October 12, 2004

 
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Flu Vaccine Shortage Causes State to Ask for Delay in Shots and Clinics
The state, through Governor Baldacci and Dora Anne Mills, M.D., MPH, Director of the Bureau of Health, asked that physicians and other direct healthcare workers delay getting flu shots until Maine's high risk population is protected. The state is also tapping Maine businesses for extra doses state officials say will be vital to protecting those most vulnerable.
Governor Baldacci also announced that he is delaying vaccinations for state workers in order to divert the state's small supply to a priority list of children, the elderly and those with medical conditions.  Approximately 40,000 Mainers are considered most at risk.  The announcements came shortly after news that British authorities halted production at a Chiron Corp. plant where the bulk of Maine's flu vaccine shots are administered.  All told, Maine has lost about 123,000 doses because of the plant closure.

Last year, there were 60 documented deaths in Maine as a result of the flu.  Currently, state officials have only 9,900 doses to work with, and are unsure how many doses may be available from business sources or from other healthcare providers, including physician offices.  Businesses that have vaccines on hand are asked to call the Maine Flu Vaccine Hotline at 1-888-257-0990.

Dr. Mills advised healthcare providers to give vaccinations only to those at high risk while the state conducts an inventory of vaccine supplies.  The state is awaiting word from the CDC as to when new supplies may become available. Dr. Mills also advised persons in high-risk groups to go ahead and schedule vaccinations with their providers.

The Bureau of Health has re prioritized who should get the vaccine, as follows:

  1. All children ages 6-23 months
  2. Adults 65 years and older
  3. Persons ages 2-64 years with underlying chronic medical conditions
  4. All women who will be pregnant during flu season; and
  5. Residents of nursing homes and long-term care facilities.

No longer on the priority list are children ages 6 months to 18 years on chronic aspirin therapy; health care workers involved in direct patient care; and out of home caregivers and household contacts of children under the age of 6 months.  Heathcare workers who come in contact with patients and caregivers of infants younger than 6 months will be next in line for the remaining doses, Dr. Mills noted.

Healthcare providers have been asked to delay clinics, in part because it is difficult to limit them to high risk patients.

Physicians and office staffs may check the web site for more information or call the Maine Flu Vaccine Hot Line for more urgently needed information.  The website is MainePublicHealth.Gov and the Hot Line number is 1-888-257-0990.

Hospital Study Commission Subcommittees Meeting Today
Commission Chair WIlliam Haggett announced at the Oct. 4 meeting of the Commission that only subcommittee meetings would take place the rest of October with the full Commission convening again in November.  Trish Riley, Director of the Governor's Office of Health Policy and Finance and Chairman Haggett also informed members and the public that they had decided to move the deadline for issuing the Commission's final report from November to mid-December.  The remaining meeting schedule is as follows;

  • Oct. 4-Nov. 8:  Subcommittee meetings
  • Nov. 8-22:  Full Commission meetings (each Monday morning)
  • Nov. 22;  Commission to review draft report
  • Dec. 6:  Public hearing in Portland
  • Dec. 9:  Public hearing in Augusta
  • Dec. 13:  Public hearing in Bangor
  • Final Report;  Dec. 21

The hearing dates and locations are considered tentative.

The subcommittees and their respective chairs are as follows:

  • Anti-trust:  Christopher (Kit) St. John, Esq.
  • Administrative Streamlining:  Robert Downs (Harvard Pilgrim Healthcare)
  • Rule Chapter 850 and Certificate of Need:  Joseph Ditre (Consumers for Affordable Healthcare)
  • Standardized Reporting:  Scott Bullock (Maine General Medical Center)

Members also agreed on Oct. 4 to delay further discussion of the concept of regionalization until the full commission meets again in November.

The Commission members have had some general discussion as to whether Maine hospitals should be subject to more (or less) state regulation.  Anti-trust officials have indicated to the Commission the need for more state regulation if the Commission is seeking more consolidation and cooperation to replace competition.  So far, the majority of Commission members appear reluctant to recommend more regulation.

Today, Oct. 12, the subcommittees meet this morning.  They will meet again on Oct. 18th and the Anti-trust subcommittee will meet Monday, Nov. 1 at the Dept. of Health and Human Services in Augusta from 9:00am -11:00am. [return to top]

Maine Quality Forum Continues Efforts on Website
The Maine Quality Forum Advisory Council met on Oct. 8 and reviewed changes to the website being developed under the direction of Forum Director Dennis Shubert, M.D., Ph.D.  Dr. Shubert had reported to the Council at its Sept. 10 meeting that the website had not gone live on Sept. 9 as originally scheduled due to concerns about some of the reported data.  The threshold for determining when data is "good enough" for public posting is a difficult one to determine, Dr. Shubert noted.  Cost and mortality data was pulled from the site based on feedback received from the Maine Hospital Association and the Maine Medical Association.

