August 2, 2004

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MMA to Initiate Professional Liability Reform Campaign
The MMA Executive Committee voted this week to initiate a major campaign aimed at averting a liability crisis. Recent high jury verdicts and a deteriorating impact of the prelitigation screening panels, as well as recent increases in premiums, are causing physicians to view liability reform as essential. Maine is already at risk of losing high risk services such as trauma surgery and obstetrics. High premiums combined with low reimbursement, as well as the emotional impact of litigation, are causing physicians to flee these specialties.
The Dirigo Health legislation contains a provision requiring the Superintendent  of Insurance to submit a report, by January 1, 2005, to the Legislature regarding, "medical malpractice lawsuits, damage awards for noneconomic damages in those lawsuits and the cost and availability of medical malpractice insurance in Maine."  At a minimum, the report must address the impact on the cost of malpractice insurance of a cap on noneconomic damages of $250,000 in malpractice lawsuits.  The joint standing committee of the Legislature having jurisdiction over insurance and financial matters has the authority to report out legislation to the First Regular Session of the 122nd Legislature in response to the report.

The Bureau of Insurance has not yet begun working on the report, but MMA representatives have a meeting with the Superintendent of Insurance on August 9th to discuss the preparation of the report and to advocate for meaningful reform, given the deteriorating conditions.

Today's Portland Press Herald includes an editorial entitled, "Medical malpractice cases served well by state panel" that is favorable to the physician perspective on liability reform.  You can read the editorial on the web at:

The advocacy campaign will include advertising and lobbying and will seek to bring together all the medical organizations who have a stake in the outcome of professional liability reform.  All physicians, whether members of MMA or not, will be solicited for support.  A separate financial account will be maintained to exclusively support the campaign.  Watch for more information on the campaign in this publication and the pages of Maine Medicine.

Commission to Study Maine's Hospitals to Meet on Monday
The Commission to Study Maine's Hospitals will meet again on Monday morning, August 2.  The tentative schedule includes a discussion of workforce issues. Last week's discussion focused on the need to obtain administrative efficiencies, particularly in the billing and collections area.  There was also considerable discussion of the topic of regionalization, a theme promoted strongly by William Haggett, the chair of the Commission.  During the portion of the meeting that allows for public comments, MMA representatives stressed the importance of receiving input from all of the facilities, particularly those which are currently operating independent of large systems.  On July 6, the Commission heard presentations by representatives of Eastern Maine Heath Systems, Maine Health and Central Maine Healthcare.  All of the presentations noted the benefits of organizing hospitals by region.

Many of the Commission members appear interested in organizing the state into two or three different regions, each operated by a regional health authority that would have some authority over health planning and the allocation of resources in the area.  In order to induce cooperation, the Commission has discussed the potential of  using medicaid reimbursement, Certificate of Need, and even state licensure, all of which could be used to ensure that all hospitals in the region "cooperate."

The Commission has tentatively scheduled dates for public hearing on its plan, but it is not yet clear how much of the plan/report will be in writing so that the public will have a meaningful opportunity to comment.  Hearings are planned for August 23 in Bangor, August 30 in Portland and Sept. 7 in Lewiston.  Following the completion of a draft of the final report in October, a final hearing would be held on Oct. 18.  The Commission must file its report with the Governor by Nov. 1.  Nov. 1 is the day before the election which gives proponents of whatever plan emerges an opportunity to claim success in at least coming forward with a plan.  The ability to accomplish any of the objectives in the plan is heavily dependent on the results of Nov. 2nd.

D. Joshua Cutler,M.D., a Portland cardiologist, represents the Maine Medical Association and its members on the Commission.  As noted in last week's MMWU, Dr. Cutler would welcome feedback and input from any Maine physician on the issues facing the Commission.  He can be reached via e-mail at [return to top]

Aetna Doubles Quarterly Profits
Aetna's second-quarter profits more than doubled to $296.3 million because of increased premiums and increasing membership, the company reported last Thursday.

Aetna reported net income for the second quarter that came to $1.79 per share compared with $138.4 million or 87 cents per share in the same period last year.

