October 25, 2004

 
Subscribe to Maine Medicine eNewsletters
Manage Your Subscriptions
Email our Editor...
Maine Medical Association Home Page
. Search back issues
. Plain Text Version
Printer Friendly

New Coalition for Liability Reform to Debut Thursday
The Coalition for Health Care Access and Liability Reform will hold a press conference in Portland on Thursday, Oct. 28 to announce its formation and to discuss the need to reform Maine's tort laws to ensure access to critical medical services in the years ahead.
A number of Maine health care organizations have come together to form a new coalition to advocate for more liability reform in Maine.  Increasing premiums, decreased reimbursement to pay for them and a deteriorating liability climate have led physicians to take a more aggressive approach to this perennial issue.  At the press conference, the coalition will call for the legislature to enact a limit on non-economic damages, which has proven nationally to be the most effective reform.  Most states enacting such reforms have established the limit at $250,000. 

The coalition includes MMA, The Maine Osteopathic Association, the Maine Hospital Association and several medical specialty societies. Individual physicians, group practices and allied health providers are expected to join as well.  Already the podiatrists and physician assistants have signed on.

All physicians are welcome to attend the press conference which will be held at 11:00am at the Holiday Inn by the Bay in Portland (Somerset room, 2nd floor).  Physicians may wish to wear their lab coats so that the strong physician support for liability reform will be obvious.

In addition to the press conference, newspaper advertisements will be run this week announcing the coalition and inviting Maine citizens to be a part of this effort.  Their access to care is at stake, particularly in some high-risk specialties.

Physicians and group practices wishing to assist in this important effort may do so by:

  • contributing to the Coalition for Health Care Access and Liability Reform, % MMA, P.O. Box 190, Manchester, Maine 04351
  • attending the press conference
  • talking with your patients about the need for reform of the state's tort laws.

By year's end, the Coalition will have a brochure to use in your office.  Physicians or practices wishing to be listed as members of the coalition should contact Gordon Smith or Andrew MacLean at MMA (622-3374 or gsmith@mainemed.com or amaclean@mainemed.com.

Amendments to CON Procedures Manual Go to Public Hearing
On Thursday, October 21, 2004, the staff of the DHHS, Bureau of Medical Services and the Governor's Office of Health Policy & Finance conducted a public hearing on proposed amendments to the BMS Rule Chapter 503, Maine Certificate of Need Procedures Manual for Health Care Facilities (other than Nursing Care Facilities).  The proposed changes reflect amendments to the CON statute enacted by the 120th Maine Legislature in 2002 and by the 121st Maine Legislature in 2003 (the Dirigo Health legislation).

You may find the proposed amendments to Chapter 503 on the web at www.maine.gov/bms/rules/c_503_p_complete.pdf.  In particular, you are urged to consider the review cycle proposed on page 23 and the new standard for approval that a project be "consistent with the State Health Plan," on pages 33-35.

The following individuals provided comments at the public hearing:

  • David Winslow, Maine Hospital Association
  • Joseph Kozak, Esq., Kozak & Gayer, P.A.
  • Paul Gray, MaineHealth
  • Rich Linnehan, MaineHealth
  • Joseph Ditre, Consumers for Affordable Healthcare
  • Stephen Randall, Insight Health Services

The comments included the following questions or points:

  • how will current applications be treated in the transition to the new procedures and the Capital Investment Fund (CIF) limits?
  • the current review process includes too many delays; the procedural steps should include specific timeframes
  • what will be the roles of various DHHS staff in the review process?
  • the timeframes are vague and sometimes difficult to interpret
  • should the manual incorporate specific sections of the State Health Plan, a document that will change frequently?
  • should the review cycles for hospital and non-hospital projects coincide?

You may read the MHA's comments on the proposed changes to Chapter 503 on the web at:  http://www.themha.org/advocacy/testimonycon.htm.

The deadline for written comments on the rule is Monday, November 1, 2004 and should be directed to:  Steven R. Keaton, Healthcare Financial Analyst, Bureau of Medical Services, Division of Financial Services, State House Station 11, Augusta, Maine 04333-0011. 

If you have further questions or comments about the rule, please contact Gordon Smith, Executive Vice President (gsmith@mainemed.com) or Andrew MacLean, V.P. & General Counsel (amaclean@mainemed.com). [return to top]

Maine DHHS Launches New Web Site
On Monday, October 18, 2004, the Department of Health & Human Services announced the launch of a new comprehensive web site, www.maine.gov/dhhs, to further the goals of combining the former Department of Human Services and the Department of Behavioral & Developmental Services. 

You may read the Governor's press release on the new web site at:  http://www.maine.gov/tools/whatsnew/index.php?topic=Portal+News&id=4043&v=article-2004. [return to top]

More on Flu Vaccine Shortage
The Maine Bureau of Health issued another health advisory on Wednesday in its continuing efforts to inform providers and the public of the extreme shortage of flu vaccine.  

The advisory can be found on the Bureau's web page at http://www.maine.gov/dhs/boh/PublicHealthAdvisory%20054.htm.  The Maine Immunization Program's Provider Line can be reached at 1-800-867-4775 and the Maine Flu Vaccine Hotline at 1-888-257-0990.

Of particular significance to physicians is the change in the recommendation regarding vaccinating health care workers.  After considering a number of factors, the Bureau now recommends vaccination only for those health care workers who meet the following requirements and further, only where the community influenza vaccine supply allows:

  •   Work full time or nearly full time;
  •   Have direct patient care; and
  •   Work in intensive care units and emergency departments, especially of referral centers.

FluMist, if no contraindications exist, is the preferred vaccine for these workers.

