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Cuomo backs hospitals in spat over medical payments

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Embattled Gov. Andrew Cuomo is going to the mat again for the hospital industry — this time in a fight over medical billing payments with health insurers and labor unions, critics claim.

Opponents said the “pay and pursue” proposal backed by Cuomo would require health insurers to immediately pay hospital billing claims without first reviewing whether the treatment for patients was medically necessary, a move that could increase costs and waste.

The change in the billing law is being discussed for inclusion in the $200 billion adoption due Thursday, April 1.

Critics said the last minute push is reminiscent of Cuomo and the Legislature’s stealth action in last year’s budget — an amendment that shielded hospitals and nursing homes from medical malpractice liability during the peak of coronavirus pandemic. The proposal was not discussed publicly and hospital industry officials praised the immunity clause they lobbied for.

This action and other Cuomo administration pandemic policies — including a controversial directive requiring nursing homes to admit recovering coronavirus patients discharged from hospitals and undercounting COVID-19 nursing home deaths — are subjects of federal probes.

The pay and pursue proposal was not included in the governor’s executive budget plan submitted in January nor in budget resolutions recently advanced by the state Assembly and Senate.

“What other industry requires consumers to pay first before explaining how much the service will cost or whether it is really necessary? This would be a huge hidden tax on employers, union benefit funds, and working families and shouldn’t be slipped in at the last minute,” said New York Health Planning Association CEO Eric Linzer said.

Some influential unions also slammed the pro-hospital measure as irresponsible.

“This proposal will result in higher hospital costs that will eventually be borne by our members and ordinary New Yorkers,” said United Federation of Teachers President Michael Mulgrew. “Giving hospitals free reign to ‘get paid first and explain later’ is a recipe for trouble.”

Bill Hammond, a health analyst for the Empire Center for Public Policy said, “someone needs to look over the hospitals’ shoulder to make sure they’re not doing unnecessary procedures.”

But the hospital industry suggested it is the for-profit health insurers who are getting greedy by opposing a process to accelerate payments of medical bills before a medical review.

“The insurance companies have gotten the upper hand. They have wrongly convinced a few labor unions to oppose this proposal—even though it does not impact them. The issue boils down to this: support for local hospitals or for obscenely profitable insurance companies,” said Brian Conway, spokesman for the Greater New York Hospital Association.

During budget testimony before the Legislature last month, GNYHA said, “while hospitals were saving thousands of lives during the pandemic—and losing revenues while absorbing enormous new costs—for-profit insurance companies made huge amounts of money as they continued to collect premiums for care that was never delivered due to the lock down and shut down of non-emergency procedures.”

The pay and pursue plan, “would prevent insurers from abusing the medical review process by requiring them to pay legitimate inpatient and emergency room claims to in-network hospitals before requesting a medical review,” GNYHA testified.

Cuomo’s office confirmed it is backing the pro-hospital pay and pursue proposal.

“This proposal is an attempt to strike a balance between insurers and caregivers – a balance between the routine denial of claims and requiring proper billing practices,” said Cuomo budget spokesman Freeman Klopott.

One key lawmaker said the measure should be dealt with separately and not jammed into the budget.

“I don’t think it’s right to put this on the table in the last week of March in budget negotiations, with no opportunity for public review or comment,” said Assembly Health Committee Chairman Richard Gottfried.

“This doesn’t need to be done as part of a budget. If it’s a good proposal, it will still be good when we’ve had time to analyze and debate it.”

GNYHA and other hospital industry sources have contributed over $1.5 million to the governor and the state Democratic Committee that reports to him.

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FDA finds peeling paint, debris at US plant making J&J’s COVID vaccine

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A US plant that was making Johnson & Johnson’s COVID-19 vaccine must fix a long list of problems including peeling paint and unsanitary conditions and practices to resume operation, according to a highly critical report by the Food and Drug Administration.

Experts said addressing the issues raised in the scathing FDA inspection report could take months.

Neither J&J nor the FDA has said when they expect vaccine production to restart at the Baltimore plant owned by Emergent Biosolutions. Only two other plants are currently equipped to supply the world with the key drug substance for J&J’s vaccine.

“It may take many months to make these changes,” said Prashant Yadav, a global health care supply chain expert at the Center for Global Development. He described some of the issues raised by the FDA as “quite significant.”

No vaccine manufactured at the Emergent plant has been distributed for use in the United States. However, J&J said it will exercise its oversight authority to ensure that all of the FDA observations are addressed promptly and comprehensively.

The Johnson & Johnson vaccine was put on a pause in the US over a potential link to a blood clotting condition.
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The health care conglomerate has drawn scrutiny for months over its halting process to scale up production of a vaccine that is easier to handle and, by virtue of being a single shot, easier to use than other authorized vaccines.

Its use in the United States has been paused since last week as health officials study a possible link to a very rare but serious blood clot condition.

Emergent has been seeking regulatory authorization to make the J&J vaccine in the United States. It stopped production at the plant recently, saying the FDA had asked it to do so after an inspection.

J&J’s plant in Leiden, the Netherlands, is still producing doses for the world. It has another facility in India, which is currently curtailing exports of the shot as it struggles to vaccinate its own population.

