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Practitioners around NY State begin learning about EI reform proposals
The powerpoint doesn't offer information that is materially different than what is already listed in the proposed budget but it is in a more readable format.
The largest issues proposed include:
1. Providers will be approved through the Department of Health and won't have contracts with local municipalities.
2. There must be an arms length relationship between service coordinators, evaluators, and service providers.
3. Providers will be required to establish and maintain contracts or agreements with a sufficient number of insurers, including Medicaid and CHP.
4. Providers will have to use the State's Fiscal Agent to bill third party payors.
5. All of this will be achieved by a mandate on insurance companies requiring them to coordinate through the State Fiscal Agent to pay for EI services.
Details that are still a little unclear include how the rate will be negotiated. Currently, there is no alignment between EI rates paid by municipalities, rates paid by insurance companies, and the Medicaid rates. It is unclear whether or not the rates will change based on the information released so far. The current plan calls for providers to continue providing services whether or not they have been reimbursed - so there will need to be some clarity so providers understand the rule systems they are being asked to operate under for reimbursement.
It is likely that this will drive some providers out of the system and that will likely create delays in service provision. That means that private therapies, at least for families that have those resources, will likely replace the EI system as the de facto methodology for children receiving services. It is another form of indirect cost sharing, and is probably intentional.
Stay tuned for ongoing analysis.
Army’s New Standard Issue Individual First Aid Kit
The U.S. Army has been trying to improve first aid medical response of soldiers in the field, and has developed the latest Individual First Aid Kit, or IFAK, to meet the unique needs that presented themselves in Iraq and Afghanistan.
But the IFAK is bulky and gets in the way of other equipment, so developers at Natick Soldier Systems Center have completely redesigned the pack to store it in the small of the back while making it easily accessible from either side by the soldier injured or another trying to help him.
Check-Cap X-ray Radar Pill Sliding Toward Commercial Introduction
GE has announced investing into an Israeli company called Check-Cap that’s developing swallowable endoscopic capsules for imaging the insides of the GI tract. Check-Cap seems to be a direct competitor of the better known Given Imaging, also an Israeli firm, that’s been producing its own PillCams for visualizing everything from the esophagus to the small intestine and beyond.
While PillCams use light in the visible spectrum and a traditional image sensor, the Check-Cap delivers low energy X-rays that provide a much different look at the internal anatomy. Because X-rays penetrate through soft material, food intake shouldn’t be a problem for the device, and all the typical preparation for a GI tract analysis may not have to apply.
Heart Stop Beating, a Film by Jeremiah Zagar
Drs. Billy Cohn and Bud Frazier at the Texas Heart Institute were faced with a patient last March who’s heart was about to succumb to the point that even a left ventricular assist device wouldn’t be sufficient to keep him alive. Described as a story of “two visionary doctors from the Texas Heart Institute who in March of 2011 successfully replaced a dying man’s heart with a ‘continuous flow’ rotor-driven device of their own design, proving that life was possible without a pulse or a heartbeat,” the film was directed by Jeremiah Zagar, whose feature-length documentary “In A Dream” was nominated for two Emmy’s in 2010.
Next Generation LipiFlow for Evaporative Dry Eye Cleared in U.S.
TearScience of Morrisville, NC received FDA clearance for the new version of the LipiFlow Thermal Pulsation System for evaporative dry eye. The condition leaves patients with too few tears, making the remaining ones feel too salty. The system heats and massages the eyelids, helping unblock the flow of lipids from the meibomian glands found under the eyelids.
The new generation of LipiFlow provides the ability to two treat both eyes simultaneously, cutting treatment time in half, to about 12 minutes. It also sports a new interface that displays treatment temperature, pressure sequence and treatment time remaining, while recording all the data for easy sharing with the clinic’s electronic medical record system.
Continuous Near-Infrared Regional Cerebral Perfusion Monitoring Shows Promise in Stroke Patients
Researchers at Mayo Clinic in Florida have shown that cerebral optically-based near infra-red spectroscopic oximetry applied to patients who have suffered a stroke can help monitor regional cerebral perfusion in real time, and thus “may serve as a useful, noninvasive, bedside intensive care unit monitoring tool to assess brain oxygenation in a direct manner.” The study looked at the device called Fore-Sight from Casmed of Branford, CT, that measures blood oxygen, similar to a finger clip pulse oximeter. The Mayo study results have been published in Journal of Neurosurgery this month.
Regional cerebral blood flow monitoring devices such as Fore-Sight are already in wide deployment in cardiac surgery, where they are thought to prevent brain ischemia in patients undergoing major surgeries on bypass (valve replacements, aortic arch surgeries, etc.).
