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(c) 2010-2026 Jon L Gelman, All Rights Reserved.

Friday, June 7, 2013

Frank Lautenberg: The Senator From Paterson

Senator Frank Lautenberg passed away this week and his legacy of helping the workers will live on for generations. "The boy Paterson," as he used to say, knew first hand of the problems confronted by those who worked in his hometown's asbestos factories.

Official Photograph of U.S. Senator Frank Laut...
Official Photograph of U.S. Senator Frank Lautenberg
1924-2013
 (Photo credit: Wikipedia)
At one of my early meetings with the late Irving J. Selikoff, MD, the world renown asbestos expert of the health dangers of asbestos fiber, the doctor highlighted the necessity for a strong link between medicine and politics. Both Dr. Selikoff and Senator Lautenberg, grew up and worked in Paterson, NJ.

Paterson, was the home of several asbestos manufacturing factories since it was on a railroad link and was equal distant to major US East coast seaports. Asbestos was a strategic commodity for the US military during World War II.  Asbestos had allegedly "miracle properties" that acted as an insulating agent on Navy ships, boiler rooms  and other heat producing equipment. The serious and adverse effects of asbestos fiber to humans was not readily made known to workers and the public at large.

Consequently, an epidemic of asbestos related disease, including: asbestosis, lung cancer and mesothelioma followed decades after exposure and inflicted disease and death in epidemic proportions. The "original 17" workers' compensation asbestos cases in New Jersey for exposures at The Union Asbestos and Rubber Company plant in Paterson NJ were heard at the Paterson (Passaic County) office of the NJ Division of Workers' Compensation. My father, Carl Gelman, represented the workers and the their dependents, and their medical expert was Dr. Irving J. Selikoff, MD. All were Patersonians.

Dr. Selikoff went onto head the Environmental Sciences Laboratory at the Mount Sinai Medical Center, NY, and continued to follow the cohort of workers through The Paterson Asbestos Control project. That lead to a research project that was published and presented at the New York Academy of Sciences in 1964. International concern was raised over the deadly hazard of asbestos fiber.

Medical research alone could not protect workers in a meaningful way, and Dr. Selikoff knew that, and impressed upon me that the US Senate and Congress would be catalysts for political change that help protect workers from asbestos and other hazardous progress. Likewise, Senator Lautenberg knew that also, and had strong and professional relationship with Dr. Selikoff.

Senator Lautenberg advanced the concept of an important medical-political relationship from asbestos to other environmental hazards and chemicals, including tobacco. The "boy from Paterson,"  sparked by a strong foundation of concern for asbestos workers and public health, brought to Washington a vision for a safer and healthier nation that made a difference to all.


Statement of Hon. Frank R. Lautenberg, U.S. Senator from the                    
State of New Jersey

"Madam Chairman, thank you for holding today's hearing on the health
effects of asbestos. Let me welcome Senator Murray to the committee and
thank her for working to keep Americans safe from asbestos.

   Every year, more than two-thousand Americans die premature and
painful deaths from exposure to asbestos. Their deaths leave children
without parents, and families struggling to make ends meet.

   New Jersey has America's sixth-highest number of deaths from
asbestos. From asbestos used in ship insulation at shipyards to
asbestos used to insulate pipes at refineries and factories, at least
two-thousand seven-hundred and seventy-five New Jerseyans died because
of asbestos exposure from 1979 to 2001. Just last week, a school in
Asbury Park was closed because part of the ceiling fell and asbestos
was found. This toxin's presence in offices, schools and homes could
pose health risks for years to come--ranging from breathing problems to
lung damage and cancer.

    One of the leading researchers on the link between asbestos and
lung disease was Dr. Irving Selikoff, who lived in New Jersey. Dr.
Selikoff did his research on workers across my state, including those
in my home town of Paterson. In 1979, Dr. Selikoff showed that one in
five asbestos workers developed a fatal lung disease. Senator Murray's
bill is a strategy for real action to reduce asbestos in the places we
live and work.

    The bill will ban the use of asbestos to the maximum extent
possible and benefit companies who are producing safer alternatives. It
also calls for more research on the health affects of asbestos, as well
as the best treatment options for asbestos-related illnesses and better
coordination among federal agencies. Congress owes our children and
grandchildren action now to protect them from asbestos in the future.

