February 7, 2005

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Commission to Study Maine's Hospitals Releases Final Report
The Commission to Study Maine's Hospitals released its final report to the Maine Legislature and the public on Wednesday. The report was followed by the release of a minority report by the two hospital representatives on the Commission. The Commission will present the majority report to the Legislature's Health and Human Services Committee in the coming weeks. Legislation based upon the report's recommendations will be drafted and submitted to the legislature for consideration.
A complete list of recommendations is included in the Executive Summary of the report at www.dirigohealth.maine.gov.  The minority report can be accessed on the Maine Hospital Association website at www.themha.org.

The Commission, which was created by the Dirigo Health Reform Act and included representatives from hospitals, physicians, the insurance industry, employers, consumers, an economist and a nurse, heard testimony from nearly 50 witnesses and met more than 30 times during the past year.  The report was finalized after the Commission held public hearings Jan. 6 and 7 in Portland, Augusta and Bangor.  Over 160 persons attended the hearings and the Commission received oral or written testimony from 50 people:  28 representing hospitals and 22 representing themselves or other organizations.

The Commission Report makes twenty recommendations, 14 of which were supported by the hospital representatives.  Perhaps the most significant issue drawing hospital opposition is the recommendation that the state create a Consortium for Hospital Collaboration.  The Consortium is described in the Commission's press release as "a voluntary strategic alliance led by hospitals with representation form State government, consumers, employers, insurers, doctors, and nurses - to be a forum where these representatives can work cooperatively seeking ways to collaborate to improve healthcare quality and efficiency for all hospitals."  The minority report calls for continued voluntary cooperation as it currently exists without state participation and intervention.

Other Commission recommendations include:

  • Amending the Hospital Cooperation Act to include physicians and to broaden its ability to make it easier for hospitals and physicians to collaborate by protecting them from anti-trust action.
  • Establishing voluntary profit margin and cost increase targets for hospitals.
  • Recommending statewide implementation of electronic medical records under the leadership of the Maine Quality Forum and providing supporting funds through issuance of state bonds.
  • Standardized reporting of hospital financial information in an electronic format, to facilitate public understanding of hospital finances.
  • Strengthening of the Certificate of Need program by enhancing staff capacity to conduct reviews, conduct follow-up on approved CONs, and improve the CON hearing process.  The Commission recommends an increase in CON application fees, if necessary after recent increases, with those revenues directed exclusively to the CON process to help support the increased staff.

The Commission makes no recommendations relative to hospital closings or mergers but urges every hospital board to evaluate possible opportunities to minimize duplication and maximize collaboration through the Consortium.  The Commission also urges hospital boards to examine the critical access program to determine if some additional hospitals should convert from fully licensed comprehensive hospitals to critical access status, under federal law.

MMA testified at two of the three public hearings and supported the majority of the Commission recommendations.  However, MMA representatives testified that they did not believe the proposed Consortium could be successful without the support of Maine's hospitals.  MMA's position on the various recommendations will continue to evolve as we now have the final language of the report, and the minority report to consider.  MMA will give its final position on the recommendations at the legislative hearings later this winter or spring.  Any MMA member wishing to have input into the deliberations of the MMA Legislative Committee and Executive Committee may contact either Gordon Smith or Andrew MacLean at gsmith@mainemed.com and amaclean@mainemed.com.

In Honor of National Women's History Month
In honor of March being National Women's History Month, MMA is hoping to increase the number of women volunteers in the Physician of the Day program at the State House for the month of March.   Please help us contribute to Women's History Month by volunteering a few hours of your day to participate in the worthwhile Physician of the Day program.  The 2005 theme for Women's History Month is "Women Change America."  While being honored as a woman physician and confirming one of many roles women have in medicine, you will also have the opportunity to take part in the day-to-day functions of our State Legislature.

Though the Legislative Session schedule has not yet been released, it is likely that the week will run Tuesday/Wednesday/Thursday for March.  The program is open to all specialties, whether an MD or DO. 

Please contact Charyl Smith at the MMA office for more information and to register.  She may be reached by phone at 207-622-3374, or email at csmith@mainemed.com. [return to top]

MMA and Maine Primary Care Association Team Up to Present HIPAA Security Pogram
The deadline for HIPAA security regulation compliance is April 21, 2005.  Practices need to start now to assess critical applications and identify threats to the electronic protected health information in the office.