The Bureau does anticipate additional vaccine to be shipped to Maine over the coming weeks.  The Bureau is anticipating receiving approximately 80,000 additional doses.  There are currently 15,000 available so eventually there may be as many as 95,000 doses for distribution.  However, this still represents a significant shortage from the 150,000 doses originally ordered from the CDC for high-risk patients in Maine.

The City of Portland, after consultation with the Bureau of Health, is holding a lottery to dispense the 290 doses of vaccine it currently has available.  To be eligible, a patient must be over 65 years of age, or 19-64 with a chronic medical condition or be pregnant.  One must also be a resident of Portland.  Pregnant patients and adults with chronic medical conditions must bring a physician note on a prescription pad, stating the need.  The registration for the lottery is Oct. 28 and 29 with the vaccinations being provided to the "winners" on Nov. 4 and 5.

Physicians in the Portland area can anticipate getting some requests this week for the physician "note."

ANTIVIRAL AVAILABILITY

In addition to surveying supplies of flu vaccine, the Bureau is checking with pharmacies and providers to evaluate the current supply of antiviral medication. Three antiviral drugs (amantadine, remantadine, and oseltamivir) are approved and commercially available for use in preventing flu.  When used for prevention, they are about 70 to 90% effective for preventing illness in healthy adults.

Four antiviral drugs (amantadine, rimantadine, zanamavir and oseltamivir) have been approved for TREATMENT of the flu.  If taken within 2 days of getting ill, these drugs can reduce the symptoms of the flu and shorten the illness by 1 to 2 days.  They can also make patients less contagious to others.

Because patients who are at high risk may benefit the most from the antiviral medications, it is recommended that priority be given to such patients when considering use of the antiviral drugs. [return to top]

Anthem Announces Pay for Performance Program
Physicians with participating provider contracts with Anthem Blue Cross Blue Shield of Maine should have received a mailing last week from the insurance carrier announcing a new Anthem East "Pay for Performance" program for primary care physicians.  Data for the program will be collected beginning Jan. 1,2005 and increases in reimbursement on July 1, 2006 will be received depending upon performance.  The potential increases of 2, 4 or 6% will be on top of any regular increases in the fee schedule.

The Anthem East program will be identical in Maine, New Hampshire and Connecticut.  However, because of the long delay before any increase in reimbursement is seen, it is likely that Maine will see a second, interim program that will be unique to Maine and be based generally on the criteria used in the Pathways to Excellence program operated by the Maine Health Management Coalition. [return to top]

Quality Counts! Selects Executive Committee
The Quality Counts! initiative announced on Friday the results of the balloting for selection of an Executive Committee to oversee the program, which is focused upon improving quality of care through the appropriate management of chronic disease. The following individuals will make up the Executive Committee;

  • Paul Campbell, Maine Center for Public Health
  • Barbara Crowley, M.D., Maine General Health
  • Barbara Leonard, Bureau of Health
  • Lisa Letourneau, M.D., Maine Health
  • Ted Rooney, Maine Health Management Coalition
  • Steve Ryan, Maine Network for Health
  • Deb Silberstein, Anthem

Last July, a group of approximately 50 individuals met to discuss the future of the program and to discuss an organizational structure and an appropriate administrative "home."  No such "home" has yet been selected and MMA has indicated a willingness to discuss the possibility of housing the project at MMA.  Other organizations are interested, as well.

The first meeting of the Executive Committee has been set for this Friday, Oct. 29th in Augusta.  Congratulations to the above individuals on their selection to lead this project. [return to top]

State Queries May Delay Anthem - WellPoint Deal
Regulators in three states that have approved Anthem, Inc.'s proposed purchase of WellPoint Health Networks, Inc., are raising new questions about the deal, increasing the possibility that it may unravel.  The sticking point is the fact that WellPoint has pledged to pay California $100 million over 20 years for health care for the poor and uninsured. Regulators in Missouri and Texas are questioning the impact of that pledge on their states.  Ironically, the purchase has been in limbo since July when the California Insurance Superintendent blocked part of the sale in that state.  However, the California Dept. of Health Care, which regulates HMO's in the state, cleared the merger, in part because of the $100 million promised. [return to top]

Commission to Study Maine's Hospitals/ Updated Schedule
The Commission to Study Maine's Hospitals will not meet again as a full Commission until next week.   This coming week, the Certificate of Need Subcommittee will meet at 9:00am on Thursday (Oct. 28) and the Standardized Reporting Subcommittee will meet at 11:00am on Thursday.  Both meetings will be in Conference Room 300 at the Cross State Office Building in Augusta.  For more information, call 624-7444. [return to top]

The Coding Center Course Scheduled for Wednesday, Oct 27 Cancelled. Nov. 3rd Course in Bangor still on.
The Coding Center course on the business of operating a practice scheduled for Lewiston on this coming Wednesday has been canceled.  But the same course is being held in Bangor on Nov. 3rd.  Registration information can be obtained by contacting Maureen Elwell at MMA (622-3374 or melwell@mainemed.com.) [return to top]

Red Sox Make History; Two Wins Away From World Championship
Physicians around the state have taken notice of the unusual action of the Red Sox this October.  After being down 3-0 to the heretofore invincible New York Yankees, the Sox achieved what had never before happened in the history of major league baseball and swept the next four games to win the American League pennant.  The Sox are currently two games up in the World Series against the St. Louis Cardinals.

Medicine played a strong part in the Sox comeback.  With Sox ace Curt Schilling ailing from a bad tendon, a unique medical procedure was performed (twice!) to allow him to pitch six innings of the sixth game of both the American League Championship Series and the second game of the World Series. Blood could be clearly seen oozing from the pitcher's right sock during both performances.  His stitched-up ankle held up and he pitched nearly scoreless baseball, a very gutsy performance. [return to top]

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