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Joint Press Release: Gov. Cuomo Vetoes Bill to Regulate Pharmacy Benefit Managers and Protect Consumers

Bill would have added accountability, increased fiscal disclosure, and addressed deceptive and anti-competitive practices

(December 26, 2019) Governor Cuomo this evening vetoed legislation to increase oversight, transparency, and accountability of pharmacy benefit managers (PBMs).  PBMs are companies that manage prescription drug benefits for health plans.  Their negotiations, discounts, and rebate structures are highly secretive and PBMs have been accused of practices including profiteering by overcharging health plans more than they subsequently reimburse pharmacists and pocketing the difference, a practice known as “spread pricing.”

In response to these and other concerns, New York’s 2019 State budget included language eliminating spread pricing and implementing other regulations on PBMs that work with Medicaid.  This bill would have applied similar rules to private health plans.

“The PBM industry spent a lot of money lobbying against this consumer protection bill,” said Assembly Health Committee Chair and bill sponsor Richard N. Gottfried.  “PBMs are widely recognized as major players in driving up drug costs and profiteering at the expense of people who pay health insurance premiums, patients, and pharmacists.  They’re a black box, operating in secret with no effective regulation.  There is plenty of evidence, including an analysis by the State Senate, showing what happens when regulators can’t see into this growing segment of the health care economy.  This veto means higher drug prices, higher costs for health plans and the people who pay their premiums, and lost income for pharmacies.”

“New York was on the cusp of becoming the leading state in protecting consumers, bringing questionable practices to light and saving millions of dollars with the bold proposal by Assemblyman Richard Gottfried and Senator Neil Breslin to finally join over two thirds of the states in regulating pharmacy benefit management companies,” said Assembly Insurance Committee Chair and bill co-sponsor Kevin Cahill.  Instead, with the stroke of his veto pen, Governor Andrew Cuomo leaves New Yorkers unprotected and these shadowy corporate behemoths free to plunder the sick, over-burdened health insurance public.”

“In this past budget, the Governor supported some protections for the Medicaid program in its dealing with PBMs,” added Gottfried.  “But he now insists that the only way he would’ve signed this bill is if we agreed to gut the bill by taking out key consumer protections, including those that parallel what we did for Medicaid.   The Governor even wanted us to take out a requirement that PBMs operate ‘with care, skill, prudence, diligence, and professionalism, and for the best interests’ of the consumer and health plans. It is incomprehensible to me.  I will be re-introducing the bill shortly and resuming the fight to get it passed and signed.”

Cahill added:  “While we remain only one of about a dozen states without any regulation of this shadow industry and with no adequate recourse for their secretive decisions, impacting millions of patients and professionals and costing millions of dollars, there is a consolation here in that we stood up to the governor’s bald attempt to substitute a fake regulatory schema that protects PBMs instead of consumers.” 

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City Limits: The Constitutional Case for ‘Medicare for All’

By Robert Buonaspina, December 19

“Promoting the general welfare” is a part of our social DNA. It is featured in the United States Constitution in the Preamble and tasked to Congress to do in Article 1 Section 8. It is part of their job scope to ensure that the general welfare needs of our people are met.

Also noted in our foundational document, as part of servicing the general welfare needs of the people, was the creation of “postal roads,” along with post offices, as resources needed by Americans. The Founding Fathers also called for the creation of free public libraries to keep our citizens informed and educated.

In short order, developing out what was meant by “general welfare” grew as the nation grew. In the early 1800s, with the construction of the Erie Canal, the government funded in the Northeast a fairly involved effort to improve upon the transportation needs of the growing country.

Also occurring during the first few decades of the new nation was the formation of free public schools to educate our population. Via the efforts of Horace Mann, Massachusetts became the first state to provide a public education to its state’s citizens. In time, as part of serving the general welfare needs of the nation, a free public education from K-12 became the norm.

The notion of building upon our transportation needs continued to be a priority with the mostly government funded and subsidized building of the Transcontinental railroad.

Year later, Republican President Dwight D. Eisenhower greatly expanded on the notion of the government providing better roads with his support of the Interstate Highway System – a mostly toll-free enterprise that greatly contributed to the growth of this nation and common general welfare needs of the people.

Any student of our history will know that in times of need, more government programs have been created to serve the general welfare needs of our people. During the Progressive Era, we created government funded police departments and fire departments, passed zoning laws and worker safety measures. All in pursuit of the general good.

