MSSNY eNews: October 21, 2020 – COVID-19: 1.6% Is the Highest Positivity Rate Since June

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Notes from Governor Cuomo’s Conference Call

COVID-19 General:
– Day 235
– Statewide positivity rate: 1.2%
– Statewide positivity rate (with hotspots): 1.6%
– Red Zone positivity rate: 6.6%
– 7 fatalities
– 950 hospitalizations
– 201 ICU patients
– 103 intubations
– 124,789 tests yesterday

Federal:
– COVID cases are increasing across the country
– 43 states are part of the travel quarantine
– Gov states New Jersey, Pennsylvania, and Connecticut are exempt because there is no easy way to enforce a quarantine against those states
– Positivity rate by state:
– Wisconsin: 13.4%
– Nevada: 58.8%
– Texas: 7.7%
– California: 2.5%
– Florida: 12.4%

Micro-Clusters:
– Gov states that micro-cluster buffer zones will be adjusted based on a 10-day average positivity rate
– Red zone becomes an orange zone if its 10-day average is less than 3%
– Orange zone becomes yellow zone: less than 2%
– Yellow zone returns to normal: less than 1.5%
– Positivity rates for the past 7 days:
– Brooklyn: 5.5%
– Queens (Forest Hills): 2.5%
– Queens (Far Rockaway): 1.8%
– Rockland: 4.8%
– Orange: 4.2%

Q&A:

– 1.6% is the highest positivity rate since June
– How can we set a standard for other states but exempt NJ, CT, and PA from travel restrictions?
– Gov: the only way we are currently enforcing the quarantine is by airports and some trains
– If we quarantined NJ, CT, and PA, we would suffer economically and people would avoid quarantine by driving
– State police are overburdened
– Gov wants to come up with a plan that uses testing to reduce quarantines
– Gov: the numbers overall are increasing because it is Fall
– Poll shows 67% of NY support the Gov’s response to the pandemic
– Gov credits the public for complying with social distancing guidelines


Two More Updates: CDC: “300,000 Deaths in 2020, Not 220,000”
1. Nearly 300,000 excess deaths have occurred this year, suggesting that the official COVID-19 tally of about 220,000 deaths is an undercount, according to a new CDC report. The agency identified an estimated 299,028 excess deaths that occurred from Jan. 26 to Oct. 3, about 66 percent of which were attributed to COVID-19.

2. The nation’s death rate for hospitalized COVID-19 patients is falling, according to two new studies cited by NPR. The decline is evident among all age groups, including patients with underlying conditions that increase the risk of virus complications. One study analyzed 5,000 hospitalizations at New York City-based NYU Langone Health between March and August. Researchers found the death rate fell by 18 percent, on average.


Please Join the NYS Department of Health Thursday, October 22nd at 1-2PM for a COVID-19 Update for Healthcare Providers

To accommodate the large number of participants, find our webinar streaming via YouTube Live (and available for viewing immediately thereafter) on the NYSDOH COVID website for providers:

https://coronavirus.health.ny.gov/weekly-healthcare-provider-update

Audio number and code: 844-512-2950 Access code 9060349#


MSSNY Joins Medical Societies to Urge Delay of Info Blocking Rule on Nov. 2
MSSNY has joined with the medical societies of California, Florida and Texas in a letter to the federal Office of the National Coordinator for Health Information Technology requesting that they delay implementation of the information blocking provisions of the 21st Century Cures Act Final Rule for at least one year. 

The rule is scheduled to go into effect on November 2, though there remains the possibility of the rule being delayed.

The state medical associations’ letter notes that “We remain completely committed to the goals of the Final Rule – ensuring that robust health care data is accessible to both clinicians and patients…however, physician practices are spending their time and effort battling the COVID-19 pandemic. Physicians are also preparing for flu season, as well as a resurgence of the coronavirus.

Physicians are struggling to maintain the financial viability of their practices during the pandemic and do not have the additional resources to dedicate to hiring consultants to develop compliance plans. Asking physicians at this moment to come into compliance with a rule set to take effect on November 2nd is simply too much to ask”.

Please go here for a lengthy summary of the information blocking rules prepared by the American Medical Association.


 


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Urge Congress to Waive “Budget Neutrality” to Prevent Steep 2021 Medicare Cut
The 2021 Medicare Physician payment rule advanced by CMS contains a number of important changes, including reduced documentation for E&M codes and long overdue increases for office visits.  However, of great concern it also sets forth a 11% cut to the Medicare conversion factor, greatly limiting the benefit of these other increases and potentially causing great harm to many practices.

The conversion factor cut is required due to statutory “budget neutrality” requirements that prohibit increases without corresponding decreases.  MSSNY and many other groups are urging Congress to pass legislation to waive these “budget neutrality” requirements to prevent devasting cuts and permit needed changes to go forward.

