May 3, 2004

 
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121st Maine Legislature Adjourns Sine Die Friday Morning
Despite a marathon all-night session last Thursday, the Maine Legislature adjourned without reaching agreement on a tax relief plan or a bond package; Governor Baldacci suggests that he may call legislators back for a special session on these issues this summer.
 

Around 8 a.m. on Friday, 4/30/04, the 121st Maine Legislature gave up work on the contentious issues of property tax relief & new state bonds & adjourned sine die (adjournment without assigning a day on which to assemble again - final adjournment).

The Legislature did complete routine business including enactment of the second supplemental budget of the session, L.D. 1919.  You can view or download the Committee Amendment (H-904) to this budget on the following web page:  http://janus.state.me.us/legis/LawMakerWeb/externalsiteframe.asp?ID=280013007&LD=1919&Type=1

The following are some highlights from the MMA's review of the $160 M budget document:

  • $2 M cut in the General Fund of DBDS for FY 04; $4.7 M cut in "other special revenue funds" for the Department in FY 05
  •  $1.2 M FY 04 "other special revenue funds" appropriation for the Dirigo Health Department
  • No cuts in the Fund for a Healthy Maine in FY 05
  • $2.3 M in General Fund savings to be achieved through increased 3rd party recovery by the MaineCare program
  • a new requirement that health care providers report to DHS infants with prenatal exposure to drugs
  • a new Behavioral Health Working Group "to facilitate improved claims processing and reimbursement for medically necessary behavioral health services, including but not limited to emergency and urgent care services, pursuant to the Maine Insurance Code and Bureau of Insurance Rule Chapter 850"  (Part FF)
  • $1.5 M in savings in FY 05 from the mental health parity law
  • an increase in the hospital tax from 0.74% to 2.23% of net operating revenue
  • a provision that hospital-based physician practices "may not discontinue acceptance of new MaineCare patients and may not limit services to MaineCare patients in any manner that differs from the acceptance and service limitation policies that apply to patients with any other payment source." (Part YY)
  • $10.8 M in additional General Fund savings in the MaineCare drug program along with a directive to the MaineCare Advisory Committee to establish a subcommittee to review the prior authorization process (Part FFF)
  • $9.5 M in additional General Fund savings from the implementation of the "MaineCare Basic" benefit redesign (Part MMM)

In an article in today's Kennebec Journal, State House reporter Susan Cover says that the next legislature will face a budget shortfall of $675 million to $700 million for the 2006-2007 biennium.  You can read the article at the following web page:  http://www.kjonline.com/news/local/623703.shtml

According to the National Conference of State Legislature's (NCSL's) State Budget Update:  April 2004, the states have reduced their cumulative budget deficit from $21.5 billion at this time last year to $720 million.  Despite $10 billion in additional federal assistance for state Medicaid programs, 28 states reported spending in excess of budgeted amounts - & more than half of those states reported Medicaid & other health care spending exceeding their budgets.

In keeping with tradition, Governor Baldacci addressed legislators just before their final adjournment.  You can read the Governor's remarks at the following web page:  http://www.maine.gov/tools/whatsnew/index.php?topic=Portal+News&id=2305&v=Article

Governor Baldacci Explains Decision to Sign Acupuncture Bill
The following is the text of Governor Baldacci's letter explaining his decision to sign the acupuncture bill.

 

April 26, 2004

 

Gordon Smith, Esq., Executive Vice President

Maine Medical Association

P.O. Box 190

Manchester, Maine 04351

Re:  L.D. 263, An Act to Define a Scope of Practice for Acupuncture

Dear Gordon:

I write in response to your recent letter regarding the above-referenced alternative medicine bill.  Having thoroughly considered the issues, I have signed this bill into law.  I note that many other states have similar legislation with few if any reported problems.

I do believe strongly in evidence based medicine and intend to pursue incentives to encourage such practice.  Those incentives are likely to include limitations on the state reimbursement for services that are not supported by mainstream clinical investigation and evidence of effectiveness.  That is not to say, however, that I wish to limit Mainers' access to alternative forms of medicine, should they choose to seek it.  I understand that many people are interested in alternative and complementary medical care.  I respect that choice and the pluralistic nature of our society.

This bill will help to ensure that Mainers continue to have access to alternative medicine, should they decide to avail themselves of such services.

Sincerely,

 

John E. Baldacci

Governor [return to top]

MMA Concludes Successful Legislative Session
Thanks to Katherine Pope, M.D., MMA Legislative Committee Chair, Legislative Committee members & conference call participants, & members who acted as "Doctor of the Day" or testified at the Legislature, the MMA has concluded another successful session representing the interests of physicians at the Maine State House.

In 2004, MMA faced no issues as significant as last session's Dirigo Health Plan legislation (L.D. 1611), but organized medicine in Maine did deflect an effort to move towards prescriptive authority for psychologists (L.D. 1713), avoid direct cuts to MaineCare physician reimbursement & the Fund for a Healthy Maine in two supplemental budgets (L.D. 1828 & L.D. 1919), ensure a prominent role for public health in the merger of DHS & DBDS (L.D. 1913), and enact a bill to initiate a prescription drug disposal system in our state (L.D. 1826).

While we are disappointed that the Legislature passed & the Governor signed the bill to expand the scope of practice of acupuncturists to include a variety of unproven techniques known as "oriental medicine," it was important for the organization to take a stand for evidence-based medicine.

The MMA's summary of legislation tracked during the 121st Maine Legislature will be available within a month.  Look for a notice in Maine Medicine & Maine Medicine Weekly Update.

