April 7, 2003

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Maine Bureau of Health Issues Health Advisory on SARS
On March 27th, Dora Anne Mills, M.D., MPH, the State Health Officer issued updated recommendations for screening and triage in the ambulatory care setting relative to suspected SARS cases.
Because of recent reports of patients with suspected SARS (Severe Acute Respiratory Syndrome) in the U.S., including two suspected cases in Maine, the Maine Bureau of Health is recommending that ALL patients with acute respiratory illness and fever (measured temperature > 100.4 degrees F)  be asked about recent travel abroad, as well as close contact with anyone who has febrile respiratory illness and has recently traveled abroad.

All patients with suspected SARS should be reported immediately by telephone to the Bureau of Health by calling 1-800-821-5821.  Additional informational materials, including an updated form for triage of suspected cases of SARS is available from the Bureau or from MMA.  Updated SARS information is available at www.cdc.gov/ncidod/sars or by calling the Bureau at the same number noted above for reporting.  The 800 # at the Bureau is available 24 hours a day.

Centers for Medicare and Medicaid Services (CMS) Projects 2004 Medicare Update
Each March, the Centers for Medicare and Medicaid Services (CMS) is required to project the update in Medicare's physician fee schedule for the following year.  The Medicare Payment Advisory Commission then reviews CMS's report and issues its own recommendations.  The final updates frequently are quite different than what CMS had predicted.  This year, CMS has tried to cover all of its bases by including a range within which the update could fall.  In a letter released to the public early last week, the agency says that its best guess at next year's update is a negative 4.2% but the update could be anywhere between negative 5.8% and a positive 0.6%.

Under the Medicare formula, physicians are subject to pay cuts any time that per beneficiary use of their services grows more rapidly than the Gross Domestic Product (GDP).  As reported in the March 26th New York Times, CMS had predicted earlier that the update in 2004 would be positive.  However, it now appears that the economy grew less and the volume and intensity of physician services grew more than previously anticipated.  That combination led to the latest conclusion that the formula is likely to produce another significant cut in physician payments next year.

The recently enacted legislation that medicine hoped had fixed the Medicare update problem injected $54 billion into baseline spending for physician services over the next ten years.  While this was enough to swing the 2003 update from negative 4.4% to positive 1.6%, the legislation only corrected an error in CMS's update calculations.  The flaws in the underlying formula remain. [return to top]

Public Citizen Ranks Performance of State Medical Boards in 2002
On March 27th, Public CItizen announced its annual list of medical board actions.  The self-proclaimed public interest group ranked the performance of the 50 state medical boards based on the rate of serious disciplinary action taken against physicians in 2002.  This year, Maine's numbers ranked the Board at 36th among the 50 states and the District of Columbia, even with an increase in its action rate to 4.58 per 1000 physicians (up from 3.39 last year). 

Nationally, state medical boards took 2,864 actions against physicians, including license revocations, surrenders, suspensions and probations/restrictions.  The national rate was 3.56 actions per 1,000 physicians.

In announcing the 'list', Sidney Wolfe, M.D., director of Public Citizen's Health Research Group, engaged in his usual hyperbole, stating that, 'It is extremely likely that patients are being injured or killed more often in states with poor doctor disciplinary records than in states with consistent top performances.' [return to top]

Medical Students "Matched" on March 20th
On March 20th, almost 24,000 applicants in the National Resident Matching Program discovered where they will be spending the next several years of their medical education.  Data from this year's residency match shows an interest in internal medicine, pediatrics and surgery.  Interest in family practice continues to decline, with U.S. medical school seniors filling only 42% of the family practice positions offered, down from 47.2% in 2002.

A record number of residency positions were offered in the 2003 match, accompanied by an all time high number of applicants matched to residency positions.  This year, the match rate for U.S. medical school seniors seeking first year residency positions was 93.2%.  The match rate for U.S. seniors is usually between 93 and 94%. [return to top]

CMS Offers New Physician Web Site
The Centers for Medicare and Medicaid Services has posted a new and improved physician web site.  There are many new features including a Physician Listserv and the Medicare Physician Fee Schedule Look-up.  The site also includes the 2003 Medicare Physician Fee Schedule, an update on CMS policies and regulations, Program Integrity/Medical Review, CMS Payment/Billing, Medicare Secondary Payer information and CMS educational opportunities.  To visit the site, go to http://www.cms.hhs.gov/physicians/ [return to top]

U.S. Supreme Court Victory for Physicians in Kentucky
The United States Supreme Court on April 2nd unanimously upheld Kentucky's 'Any Willing Provider' law by finding it not pre-empted by the Employee Retirement Income Security Act (ERISA).  The Court rejected the argument advanced by the Kentucky Association of Health Plan's that the law fell outside the state's right to regulate the business of insurance.

The decision is seen as another victory by physicians in their efforts to enact and defend patient protections acts state by state.  The AMA filed an amicus brief in the case, supporting the position of Kentucky physicians. [return to top]

Upcoming at MMA This Week
The MMA Legislative Committee meets on Tuesday night to consider more legislative proposals affecting Maine physicians.  Of particular interest will be a discussion of the Association's position on the state Certificate of Need (CON) law which is likely to be strengthened this session.  Strengthening of the law could result in its application to physician offices and the equipment physicians can purchase.

The Association's Ad Hoc Committee on Health System Reform will meet on Thursday evening to continue its work on the White Paper on reform designed to set forth the Association's blueprint for covering all Maine citizens with a basic health insurance product.

The Association's Committee on Membership and Member Benefits also meets on Thursday evening.  The Committee will hear proposals from three payroll companies vying for the Association's endorsement.  The Associations group health plan and long distance calling plan will also be discussed.

Thursday also is the day of the last scheduled MMA HIPAA education program.  The program will be held from 8:30am to 1:00pm at the Holiday Inn in Ellsworth.  Members or staff interested in the program should call Susan Feener at MMA at 622-3374. [return to top]

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