During the Great Depression, under Franklin D. Roosevelt’s New Deal, we established many government programs designed to get the nation back to work and put forth some long-term reform efforts such as the Social Security system, the Federal Deposit Insurance Corporation and the Securities Exchange Commission to help stabilize the economy and assist our people in the future.

Under the leadership of Lyndon B. Johnson and Congress, two major programs designed to serve the healthcare needs of our people—Medicare, for our senior citizens, and Medicaid, to serve the needs of our poor—were created.

Today, there is a push on the state level for the passage of the New York Health Act (NYHA) and on the national level for a Medicare for All health-care system to provide quality healthcare to all Americans.

The NYHA act, co-authored by New York State Senator Gustavo Rivera and New York State Assemblyman Richard Gottfried, would create a comprehensive health-care system for all New Yorkers covering not only medical care but also vision, dental, mental healthcare and long-term care. It would truly be a sea-change improvement on the status quo, saving most Americans expenses in the process.

A Medicare for All national system would best serve the millions of Americans currently enduring poor coverage, with private insurance poorly covering major ailments and nickle-and-diming via co-pays every aspect of seeing a doctor. It would be a logical growth to our health-care system for a government-run program aimed at addressing our entire population’s needs, cradle to grave.

Providing for tuition free-college at state schools is also a logical outgrowth to providing for the general welfare needs of the people. An educated populace is in the best interest of all of us and we compete and interact with the rest of the world.

Ultimately, it is the role of government to do what it can to assist the people it serves. We have done this since our founding and have developed a stronger safety net over time.

So the next time you attend a town hall, press your elected officials on where they stand on providing for the healthcare and educational needs of us all. And as you do, remind them of the Preamble and Congress’s responsibility to promote the general welfare of all the people. Let them know that doing so is part of who we are. It is in our national DNA to do so.

NY Post: Cuomo, Trump admin. agree on importing prescription drugs from Canada

By Bernadette Hogan, December 18, 2019

Gov. Andrew Cuomo and the Trump administration are finally on the same page, simultaneously opening the door to the importation of prescription drugs from Canada Wednesday as a solution to lowering the costs of treatment to Americans.

Cuomo plans on creating a new commission to study the process of legally and safely importing drugs from the Canadian market as part of his 2020 State of the State proposal.

A final report would be submitted to the US Department of Health and Human Services for final consideration.

“The exorbitant cost of prescription drugs is a massive burden on families across the country, and we’re determined to use every tool in the tool box and pursue every available avenue to bring real relief to New Yorkers,” Cuomo said Wednesday.

Meanwhile, the US Food and Drug Administration published drafted rules that, if given the OK, would permit certain drugs to be imported from Canada.

The agency also issued a new draft guidance governing importation procedures for drug manufacturers “including biological products, that are FDA-approved, manufactured abroad, authorized for sale in any foreign country, and originally intended for sale in that foreign country.”

President Trump made tackling the rising costs of drug prices a pillar issue during 2016 election campaign, but his administration has yet to gain approval from federal regulators.

2003 law would allow Canadian prescription drug imports, should the secretary of the Department of Health and Human Services be able to prove costs would be lowered at no compromise to the American public’s health and safety. But so far no HHS chief has signed off.

In New York, Cuomo’s plan also includes capping monthly insulin co-payments at $100, and grants the state Department of Financial Services the power to investigate drug companies when their product prices spike.

DFS would be allowed to hold hearings “to demand that manufacturers justify the increase,” and if the company is found to impose “unjustifiable” increases, they could face fines.

The plan would need legislative approval from both the state Senate and Assembly.

“The federal government makes it difficult to run an importation program, but it’s not out of the question. We get all sorts of food and other materials from Canada and they’re no less safe for human consumption than when we import them from California or Florida,” said Assemblyman Dick Gottfried (D-Manhattan), chair of the Assembly Health Committee.

He also sponsors a bill that would pave the way for Canadian drug imports.

“I don’t understand why the governor feels there is a commission needed … but it’s good that he’s thinking in the right direction” said Gottfried.

Gottfried also has a bill that would pave the way for Canadian drug imports. “It is nutty that Americans have to contemplate importing drugs from Canada in order to take advantage of reasonable prices,” he said.

Consumer advocacy groups like the AARP, a nonprofit that lobbies on issues impacting the elderly, have been clamoring for consumer fiscal relief, noting that “skyrocketing” medication costs often deter patients from refilling prescriptions, risking negative health effects.

