May 11, 2003

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Baldacci Health Care Reform Proposal Hearing Set for Thursday
The Legislature's newly-created Joint Select Committee on Health Care Reform will hold a public hearing on the two bills expected to make up the Governor's health care reform proposal on Thursday, May 15th at 1:00 p.m. The hearing will take place in Room 126 of the State House.
Since the Govenor presented his plan this past Monday, the media has carried a number of stories about the plan and reactions to it.  The 72 page plan addresses access, quality and cost in a series of wide-ranging provisions that will be considered by the Legislature this month.  While Republican legislatoros have suggested slowing down the process of consideration of the proposal, Democratic leaders and the Governor himself appear very focused on the need to pass the bills this session.  The session must adjourn by mid-June and is likely to adjourn even sooner.

Based upon the MMA's intitial review of the proposal, the Association probably can support portions of the plan, but we have serious concerns about the global budget and Certificate of Need provisions.  In addition, we need much more feedback from members on the requirement of electronic billing to all payors by 2005 and the posting of fees in the office.

Members of the MMA Executive and Legislative Committees will meet this Tuesday (5/13) at 6:00 p.m. at the MMA office in Manchester to finalize the Association's position on the proposal and to prepare for the public hearing on Thursday.  ANY MMA MEMBER IS WELCOME TO ATTEND THIS MEETING.  IF YOU WOULD LIKE TO JOIN US, PLEASE E-MAIL CHARYL SMITH AT CSMITH@MAINEMED.COM OR CALL HER AT 622-3374.

On Tuesday, the Legislature created the Joint Select Committee on Health Care Reform to handle the review of the Governor's proposal.  The Committee includes members from the Joint Standing Committee on Health and Human Services, the Joint Standing Committee on Insurance and Financial Affairs, and the Joint Standing Committee on Appropriations and Financial Affairs.  The committee members are as follows;

Sen. Lloyd P. LaFountain (D-York)

Sen. Michael Brennan (D-Cumerland), Senate Chair

Sen. Karl Turner (R-Cumberland)

Sen. Arthur Mayo (R-Sagadahoc)

Rep. William Earle (D-Damariscotta)

Rep. Anne Perry (D-Calais)

Rep. Christopher O'Neil (D-Saco), House Chair

Rep. Thomas Kane ((D-Saco)

Rep. RIchard Mailhout (D-Lewiston)

Rep. Benjamin Dudley (D-Portland)

Rep. Marilyn Canavan (D-Waterville)

Rep. Florence Young (R-Limestone)

Rep. Sawin Millett (R-Waterford)

Rep. Kevin Gynn (R-South Portland)

Rep. Thomas Shields, M.D. (R-Auburn)

Following the public hearing on Thursday, the Committee has announced work sessions on the bills for Tuesday through Thursday of the week of May 19th. 

An overview and a detailed summary of the Governor's proposal is available on the Governor's web site at  Members may also receive additional materials on the plan by communicating with Gordon Smith or Andrew MacLean at and respectively.

DHS Isues CON Moratorium
Following Governor Baldacci's health care reform speech on Monday morning, Bureau of Medical Services Director Gene Gessow issued an emergency rule prohibiting DHS from accepting any letter of intent for a certificate of need from 5/5/03 through 8/2/03 with limited exceptions.  It is expected that the Department will extend the moratorium to a full year through the regular rulemaking process.

The Governor's plan calls for a state health plan to be in place before the expiration of the moratorium.  The state health plan would be used to guide the decisions of regulators in considering CON applications.  The Governor's plan would also impose an annual CON budget on applications, called the CON Investment Account.  Regardless of the name, the fund looks suspiciously like the CON Development Account which was in existence during the tenure of the Maine Health Finance Commission.  In this case, the annual cap wold be established by the Governor's Office of Health Policy and Finance.  Once established, physicians, hospitals and other applicants would then compete for the limited funds after receiving approval of any CON project.. [return to top]

HHS Issues Compliance Guide for Pharmaceutical Promotions
On April 27th, HHS Inspector General Janet Rehnquist issued the final version of a compliance guide for the promotional practices used by pharmaceutical companies and stated that many of the current practices may violate federal fraud and abuse laws. The compliance guide states that pharmaceutical companies, at the risk of prosecution, must not:

               +Make payments to health plans or PBN's to encourage the use of their products;

                +Link research and education grants to product promotion;

                 +Pay physicians to conduct research that serves only as a "pretext to generate prescriptions of a drug."

                   +Pay physicians to allow their sales representatives to observe patients;

                    +Pay physicians to listen to promotional campaigns from sales representatives; or

                     +Report fraudulent data to Medicare or Mediciad to increase physician incomes

The full guidelines are available at [return to top]

MMA Executive Committee Endorses GWI
At its meeting on May 7th, the MMA Executive Committee accepted a recommendation from the Committee on Membership and Member Benefits to endorse Great Works Internet (GWI) as a preferred vendor of internet services.  After examining other carriers in the state, it was the opinion of the Benefits Committee that GWI offered the best pricing and the most coverage across the state. 

Both Dial-up Access and Broadband Access are available.  For the dial-up service, members will pay $9.95 per month for the first three months (paid monthly by credit card or automatic check debit) and then $19.95 per month.  Any set-up fees would be waived.   Broadband Access is available for $29.95 per month, but members receive a second month free after buying the first month, and receive free installation and modem.

