Top Tags

Tag health care

Buffalo News: The Medicaid muddle: Cuomo’s budget proposal creates worry and confusion

Cuomo said the MRT panel should hold counties “harmless” in its plan and that Medicaid recipients should not see benefits affected. What’s that leave? Real cuts to providers? Tax hikes on private insurance plans? New ways to reduce waste or fraud?

“I’m incredibly concerned that the governor’s office has yet to release the necessary details we need to assess the potential impact on our localities’ Medicaid share,” said Sen. Gustavo Rivera, a Bronx Democrat who heads the Senate health committee. He said Cuomo’s fiscal overview suggests New York City – and “particularly residents of my district” – will feel end up seeing actual Medicaid cuts.

Gottfried, the Manhattan lawmaker, is even more pointed. “It’s hard to believe that it isn’t a sham,’’ he said of the MRT route. He thinks it’s quite possible Cuomo’s budget team already has specific plans that will be rubber stamped by the MRT. Gottfried served on the 2011 MRT, and he eventually praised the end product.

Bloomberg Law: New York’s Medicaid Budget Is Bleeding; Some Want Cash Infusion

The governor, in his Jan. 8 address, called the current situation “unsustainable” and referenced the state’s Medicaid Redesign Team, or MRT, which he created in 2011.

Assembly Health Committee Chairman Richard N. Gottfried (D) called the MRT largely a “sham.”

Many of the problems the state is experiencing came from changes made by the redesign, like moving toward managed care plans, he said. “I believe that the only responsible answer to this increase in Medicaid spending is on the tax side of the ledger.”

Jamestown Post-Journal: Assembly Approves Bill To Aid Blood Drives

January 20, 2020

The state Assembly has approved legislation that would allow the state Health Department to make grants to organizations that hold blood drives.

Assemblyman Joe Giglio, R-Gowanda, voted in favor of A.1151 while Assemblyman Andrew Goodell, R-Jamestown, was marked ER for the vote. Only one Assembly member, Michael Montesano, R-Glen Head, voted against the legislation. There was no discussion of the proposal’s merits on the Assembly floor.

The legislation, S.3739, is still in the state Senate’s Health Committee.

It would amend the state Public Health Law to allow the state health commissioner to make grants to non-profits and elementary, secondary and post-secondary schools to help pay costs to hold local blood drives.

“This bill would create a program of grants to help community groups and schools run blood drives,” Assemblyman Richard Gottfried, D-New York City and legislation sponsor wrote in his legislative justification. “When community organizations or schools conduct blood drives, the blood bank generally pays for the cost of the blood collection itself. But the blood banks do not pay for promotional activities such as mailings to an organization’s members, or the cost of the space if this cost exists.”

Similar legislation has been brought up in every legislative session since 2003 and has passed the Assembly eight times. It has been vetoed three times by the governor.

NY County Politics: Gottfried Denounces Cuomo for Vetoing PBM Oversight Bill

December 30, 2019

Assemblymember Richard Gottfried (D-Chelsea, Midtown) released a statement criticizing Governor Andrew Cuomo (D) for vetoing his bill to increase oversight of pharmacy benefit managers (PBMs).

A PBM is a third-party company that manages prescription drug benefits for commercial and federal health plants. In the past few years, PBMs have become notorious among pharmacy customers for their lack of transparency. Some have been accused of engaging in “spread pricing”, a practice that has them profit on the difference between what they charge health plans and how they reimburse pharmacies.

Gottfried’s bill would have addressed these practices and mandated increased financial transparency.

“”The PBM industry spent a lot of money lobbying against this consumer protection bill,” said 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.”

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.” 

#     #     #

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.”

###

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.

WRFI (with audio): 165 New Yorkers testify on proposed New York Health Act

By Fred Balfour | November 6, 2019

At the national level, the first four Democratic primary debates discussed “Medicare for all” and how to pay for it. That topic lead all the others in total minutes.

Meanwhile, New York state’s legislature held 3 open hearings across the state to discuss the proposed New York Health Act single payer health insurance. Totaling 28 hours, over 165 people testified. 20 legislators asked questions and probed for clarity.

At last count, close to a majority of NY legislators had committed to bring the New York Health Act bill to a vote in both the senate and the assembly in the 2020 session or in about four months. If the bill passes and is signed by Governor Cuomo, New York will lead the U.S. in implementing single-payer health insurance.

Fred Balfour at the WRFI Healthcare Desk explores some of the major issues coming out of these hearings. And future programs will examine the major issues in detail.

Wall Street Journal: Hearings on Single-Payer Health-Care Plans Draw Crowds Around New York

New Yorkers are waiting hours and lining up down the street to tell state legislators the same refrain: fix health care.

Workers, physicians, nurses, parents, business owners, the elderly and the infirm have been testifying at hearings around the state about the New York Health Act, which would establish universal, guaranteed health care across the state with a single-payer plan. During the most recent forum, at a public library in the Bronx last week, people filled a 150-seat auditorium to hear testimony that ultimately ended when the library closed for the day.

Riverdale Press: Slow Road to Reforming Health Care

Dr. Phil Schneider likes to keep it simple.

Walking into the speech pathologist’s Whitehall clinic,
patients generally don’t find much more than a small sparsely decorated waiting area, leading to an office dominated by Schneider’s desk, with a big window facing Independence Avenue.

Despite running a number of similar offices throughout the
city — and even a pair in Israel — Schneider runs his practice without the standard office staff one might expect. Because of that, Schneider tends to deal with all his own paperwork, most of which deals directly with health insurance companies.

Receiving standard health care can be challenging enough
through such insurance. When it comes to specialists like Schneider, it’s an everyday uphill battle that eats more and more of his time.