February 24, 2003

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President Bush Signs Bill Increasing Medicare Payments to Physicians
On Feb. 21, President Bush signed H.J. Res. 2 into law, meaning that physicians across the nation will receive a positive 1.6% update for the Medicare conversion factor effective March 1, 2003, instead of the 4.4% cut that was orginally scheduled.
In a major victory for physicians, President Bush on Friday signed H.J. Res. 2 into law, meaning that physicians will receive a positive 1.6% update for the Medicare conversion factor effective March 1, 2003 instead of the 4.4% cut that was orginally scheduled.

The Congressional Budget Office projected that the physician payment provision would increase baseline spending by $54 billion over ten years.  Elimination of the projection errors lifts physicians out of a significant budget hole and paves the way for positive updates in the future.

In calender year 2003, each Maine physician will see an average increase of $3,700 in Medicare payments as a result of this change.  The total impact on Maine physicians will be $11 million this year, according to figures released from the AMA.  Over a ten year period, the impact per physician in Maine is $81,500 or a total of $256 million.

Physicians' Day at the Legislature March 6th
The Maine Medical Association and the Maine Osteopathic Association will hold their biennial Physicians' Day at the Legislature on Thursday, March 6th.  All physicians are invited to attend and there is no registration fee or other cost involved.  Many medical specialty groups will be exhibiting in the Hall of Flags in the State House  and a full schedule of events are planned.  The day's activities conclude with a Blaine House Tea with Governor John Baldacci.

The schedule for the day is as follows:

9:00a.m.   Welcome in the Hall of Flags (second floor of state house)

                    Comments by MMA and MOA Leadership and State Representatives Thomas Shields, M.D. and Lisa Marrache, M.D.

10:00am-adjournment:  Physicians may attend House and Senate Sessions and Committee Hearings and Work Sessions.  There are several bills of interest to physicians being worked on that day.

11:30-1:00p.m.  Lunch in the Hall of Flags with Legislators, staff and representatives from relevant state agencies  

12:30pm-1:00pm  Meeting with Senate Republican Leadership

1:00-1:30pm    Meeting with staff to Senate President Beverly Daggett

1:30-2:00pm     Meeting with House Minority Leadership

2:00-2:30pm      Meeting with House Majority Leadership

2:30-3:00pm       Meeting with Advisors to the Speaker of the House Patrick Colwell

3:00pm                 Blaine House Tea with GOvernor John E. Baldacci

There are many bills being considered this session that impact medicine, including bills cutting Medicaid reimbursement, bills expanding Certificate of Need, and bills impacting professonal liability.  Please consider volunteering some time to assist by joining your colleagues in Augusta on March 6th.

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State Smallpox Vaccination Program Delayed
Maine's pre-event vaccination program is moving ahead, but at a slower pace than originally anticipated.  The original timeline established by Maine's Office of Public Health Emergency Preparedness has been delayed largely in response to concerns over hospital liability and other potential financial responsibility for injuries caused by the vaccine.  The state is expected to send a letter out soon seeking hospital commitments to participate in the program. Hospitals in a number of other states are declining to participate in the program because of these issues.

Originally, it was hoped that the three phase program could begin by the first week in February.  The first phase would involve the inoculation of a small group of state health employees and is now expected to take place in early March.  Phase two would involve the vaccination of several hundred hospital volunteers and is now likely to take place in late April rather than late February.   Nurses met in Bangor and Portland on Friday to learn more about the plans.  Nursing concerns include whether hospitals would support them and their families if they experienced complications from the vaccine and needed to be out of work.  Under existing federal law, the liability of the hospital in such a situation is currently subject to interpretation.  While the federal government has indicated its clear intention to provide such protection, the statutory protections which now exist are ambiguous. [return to top]

MMA Meets with Anthem Officials
Representatives of two MMA Committees met with top Anthem, Inc. officials on February 13th to discuss a number of issues of mutual interest.  Members of the Association's Executive Committee and Payor Liaison Committee met for over two hours with Samuel Nussbaum, M.D., Chief Executive Officer and Chief Medical Officer for Anthem, Inc., the parent company of Anthem Blue Cross Blue Shield of Maine.  Accompanying Dr. Nussbaum were representatives of Anthem East and Jim Parker, Erin Hoeflinger and Karen Bell, M.D. from the Maine plan.

Items discussed included a letter sent to Anthem from the AMA last summer detailing a number of concerns with Anthem's contracting process and claims processing; MMA's participation in litigation pending in Connecticut against several health plans, including Anthem; and some specific billing, coding, and contracting issues.  Also discussed was Anthem's efforts to 'pay for performance' by financially incentivizing practices to improve quality.  This latter effort would include assisting practices in acquiring technology to better enable practices to track patient's conditions and compliance.

The meeting concluded with a request by MMA that its attorneys be allowed to review any offered Anthem participating provider agreements before they are distributed to physicians. [return to top]

Anthem BCBS Announces Twice Weekly Checks for Practices
Anthem BCBS of Maine announced on Friday that beginning March 11, 2003, it will issue ACES-system remittances and accompanying checks to all providers and professionals twice per week, on Tuesdays and Fridays.  This change was in direct response to several requests from practices.  The enhanced remittance schedule should assist practices in posting payments more quickly.

Hospitals will continue to receive PIP payments once per week. [return to top]

Baldacci Health Action Team to Meet Friday
Governor Baldacci's Health Action Team will meet Friday, Feb. 28th.  Subcommittees have been announced and will meet prior to each team meeting.  The subcommittees are as follows:

  •             Cost Containment, State Health Planning and Regulation
  •              Low Income Access and Finance
  •              Public Purchasing
  •              Quality and Accountability
  •              Benefits Package
  •              Crosscutting Issues of Special Populations

     Maroulla Gleaton, M.D., MMA President-elect chairs the Cost Containment subcommittee which is charged with developing proposals by March 20th, to address:

  • How do we keep cost growth contolled over time?
  • How do we establish goals for the health care system and measure performance against them?
  • How can providers and consumers be incentivized to meet goals?  How do we get the incentive right?
  • How can we incentivize disease prevention and health promotion?
  • How can we reform and promote economic development?

      All of the subcommittees are to have their proposals developed by March 20th, a daunting timeframe to say the least.  The various charges to all the subcommittees are available from MMA. [return to top]

CMS Publishes HIPAA Security Standards
As noted last week, on Feb. 20th CMS published the HIPAA Security Standards in their final form.  The final rule is 289 pages and MMA attorneys are presently reviewing the Rule to assess its potential impact on Maine practices. 

The rule addresses the need for 'technology neutrality', recognizing the great diversity in 'installed technology, size, resources and relative risk' among organizations affected by the Rule.  The Rule also discusses its interplay with the Privacy Rule and emphasizes the importance of documenting actions taken to comply with the rule.

MMA has scheduled further HIPAA programs in Waterville on March 26th and in Ellsworth the week of  April 7th.  More information on the programs is available from Susan Feener at MMA, 622-3374 or sfeener@mainemed.com. [return to top]

"Cover the Uninsured Week" begins March 10th
The Maine Medical Association will join with a number of other organizations in Maine in sponsoring 'Cover the Uninsured Week', beginning the week of March 10th.  This week-long campaign, funded primarily by the Robert Wood Johnson Foundation, will put a national spotlight on the plight of the uninsured.  Watch this publication to get more details in the next two weeks or call Anna Bragdon at MMA to get more information on the events planned in Maine: 622-3374 or abragdon@mainemed.com [return to top]

For more information or to contact us directly, please visit www.mainemed.com l ©2003, Maine Medical Association