The Health and Mental Hygiene budget bill has now passed both houses.

It isn't the last word, because more health-related stuff could and probably will pop up in the "big ugly," which is still to come.

Here are some highlights of what is public so far: (1/?)
Global cap: Despite repeal proposals, Gov. Cuomo's "global cap," limiting a portion of state Medicaid spending to medical inflation, is extended through March 2023. Monthly progress reports, which DOH has often skipped, are replaced by quarterly reports.
'Excess' malpractice coverage: State-funded supplemental malpractice insurance for physicians and dentists, which Cuomo had proposed to cut in half, is to continue without changes – effectively subsidizing a generally high-income group.
Pharmacy 'carve-out': A Cuomo plan to separate drug coverage from Medicaid managed care is postponed two years, to 4/23. The plan would have reversed one of the more successful Medicaid reforms of the governor’s first term.…
Nursing homes: A late addition to the bill would require nursing homes to spend at least 70 percent of their revenue on direct patient care, including 40 percent that must be spent on "resident-facing" staff.
Essential Plan: The bill would eliminate premiums currently charged to a portion of enrollees in the Essential Plan, a Medicaid-like program that covers people up to 200 percent of the federal poverty level. Some enrollees have been paying $20 a month.
Personal care: The bill would direct the Health Department to add back a limited number of "fiscal intermediaries" within the Consumer-Directed Personal Assistance Program, many of which recently lost their contracts after a bidding process designed to winnow their ranks.
Still to come:

A verdict on a last-minute proposal, pushed by the Cuomo and GNHYA, to change how hospitals are paid by health plans. The "pay and pursue" bill is opposed by insurers along with a range of employers and labor unions.…
Also yet to be seen is a plan for distributing a one-year surge of $1.6B in federal money for Medicaid home and community based services.…
@ShannonYoung413 of @politicony reports Cuomo is seeking unfettered control. ($)…
Also, expect surprises. Always expect surprises. (-30-)

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More from @NYHammond

6 Apr
Another ridiculous feature of Albany's budget "process" is voting in the middle of the night.

Not only is it an affront to transparency and calm deliberation, it's humiliating and unhealthy for the legislators themselves. There's a reason sleep deprivation is form of torture.
Some years back, one senator died of a heart attack not long after an all-night session. Senate Majority Leader Joe Bruno (who is now also deceased) made a point of banning late-night voting for that reason.

I'm not sure he always complied, but it was good rule.
A favorite war story from 1998, my first year in the LCA.

In a lame-duck session, the Legislature was voting on an ugly amalgam of raises for themselves, authorization for charter schools and a pricing scheme for milk. ...
Read 4 tweets
5 Apr
Saying that Cuomo "cut" Medicaid over and over again doesn't make it true.

On his watch, total Medicaid spending is up $26.1B or 49%, and this year he's proposing to increase it by another $6.6B or 8%.… Image
As of 2019, eight years into Cuomo's term, New York's per capita Medicaid spending was more than double the national average and 29% higher than any other state.… Image
"Cuomo cut Medicaid" is the "Stop the Steal" of the left.
Read 4 tweets
25 Mar
Gov Cuomo is pushing for a late addition to the state budget at the behest of the Greater NY Hospital Association.

GNYHA was also behind two of the Cuomo administration's most controversial pandemic policies: legal immunity & the 3/25 nursing home order…
The proposal is a technical change in insurance law that would compel plans to pay hospital claims first and ask questions later.

Insurers, employers and labor unions say it would enable waste and drive up health premiums.
Cuomo didn't include this item in his original budget proposal from January or his 30-day amendments in February.

The details have not yet been made public.

Yet his aides are telling the Legislature it's a priority for inclusion in the final budget, which is due in six days.
Read 5 tweets
16 Mar
This is no exaggeration. ASC was elected to the Senate in the fall of 2006. Since then, Albany has seen the resignation of a comptroller, a governor and an attorney general. Party control of the Senate has changed three times (five if you count the coup of '09). ...
Too many lawmakers have been arrested to count, including five of the six majority leaders who preceded her, four of which were convicted. Cuomo created an anti-corruption commission to go after the Legislature, then disbanded it when it went after him. ...
The U.S. attorney indicted half a dozen people over Cuomo's marquee economic development operation, including one of the governor's closest aids and his high-tech guru. And don't forget Shelly Silver. ...
Read 4 tweets
13 Mar
GNYHA's member hospitals are all not-for-profit corporations, because state law makes it effectively impossible to operate a for-profit hospital in NY.

They're still motivated to maximize revenue. (1/?)
They maximize revenue in part by manipulating Albany, where any attempt to slow spending growth is characterized as harming health care.

They spend big on lobbying and political contributions and ally themselves with one of the state's biggest labor unions. (2/?)
It's not clear what benefit New Yorkers derive from having an all not-for-profit hospital system.

This is one reason I'm skeptical that discouraging or eliminating for-profit operators will be an effective approach to regulating nursing homes. (3/?)
Read 4 tweets
12 Mar
June 30, 2020: "The death toll among residents may be thousands higher than officially reported."…
July 8, 2020: "Most glaringly, [the DOH report] relies on the Cuomo administration’s low-ball estimate of nursing home deaths, which excludes residents who were transferred to hospitals before passing away."…
Aug. 3, 2020: "I hereby request records of COVID-19-related deaths of residents of nursing homes and assisted living facilities, including those who died while physically outside of the homes."…
Read 15 tweets

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