April 19, 2004

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Happy Patriots Day; MMA Office Open for Business
MMA offices in Manchester will be open for business today despite the state holiday. Normal office hours of 7:00am to 5:00pm will be observed.
Patriots Day is a state holiday observed only in Maine and Massachusetts.  At MMA, it is considered an optional holiday and staff members have the option to work or take a PTO (paid time off) day.  Enough staff have chosen to work to keep the office open from our usual start time, 7:00am to 5:00pm.  Staff may always be reached at 622-3374 or toll free at 1-800-772-0815.

Highlights of the upcoming week at MMA include the Payor Liaison Committee meeting Wednesday evening at 6:30 (dinner available at 6:15), featuring a presentation from Anthem representatives on the company's upcoming pay for performance initiative.  MMA members are invited to attend any MMA committee meeting, but please RSVP to the office at 622-3374 for our meal planning purposes.

On Saturday, AMA delegates from the New England states will gather in New Hampshire to consider resolutions and other business for the upcoming AMA Annual meeting in June.  The delegation will be chaired Saturday by David Simmons, M.D. of Calais.  Dr. Simmons is Vice-Chair of  the New England delegation.

MMA representatives will continue this week to follow the work of the Dirigo Health Board and its various commissions and boards.  Meeting Tuesday morning (9:00am at DHS offices on Civic Center Drive in Augusta) is the Commission to Study Maine's Hospitals.

Volunteers Sought for Maine Quality Forum Provider Group
The Maine Medical Association has been asked to nominate two physicians for the Maine Quality Forum Provider Group, one a primary care physician and the second to be a specialist in a non-primary care field.  Established in the Dirigo Health legislation, the Provider Group will provide guidance to the Quality Forum as it develops strategies and practices for improving the health of Maine's citizens.

Nominations must be submitted to the Quality Forum Advisory Council by April 30th, so MMA would appreciate any volunteers or nominations being submitted to it by April 23.  Please submit a CV and letter of interest to MMA via e-mail to Gordon Smith, EVP, at gsmith@mainemed.com or mail to Mr. Smith % Maine Medical Association, P.O. Box 190, Manchester, Maine 04351.

Nominations may also be submitted directly to the Council by contacting Hilary Skillings, Project Assistant, Muskie School of Public Service, University of Southern Maine, 509 Forest Ave., PO Box 9300, Portland, Maine 04104-9300; Phone 780-4567, Fax 780-4953 or e-mail: hskillin@usm.maine.edu

By June 30, 2004, the Maine Quality Forum Advisory Council will present a proposed slate of members to the Dirigo Health Board of Directors for approval.  Members will be appointed on a staggered basis for 1 to 3 year terms and will serve in an unpaid capacity.  While it is not yet known how frequently the group will meet, at least quarterly meetings are likely, probably in or near Augusta.

The Maine Quality Forum was established last year as part of the Dirigo Health legislation.  Its purpose, as stated in the law, is to promote and oversee the quality of health care in the State through the collection and dissemination of research, adoption of quality and performance measures, promotion of evidence based medicine and practices and the public reporting of information about costs and quality of health care.

The Forum is governed by the Dirigo Board of Directors with advice from a 17-member MQF Advisory Council.  The Provider Group is expected to provide input to the Advisory Council and will consist of physicians and other providers of care including nurses, pharmacists, PA's, social workers, podiatrists, chiropractors, dentists, psychologists, optometrists and representatives of various health care institutions.

The Advisory Council is chaired by Robert E. McArtor, M.D., MPH.  Th forum is staffed by Executive Director Dennis Shubert, M.D., PhD. [return to top]

Legislature Recesses for Two Weeks; Important Work Not Yet Complete
The Maine Legislature recessed over the weekend for approximately two weeks to let legislators get some rest and to let leadership try to continue to negotiate budget amendments and tax reform proposals.  Both the House and Senate will reconvene  the week of April 26th to attempt to pass a supplemental budget,  approve a bond issue for the Fall ballot and approve for the ballot an alternative tax reform proposal.  The legislature would also deal with any gubernatorial vetoes.

MMA hopes that one of those vetoes will be L..D. 263, "An Act to Define A Scope of Practice for Acupuncture."  The bill, strongly opposed by MMA as it would license over a dozen new categories of oriental medicine, passed by only four votes in its final vote in the House.  As the Dept. of Professional and Financial Regulation recommended against passage of the bill in its "sunrise" review of the proposal this past summer, it is hoped that the Governor may stand by his own Department and veto the bill.  At a time when physicians are under strong pressure to improve quality and to practice evidence-based medicine, it is disappointing that the legislature would put the state's imprimatur on over a dozen new therapies that have no basis in science and which have no proven efficacy.

If you would like to see the roll call in the House or Senate in order to know how your legislator voted on the bill, please contact MMA's Director of Governmental Affairs Andrew MacLean at amaclean@mainemed.com. [return to top]

AMA Model Mananaged Care Contract Book Now Available
Before signing a managed care contract, check out the AMA's newly revised book, Model Managed Care Contract.

This 95-page publication offers alternatives to managed care contracts and provides tips on what you should know about developments in the law regarding medical necessity, HIPAA regulations and prompt payment.

