September 13, 2004

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Over Three Hundred Members and Guests Attend 151st Annual Session
Over three hundred members and guests attended the MMA's Annual Session this past weekend in Kennebunkport. Entitled, "Medicine Rewired: Putting Technology into Practice", the CME program, was well-attended and featured demonstrations of electronic medical information systems. Lawrence Mutty, M.D. of Castine, was installed as President and Jacob Gerritsen M.D., of Camden, was elected President-elect. Kevin Flanigan, M.D., of Pittsfield, was elected Chairman of the Executive Committee. Dr. Mutty is a psychiatrist, Dr. Gerritsen is an internist and Dr. Flanigan is an internist and pediatrician.
Over three hundred members and guests enjoyed sunny skies and a full agenda of CME and business items at the 151st Annual Session of the Maine Medical Association held this past weekend in Kennebunkport at the Colony Hotel.  The Association had not met at the Colony since l973.  The hotel staff was very accommodating, as was the weather.  The meeting was presided over by out-going President Maroulla S. Gleaton who concluded a very successful year with addresses to attendees on Saturday morning and Saturday evening.  Dr. Gleaton discussed highlights of the year including the Governor's Dirigo Health legislation. 

Governor John Baldacci spoke to guests on Friday evening after being introduced by Robert McAfee, M.D., Chairman of the Board of Dirigo Health.  The Governor discussed the factors that led to introduction and implementation of Dirigo and answered questions from members that focused mostly on public health issues (primary seat-belt enforcement, motor cycle helmets etc.), the environment and professional liability reform.  The Governor did pledge to work with MMA and its partners on liability reform and indicated his strong support for legislation allowing for primary enforcement of Maine's seat-belt law.

Congressman Tom Allen spoke on Saturday morning prior to the opening of the General Membership Session.  Congressman Allen spoke of his work on the House Energy and Commerce Committee which has jurisdiction over many health programs.  He also touched on liability reform and expressed his strong support for Maine's pre-litigation screening panels.

At the General Membership Session, members considered eight resolutions and some significant amendments to the MMA Constitution and Bylaws.  Seven of the eight Resolutions were passed and can be viewed on the MMA website at (on the homepage, under NEW).   All of the resolutions presented by the Public Health Committee were passed, although some were amended.  Resolution 2 regarding a campaign for liability reform was also passed, but amended to require funding from voluntary contributions rather than from the Association's reserves. Resolution I regarding Medicaid was defeated.  The language of the amended Resolutions will be included in next week's Maine Medicine Weekly Update and will also be placed on the website.

The most notable constitutional amendment involved "de-linking" MMA membership from the county medical societies.  For a long time, perhaps since l953 when MMA was established, it has been a requirement of membership that the physician also belong to the local county medical society.  Approximately ten years ago, MMA began permitting "direct" membership, without going through the county, in certain unique circumstances.  The Committee on the Constitution and Bylaws, with Executive Committee support, presented an amendment last year, to be voted upon this year, that would permit direct membership into MMA without applying for county membership.  The amendment passed without debate.

At the meeting, MMA EVP Gordon Smith announced that it was the Association's intention to still bill for county dues, if requested by the county, but that the county dues would be optional on the MMA invoice.  In the alternative, county societies can bill for their own dues.

Receiving special awards at the Annual Dinner on Saturday evening were Lani Graham, M.D., MPH (Special Recognition Award), Cynthia DeSoi, M.D. (Mary Floyd Cushman Humanitarian Award) and Daniel Onion, M.D., MPH (President's Award for Distinguished Service).  Watch for more information on these awards and other Annual Session activity in the Sept.-October Maine Medicine arriving on your desks in October.


Maine Health Information Network Technology (MHINT) Feasibility Study
The Maine Health Access Foundation, The Bureau of Health and the Maine Quality Forum have each contributed $50,000 to study the feasibility of creating a statewide integrated clinical information sharing infrastructure in Maine.  The infrastructure would involve building a system that would allow for the secure and immediate point-of-care sharing of key patient-specific clinical information to:

  • improve patient safety
  • improve quality of care
  • reduce duplication of services and increase efficiency and decrease cost
  • allow connectivity with emerging health care provider and public health IT infrastructure and provide consumers with access to their personal health information.

The feasibility determination will be made by the MHINT Steering Committee based on the results of an intensive, seven-month study conducted by the Maine Health Information Center and a team of consultants.  The study will take place in two phases, with an initial project "go-no-go" decision at the end of Phase I in December, 2004.  A final "go-no-go" decision will be made by the end of Phase II (March, 2005).

During 2004, Anthem, the Maine Health Access Foundation, several providers and the Maine Health Information Center reviewed the federal funding initiatives for Health Information technology (HIT) planning and implementation projects.  It was determined that Maine had a great deal of support for collaboratively building a statewide HIT initiative but a formal planning process was needed to establish the project.  WIth leadership from MeHAF and involvement from the Maine Quality Forum, the Bureau of Health and the Maine Health Information Center (MHIC), this project has been initiated to determine the feasibility of developing a system of healthcare interconnectivity in Maine.  It has been determined by many that HIT development in Maine appears to be occurring independently at the local and hospital-system levels with little attention to how patient-specific clinical data can be quickly and efficiently shared with providers outside the local community or across systems and state lines.  In fact, at this time there is no mechanism in place to monitor and coordinate any collaboration among these traditional institutional silos of patient medical record information.  This means no steps are now being taken to ensure that patient level medical information can be electronically shared across systems in a way that will ensure the protection of privacy and allow clinicians and patients timely access to the most accurate medical information available.