Revenue for the quarter was $4.9 billion, up from $4.5 billion in the same quarter of 2003.

John Rowe, M.D., chairman and chief executive officer, cited raising revenue and increasing membership as well as cost-cutting for the gain.  Medical membership increased 95,000 to more than 13.4 million at the end of March 2004.  Second-quarter dental membership increased by 214,000 and pharmacy membership increased by 91,0000. [return to top]

David Nyberg, Ph.D., Appointed to Board of Licensure in Medicine
David Nyberg, Ph.D., Visiting Scholar in Philosophy and Education at Bowdoin College has been appointed by Governor John Baldacci to a term as a public member of the Board of Licensure in Medicine.  Dr. Nyberg has a special interest in medical ethics and serves as a member of the Clinical Ethics Committee at Maine Medical Center.  He also serves on the Grievance Commission of the Board of Overseers of the Bar. 

From 1994-1995, Dr. Nyberg was a visiting scholar at the Stanford University Center for Biomedical Ethics.  From 1993 to 2001, Dr. Nyberg served on the Buffalo General Hospital Ethics Committee.

Dr. Nyberg has already been asked by the Board to chair a subcommittee to look at the current ethical and regulatory standards regarding physician prescribing for family members.  The Maine Medical Association welcomes Dr. Nyberg to the Board which consists of six physicians and three public members.  The Board currently has a full complement of members. [return to top]

Summer 2004 Issue of Governor's Council on Physical Fitness Now Available
The Summer 2004 issue of the Maine Governor's Council on Physical Fitness, Sports, Health and Wellness newsletter is now available.  This issue covers the upcoming launch of Maine in Motion, the Council's statewide pedometer project, as well as updates on the Council's spring activities (ACES, Legislative Fitness Day and Contest for Communities).

The newsletter can be accessed by going directly to the Council's website - and clicking on the Newsletter page. 

Questions about the Council can be directed to Diane Campbell, Assistant Project Director, Maine Cardiovascular Health Council, Maine Governor's Council on Physical Fitness, Sports, Health & Wellness, 11 Parkwood Drive, Augusta, ME 04330 or by phone at 622-7566.  [return to top]

Learn About EMR at MMA 151st Annual Session Sept. 10-12
9.5 hours of  CME will be available at the MMA's Annual Session, being held this year from Sept. 10-12 at the Colony Hotel in beautiful Kennebunkport.  The CME program is entitled, "Medicine Rewired:  Putting Technology into Practice"  and is intended to educate physicians and practice managers about the important decisions that go into selecting an EMR (electronic medical record) vendor.

Nearly forty vendors have registered to exhibit at the meeting and rooms are going fast.  If you are thinking of attending and have not yet made your reservaton with MMA or at the Colony, please do so this week so you will not be disappointed regarding a room.  Room rates are available at a discounted rate of $140.00 (single or double occupancy) plus 7% tax and a $5.00 per person service charge.  Reservation forms have been previously sent to all MMA members but additional forms are available by calling the office at 622-3374.  This meeting promises to be one of the best ever.  Please consider attending and participating actively in your association. [return to top]

Are You a Golfer?
The Maine Medical Association will hold its first ever Charitable Golf Tournament at the Augusta Country Club on Monday, August 30, 2004 at noon.  The day will begin with lunch on the deck at 11:00am and a shot gun start at noon.  The Augusta Country Club is a private course designed early in the century by Donald Ross.  The day concludes with a buffet dinner during which awards will be presented and a raffle held.

The format for the tournament is a traditional four-person scramble.  We can handle up to 30 teams so get your application in soon.  Applications are available by calling MMA at 622-3374.  Net proceeds from this year's tournament will support the Physician Health Program through a contribution to the Maine Medical Education Trust, a non-profit foundation recognized through section 501-c-3 of the Internal Revenue Code.

Governor Baldacci will be the anchor for Team Dirigo which includes Dr. McAfee, Tom Dunne and Dennis Shubert, M.D.  The day should be a lot of fun. [return to top]

Legal Reminders: Charging for Medical Records
A reminder that the following law became effective Sept. 13, 2003.

