By Dan Goldberg | 10/10/2017 09:58 AM EDT

WHAT HAPPENED AND WHY IT MATTERS: There's so much health policy news in New York and around the nation that it can often be difficult to keep track. So, we're going to tell you some of last week's most important news and why we think it matters.

THE LATEST SPAT — The de Blasio administration is threatening to sue the Cuomo administration over its refusal to release $190 million in federal DSH payments to NYC Health + Hospitals. (The city matches with $190 million.) ... Why it matters: Outgoing CEO Stan Brezenoff on Thursday said he would curtail hiring, a direct consequence of Gov. Andrew Cuomo's decision, and a move that could impact patient care.

... About that lawsuit: The city has filed no claim so we're reserving judgment on the merits. One thing we wonder about, however, is how strong a case the city will be able to make. As far as we can tell, the state is not legally required to make any payments by Sept. 30, the end of the federal fiscal year. They may have done so in the past but is that enough to have a solid legal claim?

LIBERIAN MENTAL HEALTH — I took a look at a Mount Sinai program that has residents coach Liberian nurses in mental health. ... Why it matters: Liberia has only three psychiatrists for its 4.6 million people. Only one of those is a native Liberian.

WHITHER CHIP — States are scrambling to shore up the government health insurance program that covers nine million low-income kids after Congress failed to meet the deadline to renew its funding over the weekend. A number of state officials are looking for ways to keep their programs afloat, hoping Congress will approve money for the federal Children's Health Insurance Program before they have to cut off coverage. ... Why it matters: New York has enough money to last through the end of the year but what happens after that is anyone's guess. The federal government has provided around $1 billion a year to help insure more than 300,000 New York children. How would the state make up for that?

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DISRUPTING THE NARRATIVE — Gov. Andrew Cuomo has insisted over the last week that his decision to withhold federal funds from New York City's public hospital system has nothing to do with politics, and the state is withholding payments from all public hospitals. At least one public hospital, though, has received its share of the funding. Tom Quatroche, president and chief executive officer of Erie County Medical Center, said the Western New York public hospital is up to date on all its Disproportionate Share Hospital payments. Read our story here.

NEW REGS — The Cuomo administration announced new regulations Sunday night reaffirming its position that home care workers who provide round-the-clock care do not need to be paid more than 13 hours per day. Read my story here.

STATE SUED — New York State's efforts to change the health insurance risk adjustment program are unconstitutional, according to a lawsuit filed by UnitedHealthcare, one of the largest insurance companies in the state. Read my story here.

NOW WE KNOW — Could a beer help sooth the symptoms of menopause? Newsweek has more.

DEVIL IS IN THE DETAILS — The Albany Times-Union reports: "The state Department of Health withheld key documents that may have led Comptroller Thomas DiNapoli's office to reject a $25 million grant awarded to a health care company that is a major donor to Gov. Andrew Cuomo's campaign fund."

DON'T DO THAT — The U.S. attorney is investigating the billing practices of Dr. David B. Samadi, one of the nation's highest-paid surgeons, according to the Boston Globe. Samadi, the chief of urology at Lenox Hill Hospital and a medical expert on Fox News, already is the focus of a state inquiry into how he handles his enormous caseload of prostate surgeries, the Globe reports.

TESTING — The state Department of Health announced the state's blood testing program for Newburgh residents has been extended through Dec. 31. More here.

GRANT LAND — The National Institutes of Health awarded SUNY Downstate Medical Center $10 million to form a translational health disparities research program, with a focus on recruiting and training underrepresented minority scientists. The money will provide for junior faculty endowments, research fellowships, and recruitment of underrepresented minority students, according to a press release SUNY is expected to release today.


BILL TRACKER — Gov. Jerry Brown signed into law a California prescription drug bill, Senate Bill 17, that will require drug manufacturers to give purchasers notice before significantly raising their drug prices. It also requires them to justify those increases.

SAVING AFRICA — The New York Times reports: "In a remarkable initiative modeled on the campaign against AIDS in Africa, two major pharmaceutical companies, working with the American Cancer Society, will steeply discount the prices of cancer medicines in Africa."


OBAMACARE LATEST — President Donald Trump said on Saturday that he had talked with Senate Minority Leader Chuck Schumer to see if Democrats want to help on a "great HealthCare Bill" — but Schumer separately indicated the conversation didn't exactly go smoothly. More here.

