; 2020 Chapter Advocacy Issues & Activities - New York Chapter of the American College of Physicians

2020 Chapter Advocacy Issues & Activities


Chapter Advocacy in Action


On Friday, April 3, Governor Cuomo signed into law, a new Article 30-D of the Public Health Law called the “Emergency or Disaster Treatment Protection Act” that extends immunity from civil and criminal liability to all physicians providing health care services during the COVID-19 emergency.  Additional provision details will be posted for review.


NYACP’s March 25th letter to Governor Cuomo urged this action, and we are grateful for Governor Cuomo's leadership on this critically important issue.


Governor Cuomo Announces Highlights of FY 2021 Budget (4/2/20)


DANY Application Deadline Extended Until June 4, 2020

Due to the COVID-19 epidemic in NYS and the response required by physicians, the deadline for the Doctors Across New York (DANY) Loan Repayment and Physician Practice Support Program Cycle VII has been extended.  The new deadline for all applications is 4:00pm on Thursday, June 4, 2020.

The DANY Program helps train and place primary care physicians and specialists in underserved communities to care for New York’s diverse populations.  All new awards require a 3-year service obligation in exchange for maximum funding in the amount of $120,000.

For more information, visit the NYS Department of Health website.


2020 NYS Budget Proposals

On Tuesday, January 21st  Governor Cuomo released the NYS Budget for FY 2021, which begins
April 1, 2020. The proposed Budget has a number of provisions relevant physicians:

  • No cuts to Medicaid funding, instead convening a Medicaid Redesign Team to find ways to reduce the  growth in Medicaid costs to help combat the $6 billion state budget deficit 
  • Restrictions on e-cigarettes, including a ban on all flavored e-liquids and menthol
  • Legalization of adult use recreational cannabis
  • Increased government authority to investigate rising prescription drug prices

 

Budget Book Highlights

  • Comprehensive tobacco control policy
    • Ban the sale or distribution of e-cigarettes with flavor
    • Ban the sale of cigarettes/e-cigarettes in all pharmacies
    • Limit e-cigarette ads targeting youth
      • Restrict claims about safety and efficacy of vaping as smoking cessation
    • Limit sale of e-liquids to NYS licensed vapor retailers
    • Vape manufacturers must disclose to the DOH commission and the public, the ingredients, byproducts and contaminants in vapor products
    • Ban certain carrier oils
    • Increased penalties for selling to minors
    • Estimated annual cost of 9.7 billion (including 2.7 billion to Medicaid) for nicotine and tobacco related illnesses and responsible for 22,000 premature deaths in NY
  • Cannabis regulation and taxation act
    • Tax cultivation of cannabis
    • Tax the sale of cannabis at 20%
    • 2% tax on sales to dispensaries
    • Create an office of cannabis management to regulate medical, industrial and adult-use cannabis
  • Medicaid
    • Local cap: has saved counties $20 billion, including $4 billion in SFY 2020 alone
    • MLTCs accounted for 33% of state share Medicaid spending
      • MLTC spending grew 301% from 2013 to 2019
      • Largely driven by Consumer Directed Personal Assistance Program which diverts members from high cost nursing home and institutional setting to less costly in home care
    • Major spending supporting minimum wage workers within the health care sector
      • 44 million to 1.8 billion over ?years
    • 160% increase in state support for distressed hospitals since 2016
    • Reforming Medicaid
      • MRT II
        • Must report back by April 1 to enact a budget plan to deliver 2.5 billion in recurring savings
        • Plan cannot rely on local governments as funding sources
        • Cannot have an impact on beneficiaries
        • Must find solutions through industry efficiencies and rooting out waste, fraud and abuse
      • Enhanced local district Medicaid controls
        • State will continue to assume costs for counties if they adhere to the 2% property tax cap and limit growth in Medicaid expenditures to 3%
      • Integrity and efficiency
        • Office of Medicaid inspector general will add 69 staff
      • Transforming Medicaid
        • Performing Provider System will continue to build on value based payment arrangements
      • Promoting the essential plan
        • Generated 1.5 billion in savings by transitioning certain individuals from state-only Medicaid benefits to federally funded coverage
        • Cap financing for essential health care providers (3.8 billion)
      • Continued support for the NYS exchange
      • Continued support for the life science laboratory public health imitative (750 million)
      • Continued AIDS/HIV funding
  • Prescription drugs
    • $100 cap on insulin co-payments
    • DFS empowered to investigate and hold manufacturers accountable for unjust price increases
    • Pharmacy benefit managers (middle men between insurers and pharmacies)
      • Do not disclose to pharmacies or insurers how much they’re keeping
      • Budget requires PBMs to register with the DFS and disclose financial incentives they received for promoting specific drugs or other arrangements
  • Water safety
    • Evaluate using NYC’s water supply to provide Nassau with additional source of drinking water
  • “NYHealthCareCompare” website to lookup cost of care and access to financial assistance programs
  • Expand access to medication assisted treatment for opioid use disorder
  • Mental Health funding
  • Gun control
    • Removing guns from domestic abusers and disqualify individuals from gun ownership for out of state crimes
    • Sharing flags from mental health professionals in other states to determine gun ownership eligibility
  • Other
    • “discontinue hospital resident compliance audits”
    • “pharmacy adult immunization expansion and collaborative drug therapy management”
    • “physician profile enhancements”
    • “enhancing physician integrity and accountability”
    • Banning fentanyl analogs
    • Antimicrobial resistance preventions

Press Conference Urging Ban on All Flavored Tobacco Product
 

On January 13, 2020, ACP Advocacy Interns Dr. Austin Schnitzer and Dr. Maaz Shiekh attended a press conference organized by Flavors Hook Kids NY campaign to announce bills banning all flavored tobacco products. Proposed bills S.428-B/A.47-A would ban the sale of flavored e-cigarettes and S.6809/A.8808 would ban flavored combustible and smokeless tobacco, including menthol cigarettes.

The NYACP strongly supports the efforts by the New York Legislature to stop the growing trend of youth vaping through increased regulation
of e-cigarettes.


2020 New York State of the State 
 

On January 8, 2020, Governor Cuomo announced a number of new healthcare initiatives during his State
of the State address, including plans to target rising healthcare costs, tackle the ongoing opioid epidemic, and reduce rising youth e-cigarette use. The governor unveiled a multi-point plan to reduce healthcare costs, focusing on increasing price transparency and combating prescription drug prices:

 

  • A cap on insulin co-payments at $100 per month
  • Granting additional authority for the state to investigate pharmaceutical companies who raise prescription drug prices
  • Creating a website for the public to compare the health care cost and quality information
  • Additional limits on out-of-network billing for emergency services and disclosure of facility fees to patients

A number of new laws targeting tobacco and e-cigarettes were also announced:

  • A ban on the sale of all flavored nicotine products and a ban on e-cigarette ads targeting youth
  • Ending the sale of tobacco and e-cigarettes at pharmacies
  • Restricting online, mail, and phone purchasing of vaping products to prevent youth access

One proposal worthy of attention included in the supplemental State of the State Book is entitled “Enhancing Physician Integrity and Accountability.” It includes a number of action points, including a few listed below:

  • Periodic renewal requirements for providers to maintain their NYS license with the stated goal of targeting “out-of-state bad actors who are licensed, but do not actually practice in New York”
  • Strengthened disciplinary oversight of licensed providers
  • Ensuring public access to up-to-date information on NYS licensed physicians, including on professional conduct

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