September 20, 2004

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MMA and Allies Launch Campaign for Liability Reform
The Maine Medical Association, the Maine Hospital Association, the Maine Osteopathic Association, Medical Mutual Insurance Co. of Maine and several specialty societies met last Tuesday evening to discuss the deteriorating liability climate in Maine and what to do about it.

Chaired by Lee Thibodeau, M.D., a neurosurgeon practicing in So. Portland,  the Coalition for Healthcare Access and Liability Reform was established last Tuesday evening.  Even before the campaign was formally established, the campaign has received checks and pledges of support totaling nearly $30,000.

More than a dozen medical specialty societies were represented at the meeting, including neurosurgery, neurology, cardiology, anesthesia, orthopedics, family medicine, internal medicine, psychiatry, ophthalmology, ob-gyn, general surgery, and pediatrics.  Prior to discussing the details of the campaign, MMA EVP Gordon Smith briefed attendees on the various liability reforms achieved in Maine law during the past 25 years.  Favorable provisions exist regarding attorney contingent fees, the statute of limitations, pre-trial screening, collateral source reform, periodic payments, and notice of claim.  Although bills have been presented numerous times providing for a limit on non-economic damages, the bills have not passed both the House and Senate.  At times, they have passed the Senate, but not the House.

Participants discussed the need for a non-economic damage cap in the amount of $250,000, a key provision of California's MICRA law for more than 20 years.  The impact of the California reforms on premium costs is significant, despite what trial lawyer interests say.

Patrick Dowling, M.D., President of Medical Mutual Insurance Co. of Maine,  presented the current status of reform efforts across the country and at the federal level.  Dr. Thibodeau led participants in a broad ranging discussion of strategy and tactics aimed at improving the legislative prospects for reform.  Efforts to educate patients, the public, and candidates running for the state legislature will be undertaken.  All physicians, hospitals (corporately and through medical staffs), and specialty societies will be solicited for support of the campaign.

Checks can be made payable to:  Coalition for Healthcare Access and Liability Reform, c/o Maine Medical Association, P.O. Box 190, Manchester, Maine 04351.  A separate account has been established for the fund which will be used solely to advance the cause of medical liability reform in Maine.  Any questions about the campaign may be directed to Gordon Smith or Andrew MacLean at MMA (622-3374 or or  Anyone wishing to volunteer to assist can contact Mr. Smith or Mr. MacLean.  An e-mail list has been developed for the purposes of communicating with one another.  Let MMA know if you would like to be put on the list to receive communications about the campaign.

MMA/Penobscot County Medical Society Celebrate 150 Years of Medicine
At a gala event on the UMO campus on Saturday evening, nearly 200 physicians and friends gathered to celebrate the 150th anniversary of the Penobscot County Medical Society and the practice of medicine in northern and eastern Maine.  Participants enjoyed a reception in the lobby of the Maine Center for the Arts on the Orono campus, dinner, a wonderful audio-visual program, and dessert. 

The program included 3 professionally-prepared video presentations on segments of the 150-year history of the society and narratives conducted by MMA President Larry Mutty, M.D., MMA EVP Gordon Smith, and Past MMA and AMA President Bob McAfee, M.D.  The following four physicians were honored for their life's work as Sesquicentennial Physicians with commemorative plaques during the program:

  • Fred J. "Doc" Pritham,M.D., a general practitioner in Greenville
  • Robert MacBride, M.D., an OB/GYN in Lubec
  • Lawrence Cutler, M.D., of Bangor, first director of the University of Maine's health center; and
  • George Wood, III, M.D., an internist in Brewer.
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Massachusetts Medical Society Hosts Meeting with CMS Regional Officials
Today, MMA President Lawrence B. Mutty, M.D., President-Elect Jacob Gerritsen, and V.P. & General Counsel Andrew MacLean attended a meeting at the Massachusetts Medical Society in Waltham, Massachusetts to discuss state quality initiatives and other matters of interest with the CMS Regional Administrator, Charlotte Yeh, M.D., and members of her staff, including Chief Medical Officer Eric M. Handler, M.D., M.P.H.  Representatives of all New England states except Vermont had an opportunity to brief the group on quality initiatives taking place in their state.

Dr. Gerritsen presented an overview of the following four quality initiatives in Maine:

  • the Maine Quality Forum established as part of the Dirigo Health Plan
  • the Maine Health Management Coalition's Pathways to Excellence initiative
  • the Quality Counts! intiative; and
  • the MMA's External Peer Review Program.

CMS Administrator Mark McClellan, M.D. joined the group by videoconference to make some brief remarks and to hear an overview of the state quality initiatives in New England.  After Dr. McClellan's comments, Dr. Yeh said that CMS is taking action to change the focus of the agency from one that is simply "transactional" (processing claims) to quality initiatives.  The CMS officials seemed genuinely interested in the activities and concerns of physicians in the field and plan to continue regional discussions like this one in the future. 

