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POLITICO New York Health Care: Cuomo talks health reform in Puerto Rico; examining latest vaccine exemption

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written by Josefa Velasquez

IN PUERTO RICO, CUOMO PUSHES HEALTH REFORM — Gov. Andrew Cuomo’s 20-hour trip to Puerto Rico, meant to show solidarity with its financially struggling government, focused attention on the critical role the federal government will play in resolving the crisis, POLITICO New York’s Dan Goldberg reports. Cuomo, who can do little directly to help Puerto Rico beyond raising the issue to policymakers in Washington, is loaning the island some of his top health-policy experts. They plan to make several return trips to see if they can improve the health care system, which is losing money, doctors and patients in a vicious cycle that threatens to undermine one-fifth of the economy. Cuomo was joined in Puerto Rico by more than a dozen New York lawmakers and public health leaders who offered advice on how to restructure an economy burdened with $72 billion of debt that Puerto Rican leaders do not believe they will be able to repay.

But the sobering reality — acknowledged by Cuomo and several other officials in between promises and platitudes — is that little will be resolved without action by Congress or the Obama administration. That's why state Medicaid director Jason Helgerson said his goal is to help Puerto Rico present a more attractive case for why it should receive new federal money. To do that, Helgerson wants to assess how Puerto Rico can remodel its health care delivery system, a move that might persuade the federal government that investing is worthwhile.

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PRECEDENT SETTING? — State education commissioner MaryEllen Elia’s decision to exempt a Russian Orthodox mother's autistic son from the mandated mumps, measles and rubella vaccine based on her religious objection to abortion may spur more parents to do the same, experts and anti-vaccine activists say. POLITICO New York’s Keshia Clukey has the whole story.

NOW WE KNOW — Teenagers are using electronic cigarettes to inhale more than liquid tobacco. More than a quarter of high schoolers who have used both marijuana and e-cigs report using the device to vaporize marijuana.

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AGE FRIENDLY — Mayor Bill de Blasio announced on Tuesday the leadership and composition of the city's Age Friendly NYC Commission, a task force charged with addressing the concerns of the city's elderly population. Audrey Weiner, president and CEO of Jewish Home Lifecare, and Essence Communications co-founder Edward Lewis will co-chair the commission. City Hall named 19 other new commission members, drawn from various medical institutions. They will join nine other previously appointed members. The commission also includes 10 elected officials who serve as ex-officio members.

SAD NEWS — The Syracuse Post-Standard reports: “An elderly Salina man diagnosed with Eastern equine encephalitis has died, according to the Onondaga County Health Department. It is the sixth reported Eastern equine encephalitis death in Central New York since 1971.”

MAKING ROUNDS — Cheryl Moore will join the New York Genome Center as President and Chief Operating Officer. Moore is currently the executive vice president and chief operating officer of the Howard Hughes Medical Institute where she leads collaborative strategic efforts and oversees key operational functions, according to a press release from the Genome Center.

PHARMA REPORT: GlaxoSmithKline Plc and its partner, Theravance Inc., said Tuesday their inhaled medicine Breo did not prolong life of patients with chronic respiratory disease in a clinical trial of 16,500 people.


-OBAMACARE NUMBERS — Roughly 9.9 million people had active health insurance coverage through so-called Obamacare exchanges on June 30, according to figures from the Department of Health and Human Services. POLITICO’s Jennifer Haberkorn reports the figure is a slight decrease from the 10.2 million who had coverage at the end of March, the last time HHS provided an update, but still higher than the 9.1 million HHS estimated had coverage at the end of the calendar year.

…95.4 percent of ACA enrollees in Mississippi received assistance, highest in the nation. In New York, 71 percent of enrollees received assistance, lowest in the nation.

