March 21, 2005

 
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Coalition Medical Liability Reform Bill is Printed as L.D. 1378
The Coalition for Health Care Access & Liability Reform will introduce L.D. 1378 at a State House press conference during Physicians' Day at the Legislature on Wednesday, March 23, 2005. Please plan to spend part of the day joining your professional colleagues in Augusta on Wednesday. Over 200 physicians and medical students are expected to attend and promote medical liability reform. The American Osteopathic Association President and the in-coming AMA President-elect will be present.
 On Thursday, March 17, 2005, the medical liability reform bill offered by the Coalition for Health Care Access & Liability Reform was printed and appeared on the Senate calendar with reference suggested to the Judiciary Committee.  The bill is L.D. 1378, An Act to Preserve the Medical Liability Climate in the State by Capping Noneconomic and Punitive Damages.  The bill's prime sponsor is Senator Karl Turner (R-Cumberland) and it is co-sponsored by Senator Bill Diamond (D-Cumberland) and Senator Carol Weston (R-Waldo) and Representatives Tom Saviello (D-Wilton), Darlene Curley (R-Scarborough), Edward Dugay (D-Cherryfield), Jonathan McKane (R-Newcastle), Lisa Marrache, M.D. (D-Waterville), Timothy Driscoll (D-Westbrook), Joan Nass (R-Acton), and Richard Woodbury (I-Yarmouth).  Representatives of the Coalition including Chairman Lee Thibodeau, M.D., Senator Turner, and representatives of the American Medical Association (AMA) and American Osteopathic Association (AOA) will participate in a press conference to announce the bill during Physicians' Day at the Legislature on Wednesday, March 23, 2005.

Please plan to spend some or all of Wednesday, March 23, 2005 with your colleagues and the MMA and MOA staff at the State House for Physicians' Day at the Legislature.  Activities will begin around 8 a.m. and will end with a reception with the Governor at 2:30 p.m.  The State House likely will be buzzing with activity that day as the legislature may have the biennial budget proposal from the Appropriations Committee and the HHS Committee has a full day of public hearings scheduled.  The MMA and MOA plan to highlight the MaineCare physician fee increase and the medical liability reform campaign.  Also, the AOA President and a representative of the AMA Board of Trustees plan to attend.

Physicians' Day at the Legislature, presented by the MMA and MOA during the first year of every Maine legislature's work, is your opportunity to discuss issues of importance to your practice with members of the legislature and to demonstrate the credibility of physicians as a key political constituency. 

If you would like more information about how your practice or specialty can participate in the event, please contact Charyl Smith, Legislative Assistant, by email at csmith@mainemed.com or by phone at 622-3374.

MMA Delegation Visits Capitol Hill
 Last week, MMA President Lawrence B. Mutty, M.D., M.P.H. and President-elect Jacob W. Gerritsen, M.D. attended the AMA National Advocacy Conference in Washington, D.C.  Participants in this conference hear from members of Congress and others in the national political scene and attend training sessions on grassroots lobbying.  On Wednesday, March 16, 2005, MMA Vice President & General Counsel Andrew MacLean joined Dr. Mutty and Dr. Gerritsen for visits with members of Maine's Congressional Delegation on Capitol Hill.  The MMA contingent was able to meet with the health policy staff and with all members except for Congressman Michaud who was unavailable.  The conversations touched upon the current key issues for organized medicine in Maine, including medical liability reform, the Medicare payment methodology (the Sustainable Growth Rate or "SGR"), and the current federal budget and its potential impact on Maine's Medicaid program.

Both Senator Snowe and Senator Collins played key roles in the debate about federal domestic spending during the past week.  Each had significant influence on the Budget Resolution that passed last Thursday.  Both Senators voted for the Feingold-Chafee "pay-as-you-go" amendment that would require new tax cut proposals to meet the same fiscal accounting test as proposals for new domestic spending.  This amendment failed with a 50-50 tie vote.