    I look forward to hearing the testimony of today's witnesses.

    Thank you Madam Chairman.

EXAMINING THE HUMAN HEALTH EFFECTS OF ASBESTOS AND THE METHODS: MITIGATING SUCH IMPACTS, Tuesday, June 12, 2007, The US Senate Committee on Environment and Public Works.
.........
 
"Mr. LAUTENBERG. Mr. President, since time is limited, I am going to get down to the nuts and bolts. I come from a State in which asbestos was prominent in manufacturing in many places. As a matter of fact, early in the 1950s, a doctor named Irving Selikoff, who was a researcher as well as a physician, discovered the lethality of asbestos. He is the one who raised the alarm about the dangers of that product.

He saw mesothelioma and asbestosis.

In my office in New Jersey, I had a man and his wife and his mature son, who was about 30 years old, come in to see me because they all had mesothelioma, but only the father worked in the manufacturing facility, the mill. His wife and child, his son, were made ill as a result of the mother washing her husband's clothes. That is how lethal, how dangerous asbestos is.

This bill is an abstract exercise. There are real people involved, people who are going to die as a result of the exposure. I have seen it up front and personal. A friend of mine who was a lawyer, after practicing 20 years, got a call from a member of a union one day that had asbestos workers, and he was told to get a chest x ray. He did. After 20 years of no illness, nothing, suddenly they found that he had a spot on his lung, and it turned into mesothelioma and he was dead soon thereafter.

I recently had a World War II vet--I am one as well--come into my office, sick from mesothelioma, from work he did 40 years ago. We have seen so many cases where the gestation period is so long, so that to suddenly close this out and say that is going to be enough money, $140 billion--it sounds like a lot, but it is not a lot when it comes to individuals who need help and who need to be able to continue to conduct their lives and do whatever they can to make life comfortable.

The Congressional Budget Office has stated that the fund will need $10 billion more. Other analysts put the figure as high as $300 billion. So it is fairly obvious that I am going to oppose this bill and support the point of order. I urge my colleagues to do the same because what we are doing is dismissing the suffering of people who have been exposed to this, even though the companies knew how dangerous the material was they were working with. They permitted people to work with it and did not do anything about it, except ultimately, in many cases, they went bankrupt as a result of their behavior.

FAIRNESS IN ASBESTOS INJURY RESOLUTION ACT OF 2005--Resumed -- (Senate - February 14, 2006)
................


"Mr. LAUTENBERG. Mr. President, I rise today in memory of a dear friend of mine, Prof. Irving J. Selikoff. Irving's uncompromised dedication to medical research and education in disease caused by hazardous materials paved the way for new standards of occupational safety. He was an extremely committed individual and I have learned a great deal about life, ethics, and public policy from him.
Dr. Selikoff's commitment to making the world a better place to live has been an inspiration to me and has further spurred my efforts to improve the public health. Mr. President, Dr. Irving Selikoff passed away on May 20, 1992, but he left us a legacy of medical knowledge that will continue to change the way people across the Nation live for many years to come. He will be missed.

Mr. President, on August 3, 1992, the industrial union department of the AFL-CIO adopted a resolution in memory of Dr. Selikoff. I want to share these words with my collegues and I ask unanimous consent that it be included in the Record.

Senator Lautenberg's Resolution in Memory of Dr. Irving J. Selikoff, January 15, 1915-May 20, 1992

Dr. Selikoff was a legend among workers. No other physician had as close a relationship with so many working people. He saw himself as a public servant, proud of working for a city medical school and being paid by the people.

He was first recognized as a scientist while serving in a public tuberculosis hospital, where he conducted the clinical trials for Isoniazid. This drug brought the `white plague', then the most serious disease in the workplace, under control. He started a clinic in Paterson, New Jersey, a community of textile workers. There, in response to disease among his own patients, all union members, he linked lung scarring and cancer to working with asbestos.

When he understood the importance of this finding, he left his clinic and established at Mt. Sinai School of Medicine a program designed to end the asbestos scourge with tools of science and medicine placed in the hands of unions. Soon his work on asbestos and many other workplace pollutants impacted every affiliate of the Industrial Union Department.