-BETTER LUCK NEXT YEAR — California’s plan to allow undocumented immigrants to purchase health insurance through the Affordable Care Act stalled in the State Sentate just days before the end of session. [PRO]

-VENDORS FAIL — More than three-quarters of the leading electronic health record (EHR) vendors failed to expose enough clinicians to their software during development to know whether it worked well, according article in the Journal of the American Medical Association, POLITICO’s Arthur Allen reports. The article examined vendors' compliance with the Office of the National Coordinator for Health Information Technology’s certification rules requiring user-centered design of EHRs. Vendors are required to publish their design methodologies, including the number of users who test their software; ONC recommends at least 15 people, preferably doctors or other clinicians, be engaged in final testing. [PRO]

-TRACKING ICD-10 — “If things are a bit tense in your doctor's office come Oct. 1, some behind-the-scenes red tape could be to blame. That's the day the nation's physicians and hospitals must start using a massive new coding system to describe your visit on insurance claims so they get paid,” the AP’s Lauren Neergaard reports. “Today, U.S. health providers use a system of roughly 14,000 codes to designate a diagnosis, for reimbursement purposes and in medical databases. To get more precise, the updated system has about 68,000 codes, essentially an expanded dictionary to capture more of the details from a patient's chart.

How precise? Get nipped feeding a bird, and the codes can distinguish if it was a goose or a parrot. Have a bike accident with one of those horse-drawn tourist carriages? Yep, there's a code for that, too. Unusual accidents aside, the government says the long-awaited change should help health officials better track quality of care, spot early warning signs of a brewing outbreak or look for illness or injury trends.”

… In August, POLITICO New York took a look at how the health care industry in New York is preparing for the switch. [PRO]

-BIPARTISAN OBAMACARE FIX? — POLITICO explains why there is bipartisan support to let states decide whether to expand the definition of the “small group” insurance market from employers with up to 50 workers to those with as many as 100 workers. The House bill, sponsored by Rep. Brett Guthrie (R-Ky.) has more than 200 sponsors, including 35 Democrats. The Senate version, introduced by Tim Scott (R-S.C.), has 28 backers, including New York’s Chuck Schumer, the third-ranking Democrat. [PRO]

-MENINGITIS B PUSH ON COLLEGE CAMPUS — As college students around the country begin the fall semester, academic institutions are offering vaccines against a rare, but life-threatening form of meningitis.

-JON STEWART JOINS ZADROGA PUSH — Former Daily Show host Jon Stewart will be joined by 100 first responders next week in the halls of Congress to push for the renewal of the James Zadroga 9/11 Health and Compensation Act, sources told the Huffington Post’s Michael McAuliff. The federal legislation, which was passed in 2011 after lengthy debate and is set to expire next year, provides benefits to victims of 9/11 as well as first responders. Stewart was one of the celebrities who initially pushed for the legislation to become law.

TODAY'S TIP Comes from the state’s Department of Health. It’s back to school time, meaning head lice time. Here’s what to do if you discover your child has lice.


-INSURANCE MERGERS — According to a study released by the American Medical Association, most insurance markets in the U.S. are dominated by a few companies, which could become fewer if Anthem acquires Cigna and Aetna buys Humana. The AMA says the proposed merger could reduce competition in 23 states. Citing federal antitrust guidelines, the study says “Mergers should not be permitted to create, enhance or entrench market power.” Under the guidelines, “a merger enhances market power if it is likely to encourage one or more firms to raise price, reduce output, diminish innovation or otherwise harm customers as a result of diminished competitive constraints.” The New York Times has more.

...Joseph Maldonado, president of the Medical Society of the State of New York, released a statement calling the study a “clarion call to our federal and state regulators to closely review the patient care implications of these proposed mergers. Undoubtedly, the mergers of Anthem (the parent of Empire BC/BS) with Cigna, and Aetna with Humana will give these companies far greater market power to reduce physician and hospital choice for our patients by further restricting networks and moving towards more burdensome administrative requirements as a precondition of our patients receiving needed care.”

-THYROID CANCER ON THE RISE — Low-risk cancers that do not present symptoms and will, presumably, not cause future problems are responsible for the uptick in cases of thyroid cancer diagnosed over the last decade, according to a study from the Mayo Clinic published in the journal Thyroid. "We are spotting more cancers, but they are cancers that are not likely to cause harm," says the study's lead author, Juan Brito Campana, MBBS, an assistant professor of medicine at the Mayo Clinic. "Their treatment, however, is likely to cause harm, as most thyroid cancers are treated by surgically removing all or part of the thyroid gland. This is a risky procedure that can damage a patient's vocal cords or leave them with lifelong calcium deficiencies."

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