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POLITICO New York Health Care: ICD-10 is here; Legionnaires' update

Dear readers: POLITICO New York Pro subscribers receive this email at 5:30 a.m. each weekday. If you'd like to receive it at that time, along with a customized real-time news feed of New York health care policy news throughout the day, please contact us at lenglander@politico.com and we'll set you up for trial access.

written by Dan Goldberg

ICD-10 IS HERE — The new ICD-10 classification system takes effect today. Most experts think the bark won’t be as bad as the bite but that will prove little consolation for the providers — even if they are in the minority — who find they are not able to get paid. ICD-10 is the latest way providers must classify a disease or ailment before they can bill. The concern is that there are simply too many new classifications. The number of options for doctors is increasing from 14,000 to 70,000 and the number of codes for hospitals is increasing from 4,000 to 72,000. Most industrialized nations have already made the switch so the U.S. is not in unchartered territory. Proponents argue that the more specific classifications will help spot trends in population health. Doctors are concerned they will be overwhelmed.

...If any providers struggle with ICD-10 over the next couple weeks, please email me at dgoldberg@politico.com We’d like to tell you story.

...Flashback:
POLITICO New York’s Josefa Velasquez took a look at how providers were faring. http://politi.co/1WxOwjs [PRO]

...And POLITICO New Jersey’s Katie Jennings reports this morning that payers and providers seem to be generally optimistic about the preparation that has taken place. The cautious optimism does come with one caveat: all of the players are anticipating as-of-yet unspecified glitches in the transition. It’s far from the doom-and gloom-scenario being promulgated by several groups before the federal government delayed implementation in 2014 to allow for more preparation time. But the unknowable impact of such a massive disruption to the industry was palpable in discussions with doctors, hospitals and insurers. Read more here: http://politi.co/1hc9sN6

...For a little fun, I pulled out some of my favorite ICD-10 codes. (These are all real.)

10) V00.1XA: Pedestrian on foot injured in collision with roller-skater, initial encounter

9) V95.40XA: Unspecified spacecraft accident injuring occupant, initial encounter

8) W56.02XA: Struck by dolphin, initial encounter (That’s different from being bit by dolphin, which is W5601XA)

7) W59.22XA: Struck by turtle, initial encounter

6) V91.30XA: Hit or struck by falling object due to accident to merchant ship, initial encounter

5) W30.3XXA: Contact with grain storage elevator, initial encounter

4) V97.33XA: Sucked into jet engine, initial encounter

3) R461: Bizarre personal appearance

2) R15.2: Fecal Urgency (This is not to be confused with R15.1: Fecal Smearing; or R11.13: Vomiting of Fecal matter)

1) Z63.1: Problems in relationship with in-laws

The Wall Street Journal lets you play around with more. http://bit.ly/1WxU9hR

SHARE ME: Like this newsletter? Please tell a friend to sign up. Give them this link: http://politi.co/1gMLiJV

AND MAKE SURE YOU FOLLOW Josefa and me on Twitter @J__Velasquez & @DanCGoldberg. And for all New Jersey health news, check out @katiedjennings

LEGIONNAIRES’ UPDATE — One person has died from Legionnaires’ disease amid a new outbreak in the East Bronx, the New York City Health Department said Wednesday.

In all, 13 people have contracted the disease in the Morris Park section of the Bronx. Of those, 11 have been hospitalized and one has been discharged. All patients, according to the release, have underlying health conditions.

NOW WE KNOW — Today is National Homemade Cookies Day, so here is a scientific video explaining why cookies bake the way they do and how to bake the best batch. http://bit.ly/1WxNunL

WE'D LOVE TO HEAR FROM YOU: This roundup is for you, so please tell us how we can make it even better. Send tips, news, ideas, calendar items, releases, promotions, job postings, birthdays, congratulations, criticisms and corrections to dgoldberg@politico.com.

NEW LAW — The City Council unanimously approved three bills that make it easier to punish business owners who sell synthetic marijuana, commonly known as K2, Scooby Snacks or Spice. The legislation would allow the city to shut down businesses that violate the law twice in a three-year period, suspend an owner’s license to sell cigarettes if they are caught selling K2 and declare the sale of synthetic marijuana a “public nuisance.” Business owners could face penalties from $500 to $50,000 a day, depending on the violation. POLITICO New York’s Gloria Pazmino has more: http://politi.co/1Lldsce

...Speaker Melissa Mark-Viverito who supports legalization of recreational marijuana, said she believes criminalizing the use of marijuana may have forced users to use K2.