Following the meeting, the MMA representatives stayed to participate in a CMS Open Door forum, a conference call during which callers from around the country could ask questions of CMS officials at their headquarters in Baltimore, MD. [return to top]

GOHPF Issues First-Year Progress Report on Dirigo Health
On September 13, 2004, Governor Baldacci and Trish Riley, Director of the Governor's Office of Health Policy & Finance, announced the release of a first-year progress report on the Dirigo Health reform initiative.  You can read the press release along with the Executive Summary of the report on the web at:[return to top]

HHS Committee Members Receive Day-long Update on Executive Activities
The Health & Human Services Committee met last week for an update on the progress of DirigoHealth and the DHS/DBDS merger, among other things.

Trish Riley from the Governor's Office of Health Policy & Finance introduced a new Senior Policy Analyst, Marta Frank, who will be responsible for chronic illness and mental health issues.  Ms. Riley also announced that Karynlee Harrington has taken Tom Dunne's place as head of DirigoHealth.  Riley reviewed the recently approved Anthem agreement for providing the Dirigo insurance product.  Details can be found on their website  Enrollment begins January 1, 2005.  The Medicaid expansion, however, still has not received a go-ahead from CMS.

The Committee was critical of the Governor's office going ahead with an emergency rule to install the Capital Investment Fund with one member noting that a real emergency is that which is going on in Florida and that the existence of a pile of CON applications on your desk does not constitute an emergency.  The Committee will have a chance to make changes to the rule when they reconvene in January.  Although the Governor's Office had held the comment deadline open until the day of the hearing in order to allow members to make suggestions, Senate Chairman Mike Brennan told Riley that the Committee couldn't absorb their rule and make comments so soon.

Gail Chase, the State Auditor, reported to the Committee that her audit showed a "convoluted" accounting system at DHHS.  Jack Nicholas, DHHS Commissioner, spelled out recent changes to the accounting system, arguing that what has happened in the past could never happen again under the new system.

Nicholas reviewed his recent meeting with Dr. Teel, noting that while he could not make changes to the coding requirements in physician offices, he has promised to work with him and his staff on other issues of concern, such as Medicaid and the drug prior authorization process.  Nicholas also told the Committee that the merger was progressing nicely, primarily focusing on the computer and accounting system changes.

Jude Walsh of BMS announced that they are allowing Lorazipan to be covered by the state for the Medicare prescription drug card even though the feds have eliminated coverage for all benzodiazepines starting January 2006.  She is looking at the cost and will
decide whether other benzos will be covered by the state.  States are allowed to cover drugs that the feds don't cover as long as they (the State) pays for it. [return to top]

Meeting Schedule for Commission to Study Maine's Hospitals
At its meeting today, members of the Commission to Study Maine's Community Hospitals were scheduled to review and discuss their draft report's chapters on Cooperation & Collaboration, Regionalization & Antitrust Issues, and Governance.  The Commission's remaining meetings are as follows:

  • 9/27:  Review & discuss draft report chapters on Administrative Streamlining, Bureau of Insurance Rule Chapter 850 geographic access standard issues, and certificate-of-need (CON) issues.
  • 10/4:  Continue review & editing of draft report
  • 10/12:  Finalize report & recommendations
  • 10/18:  Public hearing on final report & recommendations
  • 11/1:  Review proposed edits to respond to public hearing comments
  • 11/_:  Present report to Governor, Legislature, & public.
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CDC Journal Online
In the United States, chronic diseases are responsible for more than 1.7 million deaths each year.  The CDC has a peer-reviewed electronic journal entitled Preventing Chronic Disease:  Public Health Research, Practice, & Policy (PCD).  The journal is available free of charge at  Through the electronic journal, physicians can access research papers and articles on various public health topics such as tobacco control programs, nutrition, dementia surveillance, osteoporosis, population-based interventions for communities of color, diabetes prevention, law, school health, and community-based research. [return to top]

Executive Committee Vacancy in Knox County
At the MMA Annual Session last week in Kennebunkport, Camden internist Jacob Gerritsen, M.D. was elected President-elect of MMA.  The election establishes a vacancy in the MMA Executive Committee for Knox County.  As the Knox County Medical Society is no longer active, nominations for this position will be solicited directly via communication with each MMA member residing or practicing in Knox County.  If you are interested in serving or would like to nominate anyone else you think would be interested, contact either Dr. Gerritsen at or Gordon Smith at [return to top]

CMS Publishes 2005 Physician Fee Schedule
The Centers for Medicare & Medicaid Services (CMS) published proposed regulations for the 2005 physician fee schedule in the August 5, 2004 Federal Register.  In addition to addressing physician reimbursement, the proposed rules also address:

  • Physical examinations for new Medicare beneficiaries
  • New preventive benefits
  • Incentive payments to physicians in scarcity areas (separate from HPSA bonus payments)
  • Coverage for one-time hospice evaluation and counseling
  • Payment for inhalation therapy; and
  • Payment for oncology drugs.

CMS will accept comments on the new guidelines until September 24, 2004.  The agency will publish a final rule by November 1, 2004 with an effective date of January 1, 2005.  To read the rules along with a fact sheet and other information, go to: [return to top]

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