MSSNY eNews: September 30, 2020 – Must Collect School Info When Testing for COVID or Face Fines


N.Y. Docs Must Collect School Info When Testing for COVID
Clinicians to Face Fines or Professional Discipline for Not Reporting
Clinicians in New York who perform COVID-19 testing are now required to report information about patients’ school attendance, according to a Sept. 21 letter from state health commissioner Howard Zucker, MD, JD.

A new Executive Order from Gov. Andrew Cuomo (D) issued earlier this month mandated that providers must report whether a patient attends or works in a school — from elementary through higher education — along with the name of that school. Physicians must collect the information when taking specimens and submit it to the clinical lab. The data collection also applies to physician office laboratories and point-of-care testing. In those latter instances, results must be reported within 3 hours, according to the letter. The same applies to influenza testing for these groups.

Clinicians who do not collect and submit information can be fined up to $2,000 per day, according to the letter. Jonah Bruno, a spokesperson for the New York State Department of Health, said healthcare providers who don’t comply are “subject to a range of penalties, including fines and professional discipline.”

Dr. Zucker’s letter notes that the health department is working with hospitals, labs, and electronic health record vendors to create new fields for the information, but in the interim, clinicians should use the “occupation” field to enter school information. “This additional information is essential to limiting transmission and protecting our communities,” Zucker wrote in the letter.

When asked how the information would be used, Bruno said test results are “reported publicly through the COVID-19 Tracker and the School COVID-19 Report Card.”

Collecting information on schools could be used not only to inform decision making for the school, but for other community interventions as well if the proper contact tracing machinery is in place. New York’s new mandatory reporting comes amid a rise in coronavirus cases in the state, after months of relatively stable case counts. The state counted more than 1,000 new cases on Saturday for the first time since early June.

New York City Mayor Bill de Blasio said on Tuesday that the city’s COVID-19 positive test rate topped 3% for the first time in months. Case rates are growing dramatically in eight neighborhoods, accounting for more than 23% of new cases in the city, despite accounting for just 7% of its population. Against that background, New York City schools began reopening for in-person learning on Tuesday. (MedPage Today, September 29, 2020)

Please Join the NYS Department of Health Thursday, October 1st at 1-2 PM 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.

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Cuomo: COVID-19 Rate in ‘Hot Spot’ Areas is Five Times Rest of State

An average of 5 percent of people tested in New York’s top 20 “hot spot” zip codes are positive for Covid-19, five times the normal rate in the state, Gov. Andrew Cuomo said Tuesday.

Key context: The initial findings, which reflect testing conducted Monday in parts of Orange, Rockland, Kings, Queens, Broome, Westchester and Richmond counties where Covid-19 cases are surging, underscores the need for aggressive, targeted actions to prevent the virus from spreading in those communities, the governor said during a morning news conference.

Details: Cuomo said New York had a statewide positivity rate of 1.1 percent on Monday, a number increased to 1.3 percent when including the new hot spot zip codes over-sample.

He again called on local government officials to enforce mask wearing mandates and other protocols, calling them “the first line of defense…. Competent government must do compliance and enforcement,” he told reporters. “Why? A cluster today can be community spread tomorrow. … They have to do their job today.”

What’s next: Cuomo said he plans to meet with religious leaders of the Orthodox community and other local officials soon to discuss compliance and other related issues. “If you look at those clusters and you look at those zip codes you will see that there’s an overlap with large Orthodox Jewish communities — that is a fact. So, I will be directly meeting with them to talk about it,” he said. “This is a public health concern for their community.”

Cuomo added that public health rules, including mask mandates, apply to every religion and every resident of the state. (Politico Pro, 929)

Nurses at Northwell HospitalNorthwell Photo

Northwell Health Makes Source Code Available for Health Systems to
Localized COVID-19 Surveillance Dashboard

Northwell Website Patterns Predict COVID-19 Caseload

Today, Northwell Health announced that it has developed a first-of-its-kind predictive tool that can anticipate a spike in coronavirus disease 2019 (COVID-19) cases at its hospitals by mining user data patterns from its website. With the pandemic still raging worldwide, Northwell plans to give away the source code to other health systems.

The two-week advance warning system was created this summer by the customer insights group in collaboration with information technology and clinical teams in the wake of the COVID-19 surge that struck New York State’s largest health system last spring. Northwell Health treated nearly 85,000 COVID-19 patients, including 16,000 hospitalized patients between March and Labor Day – more than any health system in the United States.

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Survey Finds Boost in Likelihood of Flu Vaccination Among New Yorkers
Nonprofit health insurer EmblemHealth, headquartered in the Financial District, said Monday that a new survey of New Yorkers found nearly half are more likely to get a flu vaccination this fall due to the coinciding COVID-19 crisis.

The survey—commissioned by EmblemHealth and conducted by global research firm Dynata—found that 47% of 1,005 respondents across the five boroughs reported that COVID has made them more likely to get the flu vaccine this year than previously. However, it found that other respondents remained concerned about the flu vaccine’s effectiveness and side effects.

The concerns signal an opportunity for health care organizations to educate and engage the public, EmblemHealth said, at a time when getting the flu vaccine may be more important to overall health than ever. (Crain’s New York, Sept. 28)

COVID-19 has triggered a lot of uncertainty and anxiety for what the months ahead might hold,” said Dr. Richard Dal Col, chief medical officer of EmblemHealth, in a statement. “The flu vaccination can help give New Yorkers peace of mind by reducing their likelihood of contracting the flu, which has similar symptoms to COVID-19 and can weaken their overall immune response to COVID-19 and other illnesses.”