Johnson & Johnson reiterated on Wednesday that it was working to establish a global supply chain in which 10 manufacturing sites would be involved in the production of its COVID-19 vaccine, in addition to the Leiden plant.

The company has a US government-brokered agreement with rival drugmaker Merck, which is preparing to make doses of J&J’s vaccine.

Failure to train personnel

The FDA in its final 12-page inspection report said it had reviewed security camera footage in addition to an in-person site visit to the Emergent plant.

It found a failure to train personnel to avoid cross-contamination of COVID-19 vaccines from Johnson & Johnson and AstraZeneca, which had also been produced at the site. The agency also cited staff carrying unsealed bags of medical waste in the facility, bringing it in contact with containers of material used in manufacturing.

The FDA reviewed security camera footage and visited the Emergent BioSolutions plant in Baltimore.
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Earlier this week, the House launched an investigation into whether Emergent used its relationship with a Trump administration official to get a vaccine manufacturing contract despite a record of not delivering on contracts.

Emergent said in a statement that it is working with the FDA and J&J to quickly resolve the issues outlined in the report.

Production of the AstraZeneca vaccine, which is not yet authorized for use in the United States, was previously stopped at the Emergent plant after ingredients from that shot contaminated a batch of J&J vaccine, ruining millions of doses.

The FDA also noted that Emergent did not produce adequate reports showing that the vaccines it was producing met quality standards.

The inspection, carried out between April 12 and April 20, also found the building not of suitable size or design to facilitate cleaning, maintenance or proper operations.

J&J said it was redoubling its efforts to get authorization for the facility as quickly as possible.

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One dead after pair of fires breaks out in Manhattan

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One person was killed and several others were injured in a pair of Manhattan fires Wednesday morning, officials said.

The first blaze erupted in Midtown around 8:15 a.m. inside a DSW Designer Shoe Warehouse at 213 W. 34th St., where an escalator became fully engulfed in flames — sending smoke billowing into the first and second floor and the interconnected 40-story hotel building, fire officials said.

It was not immediately clear which hotel it was.

Five firefighters suffered minor injuries putting out the blaze.

“The fire went out, but we have a smoke condition that we’re trying to alleviate,” FDNY Battalion Chief John Porretto said at the scene. “Units are going to remain on scene until all the smoke alleviates.”

The fire marshal will determine the causes of the fire.

A second blaze broke out 15 minutes later on the Upper East Side at 1576 2nd Ave., officials said.

A three-alarm fire at 213 W. 34th Street in Manhattan that left one dead
A three-alarm fire at 213 W. 34th St. in Manhattan left one dead.
NYFD

One man died in the fire and a second man was in serious condition at Lenox Hill Hospital, police said.

A firefighter suffered minor injuries battling the blaze and was taken to Cornell Hospital, fire officials said.

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NYC school leaders react to Derek Chauvin guilty verdict

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The leaders of the city’s public schools and largest charter network both weighed in on the Derek Chauvin verdict with passionate statements about how there is still a long way to go to reach systemic equality.

Department of Education Chancellor Meisha Ross-Porter issued a personal commentary Tuesday night after the murder conviction of former Minnesota cop Chauvin.

“I felt pain and rage, deep in my bones,” she said of her initial reaction to George Floyd’s death. “It wasn’t a new feeling. I have felt that many times in my life, as a Black woman, sister, daughter, and mother to Black children—and as an educator who has served children of color in this city for more than 20 years.”

Ross-Porter said the Department of Education would be issuing guidance for teachers and families to help them process the verdict.

Eva Moskowitz with two students, the CEO and Founder of the Success Academy
Success Academy CEO Eva Moskowitz issued a statement on the Derek Chauvin verdict.
Brigitte Stelzer

“For our Black and brown children to know that they matter, the accountability this verdict represents is so important,” she stated. “In a world that too often tells them otherwise, accountability in this moment tells the Black and brown children in our schools that their lives matter, and lifts up the importance of their futures.”

Several teachers told The Post on Wednesday morning that they planned to broach the topic with their students to allow them to discuss Floyd’s death and Chauvin’s conviction.

Schools Chancellor Meisha Ross-Porter said the Department of Education would issue guidance to help teachers and families process the verdict.
Schools Chancellor Meisha Ross-Porter said the Department of Education would issue guidance to help teachers and families process the verdict.
Mark Lennihan/AP

“Because while the individual who took George Floyd’s life will be held accountable, we recognize that systemic racism, and the violence it fuels, is still creating tragedy and inequality across our country every single day,” Ross-Porter said. “We are all part of the work to undo this harm and reach true justice.”

Success Academy CEO Eva Moskowitz, who oversees the city’s largest charter school network, also issued a statement.

People react after the verdict was read in the Derek Chauvin trial in Minneapolis.
People react after the verdict was read in the Derek Chauvin trial in Minneapolis.
Scott Olson/Getty Images

“We are grateful that justice has been served and that the judicial process has worked as intended,” she wrote. “We recognize, however, that this verdict does not resolve the systemic inequities that led to Floyd’s death; nor does it heal the anguish we feel witnessing our fellow citizens die at the hands of the public servants tasked with protecting us.”

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