For more information on this topic, go to the Maine Medical Association website at (Homepage, under NEW).

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Join Us for A 150th Anniversary Celebration this Saturday in Orono!
Be sure to mark your calendars  for September 18, as the Penobscot County Medical Association and Maine Medical Association celebrate their 150th anniversaries!

The Maine Center for the Arts on the University of Maine campus in Orono will be the site of this important celebration.  The Penobscot County Medical Society was organized on February 15, 1854 at the home of Dr. Hosea Rich of Bangor, making it the oldest county medical society in the state.

On the 18th, MMA and the county society will join together to host an anniversary gala featuring a look back at 150 years of medicine in Maine.  Invitations have been sent to every Penobsoct County physician as well as Maine Medical Association members in Aroostook, Hancock, Piscataquis, and Washington Counties.  The event begins with a reception in the lobby of the Maine Center for the Arts at 5:30 p.m. with dinner at 7 p.m.

The program which follows at 8 p.m., is open to the public. Don't miss this opportunity to celebrate the medical profession in Maine, and those physicians who have improved the lives of Mainers for 150 years!   For more information, contact the Maine Medical Association at (207) 622-3374. [return to top]

HHS Secretary Tommy Thompson Visits Maine This Thursday
U.S. Health & Human Services Secretary Tommy Thompson will headline a fundraising event for the Maine Republican Party at the Inn by the Sea, 40 Bowery Beach Road, Cape Elizabeth on Thursday, September 16th from 5:30 p.m. to 7:00 p.m.  Tickets to the general reception are $50 per person.  A private VIP reception is available beginning at 5:15 p.m. for $200 per person.

Contributions are payable to Maine Victory 2004, 9 Higgins Street, Augusta, Maine 04330 and will be used for the Maine Republican Party's "get out the vote" efforts. [return to top]

Hospital Study Commission Continues Review of Draft Report
At its last two meetings on Tuesday, September 7th and Monday, September 13th, the Commission to Study Maine's Community Hospitals, established in the Dirigo Health legislation, reviewed a draft report and recommendations.  Commission Chair Bill Haggett, former CEO of Bath Iron Works, is the principal author of the draft report.  While a number of Mr. Haggett's recommendations challenge the status quo, the most controversial proposal has been to eliminate 3500 hospital jobs to save money.  At yesterday's meeting, the group discussed sections of the draft report on payment issues, wellness, and a "special circumstances" section with a series of recommendations that hospital administrations and boards would be asked to consider.  For instance, Mr. Haggett suggested that hospitals might consider terminating their relationships with the Quorum management company and obtain those services at lower cost through the regional boards contemplated in the Commission's work.  Commission members have spent both meetings contributing editorial comments on the draft report which has not yet been released to the public.  The group's discussion has involved considerable debate about the tone of the report - - the degree to which the report is critical of the state's hospitals. [return to top]

Legislature's Health and Human Services Committee to Meet Wednesday, Sept. 15
The Health and Human Services Committee will hold one of its interim meetings on Wednesday, Sept. 15, 2004 from 10:00am to 3:00pm in Room 202 of the Cross State Office Building in Augusta.

Of particular interest to physicians will be the 10:30am presentation by Trish Riley, Director and Ellen Schneiter, Deputy Director of the Governor's Office of Health Policy and Finance.  They will report on the current status of  Dirigo Health, including segments on the product called DirigoChoice to be offered by Anthem, the State Health Plan, the Capital Investment Fund and Certificate of Need.

At 1:00pm,  Commissioner Jack Nicholas will discuss MaineCare issues, including the regulatory burden on health care providers, which is a follow-up to discussion at the July meeting when Allan Teel, M.D., a family physician from Damariscotta made a presentation to the Committee detailing the difficulties of private practice in the current environment.  Commissioner Nicholas will also discuss prescription drug programs, including the subject of prior authorization in the MaineCare program.  It is a positive sign that the Committee is demanding more information on these subjects of great interest to physicians.

MMA staff will attend and monitor the meeting.  We will report to members on the results of the meeting in next  week's newsletter. [return to top]

Anthem to Hold Regional Provider Meetings Sept. 30-Oct. 27, 2004
Anthem Blue Cross Blue Shield has scheduled a series of regional provider meetings beginning on Sept. 30 and running through most of October.  The purpose of the meetings is to share information about the Dirigo Health Plan, Anthem's Medical Management and Case Mangagement programs, review upcoming physician claim data reports and discuss electronic claims submission.

These meetings are designed for staff in physician and professional offices.  Refreshments will be provided.