Dr. Selikoff studied and counseled workers and their families in Baltimore, Charleston, Lansing, Duluth, Midland, Norfolk, Nitro, Port Allegheny, New York's Chinatown, the Rocky Mountains and the mountains of Vermont, Canada's Mohawk reservation and hundreds of other places. He became known as a great scientist, but he never stopped being a doctor who worked tirelessly every day of the week, examining chartered plane loads of workers on Sunday and bringing clinics to wherever workers gathered, whether in the union hall at night or the convention on Saturday.

He knew that doctors need to understand the workplace and the labor movement. He required all his students to work in or with the Industrial Union Department. He gave us a network of physicians and scientists who continue to help us, whether in the clinic or before the Congress.

He knew that labor and science function internationally. He gave us a community of university allies in thirty countries under the aegis of Collegium Ramazzini and its Institute for Occupational and Environmental Health Research.

He knew that we seldom could achieve zero exposure to most toxic substances in the workplace. He helped us create the Workplace Health Fund to assist workers at risk, become partners in cancer treatment research and develop special programs of education.

Dr. Selikoff gave us an agenda for the future, and a Center at Mt. Sinai, the Selikoff Fund of the Workplace Health Fund, and the Ramazzini Institute for Occupational and Environmental Health Research to carry out the agenda. It is up to those of us who benefitted from his life work to continue to support the institutions he created.
  • IRVING J. SELIKOFF TRIBUTE (Senate - August 04, 1992)
    [Page: S11410]

Thursday, June 6, 2013

OSHA fines South River, NJ, masonry contractor nearly $91,000 for fall, scaffold hazard

The U.S. Department of Labor's Occupational Safety and Health Administration has cited South River-based Mr. Concrete Corp. with four repeat and five serious safety violations, including scaffold and fall hazards, found at a Maywood work site. OSHA's February inspection was initiated in response to imminent fall hazards observed by an OSHA compliance officer.

The repeat violations, with $69,300 in fines, involve exposure to fall hazards of approximately 20
feet while working from a scaffold lacking a fall protection system; workers on a scaffold more than 10 feet above a lower level while not protected from falling to that lower level; tubular welded frames and panels not properly braced; no limited access zone established during masonry wall construction; and lack of appropriate ladders, stair towers, walkways or access to scaffold platforms more than 2 feet above or below a point of access. The same violations were cited in 2010. A repeat violation is issued when an employer previously has been cited for the same or a similar violation of a standard, regulation, rule or order at any other facility in federal enforcement states within the last five years.

The serious violations, with a $20,790 penalty, involve failing to guard the point of operation of a mortar mixer, ensure electrical equipment was properly grounded, ensure makeshift devices were not used to increase scaffold height, and to properly install toeboards on the scaffold edge. A serious citation is issued when there is substantial probability that death or serious physical harm could result and the employer knew, or should have known, of the hazard.

Wednesday, June 5, 2013

NIOSH to Establish a National Workers' Compensation Data/Analysis Center

The long wait is over, the Federal government in getting into the workers' compensation data collection and analysis business. NIOSH (The National Institute for Occupational Safety and Health) has announced that it is entering into the arena, largely filled by the insurance industry  and NISOH will establish the NIOSH Center for Workers' Compensation Studies (CWCS).

In 2013,the NIOSH Center for Workers’ Compensation Studies (CWCS) was created to organize workers’
compensation data that are already being analyzed by NIOSH researchers in existing programs, such as the Economics ProgramSurveillance Program, and the Center for Motor Vehicle Safety. This is important because coordinated workers’ compensation research has been conducted mostly at large commercial insurers, state-based insurers, or organizations such as the National Council on Compensation Insurance (NCCI)External Web Site Icon, which cannot always widely distribute their research findings.
We are conducting analyses across a wide range of industry sectors, including:
  • Construction
  • Healthcare and social assistance
  • Manufacturing
  • Public safety
  • Services
  • Mining
  • Transportation
  • Warehousing
  • Wholesale and retail trade
The mission of the CWCS is to use workers’ compensation data to prevent and reduce the severity of workplace injuries and illnesses. We will work with public and private partners to maximize the use of their own workers’ compensation data.