Both Senators also voted for the Smith-Bingaman amendment that eliminates the Bush Administration's proposed $14 billion in cuts to Medicaid over the next 5 years and creates a national Medicaid Commission to examine rational ways to control Medicaid spending in the future.  The Smith-Bingaman amendment passed 52-48.  The MMA visit with Senator Collins was timed perfectly.  Our meeting took place at 4:15 p.m. on Wednesday in the reception room just off the Senate chamber where the budget was very much a focus of discussion.  The MMA thanks both Senator Snowe and Senator Collins for their courage in voting against the Bush Administration and their Senate leadership.  Their votes were instrumental in avoiding dangerous cuts in health care funding for Maine. [return to top]

MMA EVP Gordon Smith Participates in Press Conference on Cigarette Tax
On Wednesday, March 16, 2005, MMA EVP Gordon Smith joined other members of the Maine Coalition on Smoking OR Health at a State House press conference urging legislators to increase the state's cigarette excise tax by $1.50.  It is currently $1.00 placing Maine as the second lowest among the 9 states in the Northeast and 3 bordering Canadian provinces.  The legislature has no specific bill to raise the cigarette tax, but it could be incorporated in a budget bill.

The following are some talking points on the Coalition's proposed cigarette tax increase.

INCREASING THE PRICE OF CIGARETTES:

AN INVESTMENT IN THE HEALTH OF MAINE

  • a $1.50 increase in Maine's cigarette tax would avoid 9900 smoking-related deaths and save $438 million in lifetime health costs.
  • Every year, 3800 Maine kids become addicted to tobacco.  More than 1/3 of them will die prematurely because of this addiction.  More than 2100 Maine residents die each year from tobacco use - that's nearly 6 deaths per day from smoking-related diseases.
  • Raising the price of cigarettes is a proven method to lower youth smoking rates and reduce overall consumption of cigarettes.  Every 10% increase in the price of cigarettes reduces youth smoking rates by as much as 6.5%.  A 10% increase reduces adult consumption by about 4%.  Tobacco pricing policies are an integral component of any comprehensive tobacco control program.
  • Raising the price of cigarettes significantly reduces the burden on the health care system because of its impact on smoking rates.  A tax increase of $1.50 would lead to 33,000 fewer smokers in Maine.  Every youth who doesn't start smoking saves the health care system about $16,000 in lifetime health costs.  Every adult who quits saves about $8500. 
  • Mainers overwhelmingly support increasing the cigarette tax.  In a survey conducted in December 2003, 72% of respondents believed that the excise tax on cigarettes should be increased in order to reduce youth smoking.

The MMA will continue working with its partners in the Maine Coalition on Smoking OR Health to pursue an increase in Maine's cigarette excise tax in the 122nd Legislature. [return to top]

Bipartisan Budget Talks Break Down; Democrats to Propose Budget Plan
Following budget negotiations last week, the members of the Appropriations Committee and leadership acknowledged that they were unable to reach the bipartisan consensus on the Governor's Part I 2006-2007 budget necessary to ensure passage by 2/3.  The Democratic majority finished a 2-year $5.8 billion proposal early Saturday morning.  The budget now will go to the floor for debate during the next 2 weeks and will be adopted by April 1, 2005.  The MMA will analyze the proposed majority budget this week, but we believe it includes the $3 million MaineCare fee increase and the primary seat belt enforcement provision. [return to top]

CDC: Medical Providers Slow to Adopt EMRs; More Providers Outsourcing IT
Less than one-third of the nation's hospital emergency and outpatient departments use electronic medical records (EMRs), according to a report released today by the Centers for Disease Control and Prevention (CDC). According to surveys conducted by the CDC from 2001-2003, about 31 percent of hospital emergency departments, 29 percent of outpatient departments, and 17 percent of doctors' offices use EMRs to support patient care. The report also found that about 8 percent of physicians use a computerized physician order entry system (CPOE), which orders patient drugs and diagnostic tests electronically, with physicians under 50 years of age twice as likely to use CPOEs than physicians over age 50. The use of electronic records in health care lags far behind the computerization of information in other sectors of the economy. In healthcare, billing applications were the first to be computerized, with electronic billing systems now used in three-quarters of physician office practices.