The MMA staff will be developing a legislative agenda for the 122nd Legislature from now through late fall.  If you have issues you would like the MMA to consider addressing through legislation, please contact Andrew MacLean, General Counsel & Director of Governmental Affairs at amaclean@mainemed.com or 622-3374. [return to top]

President Bush Announces National Health IT Coordinator
In an Executive Order issued 4/27/04 (Executive Order 13335; 69 Fed. Reg. 24057, 4/30/04), President Bush announced the creation of a position for a National Health Information Technology Coordinator who will report to the Secretary of Health & Human Services & will work to ensure that every American has a personal electronic medical record within 10 years.

You can read the Executive Order at the following web page:  http://a257.g.akamaitech.net/7/257/2422/14mar20010800/edocket.access.gpo.gov/2004/pdf/04-10024.pdf

The Coordinator will work to hasten the use of health information technology in public & private health care delivery systems.  Senate Republicans issued a statement on 4/27/04 indicating that they are working on legislation to be offered in May that will track the President's health information technology agenda.  [return to top]

Leapfrog Group Announces 27 New Hospital Patient Safety Practices
On 4/27/04, the Leapfrog Group, a national organization representing more than 150 large employers & purchasers of health care services, announced the addition of 27 additional hospital patient safety practices to supplement the three practices it has been advocating since 2001. 

The 3 original Leapfrog hospital quality measures are:

  • computerized physician order entry;
  • specialized staffing of hospital ICUs; &
  • the degree of experience in 7 high-risk procedures.

Leapfrog drew the 27 new measures from the National Quality Forum's May 2003 report, Safe Practices for  Better Healthcare:  A Consensus Report.

You can find more information about the Leapfrog group at www.leapfroggroup.org.

You can read the NQF report at www.qualityforum.org/txsafeexecsumm+order6-8-03PUBLIC.pdf.

 

  [return to top]

Governor Will Seek "Preferred Sponsor" for Medicare Drug Card
On 4/28/04, Governor Baldacci announced that his Office of Health Policy & Finance will select a "preferred sponsor" from among 39 Medicare drug card sponsors during the week of 5/10/04.  The State issued a request-for-proposals on 4/23/04.  Federal law prohibits making the preferred sponsor mandatory, but the State will provide incentives to use the preferred sponsor.

You can read the Governor's comments about the Medicare drug card plan on the following page of his web site:  http://www.maine.gov/tools/whatsnew/index.php?topic=Portal+News&id=2270&v=Article. [return to top]

Maine AAP Chapter Spring Meeting this Weekend
The Maine Chapter of the American Academy of Pediatrics is holding it's Spring Conference this coming weekend.  The meeting, which will take place at the Samoset Resort in Rockport,Maine, is titled, "Improving the Quality of Office Practice with Evidence-Based Pediatrics."

It is not too late to register!  Please call Chandra Leister at MMA at 622-3374 x218 or e-mail cleister@mainemed.com for more information or to register.

Presenters include Dan Meyer, PhD, Timothy Ferris, MD, MPH, Sydney Sewall, MD, MPH, Victoria Rogers, MD, Chris Stenberg, MD, Jan Wnek, MD, Ted Rooney and Robert McAfee, MD.  Dr. McAfee will speak at the Saturday evening banquet on the Governor's Dirigo Health Plan.  Dr. McAfee, a former AMA and MMA President, chairs the Board of Dirigo Health.

Dr. Lisa Ryan is President of the Chapter. [return to top]

Submit HIPAA-Compliant Claims by July l, 2004
The Centers for Medicare and Medicaid Services (CMS) is urging physicians and other providers to submit claims that comply with the Health Insurance Portability and Accountability Act of l996 (HIPAA) by July 1.  Beginning July 1, carriers and intermediaries will not process non-compliant HIPAA electronic claims until the 27th day after receipt.  This effectively represents a two-week delay in the processing of claims.  CMS will continue to process HIPAA-compliant claims in 14 days.

CMS data indicates that about 68 percent of all claims that Medicare receives are already HIPAA compliant.  This announcement is intended to encourage practices to take steps to become compliant if they haven't done so already.

Visit http://www.ama-assn.org/go/hipaa to access the AMA's HIPAA resources for physicians. [return to top]

Political Fundraising Season begins with May 24 Senate GOP Event at Woodlands
MMA and its political action committee, the Maine Physician Action Fund, will be busy this election season supporting candidates who are deserving of the support of physicians and their patients.  The Fund is non-partisan, and will participate in several events benefitting candidates of both parties.

On May 24, the Fund will host a fundraising event for the state Senate Republican Caucus from 5:30pm to 7:00pm at the Woodlands Country Club in Falmouth.  United States Senator Susan Collins will be present to talk with Maine physicians about current issues in Washington.  Many Republican state senators and candidates will be present as well.  Invitations will be sent soon to area physicians, but you may communicate with Charyl Smith at MMA (622-3374 or csmith@mainemed.com) if you wish to secure a spot.  $100 a person with host organizations and individuals contributing $1,000. [return to top]

Anthem First Quarter Profit Rises
Anthem, Inc. posted a profit of $295.6 million for the 2004 first quarter, compared to $191.7 million for the same time period in 2003.  The health insurer earned $1.61 per share, slightly better than the average analysts had earlier predicted of $1.46 per share.

Once the merger between WellPoint and Anthem goes through, which is expected to happen by mid-year, the two Blue Cross carriers will have a total enrollment of approximately 26 million members. [return to top]

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