P.L. 418.  Charges to patients or their representatives for a copy of their medical record cannot exceed $10 for the first page and  $.35 per page thereafter. 

MMA opposed this bill in the legislature but ultimately lost after a floor debate and vote.  The bill had been presented at the request of the Maine Trial Lawyers Association, with some trial lawyers believing that charges were exorbitant. [return to top]

Congressmen Allen & Michaud, Challengers Meet MPAF Trustees this Week
The trustees of the MMA's Political Action Committee (PAC), the Maine Physicians Action Fund (MPAF), will meet with the candidates for Maine's two Congressional seats at the MMA headquarters on Wednesday evening, August 4, 2004.  ANY INTERESTED MEMBER IS WELCOME TO ATTEND!

The interview schedule follows:

  • Congressman Tom Allen (D-1st District), 7:00 p.m.
  • 1st District Challenger Charlie Summers (R), 7:30 p.m.
  • 2nd District Challenger Brian Hamel (R), 8:30 p.m.
  • Congressman Mike Michaud (D-2nd District), 9:00 p.m.

The meeting will begin at 6 p.m. with dinner.  In addition to the interviews mentioned above, the agenda will include the following items:

  • Review of MPAF membership & finances
  • Review of MPAF trustee terms
  • Review of candidates for the 122nd Maine Legislature
  • Discussion of MPAF role in an election environment increasingly influenced by Maine's system of public financing, the Maine Clean Election Act (MCEA).

John B. Makin, Jr., M.D., a Waterville OB/GYN, is the Chair of MPAF.  If you would like to attend the meeting, please contact Charyl Smith, Legislative Assistant, to ensure a proper count for the meal.  You can reach Charyl by phone at 622-3374 or by e-mail at [return to top]

HHS Committee Meets For First Time Since Adjournment
Last Tuesday, July 27, the Health & Human Services Committee met for the first time since the session ended on April 30, 2004.  Members received breifings from DHHS Commissioner Jack Nicolas, OSA Director Kim Johnson, and GOHPF Director Trish Riley during a daylong session.

Commissioner Nicholas addressed the progress on merging DHS with DBDS, staffing issues at the Riverview Psychiatric Center, quality improvement efforts in child welfare services, and the state of the Department's finances.  Commissioner Nicholas appeared poised and confident in his new position and Committee members reacted favorably to his report.

OSA Director Kim Johnson discussed efforts to treat opiate addiction in Maine, including state and private sector efforts to increase the number of Maine physicians certified to treat opiate addiction with buprenorphine.  Maine currently has 57 physicians certified to prescribe the drug.

Trish Riley and GOHPF Deputy Director Ellen Schneiter updated members on the progress of implementing the Dirigo Health Plan, including the insurance product, the State Health Plan, applications for certificates-of-need, and the Capital Investment Fund rulemaking.  The Baldacci Administration officials faced tough questions and comments from members, particularly minority Republicans, about excluding the legislature from the implementation process and about adopting the Capital Investment Fund methodology through emergency rulemaking.

The HHS Committee will meet again on Wednesday, September 15, 2004 when it will address the same topics. [return to top]

FTC/DOJ Releases Report Endorsing Competition in Health Care
In contrast to the policies being pursued by the Baldacci Administration in the Dirigo Health Plan, the Federal Trade Commission (FTC) and Department of Justice (DOJ) recently released a report entitled Improving Health Care:  a Dose of Competition.  The report suggests in general that competition rather than regulation is the way to improve quality and decrease costs in the health care system. 

The report includes 6 recommendations and 11 observations on antitrust issues in the health care arena.  The report's conclusions favor price transparency and discourage CON laws, physician collective bargaining, "any willing provider" laws, and mandated health insurance benefits.

Both the MMA and the Maine Hospital Association have encouraged the Commission to Study Maine's Hospitals and the other Dirigo working groups to review the report.  You can find the report on the web at:

  [return to top]

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