To read the report: http://www.cdc.gov/nchs/data/ad/ad353.pdf (Acrobat Reader required) [return to top]

MECMS Update: Problems Continue - Provider Outreach and Feedback Meetings Scheduled
This past week MaineCare's new claims managmeent system, called MECMS, processed claims but many providers were paid charges rather than the  MaineCare fee.  The Bureau of Medical Services issued an announcement late in the week advising providers not to return the checks with the overpayments but rather to depost them and work with the Bureau later to reconcile.

In a  MECMS update 2 dated March 14, the Bureau provided detailed information on the prospective interim payments.  The Bureau's website address has been updated and is now: http://www.maine..gov/dhhs/bms

Finally provider outreach and feedback meetings are scheduled this week (March 21-25) at DHHS offices in the following cities:

March 21   Bangor 8:30-10

March 22    Lewiston 8:30-10     Biddeford 1:30-3

March 23    Rockland 8:30-10     South Paris 1:30-3

                     Machias 12:00 - 2

March 24    Portland  8:30 - 10    Houlton 12:00 - 2:00

                     Farmington 1:30 - 3

March 25    Augusta 8:30 - 10

 

 

  [return to top]

MaineCare Claims Management System (MECMS) Payment Schedule and Status

This report summarizes progress and current status:

 

a. System and Interim payments:

 

System Payments

Claims paid for week ending 03/11/2005

Claims paid for week ending03/18/2005

% Change

# providers paid through system

1,790

1,827

+2%

# claims processed in the system

90,500

163,591

+80.8%

# claims paid through system

50,874

76,602

+50.6%

amount paid through system

$26,589,454

$28,914,137

+8.7%

claims paid as percent of processed

56.2%

46.8%

-9.4%

 

Note: Claims processed in the system are released for payment by EFT on Friday and checks are mailed on the following Monday.The number of claims and amount paid for the current week has again increased.The higher volume paid reflects both system performance improvements and the increase in overall claims processed by the system.

Interim payments

Payments released on 03/15

Payments projected for release on 03/22

# providers paid interim payment

885

1,428

amount paid interim

$4,253,466

$7,372,436

Note: Interim payments are released for payment by EFT on Tuesdays and checks mailed on Wednesday.The projected interim payment for 03/22 reflects the increase in MECMS paid claims for the week ending 3/18/05 and application of criteria for interim payments.

b. Reconciliation for Interim Payments

Interim payments will be set up as Accounts Receivables or Advanced Payments.  The Department will “recapture” interim payments by offsetting future claims as they process through the system successfully.  This process will begin with offsets to claims paid the week ending 03/25.Reconciliation challenges to be addressed in meetings with providers.

c. Actions to Improve Provider and System Issues

i. Contracted with outside vendor to add staff to assist with answering provider inquiry calls. Staff will begin work in early April.

ii. Weekly mailings to all providers

iii. System upgraded on March 12 to improve performance and system response.Tables added to system to give inquiry staff rapid retrieval of claims status.

iv. Implemented improved configuration management issues. For example, pricing tested logic errors resulted in overpayment for some claims processed this week.Fix to be tested and implemented by 3/21.

v. Reduced backlog of claims in the system resulting in increase of claims processed and paid with remittance advices.Remaining backlog should be eliminated by March 25.

vi. Providers can access payment information by provider number on BMS website:
http://payments.dhs.maine.gov/

vii. Statewide provider meetings scheduled for week of March 21

viii. Creating a provider advisory committee to assist with implementation issues

ix: Reviewing need to upgrade phone system to allow easier provider access

[return to top]

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