The website is expected to be up and accessible to the public by the end of October and will contain explanatory material and charts on geographical variations in certain types of surgery and medical admissions. While the data does not identify individual physicians, it does identify individual hospitals and by implication, some physicians can be indirectly identified.  The MMA and MHA have been given an opportunity to prepare a statement regarding the data which both organizations have done.  The statements will be available to the public via a link from the site. The MMA statement was previously shared with members through an earlier edition of this newsletter.

The most consistent theme of the original text and data involves suggesting to patients that a second opinion may be in order if they live in a community or service area which is the subject of wide variations in the procedure they are undergoing.    The website has been the subject of considerable controversy, even within the Advisory Council itself.  The next meeting of the Council is Nov. 12 in Augusta. [return to top]

Maine Health Access Foundation Releases 2005 Program and Policy/Data Grants RFP
The Maine Health Access Foundation (MeHAF) has released its 2005 Program and Policy/Data Grants RFP.  Up to $100,000 is available for up to two years.  Bidders conferences relating to this RFP - as well as a special workshop, "Applying for Health Care Funding for Non-Health Care Organization" -will be held within the next few weeks.

Register on the MeHAF website at http://mehaf.org/popup.asp?contentID=764.  The 2005A RFP can be downloaded from the website at http:www.mehaf.org/default.asp?

The Maine Health Access Foundation was established with the net proceeds from the sale of Blue Cross Blue Shield of Maine to Anthem, Inc.. [return to top]

MaineCare Drug Utilization Review Committee Meets Tonight in Augusta
The MaineCare Drug Utilization Review Committee will meet on Tuesday, Oct. 12, 2004 in Conference Room 1A & B at the Department of Human Services, 442 Civic Center Drive, Augusta  from 6:00pm to 8:00pm.  A public comment period will begin at 6:00pm.

During the public session, the Committee expects to hear comments on the preferred drug list and the prior authorization process.  The Committee will also discuss the psychiatric medication disease management program and look at initial data on the project.

During the executive session, the committee will consider additional supplemental rebates and look at drug cost comparisons on Alinia, Elestat, Campral, Sanctura, Factive, Apokyn, Zegerid and Estrogel.  The committee will also review commonly encountered unapproved uses of gabapentin.

The Committee meets again on Nov. 9, also at 6:00pm. in Augusta.

At a recent meeting with leaders of the Maine Osteopathic Association, Governor Baldacci indicated an intent to submit legislation in January  aimed at responding to the most serious complaints about the MaineCare PDL and PA process.  MMA representatives plan to discuss these issues further with HHS Commissioner Jack Nicholas at an upcoming meeting on November 2. [return to top]

MMA Announces Fall Seminar Series with Programs in Portland and Manchester
Watch for an insert in your Maine Medicine arriving this week which contains registration materials for MMA's Fall Seminar Series.

On Wednesday, Nov. 3 in Portland, at the Dana Center, we will present the "Best of the 2004 Physician Survival Seminars."  The program will be in a half day format, from 1:00pm to 5:00pm.  The program features the most highly rated speakers and topics from our Spring program, including:

  • Michael Duddy, Esq, on "Managing the Unruly Patient: Guidance for Physicians and Staff in the Office Setting."
  • Kenneth Lehman, Esq., on, "Responding to Administrative, Criminal and other Investigations."
  • Andrew MacLean, Esq., "Legislative and Regulatory Update"; and
  • Lisa LeTourneau, M.D., "Improving Chronic Illness Care in your Practice and your Community."

On Wednesday morning,  Nov. 17, we present a "HIPAA Update: Privacy and Security" at the MMA office in Manchester.  Speakers are Sari Greene from Sage Data Security and Gordon Smith, Esq.  This program follows up on the very successful HIPAA series that Mr. Smith presented in 2002 and early 2003.

On Tuesday, Nov. 30, again at the Dana Center in Portland from 1:00pm to 5:00pm,  we present a Dirigo Update, intended to offer physicians and office managers a first hand opportunity to hear from the persons on the front lines  putting the DirigoChoice product together and marketing it.  These persons include Sharon Roberts from Anthem and KarynLee Harrington, Director of Dirigo Health.  Also presenting will be the Chairman of the Board of DIrigo,  Robert McAfee, M.D.   Presenting a different point of view will be Tarren Bragdon of the Maine Heritage Policy Center.

The programs are offered at only $75 per person or someone from an office can attend all three programs for $175.  For more information, call Chandra Leister at MMA at 622-3374 or via e-mail to cleister@mainemed.com.  CME is available for the programs through the Maine Medical Education Trust. [return to top]

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