“The cost of prescription drug treatment grew more than five times the average New Yorker’s income from 2012 to 2017, as the price for key drugs that nearly 4 million New Yorkers rely on to treat cancer, diabetes and heart disease all rose by 62% to 96%,” said AARP NYS director Beth Finkel.

“The result: one in five adult New Yorkers stopped taking prescribed medications, mainly due to cost,” she added.

The Medical Society of the State of New York also supports the governor’s proposal.

“Patients in need of life-saving and health-maintaining medications, including insulin, must be able to receive them in a timely manner,” said Art Fougner, MD, MSSNY president.

“We must continue to examine ways to ensure our patients are truly able to obtain the medications they need to lead a healthy life, including preventing inappropriate PBM or health insurer interference with patients receiving these needed medications.”

Press release: Nursing home oversight bill signed into law

December 19, 2019

Nursing home oversight:

Governor signs bill expanding reporting, enforcement processes

A new law expanding nursing home reporting requirements, quality oversight, and financial transparency was signed by Governor Cuomo on December 16. The bill, A4757A/S5908, was sponsored by Assembly Health Committee Chair Richard Gottfried and Senate Health Committee Chair Gustavo Rivera. The new law:

  • Requires nursing home employees and contractors to report all types of abuse of residents to the Health Department. The current law is limited to just physical abuse. The bill also adds reporting requirements in the event of theft from residents;
  • Authorizes appointment of independent quality monitors to ensure that facilities comply with written corrective plans;
  • Requires disclosure to DOH of any co-ownership or familial ties between the nursing home operator and anyone providing services to the nursing home;
  • Requires facilities to provide prospective residents with residency agreement terms, including posting residency agreements on their websites; and
  • Requires 90 day notice to the Department in the event of sale of nursing home properties and authorizes State recoupment of some Medicaid payments if a facility is sold to be used for purposes other than providing health care.

“To protect patient safety and quality of care, we need stronger enforcement, better transparency for residents and their families, and better screening of ownership and financial transactions,” said Gottfried. “Our next priorities must include similar legislation for adult homes and ensuring adequate staffing levels in hospitals and nursing homes.”

“This new law strengthens nursing home oversight and accountability, while further protecting residents from being victims of abuse or theft,” said State Senator Gustavo Rivera. “I look forward to working with Assembly Member Gottfried as we continue to work to enhance protections for New Yorkers as they navigate elder care services.”

“This bill establishes common-sense reporting requirements for resident abuse, neglect, and theft which will undoubtedly improve the lives of residents and save untold numbers of New York families from heartache and grief,” said Richard J. Mollot, Executive Director of the Long Term Care Community Coalition. “It also provides important oversight and financial integrity mechanisms that will help ensure that the public funds that pay for care are used wisely and efficiently.  We thank Assemblymember Gottfried and Senator Rivera for their leadership in sponsoring and passing this bill in the legislature, and Governor Cuomo for signing it into law.”


Gotham Gazette: Toward a Binary Free NYC

For nearly 100 years, Democrats in the State of New York have elected one man and one woman per Assembly District to serve in the Democratic Party’s governing body, the State Committee. A rule change passed last month means that after 2020, this will no longer be the case.

Five Buildings on Tin Pan Alley Are Designated NYC Landmarks

For several years, I’ve joined with the community members, other elected officials, preservationists, and neighborhood organizations like the 29th Street Association to urge the New York City Landmarks Preservation Commission (LPC) to designate Tin Pan Alley on 28th Street between Broadway and Sixth Avenue as a New York City landmark. We were gratified when the LPC designated five Tin Pan Alley buildings as individual landmarks on December 10, 2019. Here’s a news account from Untapped Cities:

Tin Pan Alley on 28th Street Designated NYC Landmark

by Michelle Young

Within the former Tenderloin district, Tin Pan Alley was the tiny sliver of a block of 28th Street between Broadway and Sixth Avenue. Starting in the late 1800s, the stretch was synonymous with American popular music. Scores of music publishers and songwriters were located there, in former Italianite rowhouses that can still be seen. It was here that songs like “Take Me Out to the Ball Game” and “God Bless America” were published. Until recently, those buildings had been at risk of demolition but today, the New York City Landmarks Preservation Commission approved the designation of Tin Pan Alley as an official landmarks.

