July 25, 2005

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Update on Key Health Legislation in Congress
Legislation of critical interest to physicians is being voted upon in the U.S. House of Representatives this week. H.R. 5 would cap non-economic damages in medical liability cases at $250,000. This type of federal legislation is essential if liability reform in Maine continues to fall short. With liability premiums in Maine increasing significantly, federal reform may provide Maine physicians with the best hope for relief.
1.  Medical Liability Reform.

The House is expected to vote on medical liability reform legislation this week.  H.R. 5, sponsored by Rep. Phil Gingrey (R-GA), is essentially the same as H.R. 5, the Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2003 that has passed in the House several times.  Its core element is a $250,000 cap on non-economic damages in medical malpractice actions.  While they are sympathetic to the MMA's concerns about maintaining a positive medical liability climate in Maine, Congressmen Allen and Michaud never have supported such a cap and are not expected to do so this year.  They have always emphasized their support for our pre-litigation screening panels.  H.R. 5 likely will pass in the House, but it will be difficult, as in past years, to achieve 60 votes in the Senate to force a substantive vote on medical liability reform in that chamber.

2.  Patient Safety.

On July 21, 2005, the Senate unanimously adopted S. 544, the Patient Safety & Quality Improvement Act of 2005, sponsored by Senator James Jeffords (I-VT).  Senator Collins is a co-sponsor of the bill.  The bill establishes a federal structure to encourage medical error reporting with strong confidentiality protections for providers, but it does not preempt state law.  The 120th Maine Legislature enacted a mandatory sentinel event reporting law in 2003 (P.L. 2001, Chapter 678, An Act to Reduce Medical Errors and Improve Patient Health).  The House is expected to take up identical legislation this week.

3.  Medicare Payment Issues. 

Congress is considering several bills addressing the Medicare physician payment formula, the Sustainable Growth Rate (SGR), and Pay-for-Performance (P4P).  The 2 primary bills designed to change the payment methodology are S. 1081, the Preserving Patient Access to Physicians Act of 2005, sponsored by Senator Jon Kyl (R-AZ) and H.R. 2356, sponsored by Rep. E. Clay Shaw (R-FL).  These bills would stop the planned Medicare payment cuts of 26% over 6 years, including a 4.3% cut scheduled for January 1, 2006 and would replace the SGR with a new formula that reflects changes in the Medicare Economic Index.  Congressmen Allen and Michaud both are co-sponsors of H.R. 2356.  Neither of Maine's Senators has yet signed on to co-sponsor S. 1081, but their staffs have repeatedly acknowledged the MMA's concerns with the Medicare payment forumula.

S. 1356, sponsored by Senate Finance Committee Chairman Charles Grassley (R-IA) is a Senate bill that would create a pay-for-performance program for Medicare providers by establishing a withhold of 1-2% to be paid to providers meeting certain quality standards.  During a House Ways & Means Health Subcommittee hearing on P4P and physician payment issues last week, Chairman Nancy Johnson (R-CT) said that P4P programs would fail if the Administration and Congress do not fix the SGR.  The AMA called P4P and the SGR "inconsistent concepts."  Also, CMS is planning to begin a Medicaid P4P initiative based upon a half dozen model states including California, Nebraska, and Vermont.

If you want more information on these bills or if you would like to communicate with members of Maine's Congressional delegation about these issues, please contact the AMA's Grassroots Action Center:

Hotline:  800-833-6354
Grassroots Action Center:  http://capwiz.com/ama/home/   

Senate Confirms Crawford as FDA Commissioner
On July 18, 2005, the Senate voted 78-16 to confirm Lester M. Crawford, a veterinarian, as Commissioner of the Food and Drug Administration.  Crawford has been Acting Commissioner of the FDA since March 2004. 