MMA EVP Gordon Smith noted that HIPAA requires both a user name and a password.  Otherwise, anyone can log onto your office system and access health information.  If you have wireless personal computers for physician use, make sure you properly activate encryption software.  Encryption software scrambles the information being transmitted via wireless so others outside the office cannot gain access.  

Some additional tips:

  • Properly implement firewalls
  • Turn on encryption for use with wireless systems
  • Make use of passwords and user names
  • Keep the operating system and patches (fixes) up to date

MMA had teamed up with the Maine Primary Care Association to offer two additional HIPAA Security briefings in early March.  The half-day sessions will feature Sari Greene, a Certified Information Systems Security Professional with a strong background in design and application of generally accepted security principles.  An update of HIPAA privacy will be provided by attorneys Gordon Smith and John Kelley.  Mr. Kelley is Compliance and Community Development Manager at the Primary Care Association.

The programs are being held in Bangor on Wednesday, March 2 from 8:30am to noon and on Friday, March 4 in Auburn, also from 8:30am to noon.  Registration materials are included in this month's Maine Medicine which should arrive in your office this week.  You may also register by contacting Chandra Leister at MMA at 622-3374 or via e-mail to cleister@mainemed.com. [return to top]

Fourteenth Annual Physician Survival Seminars to be held in May and June
MMA's Fourteenth Annual Physician Survival Seminars will be held from 8:30 a.m. to 5:00 p.m. on May 18, 2005 at the Sheraton Hotel in South Portland, and June 8, 2005 at the Spectacular Event Center in Bangor.

The seminar's keynote will be Helen Jameson, JD, the Director of Marketplace Advocacy for the AMA's Private Sector Advocacy Group. The morning sessions will focus on Pay for Performance, Dirigo Overview, MaineCare and Medicare Updates as well as Improving Outcomes.

Attendees may choose to follow one of three tracks in the breakout sessions in the afternoon- Technology, Compliance or Managing your Practice, or choose a session from each track.

Registration materials will arrive in this month's issue of the Maine Medicine. Please contact Chandra Leister with any questions or to reserve your space: cleister@mainemed.com or 622-3374. [return to top]

Maine House Speaker John Richardson will speak to Maine Gastroenterologists
The Maine Society of Gastroenterologists will hear from John Richardson, Speaker of the Maine House of Represenatives,  at an annual dinner on April 28, 2005 at the Harraseeket Inn, in Freeport.

The dinner is the kickoff to the Society's annual conference entitled,  "Topics in Gastroenterology for Primary Care" at the Harraseeket Inn, in Freeport on Friday, April 29, 2005.

For more information, or to register for "Topics in Gastroenterology for Primary Care", please contact Chandra Leister via email cleister@mainemed.com or phone 622-3374. [return to top]

Medicare Contractor Advisory Committee Meeting Announcement
The next meeting of the Contractor Advisory Committee (CAC) is scheduled for Monday, February 14, 2005, from 2:30 to 5 p.m. (Please note the new ending time).  The teleconference will originate from the headquarters of the Massachusetts Medical Society in Waltham, MA and will be videoconferenced to the Dartmouth-Hitchcock Medical Center in Lebanon, NH; Fletcher Allen Medical Center in Burlington, VT; Maine Medical Center in Portland, ME and Eastern Maine Medical Center in Bangor, ME.

NHIC is pleased to announce the guest speakers for a discussion of  Virtual Colonoscopy:                                 

  • Joseph T. Ferrucci, Jr., MD, Professor of Radiology and Chairman Emeritus, Boston University School of Medicine, Boston Medical Center, Program Chair of the International Symposium on Virtual Colonoscopy


  • Daniel K. Podolsky, MD, Division Chief , Gastroentrology, Massachusetts General Hospital, AGA Immediate Past Resident (during the AGA's CT Colonography Task Force)

This should be a very interesting and timely discussion of both the diagnostic and screening aspect of this emerging technology.

Directions to all the sites, the agenda, and materials for the meeting are posted at the CAC web-site; https://www.medicarenhic.com/cac.  You may attend at the site of your choice. [return to top]

NHIC Enhances Automated Response Unit
National Heritage Insurance Company (NHIC), the Medicare Part B Carrier for Maine, is enhancing its Automated Response Unit (ARU) for providers to include speech recognition.

