The lobbying powerhouse behind two of Gov. Cuomo's nastiest scandals is back with another big request from Albany. And Cuomo — seemingly determined not to learn from his mistakes — is once again striving to give the group what it wants with the least possible debate or public scrutiny. It's a sign that the Greater New York Hospital Association remains one of the governor's tightest allies, in spite of its central role in his recent troubles. As GNYHA officials have confirmed, it was their idea last March for the Cuomo administration to move COVID-positive patients out of hospitals and into nursing homes at the height of the state's pandemic. That policy probably led to additional deaths — and definitely led to Cuomo's months-long coverup of nursing home data, a federal investigation and an impeachment inquiry. GNYHA also led a behind-the-scenes push to give health-care providers special protection from lawsuits during the pandemic. The group even wrote a first draft of language that Cuomo and legislative leaders slipped into last year's state budget with no public notice. These machinations, too, have been blamed for worsening the pandemic — and have caught the interest of federal prosecutors. Unfazed by these episodes, Cuomo is now pushing the hospitals' agenda on another front — squeezing more money out of insurers. GNYHA is campaigning for a state law requiring health plans to approve hospital claims without verifying in advance that the treatment in question is medically necessary — a routine check that insurers use to avoid waste and control costs. Instead, plans would have to pay claims up-front, review them after the fact, then fight for refunds. The group is airing TV ads that highlight hospital heroics during the pandemic and end with the slogan: "Tell Albany: protect hospitals, not insurers." The opposition to this "pay and pursue" plan includes not just insurers, but also employers and labor unions who argue that it will further drive up the state's health premiums, which are already among the highest in the U.S. The state would also face higher costs, because the new law would apply to Medicaid managed care plans. But Cuomo is solidly in GNYHA's corner. His aides have told the Legislature they want to make pay-and-pursue a last-minute addition to the state budget, which is due to be passed this week. This is the same classic Albany maneuver that Cuomo used last year to help GNYHA win liability protections.