You can send a letter to supplement these efforts here.

We also thank the many members of the New York Congressional delegation who joined their colleagues in a bi-partisan letter initiated by Rep. Ami Bera, MD (D-CA) and Rep. Larry Bucshon, MD (R-IN) urging that legislation be passed by Congress to prevent these steep Medicare cuts.  The New York Congressional members – both Democrats and Republicans – that signed the letter include Representatives: Brindisi, Clarke, Delgado, Jacobs, Katko, S.P. Maloney, Meeks, Morelle, Reed, Rice, Stefanik, Suozzi, and Tonko

For a comprehensive summary by the AMA of the proposed Medicare 2021 payment rule, please click here.


 

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FDA Advisory Panel to Publicly Discuss COVID-19 Vaccine Approval Process
A committee of outside experts will meet Oct. 22 to advise the FDA on its COVID-19 vaccine approval process for the first time, STAT reported. The convening of the panel, known as the Vaccines and Related Biological Products Advisory Committee, could reassure members of the public who worry the FDA is basing its COVID-19 decisions on politics more than science. An October survey conducted by STAT and the Harris Poll revealed that Americans’ acceptance of a potential COVID-19 vaccine is declining rapidly.

The FDA has listed a roster of 20 committee members, consisting of physicians, academics, disease experts and biostatisticians. The committee will also feature a representative from the pharmaceutical industry, Paula Annunziato, MD, Merck’s vice president of vaccine and clinical research, but she cannot vote when the committee is making decisions.

VRBPAC will convene as many as three times in November and three times in December, according to STAT. Members must be vetted for conflicts of interest before each meeting.

The FDA is not required to heed the advice of the VRBPAC, though it usually does.  (Becker’s Hospital Review 10/20)


FOR YOUR PATIENTS
From NYSDOH: Halloween Should Be Spooky, Not Scary!
Creative ways to celebrate more safely


Medicare Punishes Labs with Slow COVID-19 Test Turnaround; Laggards to Receive $25 Less Per Test
Medicare is clamping down on clinical labs that fail to return COVID-19 test results fast enough.

“CMS previously took action in April 2020 by increasing the Medicare payment to laboratories for high throughput COVID-19 diagnostic tests from approximately $51 to $100 per test. CMS announced that starting January 1, 2021, Medicare will pay $100 only to laboratories that complete high throughput COVID-19 diagnostic tests within two calendar days of the specimen being collected,” CMS said in a press release Thursday. “Also, effective January 1, 2021, for laboratories that take longer than two days to complete these tests, Medicare will pay a rate of $75. CMS is working to ensure that patients who test positive for the virus are alerted quickly so they can self-isolate and receive medical treatment.”

“As America continues to grapple with the COVID-19 pandemic, prompt testing turnaround times are more important than ever,” said CMS Administrator Seema Verma. “Today’s announcement supports faster high throughput testing, which will allow patients and physicians to act quickly and decisively with respect to treatment decisions, physical isolation, and contact tracing.”

Turnaround times for COVID-19 lab tests have been a matter of contention in many states. Quest Diagnostics announced that as of Oct. 12, its turnaround time is “2 days across all populations and 1-2 days for our priority population, which includes hospitalized patients, individuals in long-term care (such as nursing homes), and presurgical patients.”

Not surprisingly, laboratories were not happy with the CMS announcement. “ACLA member laboratories have already implemented innovative solutions and reworked operations to support increased COVID-19 testing capacity and faster turnaround times,” the American Clinical Laboratory Association said in a statement. “We’re concerned this policy could create a domino effect where patient access to testing is severely reduced. Cutting laboratory reimbursement will not address the root causes of delayed turnaround times. Turnaround time is driven largely by fluctuations in demand and access to critical supplies. As states across the country experience a surge in new cases, the global demand for testing supplies remains high.” (Oct.16 Medpage)


Veterans Matters: TBI in Returning Veterans Webinar
The Medical Society of the State of New York and Nassau County Medical Society are hosting a CME live webinar entitled Veterans Matters: TBI in Returning Veterans on Tuesday, November 3, 2020 at 7:30 am.
Click HERE to view the flyer and register for the program!
When:   November 3, 2020 at 7:30 am
Faculty:  David Podwall, MD
.Educational Objectives:

  • Identify signs and symptoms indicative of the spectrum from concussion/mild TBI to severe TBI
  • Examine evidence-based treatment modalities and when to refer to a specialist
  • Identify red flags that indicate alternate or more severe pathology
  • Outline an appropriate management plan for a patient presenting with concussion/TBI including a return to “normal life” protocol
  • For more information, contact Jangmu Sherpa at jsherpa@mssny.org or call (518) 465-8085

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.


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