Thursday, September 30......Kennebunkport.....The Nonantum Resort, Ocean Avenue
Tuesday, October 5................Rockport................The Farmhouse, 399 Commercial Street
Thursday, October 7...............Portland.................Holiday Inn, Exit 8
Wednesday, October 13........Auburn...................Martindale Country Club, 527 Beech Hill Rd
Thursday, October 14.............Portland.................Holiday Inn, Exit 8
Tuesday, October 19..............Augusta.................Senator Inn, 284 Western Avenue
Wednesday, October 20........Waterville...............John Martin Manor, 54 College Avenue
Thursday, October21..............Webcast Meeting
Tuesday, October 26..............Presque Isle.........Northeastland, 436 Main Street
Wednesday, October 27.........Brewer...................Jeff's Catering, East/West Industrial Park

DAILY AGENDA (including webcast meeting):

8:00 - 8:30........Registration
8:30 - 9:15........Dirigo Health Plan
9:15 - 9:45........Information about Medical and Case Management Programs & Online Forms
9:45 - 10:00......Break
10:00 - 10:30....Information about Physician Claim Report Tool
10:30 - 11:00....EDI - Electronic Claims Submission
11:00 - 11:30....BlueCard Program Update
11:30 - 12:00....Q & A

For more information, call Kay Doucette at 207-822-7162.

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Prospects Dimming for Passage of Drug Import/Patient Safety Bills
With only a couple of months left in the Congressional calendar, it appears unlikely that a bill to allow drug importation will come up for a vote.  Senate Health, Education, Labor, & Pensions Committee Chairman Judd Gregg (R-NH) postponed a vote on his drug import bill (S. 2493) that had been scheduled for July 21st and last week Senate Majority Leader Bill Frist, M.D. (R-TN) said that it looked unlikely that there would be sufficient time for a vote before the end of this session.

Patient safety legislation faces somewhat better prospects for passage.  Two patient safety bills (S. 720 and H.R. 663) are awaiting consideration by a conference committee.   The House and Senate bills both propose a voluntary medical error reporting system and establish a federal evidentiary privilege and confidentiality protections to promote error reporting by health care providers.  The House bill also includes a provision for grants to health care providers and facilities to help with the costs of acquiring or implementing information technology to improve patient safety or to enhance health care quality.

The Senate conferees are:

  • Senate Majority Leader Bill Frist (R-TN)
  • Sen. Judd Gregg (R-NH)
  • Sen. Mike Enzi (R-WY)
  • Sen. Lamar Alexander (R-TN)
  • Sen. Edward M. Kennedy (D-MA)
  • Sen. Christopher J. Dodd (D-CT)
  • Sen. James M. Jeffords (I-VT)

The House has not yet named its conferees.

The AMA shortly will send the following letter to the Speaker of the House urging action on this issue.

September 15, 2004


The Honorable J. Dennis Hastert


U.S. House of Representatives

H-232, The Capitol

Washington, DC  20515


Re: Patient Safety and Quality Improvement Act


Dear Mr. Speaker:


On July 22, 2004, the Senate amended and passed by unanimous consent H.R. 663, the “Patient Safety and Quality Improvement Act,” which the House of Representatives passed on March 12, 2003, by a vote of 418-6.  The undersigned organizations strongly urge that the necessary steps be taken to move H.R. 663 so it can be enacted this month.  It is critical that we do not miss this opportunity to improve patient safety.


There is broad agreement among leading patient safety experts and institutions that our health care system needs to transform the existing culture of blame and punishment that suppresses information about errors into a culture focused on patient safety and quality improvement.  H.R. 663 would significantly advance an environment in which health care professionals and organizations can report and analyze health care errors and share their experiences with others in order to prevent similar occurrences.  H.R. 663 would achieve this without jeopardizing the regulatory and oversight functions of state and federal governments, or patients’ rights to information relating to their care.


Our collective memberships represent a broad array of interests and perspectives on the issue of health care.  We speak in unison, however, on the critical need to improve patient safety and quality.  We believe that the benefits of improving patient safety and quality in our nation’s health care system are too compelling not to achieve an effective reporting system without delay.  By enacting H.R. 663, we can promote patient safety and quality by ensuring that errors are systematically reported and analyzed—so they won't happen again.  We strongly urge you to promptly move H.R. 663 to advance patient safety.



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Myths and Facts Regarding the 2005 Medicare Part B Premium Increase
Many of the press reports about the 17.4% increase in the 2005 Medicare Part B premium have suggested, implicitly or explicitly, that the physician payment updates included in the Medicare Modernization Act (MMA) are the main force driving the increase.  Information provided to the American Medical Association by the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary demonstrates that this information is not correct.

A table recently prepared by the CMS Actuary breaks down the specific factors that went into the 17.4% increase in the Part B premium for 2005.  The last column of that table indicates that, of the 17.4% premium increase, physician fee schedule services accounted for 5.6%. This means that approximately one third (32%) of the premium increase is due to physician fee schedule services.

Overall, 9.3% of the 17.4% is attributable to increased costs in the Part B fee-for-service program.  Besides physician services, other Part B components include hospital outpatient services, dialysis, services srvices, ambulatory surgical centers, ambulance services, laboratory services and home health.  An additional 2.3% is due to increased spending for Medicare managed care. [return to top]

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