... Schumer responds: "The president wanted to make another run at repeal and replace and I told the president that's off the table. If he wants to work together to improve the existing health care system, we Democrats are open to his suggestions."

TRUMP ROLLS BACK CONTRACEPTION MANDATE — The Trump administration rolled back Obamacare's birth control coverage mandate by allowing virtually any employer to claim a religious or moral objection to the law.

— House Speaker Paul Ryan cheered Trump for "standing up for religious liberty." Religious groups cheered the rule as a major victory.

... The ACLU announced that it has already filed a lawsuit claiming the new rules violate the Constitution's establishment and equal protection clauses by authorizing and promoting religiously motivated and other discrimination against women seeking reproductive health care. More on that here.

... SCHNEIDERMAN SUES — New York Attorney General Eric Schneiderman lambasted the Trump administration's decision to roll back the birth control coverage mandate implemented under the prior administration. Schneiderman's release said his office is reviewing legal recourse and urged the state Legislature to pass the Comprehensive Contraception Coverage Act, which has failed to gain traction in the GOP-controlled state Senate.

... Nicholas Bagley at The Incidental Economist has a compelling argument for why the courts will block the president's move.

MORE ORDERS COMING — The New York Times reports: "Stymied in his efforts to repeal the Affordable Care Act, President Trump is poised to issue an order that could ease some federal rules governing health insurance and make it easier for people to band together and buy coverage on their own, administration officials said Saturday. One official said the directive could move the president a step closer to one of his longstanding goals: allowing consumers to buy health insurance across state lines."

Possible winners

Trade associations: Some associations have lobbied for this change, which would give them a more central role in the lives of their members.

Young, healthy Americans: They'd likely get cheaper alternatives to the plans being sold through the ACA, although the coverage would be less comprehensive.

Sens. Rand Paul, Mike Enzi: Both men have long argued for the model, with Paul urging the president to adopt the proposal and Enzi including it in the Senate health care bill that collapsed in July.

Possible losers

Health insurers: They say that association health plans would attract the healthiest, least expensive patients and leave them with sicker, more expensive patients — and possibly drive them out of the ACA's markets.

Older, sicker Americans: Their rates could go up if insurers lose younger, healthier customers as expected.

WANT TO KNOW WHY THE EXECUTIVE ORDERS ARE COMING? — For the first time, rank-and-file Republicans are acknowledging Obamacare may never be repealed. After multiple failures to repeal the law, the White House and many GOP lawmakers are publicly promising to try again in early 2018. But privately, both House and Senate Republicans acknowledge they may never be able to deliver on their seven-year vow to scrap the law. Read more from my D.C. colleagues here.

AT THE STATE LEVEL — The Wall Street Journal reports: "The collapse of the Republican effort to overhaul the health-care system and the resulting standoff in Washington has pushed the fight to the states, where a brewing conflict over Medicaid is shaping up as the next battleground."

THE PLAGUE — reports: "People in Madagascar are scrambling to get their hands on antibiotics and face masks, while public gatherings have been canceled, as a rare pneumonic plague epidemic spreads quickly across the country."

TODAY'S TIP — Comes from the Mayo Clinic: "Switch up your usual chicken routine and pick up some shrimp."


RACIAL GAP — Pre-exposure prophylaxis (PrEP) prescriptions in New York City increased by nearly 1,000 percent between 2014 and 2016, but men of color, women and patients outside the city center were less likely to be prescribed the HIV prevention medication, according to an analysis of electronic health records from the New York City Department of Health and Mental Hygiene. Read more from Vice here.

END OF LIFE CARE — Researchers at the University at Buffalo found that as of the late 1990s, fewer than 1 percent of people with intellectual disabilities had ever documented or discussed their end-of-life wishes but 62 percent of the EMS providers surveyed had treated someone with an intellectual or developmental disability who had these forms. That gap means more research is needed, according to Jacqueline McGinley, a doctoral candidate in UB's School of Social Work. More here.

NURSING SHORTAGE — The percentage of nurses with bachelor's degrees increased to 57 percent in 2013, up from 44 percent in 2004, but the nation will fall short of its 80 percent goal, according to study from NYU Rory Meyers College of Nursing published in the Journal of Nursing Scholarship. Read more here.

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