Specifically, five buildings on 28th Street, numbers 47, 49, 51, 53 and 55, are the latest New York City landmarks. Landmarks Preservation Commission Chair Sarah Carroll said, “Tin Pan Alley was the birthplace of American popular music, was defined by achievements of songwriters and publishers of color, and paved the way for what would become ‘the Great American Songbook.’ Together, these five buildings represent one of the most important and diverse contributions to popular culture.”

The Landmarks Preservation Commission notes the unique coalescing of activities in Tin Pan Alley that would have a profound influence on how popular music was produced and promoted: “Here, composers, arrangers, lyricists, performers, and printers came together as collaborative firms and revolutionized the music industry’s practices,” the Commission contends in a press release.

And equally important was the opportunities afforded by the Tin Pan Alley businesses to marginalized populations, like Blacks and Jews. According to the Commission, “Tin Pan Alley’s music publishing brought ragtime to an international public, and Jewish and African-American artists and publishers were able to create new and unprecedented opportunities for themselves in mainstream American music.”  Some of the most prominent among them include Irving Berlin, George Gershwin, Duke Ellington, and Cole Porter.

Tin Pan Alley also has a fun Erie Canal connection.  According to Jack Kelly, the author of Heaven’s Ditch: God, Gold, and Murder on the Erie Canal who wrote an article for us at the launch of his book, “In 1905 a Tin Pan Alley songwriter named Thomas Allen published sheet music for a tune called “Low Bridge, Everybody Down.” The piece begins, “I’ve got a mule and her name is Sal . . .” It became the classic Erie Canal song, offering a nostalgic look backward at a time when mules were being phased out. Pete Seeger, Bruce Springsteen, and countless millions of school children have sung the song down the decades.”

Today, Tin Pan Alley overlaps with the city’s Flower District, itself a disappearing industry existing on top of another already lost. On a visit during a weekday, you may see flowers and trees taking over part of the road and workers actively cutting and arranging the goods.

The effort to landmark Tin Pan Alley has been a multi-year effort and in addition to the testimony of local preservationists and political figures, the descendants of many of the musicians such as the grandchildren of Duke Ellington, also wrote in support.

City and State: Democratic lawmakers’ big plans for health care

This year has been a big one for health care in state government. The state Legislature finally passed the Reproductive Health Act and other legislation that had stalled in the state Senate when it was under GOP control. Gov. Andrew Cuomo led a successful effort to codify Obamacare in state law, just in case Republicans succeed in repealing the landmark health care law at the federal level. State lawmakers even got a chance to stage a statewide series of public hearings on single-payer health care – one of the most controversial proposals in state politics.

A new session of the state Legislature will begin in January, and it is likely that Democratic control of both houses of the Legislature will once again smooth the passage of numerous proposals affecting health care across the Empire State. Here’s a look at some issues coming up in the months ahead.

Businesswire: New York Makes Plant-Based Hospital Meals the Law

Bill S1471A/A4072, introduced by Senator Brad Hoylman and Assembly Member Richard Gottfried, requires hospitals in New York to make available upon request plant-based meals and snacks containing no animal products or by-products that are nutritionally equivalent to other menu items. The bill also requires hospitals to list the plant-based options on all written materials and menus.

Chelsea Community News Op-Ed: “Let’s Get Big-Money Special Interests Out of NY Politics”

By Assembly Member Richard N. Gottfried

Assembly Member Gottfried. | Chelsea Community News File photo by Winnie McCroy

(Nov. 22, 2019) New York badly needs to combat the influence that big-money interests exert on State government—and I’ve been fighting to change the system.

This is not a new cause for me. I wrote New York’s first bill on public campaign financing. That bill, modified over the years, has passed the Assembly many times. It served as a model for New York City’s very successful public campaign finance system.

Under our current laws, large, well-heeled donors can exert an outsized impact on elections in New York. State campaign contribution limits allow a single donor to contribute up to $22,600 to a statewide primary campaign and $47,100 to a general election bid—a total of almost $70,000 to a single candidate, far more than that donor could legally contribute to a campaign for President or U.S. Senator!

A report earlier this year by New York University’s Brennan Center for Justice showed that deep-pocketed donors dominated New York’s 2018 State elections, with the top 100 donors contributing more in campaign donations than all the estimated 137,000 small donors combined. Smaller donations were only 5% of all the money donated to candidates for New York State offices last year.

