All eyes on Medicaid

Good morning and welcome to Monday’s New York Health Care newsletter, where we keep you posted on what’s coming up this week in health care news, and offer a look back at the important news from last week.

All eyes are on Medicaid ahead of the release Wednesday of Gov. Kathy Hochul’s executive budget for the 2014 fiscal year, with stakeholders in New York’s health care industry clamoring for increased reimbursement rates.

The Greater New York Hospital Association, which is lobbying for a 10 percent rate increase, teamed up with the union 1199 SEIU United Healthcare Workers East to build support in Albany. Nursing homes have called for a 20 percent increase.

Hochul remained mum on Medicaid in her 2023 State of the State address, the Empire Center’s Bill Hammond observed.

But the 277-page State of the State proposals book that accompanied her speech made more than three dozen mentions of the program.

Among the agenda items listed there are expanding Medicaid coverage of mental health and preventative services and raising reimbursement rates for primary care and reproductive health care providers.

Not to mention, Hochul previously raised Medicaid rates for hospitals’ psychiatric beds by 20 percent. (The Greater New York Hospital Association says the increase is still awaiting federal approval so has yet to go into effect.)

IN OTHER NEWS:

— N.Y.U. Langone will receive $510 million from Turner Construction Co. to settle claims that the contractor failed to protect the lower Manhattan hospital from damage during Superstorm Sandy.

N.Y.U. alleged that Turner — which was in the middle of a $148 million construction project for the medical school when Sandy hit New York City on Oct. 29, 2012 — was to blame for 11 million gallons of water pouring through an exposed ventilation shaft at the work site, according to a complaint filed in state Supreme Court in 2015. N.Y.U. also accused Turner of defectively installing a piece of equipment that led a hospital generator to fail.

A representative for N.Y.U. Langone declined to comment. A Turner Construction spokesperson did not respond to requests for comment.

ON THE AGENDA THIS WEEK:

— The City Council’s Health Committee hosts a hearing at 10 a.m. Wednesday on the diabetes epidemic, the Age in Place NYC legislative package and a proposal to require chain restaurants to identify menu items with high levels of added sugars.

— Hochul presents her executive budget for fiscal year 2024 at noon Wednesday in the State Capitol.

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A message from Healthcare Education Project:

It’s time to Close the Medicaid Coverage Gap. Despite COVID-19 and rising healthcare costs, there has been no significant increase to New York’s Medicaid reimbursement rate for years. As a result, pediatricians are forced to turn away low-income children, seniors face dangerously long wait times for care, and a growing mental health crisis is threatening our hospitals and putting communities at risk. The Legislature must Close the Medicaid Coverage Gap. Learn more.

FIGHTING MEDICARE ADVANTAGE: Retired FDNY emergency medical specialist Marianne Pizzitola and her 35,000-member group, the NYC Organization of Public Service Retirees, has all but killed a City Council bill backed by Mayor Eric Adams that would have forced former municipal workers to pay $191-a-month for their Cadillac-quality health insurance, POLITICO’s Madina Touré reported.

“We were like sofa warriors,” she said. “We would get up in the morning with each other to talk and strategize or take care of things that needed to be done.”

The retirees’ organizing has thrown a wrench in the city’s plans to shift former city workers into a new Medicare Advantage plan that would save $3 billion over the next five years.

ALBANY INFLUENCE: The state Legislature looms large over Mayor Eric Adams’ plans for his second year in office, POLITICO’s Sally Goldenberg reported. Adams gushed over Gov. Kathy Hochul five times in his written State of the City remarks — and he ad-libbed a few more upon delivering the address Thursday.

It was notable to those who experienced the open warfare between their respective predecessors Gov. Andrew Cuomo and Mayor Bill de Blasio.

But neither of the two legislative leaders, who hold much of the fate of Adams’ ambitious agenda in their conferences, attended their fellow Democrat’s speech.

NOW WE KNOW — Thousands of nurses in the U.S. could be working with bogus credentials, under a scheme revealed last week in which three Florida nursing schools issued phony diplomas.

TODAY’S TIP — Via CNN: To cope with the release of violent videos, manage stress and know your own limits.

STUDY THIS — Rates of long Covid have been on the decline since last summer, but there’s still a significant share of people reporting current symptoms, a recent KFF analysis found.

A message from Healthcare Education Project:

— New Yorkers are suing the city over delays to food stamps, Gothamist reports.

— Staff at New York schools serving children with disabilities intentionally misused physical restraints, the Albany Times Union reports.

— Surgeon General says 13 is ‘too early’ to join social media, CNN reports.

— Deaths among pregnant women and new mothersrose sharply during the pandemic, The New York Times reports.

— Kaiser Health Newsreleased details of 90 previously secret government audits that reveal millions of dollars in overpayments to Medicare Advantage plans.

— FDA proposes easing blood donation restrictions for men who have sex with men, Katherine Ellen Foley and David Lim report.

— Via POLITICO’s Ry Rivard: Why whale deaths in New York and New Jersey are dividing environmentalists.

— Medical device makers renew lobbying amid efforts to limit emissions of a carcinogenic gas used to sterilize products, David Lim reports.

MISSED A ROUNDUP? Get caught up on the New York Health Care Newsletter.

A message from Healthcare Education Project:

The Medicaid Coverage Gap is making New York’s mental health crisis worse and putting our most vulnerable communities at risk. It’s time to close it.

Medicaid provides essential health coverage to millions of vulnerable New Yorkers. Yet, despite the ravages of COVID-19 and rising healthcare costs, there has been no significant increase in New York’s Medicaid reimbursement rate for years. Because of this Medicaid Coverage Gap, pediatricians are forced to turn away low-income children, seniors face dangerously long wait times for care, and a growing mental health crisis is threatening our hospitals and putting communities at risk.

As the New York Legislature considers the 2023-2024 state budget, it is imperative that they Close the Medicaid Coverage Gap and include a 10 percent increase to the Medicaid reimbursement rate. Closing the Medicaid Coverage Gap will help address our mental health crisis and protect our most vulnerable communities. Learn how.