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  • State Update

    The results of New York State's primary election, held September 13, re-affirm that all politics is local.

    Six of the eight senators who comprised the now disbanded Independent Democratic Conference (IDC) lost to their challengers. The IDC members, up until this spring, caucused with the state's Senate Republicans and shared a balance of power with them. The victorious Democratic challengers lean progressive and, should they win the November elections, Albany's agenda will surely reflect their ideology.

    The Republican Senate has long maintained a cautious approach when it comes to hospital and healthcare policy, weighing the regulatory and economic burdens on providers, as well as the financial pressures facing patients and payers when deliberating and implementing healthcare legislation. Led by Senate Health Committee Chair, Senator Kemp Hannon, legislators have worked with hospitals and other providers to ensure fair and reasonable legislation that strikes a balance between the concerns of providers, patients, and payers.

    The results of New York's primaries also underscore the growing interest in a single-payer model in New York State. Independent analyses confirm the difficulty in implementing such a system in terms of state/federal waiver needs and a massive increase in the tax burden on employers and employees in order to fund the system. These hurdles are in addition to the lower reimbursement providers would undoubtedly receive, if such a system were in place.

    Governor Cuomo also won the Democratic primary election, as did current Lieutenant Governor Kathy Hochul. New York City Public Advocate Letitia James won the Democratic primary for New York State Attorney General.

     

    Federal Update

    Senate Approves Spending for Several Agencies

    Funding Bills - The House and Senate approved an $845 billion spending bill that avoids a government shutdown come September 30, 2018. The legislation offers stability for some government departments until next September 30th - when the 2019 federal fiscal year ends. The departments include Defense, Education, Labor, and Health and Human Services. A short-term measure, known as a continuing resolution, will keep the remaining agencies funded until December 7, 2018. The package, which includes two appropriations bills, makes up about two-thirds of the annual appropriations total for the fiscal year.

    President Trump has indicated he will sign the legislation. In earlier weeks, he had stated he would not sign a bill that did not include funding for the proposed border wall.

    Opioid Legislation - Congressional members from both chambers have reached agreement on a comprehensive opioid bill. It includes the elimination of the Institute of Mental Disease (IMD) exclusion that has been a barrier to care. The bill lifts the exclusion not just for treatment of opioid abuse, but for treatment of all forms of addiction. The final bill allows states to receive federal Medicaid matching funds for up to 30 days per year for services provided to adults age 21-64 for substance use disorders in an IMD.

    Hospitals pushed for modification of the IMD exclusion, because of its prohibition of federal Medicaid payments to states for services for adult Medicaid beneficiaries between the ages of 21 and 64 who are treated at facilities that have more than 16 beds, and that provide inpatient or residential behavioral treatment. As a result, acute care hospitals, classified under Article 28 of New York State health law often run at or over capacity without an option to refer patients to these specialized centers, classified as Article 31 facilities under state law.

    The sweeping legislation includes many provisions designed to expand access to treatment and prevention programs, to stop the flow of illegal drugs across the borders, to improve prescription drug monitoring programs, to establish comprehensive opioid recovery centers and more. The bill now goes to the president for his consideration.