More Regulation Called for of State Opt-Out Plans

A recently published report by the New Street Group, sponsored by Sedgwick  calls for the intervention of state regulation over workers' compensation opt-out plans. Recognizing the gray line between State and Federal insurance programs, the report concludes that the Federal  and state courts may ultimately decide the direction of workers' compensation in the US.
By Peter Rousmaniere and Jack Roberts


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An activist movement is encouraging individuals to opt-out of going through airport x-ray scanners during Thanksgiving travel. Health concerns have been raised over the use of machines. Many United States unions have ...


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Sunday, June 2, 2013

The Global Adult Tobacco Survey: Saving Lives From Tobacco Related Diseases

Antismoking mass media campaigns can help reduce the prevalence of smoking by discouraging young persons from initiating smoking and by encouraging current smokers to quit (1,2). Smoking cessation is a multistage process; intention to quit smoking precedes quit attempts (3). 
To assess whether awareness of anti-cigarette smoking information in four mass media channels (television, radio, billboards, and newspapers or magazines) was significantly associated with a current cigarette smoker's intention to quit, CDC analyzed data from 17 countries that participated in the Global Adult Tobacco Survey (GATS). Logistic regression was used to analyze the relationship between awareness of antismoking messages and intent to quit smoking; odds ratios were adjusted to control for demographic factors, awareness of warning labels on cigarette packages, and awareness of tobacco advertisements. 

In nine of 17 countries, intent to quit was significantly associated with awareness of antismoking messages in a single media channel versus no awareness, with adjusted odds ratios ranging from 1.3 to 1.9. In 14 countries, intent to quit was significantly associated with awareness of messages in multiple channels versus no awareness, with adjusted odds ratios ranging from 1.5 to 3.2. Antismoking information in mass media channels can help reduce tobacco consumption by encouraging smokers to contemplate quitting and might be more effective when presented in multiple channels.

Friday, May 31, 2013

CDC Reports Hospital Infections (MRSA) Can be Dramatically Reduced With Soap and Water

Many injured workers, and other hospital patients, reportedly contract compensable serious hospital infection as a result of poor hygiene. The Centers for Disease Control (CDC) reports that increased use of better hygiene in hospitals will dramatically improve the problem of contracting hospital infections.


English: Magnified 20,000X, this colorized sca...
English: Magnified 20,000X, this colorized scanning electron micrograph (SEM) depicts a grouping of methicillin resistant Staphylococcus aureus (MRSA) bacteria. See PHIL 617 for a black and white view of this image. These S. aureus bacteria are methicillin-resistant, and are from one of the first isolates in the U.S. that showed increased resistance to vancomycin as well. Note the increase in cell wall material seen as clumps on the organisms’ surface. (Photo credit: Wikipedia)
Today, on CDC's Safe Healthcare blog, lead author of the REDUCE MRSA trial, Dr. Susan Huang, discusses the results of the landmarkstudy and provides insight into what the findings mean for infection prevention and patient safety. The REDUCE MRSA trial found that using germ-killing soap and ointment on all intensive-care unit (ICU) patients could reduce bloodstream infections by up to 44 percent and significantly reduce the presence of methicillin-resistant Staphylococcus aureus (MRSA) in ICUs.

Dr. Huang is an Associate Professor at the University of California Irvine School of Medicine and Medical Director of Epidemiology and Infection Prevention at UC Irvine Health.

Join the conversation at http://blogs.cdc.gov/safehealthcare.


Wednesday, May 29, 2013

US Publishes Guidelines to Minimize Distracted Driving

Transportation accidents rank on the top of the list for worker fatalities. Now the federal government is attempting to reduce that number by restricting distractions while driving.driving. Voluntary guidelines reduce visual-manual distraction - the greatest safety risk to drivers in NHTSA's new study

U.S. Transportation Secretary Ray LaHood today released distraction guidelines that

encourage automobile manufacturers to limit the distraction risk connected to electronic devices built into their vehicles, such as communications, entertainment and navigation devices.

"Distracted driving is a deadly epidemic that has devastating consequences on our nation's roadways," said Secretary LaHood. "These guidelines recognize that today's drivers appreciate technology, while providing automakers with a way to balance the innovation consumers want with the safety we all need. Combined with good laws, good enforcement and good education, these guidelines can save lives."

Friday, May 24, 2013

Cancer Alley: NJ Meadowlands to be Tested for Cancer Causing Substances

The area around the NJ Turnpike has long been called "Cancer Alley," the the US EPA is now going to investigate past dumping of cancer causing substances in the New Jersey Meadowlands near the Hackensack River.

