut,” referring to the many other states that have a medical marijuana program in place. Gottfried was equally cutting, asking Shah where New Yorkers might get anything “beyond street-grade, dried leaf” without a legislative framework, and pointing out that Shah's description of the program was far more limited in scope than what Cuomo hyped during his State of the State Address.

FRACK YOU -– Shah was repeatedly prodded by lawmakers as to when he would release his findings on the health impacts of fracking, and he repeatedly said when he was good and ready. Shah said he was waiting for a tipping point in the science but didn't make clear what that tipping point would be. He did not elaborate as to where he traveled or with whom he was speaking during his studies, which have stretched on for more than a year, giving Cuomo cover to avoid taking a politically difficult position.

COMING SOON –- There is a lot more that came out of Monday's hearing in Albany. Over the next few weeks, Capital will be tackling several of these issues in depth. Specifically, I'll be working on private equity in hospitals: Kenneth Raske said his members are divided on the issue. Hospitals have concerns about who the investors are, but this is a literal case of beggars can't be choosers.

Network adequacy: Shah said it was premature to discuss any plans or ideas but the health department was monitoring the situation.

Research grants: Sen. Golden is concerned that New York could see a brain drain because other states are aggressively offering research grants.

... HIV battle: There are tens of thousands of New Yorkers living with HIV who don't know they have it and the health department is determined to decrease the prevalence of the virus.

NEW NUMBERS –- The Department of Health announced Monday that nearly 381,000 New Yorkers have enrolled in health insurance plans through the exchange. That's a 65 percent bump since Christmas. Of the enrollees, 241,242 enrolled in a private health insurance plan and 139,505 signed up for Medicaid. The deadline to enroll is March 31.

LAYOFFS -– Carthage Area Hospital is laying off 90 employees and eliminating 20 beds in its second restructuring plan in the last three months. The Watertown Daily News reported the layoffs equal 20 percent of the hospital’s staff and follow cutbacks at the end of 2013 that eliminated 29 jobs. The hospital cafeteria will be closed and it is unclear whether other services have been lost. The layoffs come amid contract negotiations between the hospital and NYSNA.

WHAT WE'RE READING –- NYU Langone’s Dave Chokshi's piece for Scientific American on the need for better preventive screening for chronic diseases like diabetes.

ANOTHER CASE -– Another infant has contracted genital herpes from a rarely-practiced circumcision ritual called metzitzah b’peh, according to the Forward. The ritual has the mohel put his mouth on the baby’s wound. The New York City Department of Health and Mental Hygiene issued a health alert about the baby’s case on Jan. 28. At least 11 boys contracted herpes between 2004 and 2011, according to New York City health officials. Certain sects of the Jewish community want de Blasio to reverse a Bloomberg decision that mandates parents sign a form acknowledging they are aware of the risks of the ritual. The new mayor has said it will stay in place until a more effective solution can be found.

OPEN UP -- The Department of Health told that if labor and delivery services are not restarted at North Central Bronx Hospital by April 30, the hospital will have to decertify its maternity and neonatal beds and services from its operating certificate. The ward has been closed since August after concerns arose that there were too few doctors available. Community health advocates told womensnews that H.H.C. has been mum on when it will reopen.

BILL TRACKER -– Assemblyman Titone introduced a bill Monday that requires patients be notified that an out-of-network physician may be used during their procedure. It further requires that the insurance company pay for the service if a patient is not notified. The bill was referred to the insurance committee. This follows an article in The New York Times that highlighted the problem of patients who checked to make sure their surgeon was in-network but were unaware their anesthesiologist might be out-of-network.

... Assemblyman Rodriguez sponsored a bill requiring medical professionals undergo “cultural awareness and competence training.” Sen. Sorrano has a companion bill in the Senate. The bill was referred to the higher education committee.

CALENDAR -– Montefiore's Dr. Robert Michler is giving a lecture at 7p.m. at the 92nd Street Y where he will ask “How old is your heart” and explore risk factors and what can be done to lower them. This is part of the hospital's heart awareness month.

UNION NEWS –- Dr. Frank Proscia, a psychiatrist, is the new President of Doctors Council SEIU and Dr. Matthews Hurley, an internist, is the 1st Vice President and Executive Director. Proscia is from Mount Sinai School of Medicine and Hurley from Columbia University College of Physicians and Surgeons.

SURVIVING –- The TLC Health Network delayed the closing of Lake Shore Health Care Center by at least two months, according to Buffalo Business First. John Galati, interim CEO, said he has enough cash on hand to continue operating through March 29.

IN CASE YOU MISSED –- President Barack Obama’s selection of a 36-year-old founder of an Obamacare advocacy group to serve as the nation’s top doctor has proven controversial. Vivek Murthy, a Boston physician, software entrepreneur and political ally of the president, will face a Senate confirmation hearing today.

AWARDS –- Oswego Health's February “I Care Award” was presented to JoEllen Quenville, Executive Assistance for Hospital Administration.

… Cheryl Clow has been named Albany Medical Center’s 2013 Employee of the Year. The 23-year old works with patients who have complex genetic conditions as the metabolic clinical care coordinator for the Division of Genetics and Metabolism in the Department of Pediatrics.

… Dr. Ronald G. Crystal, of Weill Cornell Medical College, has received a Pioneer Award from Human Gene Therapy, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The award recognizes Crystal's work on adenoviral vectors.

TODAY'S TIP –- Comes from the state Department of Health, which reminds us that the “best time to prepare for emergencies is now. Pack a to-go bag w/clothing, food, H2O and meds.”


-DANGEROUS TREND -– Researchers at New York-Presbyterian/Weill Cornell Medical Center are set to report that home births are far more dangerous than hospital births. The study will be presented Friday at the Society for Maternal-Fetal Medicine's annual meeting, and demonstrate that those who delivered at home with midwives had a four-fold greater risk of neonatal deaths than babies delivered in the hospital by midwives. Those findings were because of location, not the credentials of the midwife, the report will say. The study found risks were even higher for first-time mothers. If home births continue to grow at present rates, the researchers estimated that the excess total neonatal mortality of home births by midwives would nearly double by 2016.

-COLD TRUTH –- Pregnant women who come down with the common cold and other viral infections are at greater risk of their child developing asthma, according to a study published in February's issue of Annals of Allergy, Asthma and Immunology.

MISSED A ROUNDUP? Get caught up here: 2/3, 1/31, 1/30, 1/29, 1/28, 1/27