Providers will be able to access information either by speaking into the phone or using the telephone keypad. Available options through the new Interactive Voice Recognition System include: eligibility information, claim status, deductible information, check status, seminar schedules, telephone numbers and addresses, and information on appeal rights.

Keep your eyes open for development updates on this exciting new tool. For the most current updates, join the NHIC website mailing list. [return to top]

Dirigo Health Agency Board Update
On Monday, February 7, 2005, the Dirigo Health Agency Board of Directors held a regular board meeting.  Members of the Board were briefed by Trish Riley, Director of the Governor's Office of Health Policy & Finance, Dennis Shubert, M.D., Executive Director of the Maine Quality Forum, and Karynlee Harrington, Executive Director of the Dirigo Health Agency. 

Trish mentioned the recent DHHS report on the hospital sentinel events reporting law, expressed concern that the details of hospital reports are not public, and stated that the MQF should review the report and react to it.  Trish also provided an update on the "Tough Choices" campaign and mentioned two aspects of the Governor's proposed biennial budget.  Regarding the 2006-2007 biennial budget, she mentioned that the Administration had included a $3 million Medicaid fee increase at the recommendation of the MMA and had adjusted the hospital prospective interim payment methodology to benefit the hospitals.

Dr. Shubert next provided an update on the activities of the Maine Quality Forum.  He commented on the sentinel event law report and stated that the MQF has published this information in comparison to similar data from Minnesota on the MQF web site.  The MQF staff also gave an update on the "Recognized Provider" project (will offer recognition to hospitals that meet or exceed established levels on the 30 NQF measures of patient safety) and the MHINT project.

Karynlee Harrington offered a status report on DirigoChoice enrollment.  She highlighted a DirigoChoice member's op-ed in the weekend Bangor Daily News.  You can read Chris Kelley's opinion piece in response to Tarren Bragdon's critique on the web at:  http://www.bangornews.com/news/templates/?a=108276.  Also, she provided the following enrollment numbers:

  • January:  62% sole proprietors; 38% small group
  • February:  42% sole proprietors; 58% small group (966 members)
  • March:  44% sole proprietors; 56% small group (1200 potential members in negotiation)
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Maine DHHS Releases First Annual Report on Sentinel Event Reporting
Maine's sentinel event reporting law took effect on May 1, 2003 and provided a system for the reporting of sentinel events for the purpose of improving the quality of health care  and increasing patient safety.  The reports are confidential, but information can be released on an aggregate basis.  Oversight for the reporting system lies with the Division of Licensing and Certification within the Department of Health and Human Services.

Last week, the first Annual Report was released to the Legislature and the public.  It includes summary data of the number and types of sentinel events of the prior year by type of health care facility, rates of change and other analysis.  The report found 24 reportable sentinel events, 23 of which were in hospitals and one in an ambulatory care setting.  Of those events, 15 were deaths, five were loss of function and four were wrong site surgery or surgery on the wrong patient.  The report also includes risk reduction actions taken by facilities in response to events.

While individual institutions are not identified in the report, and cannot be under the state law, MMA and the Maine Hospital are very concerned about efforts to make the reports public.  An editorial advocating such appeared in Monday's Kennebec Journal and Waterville Sentinel.  As the reporting system was established to be educational and non-punitive, MMA and MHA will strenuously resist such information becoming public, except on an aggregate basis.  Release of the information to the public, by institution, would provide a clear roadmap for trial attorneys.

A copy of the report and attachments (approximately 20 pages) is available from MMA by calling Julie Banta at 622-3374 or via e-mail to jbanta@mainemed.com. [return to top]

MaineCare Continues to Struggle with Transition to New Claims Management System
MMA continues to hear of significant delays in MaineCare reimbursement as a result of the transition to a new claims management system.  We have forwarded problems and communications on to the Bureau of Medical Services and met last week with Acting Bureau Director Chris Gianopoulos to express our concern.   Please let MMA know via e-mail of your experiences with the transition as it is a valuable means of our monitoring the situation.

Practices which are in financial distress as a result of any delays in payment may be eligible to receive an interim prospective payment under a Bureau contingency plan for "vulnerable " practices.

Send communications on this matter to gsmith@mainemed.com. [return to top]

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