Budget Battle in High Gear

By Jerry Hoffman
Tuesday, February 21, 2017

As the New York State Legislature heads into the month of March, both the State Senate and the State Assembly face the mandated deadline of April 1 to pass a state budget for the 2017–2018 fiscal year, which begins on that date.

Jerry Hoffman

State Senator John DeFrancisco of Syracuse, Deputy Majority Leader of the Senate and former chair of the Senate Finance Committee, will be a key player in budget deliberations. The battle of the budget will be the main item of business in the coming days and weeks.

Gov. Andrew Cuomo broke tradition in January by not delivering his State of the State address in Albany at a rare joint session of the Senate and the Assembly. Instead, he opted to visit several cities in the state to outline his objectives for 2017 in appearances at meetings that were open to the public.

In mid-January the governor unveiled his proposed $152.3 billion budget including the retention of the “millionaires tax” for three more years. Senate Majority Leader John Flanagan wasted little time in declaring his opposition to this item. The tax’s fate could still be unknown as budget deliberations continue.

The budget package must address a $3.5 billion deficit. Other budget proposals include reducing taxes for those with incomes of $300,000 or less. The budget would also approve three more years of the health financing measures of the Health Care Reform Act (HCRA) for a wide range of “public good” programs. On Feb. 16, the Medical Society of the State of New York (MSSNY) presented testimony about budget issues related to physicians and health care at a joint Senate and Assembly public hearing concerning budget issues related to health care.

Of special interest to physicians, especially those in high-risk specialties, was $127.4 million in proposed funding for the vital Excess Medical Malpractice Insurance Program. The governor is trying again to couple this funding with a requirement that physicians must obtain “a tax clearance” in order to qualify for this coverage.

Gov. Cuomo’s budget would appropriate $990,000 to MSSNY’s Committee for Physician Health. Other noteworthy measures in the budget would “tax e-cigarettes in the same manner as tobacco-cigarettes, require the registration and regulation of Pharmaceutical Benefit Managers, and the elimination of “prescriber prevails which are protections that currently exist in Medicaid and Medicaid Managed Care, except for atypical antipsychotic and anti-depressant medications.”

Other items in the budget proposal “permit physicians/nurse practitioners to create comprehensive medication management protocols” with pharmacists for patients with a chronic disease or diseases who have not met clinical goals of therapy, are at risk for hospitalization, or whom the physician or nurse practitioner deems to need comprehensive medication management services. This would make the inappropriate prescribing of opioids an unacceptable provider practice in the Medicaid program, which could result in a physician or other provider’s exclusion from the program. Testing of public systems every three years for containments would be required.

In recent years, the public opinions of members and staff of the Senate and the Assembly have taken a nosedrive in light of the forced resignations of several state legislators including Sheldon Silver, former Assembly speaker, and Dean Skelos, former Senate majority leader. In response to pressure from the public and the news media, the Senate and the Assembly gave final legislative approval in January to a bill that now will go before New York state voters in the fall for approval of an amendment to the State Constitution. If voters OK the changes, after Jan. 1, 2018, public officials in the state convicted of corruption-related felonies would no longer be allowed to collect their taxpayer-financed pensions.

After passage of the budget, the Senate and the Assembly will turn their attention to the typical volume of bills introduced by members of each house. Many of them are duplicates of bills that have been introduced in the past. Going forward many issues could arise which individual lawmakers, committee chairs, the governor and state departments feel should be addressed by the state Legislature.

Gerald N. (Jerry) Hoffman was chief executive officer of the Onondaga County Medical Society from 1981 until his retirement on Jan. 31, 2014, and is co-author of two books, Medical Malpractice Insurance: A Legislator’s View, and The History of Local Medical Care, 1806–2006.