To complement the book, the AMA produced a pamphlet, "15 Questions to Ask Before Signing," to help physicians as they evaluate contracts.  The publication answers such questions as:

  • What are your rights to appeal a reimbursement decision?
  • Is reimbursement sufficient?
  • Does the managed care contract organization have an obligation to pay you promptly?
  • Does the contract give the MCO the right to unilaterally "off-set" alleged "overpayments" from amounts otherwise due?
  • How can you terminate the contract?

Both publications are available free of charge at www.ama-assn.org/go/psa [return to top]

Registration Forms Now Available for Physician Survival Programs May 26 and June 23
Your mailed Maine Medicine for March/April contained materials, including a registration form, for the MMA's two upcoming educational programs in Auburn (May 26) and Bangor (June 23).  Designed for physicians and practice managers, these popular programs offer seven and one-half hours of category one CME.

Keynoting the programs is U.S. Attorney Paula Silsby.  Updates will be provided on drug diversion, Dirigo Health, MaineCare, malpractice, reimbursement, disease management, HIPAA, the Board of Licensure in Medicine, payor contracting and Certificate of Need (partial listing).

If you have not received the registration form and would like to attend, contact Chandra Leister at cleister@mainemed.com.

MMA thanks the following corporate affiliates for their support of the programs:  Appletree, Avasa Systems, Boise Office Solutions, HRH Northern New England/Dunlap, Medical Mutual Insurance Company of Maine, Sage Data Security, The Coding Center and The Thomas Agency.  These sponsors will be exhibiting at the programs. [return to top]

Annual Corporate Affiliate Breakfast May 21 at Harraseeket
Following up on a very successful event last year, the Association will host its corporate affiliates at a breakfast on Friday morning, May 21st at the Harraseeket Inn in Freeport.  The breakfast will be at 7:30am and is expected to conclude by 9:00am.  Speaking will be Robert McAfee, M.D., former AMA and MMA President and current Chairman of the Board of Dirigo Health.  There is no charge.

Invitations will be sent to all of the corporate affiliates within the next 10 days.  If you do not receive yours or have questions about the event, contact Lisa Martin or Buell Miller, M.D. at MMA (lmartin@mainemed,com or bmiller@mainemed.com). [return to top]

MMA Payor Liaison Committee to Meet with Anthem Wednesday
MMA's Payor Liaison Committee will meet  Wednesday night, April 21, with representatives of Anthem Blue Cross and Blue Shield.  Among those attending will be Patricia Richards, Vice President of Medical Management and Dan McCormick of the contracting staff.

At the meeting, MMA expects to learn about the company's plans to begin compensating participating physicians based upon performance.  While no practice is expected to receive a decrease in reimbursement, future increases may well be dependent upon such methodologies.

MMA members and their office staff are invited to attend, even if they are not a member of the committee.  However, please let Chandra Leister know, at MMA, for our meal planning purposes (cleister@mainemed.com)..  Dinner at 6:15pm, meeting at 6:30, all at MMA offices in the Frank O. Stred Building, Manchester. [return to top]

Need a Palm Pilot for E-prescribing?
The Maine Health Alliance has secured a grant that will make it possible to provide palm pilots to all Alliance members, with the necessary software to do electronic prescribing.  Before making its volume purchase, the Alliance has inquired of MMA whether it would be interested in purchasing some devices at the substantial discount being offered the Alliance.  Before responding, we are interested in knowing whether there are members/practices who may wish to purchase such devices, and whom have not already done so.  If you or your practice may be interested, please let Gordon Smith at MMA know of your interest by April 22.  If sufficient interest is shown,  MMA will consider buying some and making them available at our cost to members.  (gsmith@mainemed.com) [return to top]

Downeast Association of Physician Assistants Announces Annual Awards
At its Annual Meeting held at the MMA's Frank O. Stred Building on Saturday, the Downeast Association of Physician Assistants presented three awards, recognizing exceptional service or activity on the part of the recipients.

Receiving the Physician of the Year Award was Jeffrey Handler, M.D.  The award is presented to a Maine physician who has demonstrated outstanding support of physician assistants and the PA profession by precepting, educating, legislating or by exemplifying the PA/Physician Team approach to medicine.  Since retiring from a successful cardiology practice in Lewiston, in the late 1990's, Dr. Handler has taught in the PA school at the University of New England.  He now is the medical director of the program.

Receiving the Outstanding Rural Physician Assistant Award was John Thing, PA-C,  who works in the ER at The Aroostook Medical Center in Presque Isle.  The award is presented each year to a Maine PA in recognition of dedicated service to a rural community, both as a health care provider and as a citizen.  It was a testament to John's work that over 30 members of his staff and family attended the presentation.

Receiving the Robert J. Lapham Outstanding Service Award was Karen Nichols PA-C, who practices with Sunbury Primary Care in Bangor.  The award is presented to a Maine PA in recognition of outstanding service to the PA profession and the the Downeast Association of Physician Assistants.

Speaking at the Annual Meeting were Gordon Smith, EVP of MMA and Randal Manning, Executive Director of the Maine Board of Licensure in Medicine.  The meeting was chaired by DEAPA President Shawn McGlew PA-C.  Shawn practices in the ER at Maine General Hospital in Waterville. [return to top]

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