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Active TB Increases in Minnesota; 90 Percent Foreign-Born, 11 Refugees Diagnosed Overseas Before Arrival

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The number of active tuberculosis (TB) cases diagnosed in Minnesota increased 12 percent in 2016 to 168, up from 150 one year earlier, according to the Minnesota Department of Health’s (MDH) Tuberculosis Prevention and Control Program’s Quarterly Surveillance Report, October 1, 2016 – December 31, 2016.

Ninety percent of these 168 cases (152 of 168) were foreign-born, significantly higher than the national 2016 average of 67.9 percent of active TB cases that were foreign-born.

Fourteen of these 168 cases, or 9 percent were diagnosed within the first year in the United States of the 2,635 refugees who were resettled in Minnesota in FY 2016. The majority of these refugees came from two high TB burden countries: 1,195 came from Somalia, and 653 came from Burma, according to the State Department’s interactive website.

Eleven of these 14 cases of active TB in refugees were actually diagnosed in pre-immigration exams overseas before their arrival in Minnesota – a remarkable situation that would have either violated U.S. law or required the granting of a waiver by the United States Citizenship and Immigration Services (USCIS) office within the Department of Homeland Security, since active TB is a “Class A” health risk which is prohibited entry to the U.S. without such a waiver.

Three of these 14 cases of active TB in refugees were diagnosed during the refugee health exams conducted after their arrival in the United States. (Read more from “Active TB Increases in Minnesota; 90 Percent Foreign-Born, 11 Refugees Diagnosed Overseas Before Arrival” HERE)

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Here Are the ‘Official’ Amount of Ways to Get Sick or Die

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There are 70,000 ways to get sick, hurt or mortally injured, and the U.S. is making them official.

On Thursday, U.S. hospitals, doctors and other care providers have to start using internationally developed standards called ICD-10 codes to bill government programs and private insurers in the nation’s $2.9 trillion-a-year health-care system. The codes cover everything from parrot bites to getting sucked into a jet engine.

Doctors have already begun mocking the diagnostic list, picking out the most absurd and arcane, such as Z63.1, “Problems in relationship with in-laws,” or V91.07XA, “Burn due to water skis on fire.” Yet for health-care providers who have payments at stake, the complex change is no joke.

Health insurers and government programs stopped accepting the old set of codes, called ICD-9, in the early morning hours Thursday, completing the switch. In a study released last month, the Government Accountability Office, the investigative arm of Congress, said “little is known” about how much it will cost the health-care system to make the transition. HCA Holdings Inc., the Nashville, Tennessee-based hospital chain, said 2015 costs for the transition to the new codes will be about $30 million.

Insurers began preparing for ICD-10 in 2010 and have been ready since the government first delayed implementation in 2012, said Clare Krusing, a spokeswoman for America’s Health Insurance Plans, a Washington-based industry group. “Every deadline that has come up, we were ready.” (Read more from “Here Are the ‘Official’ Amount of Ways to Get Sick or Die” HERE)

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