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POLITICO New York Health Care: DSH cuts coming -- Workers' comp fight -- Graham-Cassidy hitting the skids

By Dan Goldberg | 09/12/2017 09:59 AM EDT

DSH CUTS COMING — The Disproportionate Share Hospital cuts the industry has feared for years are scheduled to begin taking effect in less than three weeks, creating a tough choice for the Cuomo administration, which may have to decide how to apportion a much smaller pot of money. New York stands to lose $329 million in federal payments, according to a proposed rule from the Centers for Medicare and Medicaid Services. That's 16 percent of New York's total allotment and the largest cut, in terms of dollars, for any state. Read more here.

NOW WE KNOW Your dog may really love you, and not just for the food and tummy rubs, according to a new book called "What It's Like to Be a Dog." The author is Dr. Gregory Berns, 53, a neuroscientist at Emory University in Atlanta, who spends his days scanning the brains of dogs, trying to figure out what they're thinking, according to The New York Times.

WORKERS' COMP — Leading state labor figures, including the AFL-CIO, are opposed to new impairment guidelines proposed by the Workers' Compensation Board. They argue that they will drastically reduce payments for workers who've suffered impairment that diminishes their capacity to work, while business advocates argue that the previous standards were out-of-date relative to medical advancement. Read more here.

BREAST CANCER GUIDELINES — Montefiore surgeons, writing in the Annals of Surgical Oncology, have new guidelines for treating breast cancer related lymphedema, a side effect of surgery and radiation. "The swelling, which can impair arm mobility, frequently happens just when people are starting to regain their energy and resume their lives following breast cancer treatment," Dr. Sheldon Feldman, chief of the Division of Breast Surgery and Surgical Oncology and Director of Breast Cancer Services at Montefiore Einstein Center for Cancer Care, the clinical arm of the NCI-designated Albert Einstein Cancer Center, said in a press release. The guidelines include establishing surveillance plans with baseline measurements at diagnosis to prevent BCRL progression by ensuring proper follow up. It is also recommended that more patients undergo "axillary reverse mapping," which preserves healthy lymph nodes in the armpit, as only breast cancer specific lymph nodes are impacted by surgery.

MAKE SURE YOU FOLLOW Dan on Twitter @DanCGoldberg and Nick @NickNiedz. And for all New Jersey health news, check out @katiedjennings.

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PHARMA LOSES IN CA — California's Assembly Monday evening passed a drug transparency bill that has been hotly contested by the pharmaceutical industry. CA Senate Bill 17 would require drugmakers to give advance notification of substantial price hikes and health plans would have to disclose which drugs cost them the most. The measure passed 59-10 and now heads to the Senate, which already passed an earlier version and is expected to approve the latest changes. The bill would then go to Gov. Jerry Brown's desk.

ASTHMA DRUG FAILS — Reuters reports


MUST READ JOURNALISM — The Cincinnati Enquirer sent more than 60 reporters, photographers and videographers into their communities to chronicle the heroin epidemic for one week. Read it here.

THIS ISN'T GOOD — Guess which company holds the contract to check incomes and other data of people who purchase insurance in the Obamacare markets. Yep, it is Equifax Inc., which said last week it suffered a breach that exposed the personal data of 143 million Americans. Bloomberg has the story.

GRAHAM-CASSIDY HITTING SKIDS? — The last-ditch Obamacare repeal-and-replace plan didn't make its promised debut on Monday, the latest hiccup for the bill still being crafted by Sens. Lindsey Graham, Bill Cassidy and Dean Heller. Cassidy said he's already been running pieces of the bill past staffers at the Congressional Budget Office and is hoping to now unveil the legislation on Wednesday.

... But Orrin Hatch is pessimistic. The Senate Finance Committee chairman told reporters on Monday that he doesn't think the yet-to-be-released plan will get a floor vote, echoing Senate Majority Whip John Cornyn's comments last week and the pessimism from other leading Republicans. And Rand Paul said the bill is a "bad idea."

HOUSE DEMS TO INTRO MEDICARE BUY-IN PLAN TODAY — The plan would allow Americans aged 50 through 64 to buy into Medicare Parts A, B and D for a premium potentially as low as $8,212 per year, significantly cheaper than many Silver and Gold insurance plans available for older Americans on the ACA exchanges. "Aspirationally, people want single payer," co-author Rep. John Larson told POLITICO. "And hey, I agree with [them]. Realistically, I think we have a more ... doable approach to get there" through Medicare buy-in.

... What else is in it: The proposal includes other changes to the Medicare program, such as allowing Medicare to negotiate drug prices — a provision that Larson notes has bipartisan appeal and is projected to lower the program's drug spending by 24 percent. It would also create a new commission with power to address Medicare's long-term costs and increase program funding to fight fraud and abuse. The legislation also would include measures intended to shore up Obamacare, such as guaranteeing funding for the law's cost-sharing reductions, extending the ACA's risk corridors through 2020 and re-establishing its reinsurance program.

PULSE CHECK: WHEN POLITICIANS USED MEDICARE AS A PIGGY BANK — A late-night deal more than a decade ago let politicians make Medicare changes to benefit hospitals and ultimately reap higher campaign contributions, argues a Yale economist — who says he's got the evidence to prove it. There's "a really close link between how Medicare sets its payment policies and some of the games that politicians play and the electoral process," economist Zack Cooper said on POLITICO's "Pulse Check" podcast . "Part of the reason we struggle so much with constraining health care spending actually has to do with the politics." Listen to the podcast.

HARVEY — "Floodwaters in two Houston neighborhoods have been contaminated with bacteria and toxins that can make people sick, testing organized by The New York Times has found. Residents will need to take precautions to return safely to their homes, public health experts said. It is not clear how far the toxic waters have spread."

SOLEMN TASK — The New York Times editorial board writes about the ongoing work of matching 9/11 victims to their remains: "For the chief medical examiner, Dr. Barbara Sampson, and her staff, the terrorist attacks of Sept. 11, 2001, are never past. All these years later, the team still strives to scientifically identify each of the 2,753 people who were killed in the destruction of the twin towers."

TODAY'S TIP — Comes from the Cleveland Clinic, which shares tips to help patients find a doctor who is a partner in care.


ANOTHER IMMUNOTHERAPY REVELATION — Nivolumab was shown to be more effective for treating patients with resected stage III and stage IV melanoma than ipilimumab, the current standard of care, according to a study from researchers at NYU Langone Health's Perlmutter Cancer Center published in the New England Journal of Medicine. Here is a video of Dr. Jeffrey Weber explaining his findings.

CAN'T QUIT YOU — Cocaine addicts enjoy cocaine less as the years go on but still have trouble quitting, and researchers from the Icahn School of Medicine at Mount Sinai think they know why, according to a study in Addiction Biology. Read more here.

DRUG DEVELOPMENT COSTS MUCH LESS THAN INDUSTRY ESTIMATES — It typically costs pharmaceutical companies $648 million for research and development to bring a cancer drug to market, much less than what the industry often claims, according to a new study in JAMA Internal Medicine.

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