The U.S. Environmental Protection Agency today announced a legal agreement with

Apogent Transition Corp., Beazer East, Inc., Cooper Industries, LLC and Occidental Chemical Corporation to conduct a study of the contamination at the Standard Chlorine Chemical Company, Inc. Superfund site in Kearny, New Jersey as part of the cleanup plan for the site. The site, which is in the New Jersey Meadowlands and is next to the Hackensack River, is contaminated with a number of hazardous chemicals including polychlorinated biphenyls (PCBs) and dioxin. The study of the nature and extent of the contamination and an evaluation of potential cleanup methods are essential steps in the cleanup process. The estimated value of the study work is $750,000. The companies will also pay for the EPA’s costs in overseeing the performance of the study.

Fish consumption advisories have been issued for the Hackensack River due to the PCBs and dioxin contamination, originating in part from the Standard Chlorine site. PCBs are likely cancer causing chemicals and can have serious neurological effects. Exposure to dioxin can also result in serious health effects, including cancer.

“This agreement marks an important step in the cleanup of the Standard Chlorine Chemical site,” said EPA Regional Administrator Judith A. Enck. “Today’s agreement illustrates how the Superfund law works to make polluters, not taxpayers, pay to clean up sites like this one.”

The 25-acre site was formerly used for chemical manufacturing by various companies from the early 1900s to the 1990s. Operations at the site included the refinement of naphthalene for use in the production of certain industrial products, the processing of liquid petroleum naphthalene and the manufacturing of lead-acid batteries, drain-cleaner products and the packing of dichlorobenzene products. The soil, ground water and two lagoons were contaminated with dioxin, benzene, naphthalene, PCBs and volatile organic compounds. The site was originally littered with tanks and drums containing hazardous substances including dioxin and asbestos. Prior to placement on the Superfund list, the New Jersey Department of Environmental Protection sampled and studied the site and partially cleaned it up along with instituting measures to contain the pollution in the short-term. At the request of the NJDEP, the EPA added the site to the Superfund list in September 2007.

EPA Adds the Riverside Industrial Park in Newark, New Jersey to the Superfund List

Seven Acre Site along the Passaic River Contaminated with PCBs and Volatile Organic Compounds

The U.S. Environmental Protection Agency has added the Riverside Industrial Park in Newark, New Jersey to the Superfund National Priorities List of the country’s most hazardous waste sites. After a 2009 spill of oily material from the industrial park into the Passaic River, the EPA discovered that chemicals, including benzene, mercury, chromium and arsenic, were improperly stored at the site. The agency took emergency actions to prevent further release of these chemicals into the river. Further investigation showed that soil, ground water and tanks at the Riverside Industrial Park are contaminated with volatile organic compounds and polychlorinated biphenyls (PCBs).


Benzene, mercury, chromium and arsenic are all highly toxic and can cause serious damage to people’s health and the environment. Many volatile organic compounds are known to cause cancer in animals and can cause cancer in people. Polychlorinated biphenyls are chemicals that persist in the environment and can affect the immune, reproductive, nervous and endocrine systems and are potentially cancer-causing.

EPA proposed the site to the Superfund list in September 2012 and encouraged the public to comment during a 60-day public comment period. After considering public comments and receiving the support of the New Jersey Department of Environmental Protection for listing the site, the EPA is putting it on the Superfund list.

“The EPA has kept people out of immediate danger from this contaminated industrial park and can now develop long-term plans to protect the community,” said Judith A. Enck, EPA Regional Administrator. “By adding the site to the Superfund list, the EPA can do the extensive investigation needed to determine the best ways to clean up the contamination and protect public health.”

Since the early 1900s, the Riverside Industrial Park, at 29 Riverside Avenue in Newark, has been used by many businesses, including a paint manufacturer, a packaging company and a chemical warehouse. The site covers approximately seven acres and contains a variety of industrial buildings, some of which are vacant. In 2009, at the request of the New Jersey Department of Environmental Protection, the EPA responded to an oil spill on the Passaic River that was eventually traced to the Riverside Avenue site. The state and the city of Newark requested the EPA’s help in assessing the contamination at the site and performing emergency actions to identify and stop the source of the spill. 