A promotional flier will be included in an upcoming edition of Maine Medicine, but members wanting information currently may call Deborah Lee Dagan, Marketing Manager at GWI at 207-286-8686 or via e-mail to  Questions about any MMA member benefit can be directed to Lisa Martin, Membership Coordinator at MMA at 622-3374 or via e-mail at

Under this program, the Association receives a small one-time commission on MMA member accounts.  [return to top]

GAO Notes Smallpox Vaccination Program Problems
Investigators from the General Accounting Office said in a recent report to Congress that federal health officials are responsible for many of the issues that have hampered the national smallpox vaccination program.  About 33,000 people have received the vaccine as of April 18th, but the Bush administration had originally hoped that 500,000 healthcare workers would have been vaccinated in the first phase of the national campaign which was launched on January 24th.  The GAO investigation faulted federal health officials for some of the campaign's problems, including:

              +Expanding the program too quickly

               +Releasing contradictory information about who should get the vaccine

                +Not distributing potentially safer needles for administration of the vaccine, resulting in healthcare workers' fear of needle-stick injuries; and

                  +Underestimating the cost of administering the vaccine at $13 a person.  State and local officials said the actual cost  ranged from $75 to $265 a person, according to an April 30th New York Times report.

     Administration officials told the GAO that there is not a deadline for vaccinating healthcare workers as part of the plan's first stage, and that as few as 50,000 vaccinated healthcare workers nationwide would be sufficient to respond to a smallpox attack.  However, the report notes that the CDC has not established a new goal for the campaign's first phase or explained how it obtained the 50,000 worker figure, which is lower than earlier estimates.  The report also said the CDC has not requested that states rework their plans for vaccinating healthcare workers.  The GAO said the federal government should work with officials at the state and local levels to "revise their goals" and evaluate their capacity to respond to a smallpox outbreak.  In a number of states, health officials say the campaign should focus less on the number of people vaccinated and more on the capacity to detect and isolate an outbreak of the disease.   The second phase of the vaccination program, which is supposed to vaccinate up to 10 million civilian and emergency workers, is scheduled to begin in June in certain states.

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Ad Hoc Committee on Health System Reform: Correction
In the story last week on the work of the Association's Ad Hoc Committee on Health System Reform and its White Paper, MMA regrets that one members of the Committee was inadvertantly deleted from the list of the 26 Committee members.  Daniel Onion, M.D., of Augusta participated on the Committee and should have been listed.  MMA regrets the omission. [return to top]

Upcoming County Medical Society Meetings
The Aroostook County Medical Society will meet on Wednesday evening, May 28 at the Aroostook Valley Country Club in Fort Fairfield.  The Cumberland County Medical Society holds its Annual Meeting the next night, May 29th, at the Marriott in South Portland.  On June 4th, the Washington County Medical Society meets in Machias.

On this coming Wednesday eveing, May 14th, a group of York County physicians will meet at the restaurant "On the Marsh" to discuss the future of the York County Medical Society with MMA EVP Gordon Smith.  Buell Miller, M.D. will also be present to discuss new MMA member benefits and the Corporate Affiliate Program.  MMA President Krishna Bhatta will update attendees on current MMA activities.  Any York County member interested in attending should contact  Dr. Miller and Mr. Smith at 622-3374.


  [return to top]

MMA Executive Committee tackles Healthcare Reform and Governance
The MMA Executive Committee held a regularly scheduled meeting on May 7th.  Under the leadership of Committee Chair Lawrence Mutty, M.D., members spent most of the meeting discussing Governor Baldacci's Health Plan proposal and recommendations from the 2nd Ad Hoc Committee on Governance. The Governance Committee was chaired by Margaret Duston, M.D.   The Executive Committee accepted several recommendations from the Ad Hoc Committee, sending proposals to the Bylaws Committee for drafting.  The following two recommendations are of particular significance:

              1.  MMA members in Counties without active County Medical Societies will be able to elect a representative to the MMA Executive COmmittee via a nominating process and mail ballot.

                2.  After a long history of being "unified" with the County Medical Societies, the Committee proposes "de-unification" in 2005.  This action, if voted by the members at the Annual Meeting in September, would mean that beginning in 2005 physicians could belong to the MMA without belonging to a County Medical Society and vice-versa.  If a County Society asked, MMA would still collect its dues but the County dues would be optional on the MMA does invoice.

          As the above actions require amendments to the MMA Constitution, initial consideration can be given in 2003 but a final vote would take place at the 2004 Annual Meeting.

  [return to top]

Jana Purrell, CPC to begin at The Coding Center
Jana Purrell, CPC, of Harpswell will begin work at The Coding Center on Monday, May 12th.  Most recently with Maine Cardiology Associates in Portland, Jana is a certified procedural coder and has taught some of the coding courses offered by the Center.  The Center is directed by Laurie Desjardins, CPC.

The Coding Center is a for-profit subsidiary corporation owned by the Maine Medical Association, The New Hampshire Medical Society and the Vermont Medical Asosciation.  The Center provides a wide array of coding and reimbursement education to state medical society members and their staffs.  The Center may be reached at 1-888-889-6597 or through e-mail to [return to top]

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