Other findings included that seniors were much more likely to have received the flu vaccine in the past compared to other age groups. Ninety-eight percent of surveyed seniors who received a flu vaccine in the past three years reported they are just as likely or more likely to get one this year, whether through a home health aide, primary care physician, pharmacy or other setting.

The survey also found that disparities in flu vaccination rates mirror those brought to greater light by the Covid-19 crisis, EmblemHealth said. Manhattan had the highest number of respondents who have received the flu vaccine at least once in the past three years—84%. That compares with 77% in Staten Island, 73% in Queens, 72% in Brooklyn and 68% in the Bronx. Additionally, 41% of Black respondents reported having received a flu vaccine every year for the past three years, compared with 59% of Hispanic respondents and 61% of white respondents, EmblemHealth said.

“As we look forward, many of the communities that were devastated by the COVID-19 pandemic earlier this year are now facing an impending twindemic,” Dal Col said.

He added that the insurer is working with its community and provider partners to increase education about the importance of the flu vaccine and access to it. (Crain’s Health Pulse)

UnitedHealthcare Ending No Cost to Patients Virtual Visit
The insurance giant UnitedHealthcare is ending a “virtual visit” benefit that had been expanded to many members during the Covid-19 pandemic, through which it was covering the full cost of visits — without any cost to patients — for individuals who were seeing in-network providers virtually for medical issues not related to Covid-19. (Asked by STAT for details, a UHC spokesperson pointed to a page on the company’s website.)

And Anthem, the company behind several affiliated health plans across the country, will stop waiving the cost of copays, coinsurance, and deductibles for virtual visits not related to Covid-19. Beginning Oct. 1, a commercially insured “member’s cost shares will be applied based on the terms of the plan they purchased,” the spokesperson said, adding that Anthem-affiliated health plans “have a long history of covering telehealth visits.” The spokesperson did not return STAT’s request for details about the coverage changes for different Anthem-affiliated health plans. (STAT, Sept.29)

39 Health Systems Declare Racism a Public Health Crisis, Vow to Fight It
Thirty-nine health systems across the U.S. declared racism a public health crisis and committed to address healthcare disparities across the nation. The health systems are part of the Healthcare Anchor Network, which was formed in 2016 to collectively work to improve community health. The Healthcare Anchor Network announced the declaration and pledge Sept. 27.

The 39 health systems have pledged to take several steps to address healthcare disparities and structural racism in their organizations. Some of the steps include providing access to COVID-19 testing in underserved communities, making hiring efforts inclusive and increasing spending with diverse-owned vendors and suppliers.

“Systemic racism results in generational trauma and poverty, while also unquestionably causing higher rates of illness and death in Black and Indigenous communities and communities of color. We have seen — in its rawest form — how the trauma of systemic racism adds to the historical injustices that have disproportionately affected communities of color,” the statement from the health systems reads.

The pledge and statement were modeled after a June statement signed by 36 Chicago-area health systems.

The organizations also committed to take several other steps, including:

  • Re-examine institutional policies with an equity lens
  • Boost access to primary and specialty care
  • Renew and expand unconscious bias training and anti-racism work
  • Continue to focus on improving care of patients with chronic conditions
  • Advocate for investments and innovations to boost access, quality, and health for underserved communities
  • Hire locally, promote and retain leaders of color (Becker’s Hospital Review, Sept.

Study Finds Statins Could Reduce COVID-19 Severity and Hospital Stays
Statins, a class of commonly-prescribed cholesterol-lowering drugs, could reduce patients’ risk of developing severe COVID-19, according to research recently published in the American Journal of Cardiology.

University of California San Diego researchers published a clinical study Sept. 15 in which they examined the medical records of 170 COVID-19 patients and 5,281 control patients without the disease who were hospitalized at UC San Diego Health between February and June. They analyzed the anonymized data to better understand the relationship between the use of statins before hospitalization and duration of hospital stay, disease severity and outcome.

The research team found that taking statins before hospitalization decreased COVID-19 patients’ risk of developing a severe case of the disease by more than 50 percent, as well as resulted in faster recovery times. A second UC San Diego research team on Sept. 18 published a mechanistic study in The EMBO Journal explaining that statins’ potential to reduce the risk of severe COVID-19 stems from the drug class’s ability to remove cholesterol from cell membranes, which prevents the novel coronavirus from getting in.

CVS Accused of Patient Steering
A majority of community pharmacies have lost patients in the last six months due to unfair patient steering, and CVS Health is most often the culprit, the National Community Pharmacists Association claims.

The NCPA conducted a survey of 412 community pharmacies between Sept. 8 and Sept. 11 and found that 79 percent of community pharmacies said patient steering happened with one or more of their patients in the past six months, and almost 78 percent said some of their patients then moved their prescriptions to CVS.

Patient steering happens when an insurance company moves a patient’s prescriptions to a different pharmacy without their knowledge or consent.

CVS Health owns insurance companies Aetna and Caremark. NCPA CEO Douglas Hoey said that because CVS owns pharmacies and insurance companies, that “allows it to eavesdrop on when and where patients are getting their prescriptions and, as the survey reported, coerce unknowing patients into CVS stores.”

“Our pharmacies only initiate prescription transfers when requested by a patient,” the spokesperson said. “In fact, more than 40% of the pharmacies in our network are independently owned. If a plan sponsor chooses a particular network design that includes specific pharmacies, their members are notified in advance.”

“Accusations that we transferred patients’ prescriptions to our own pharmacies without their knowledge or consent are simply not true,” he added.

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