The EPA plugged discharge pipes from several buildings and two tanks that were identified as the source of the contamination. In its initial assessment of the site, the EPA also found ten abandoned 12,000 to 15,000 gallon underground storage tanks containing hazardous waste, approximately one hundred 3,000 to 10,000 gallon aboveground storage tanks, two tanks containing oily waste, as well as dozens of 55-gallon drums and smaller containers. These containers held a variety of hazardous industrial waste and solvents. Two underground tanks and most of the other containers were removed by the EPA in 2012. 

The EPA periodically proposes sites to the Superfund list and, after responding to public comments, designates them as final Superfund sites. The Superfund final designation makes them eligible for funds to conduct long-term cleanups. 

The Superfund program operates on the principle that polluters should pay for the cleanups, rather than passing the costs to taxpayers. After sites are placed on the Superfund list of the most contaminated waste sites, the EPA searches for parties responsible for the contamination and holds them accountable for the costs of investigations and cleanups. The search for the parties responsible for the contamination at the Riverside Industrial Park site is ongoing.
......
For over 4 decades the Law Offices of Jon L. Gelman  1.973.696.7900  jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.  Click here now to submit a case inquiry.

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Doctors and hospitals’ use of health IT more than doubles since 2012


More than half of America’s doctors have adopted electronic health records
HHS Secretary Kathleen Sebelius today announced that more than half of all doctors and other eligible providers have received Medicare or Medicaid incentive payments for adopting or meaningfully using electronic health records (EHRs).
HHS has met and exceeded its goal for 50 percent of doctor offices and 80 percent of eligible hospitals to have EHRs by the end of 2013.
Adoption of Electronic Health Records by Physicians and Other Providers - Click for larger graphSince the Obama administration started encouraging providers to adopt EHRs, usage has increased dramatically. According to the Centers for Disease Control and Prevention survey in 2012, the percent of physicians using an advanced EHR system was just 17 percent in 2008. Today, more than 50 percent of eligible professionals (mostly physicians) have demonstrated meaningful use and received an incentive payment. For hospitals, just nine percent had adopted EHRs in 2008, but today, more than 80 percent have demonstrated meaningful use of EHRs.
“We have reached a tipping point in adoption of electronic health records,” said Secretary Sebelius. “More than half of eligible professionals and 80 percent of eligible hospitals have adopted these systems, which are critical to modernizing our health care system. Health IT helps providers better coordinate care, which can improve patients’ health and save money at the same time.”
Adoption of Electronic Health Records by Eligible Hospitals - Click for larger graphThe Obama administration has encouraged the adoption of health IT starting with the passage of the Recovery Act in 2009 because it is an integral element of health care quality and efficiency improvements. Doctors, hospitals, and other eligible providers that adopt and meaningfully use certified electronic health records receive incentive payments through the Medicare and Medicaid EHR Incentive Programs. Part of the Recovery Act, these programs began in 2011 and are administered by the Centers for Medicare & Medicaid Services and the Office of the National Coordinator of Health Information Technology.
Adoption of EHRs is also critical to the broader health care improvement efforts that have started as a result of the Affordable Care Act. These efforts – improving care coordination, reducing duplicative tests and procedures, and rewarding hospitals for keeping patients healthier – all made possible by widespread use of EHRs. Health IT systems give doctors, hospitals, and other providers the ability to better coordinate care and reduce errors and readmissions that can cost more money and leave patients less healthy. In turn, efforts to improve care coordination and efficiency create further incentive for providers to adopt health IT.
As of the end of April 2013:
  • More than 291,000 eligible professionals and over 3,800 eligible hospitals have received incentive payments from the Medicare and Medicaid EHR Incentive Programs.
  • Approximately 80 percent of all eligible hospitals and critical access hospitals in the U.S. have received an incentive payment for adopting, implementing, upgrading, or meaningfully using an EHR.
  • More than half of physicians and other eligible professionals in the U.S. have received an incentive payment for adopting, implementing, upgrading, or meaningfully using an EHR.
For more information about the Administration’s efforts to promote implementation, adoption and meaningful use of EHRs and health IT systems, please visit: http://www.cms.gov/EHRIncentivePrograms and http://www.healthit.gov.
......
For over 4 decades the Law Offices of Jon L. Gelman  1.973.696.7900  jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.  Click here now to submit a case inquiry.
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