To help address mega-donors’ outsized influence on New York’s government, the new State Senate majority this year joined the Assembly in enacting a bill to close the “LLC loophole” that allowed real estate and other interests to eviscerate the spirit and intent of our campaign finance laws. But much more needs to be done: along with demanding greater transparency about the source of campaign funding, New York State needs to create and implement a small-donor matching system for elections for State offices. By matching small donations with public funding, we can strengthen the voices of all New Yorkers, instead of letting them be overwhelmed by well-heeled special interests.

Unfortunately, the Legislature and the Governor did not come to agreement on a campaign finance reform program before the end of the legislative session in June. Instead, we created a “Public Financing Commission” charged with approving a campaign finance reform package by December, with Governor Cuomo promising that it would establish a campaign finance system that would serve as a “model for the nation.” Its recommendations will become law unless the Legislature amends or repeals them before the end of the year.

This commission process has been highly questionable, with its members apparently getting side-tracked by questions like whether to ban “fusion” voting, which allows different political parties to nominate the same general-election candidate; how many votes a “minor” party’s candidate for governor would have to receive in order for that party to maintain a regular ballot line for the next four years; and limiting “matchable” campaign contributions to only those donations made by persons who live in the Assembly or State Senate district in which a campaign is waged.

I’ve joined with 38 of my colleagues in the Legislature in writing to Commission members asking them to achieve several critical goals whose realization inspired the Commission’s formation in the first place.  Among several strong recommendations, we urged the Commission to ensure that:

–small donations be provided at least a 6-1 match, to ensure that participating candidates are able to raise significant sums from small donors

–the maximum amount of a campaign contribution by an individual donations be greatly decreased so as to minimize the disproportionate influence of mega-donors and increase the impact of small donors

–the State establish a truly independent campaign finance agency, separate from the NYS Board of Elections, to guard against fraud but also to help candidates comply with campaign finance regulations

–fusion voting and cross-endorsements by “minor” political parties—which are completely unrelated to public financing—be maintained

At the end of our letter, we reminded the Commission members that the Legislature takes “seriously our statutory responsibility to craft and sponsor legislation” in December if needed.

As we await the Commission’s findings, we remain resolute in our determination to fix New York State’s broken campaign finance system. Candidates don’t need to out-spend their opponents to win elective office. They need a winning message and enough money to get their message out to the voters. A small-donor matching system with meaningful restrictions on special-interest big money contributions can help make that possible. Our democracy demands no less.

Assembly Member Gottfried represents the 75th Assembly District, which includes the neighborhoods of Chelsea, Hell’s Kitchen, Midtown, and part of the East Side and area around lower Central Park.

Adoptees Can Now Obtain Their Birth Certificates in New York

Access to your personal information – who you are and where you come from – is a human right; it’s been wrong for the government to deny you access to it. Connecting adoptees with birth parents works; in the overwhelming majority of cases, these reunions are cherished by both parties. And people need their personal and medical histories. I’m proud to have co-sponsored this bill and admire my Assembly colleague David Weprin’s persistence in getting it passed. Here’s an article from the New York Post about the new law:h

New Law Lets Adoptees Obtain Birth Certificates in NY

by Bernadette Hogan

People who were adopted will soon be able to obtain their birth certificates, under a new law signed Thursday by Gov. Andrew Cuomo.

The legislation allows any adoptee upon turning 18 to apply to their local or state health department to get an original copy of their certified birth certificate. Such a request had previously been denied.

That would allow adopted people to figure out who their biological parents are as well as providing valuable information about their family’s medical history.

The law also removes a government agency’s ability to impose any restrictions on an individual’s attempt to obtain the information.

“Where you came from informs who you are, and every New Yorker deserves access to the same birth records — it’s a basic human right,” said Cuomo.

“For too many years, adoptees have been wrongly denied access to this information and I am proud to sign this legislation into law and correct this inequity once and for all.”

Cuomo vetoed a different version of the bill in 2017 despite its passage in both legislative chambers.

“Why should an adult have any less rights than any non-adoptee? It has major psychological implications, and that simple piece of paper is part of their DNA and really belongs to them,” the bill’s Assembly sponsor David Weprin (D-Queens) told The Post.

The law officially takes effect Jan. 15, 2020, but in the meantime the commissioner of the state health department will be directed to sort out the new rules and regulations for how to comply.

New York will become the 10th state to provide the documents with unrestricted access.