FLANAGAN DISCUSSES PAID FAMILY LEAVE — State Senate majority leader John Flanagan would not rule out paid family leave. Speaking at a panel in New York City hosted by Crain's New York Business, the Republican said he supported the concept but was unsure if he supported the current family leave proposals in the Legislature. Paid family leave, he said, has some “real good points,” but like any other piece of legislation should be thoroughly studied with input from employers and employees. In February, Gov. Andrew Cuomo said that he thought lawmakers lacked "the appetite" to consider such a proposal. A month later, the administration said it was seriously studying the issue. http://politi.co/1Llgayi [PRO]

REBRANDING — HealthPlus Amerigroup, which offers Medicare and Medicaid plans, will be renamed Empire BlueCross BlueShield HealthPlus under a rebranding set to take effect today.

MAKING ROUNDS — Dr. Martin Morgan, director of the R/Bioconductor Project, is joining the staff at Roswell Park Cancer Institute, according to a press release from RPCI. Morgan joins Roswell Park and the University at Buffalo’s School of Public Health and Health Professions, where he will serve as Research Professor in the Department of Biostatistics.

PHARMA REPORT: Ed Silverman is back and his latest piece calls for drug companies to open their books. “If the pharmaceutical industry wants to win consumer confidence, it will have to come clean about the mechanics behind its pricing. Otherwise, drug makers should brace themselves for increased scrutiny and calls for greater oversight.” http://bit.ly/1hced9r

WHAT WE’RE READING:

-SECRET SERVICE — Are Alabama hospitals secretly drug-testing new moms and their infants? ProPublica and AL.com present disturbing findings. http://bit.ly/1Llf8m9

-SOUND FAMILIAR? — POLITICO reports that “Democrats in the House and Senate have introduced bills to move the national tobacco age from 18 to 21. The House bill is sponsored by Reps. Diana DeGette and Mark Takai. The Senate bill is sponsored by Sens. Brian Schatz, Dick Durbin and Sherrod Brown.” New York City passed that law in 2013, one of Mayor Michael Bloomberg’s final public health acts.

-FOLLOW THE MONEY — The New York Times reports on a federal audit that found “nursing homes receive far more in Medicare payments than it costs them to provide care, exploiting the billing system in some cases by giving patients more therapy services than they need.” http://nyti.ms/1Lle0ib

-SCARE OUT OF CARE — Violence against nurses is on the rise and the Florida Nurses Association is taking steps to let people know that it’s not acceptable. The group has launched the “Take the Scare Out of Care” initiative, which includes an educational campaign as well as a legislative push to stiffen the penalties for assault and battery against nurses in the workplace.

-WHO’S LOOKING? — Kaiser Health News looks at how some wellness companies are selling employee health data. “Wellness vendors charge employers a per-person fee to assess workers’ health and motivate them to exercise, eat well, see doctors and take pills. Companies push workers to participate with gift cards, insurance discounts and other rewards or penalties.” http://bit.ly/1LleN2E

-NEW RECOMMENDATION —
The World Health Organization says everyone who has HIV should be put on antiretroviral triple therapy and everyone at risk of becoming infected should be offered protective doses of similar drugs. Previously, the WHO had only recommended this for men who have sex with men, prostitutes and people with infected partners. The problem is no one know who will pay for all this new treatment. http://nyti.ms/1Lleoxn

TODAY'S TIP — Comes from Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, who reminds us: “Flu vaccination prevented an est. 7.2 million flu-related illnesses & 3.1 million medical visits last flu season.” http://ow.ly/Sxfbg

STUDY THIS:

-GOOD CHOLESTEROL — Researchers from the University at Buffalo, writing in the Journal of Lipid Research say that HDL cholesterol — the good cholesterol — protects the blood-brain barrier from injury in patients with Multiple Sclerosis. “This finding is especially important because we found this protective effect very early in the disease,” lead author Dr. Murali Ramanathan, professor of pharmaceutical sciences in the UB School of Pharmacy and Pharmaceutical Sciences and professor of neurology in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, said in a press release accompanying the article. “The breakdown of the [blood brain barrier] is the first step in the formation of brain lesions because it allows immune cells to enter the brain, form long-lasting lesions and mediate tissue injury.” http://bit.ly/1hciSZ3

-PSORIASIS TREATMENT — Mount Sinai researchers published an article in the New England Journal of Medicine that explained that brodalumab, an experimental biologic, achieved 100 percent reduction in psoriasis symptoms in twice as many patients as a second more commonly used treatment. Brodalumab is designed to block the immune signaling protein interleukin 17 (IL-17). If that’s not blocked, the protein contributes to abnormal, psoriatic inflammation. Treatment was so effective that many patients did not have a dot of psoriasis left on their bodies, according to a press release from Sinai. http://bit.ly/1LR6WIN

GOT SOMETHING TO SAY? We're happy to listen...and so are our influential readers! Email us at ny-advertising@politico.com and we'll clue you in on messaging options in our newsletters and on POLITICO New York’s web and mobile sites. We'll craft a program tailored to your voice.

MISSED A ROUNDUP? Get caught up here: 9/30, 9/29, 9/28, 9/25, 9/24

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