A final vote on the nomination had been held by several Senators for different reasons.  Senators Hillary Rodham Clinton (D-NY) and Patty Murray (D-WA) placed a hold on the nomination because of the FDA's inaction on Barr Pharmaceutical, Inc.'s application to sell emergency contraceptives (Plan B) over the counter.  Senators Clinton and Murray voted against Crawford in the floor vote.  DHHS Secretary Michael Leavitt assured the Senators that the FDA would act upon the application by September 1, 2005.  In late 2003, a FDA advisory panel recommended that the agency approve OTC sales of Plan B.

Senator Tom Coburn (R-OK), a physician, placed a hold on the nomination because of concerns about condom labeling.

Senator Charles E. Grassley (R-IA), Chairman of the Senate Finance Committee, voted against Crawford's nomination because he does not believe Dr. Crawford is the right person to improve the FDA's record on oversight of drug safety. [return to top]

Committee on Loan and Trust Administration Approves Loans to Maine Medical Students
The Maine Medical Education Foundation is a 501(c)3 entity designed to loan funds to Maine residents enrolled in or accepted to approved medical schools.  The MMEF Committee on Loan and Trust Administration met on Wednesday, July 20, 2005 to review 17 loan applications.  Listed below are the students that will be receiving loans from the MMEF.  Congratulations.

 Letizia Alto  $20,000
 Jessica Aslam  $10,000
 Sunny Aslam  $10,000
 Rebecca Bagley  $15,000
 Carl Barus  $14,000
 Thomas Cassidy  $15,000
 Kendra Emery  $15,000
 Megan Greenleaf  $10,000
 Brian Hagan  $15,000
 Brad MacKinnon  $10,000
 John Martel  $15,000
 Jennifer Palminteri  $12,000
 Dwight  Pringle  $15,000
 Gregory Sawyer  $  7,200
 Walter Schuyler, III  $10,000
 Evangeline Thibodeau  $25,000
 Heather Tory  $20,000

Dr. Mark Bolduc, Chairman of the Committee on Loan and Trust Administration, would like to encourage Maine medical students to submit late applications for loans.  The committee always has funds available for late applications.  If you are interested in information on how to submit your application please contact Pat Capozza at Maine Educational Services at 1-800-922-6352.  [return to top]

Legislature Expected to Return For Special Session this Friday
While the Governor has not yet issued a proclamation calling the Legislature into special session, most observers do expect Maine's 186 legislators to return to the State House this Friday, July 29, 2005, to consider a bond package negotiated by the legislative leadership.  The $83 million bond package includes the following elements:

  • $20 million for jobs;
  • $34 million for transportation;
  • $9 million for education;
  • $10 million for land conservation; and
  • $10 million for clean water, environment and health projects.
[return to top]

Maine Medical Education Foundation Loan Availability
The Maine Medical Education Foundation was established by the Maine Medical Association to make loans available to Maine residents enrolled in or accepted to approved medical schools. This loan can fill the gap between federal loan programs and the full cost of education.
Maine resident applications were due by May 1st, 2005. However, there are funds available for late applications. Loans in the program range from $2,000 to the full cost of education. Interest does not accrue while the student is in school. The loan principal may be deferred up to 36 months following graduation. Loan recipients are responsible for interest only payments during the principal deferment period.  Maximum interest on the loans is currently 5%.
For more information regarding late application loan information please contact:
Pat Capozza
Maine Educational Services Foundation
One City Center, 11th Floor
Portland, Maine 04101
Telephone: 1-800-922-6352
Website: www.mesfoundation.com [return to top]

Senate Approves Patient Safety and Quality Improvement Act of 2005

The U.S. Senate has approved the Patient Safety and Quality Improvement Act of 2005, which establishes a national patient safety data base to encourage the reporting of medical errors. The Act amends the Public Health Service Act to designate patient safety data as privileged and confidential and protects those who, in good faith, report information. The measure also requires the Secretary of Health and Human Services to maintain a network of databases for analyzing reported patient safety data, to develop or adopt voluntary national standards to promote the electronic exchange of health care information and to study the impact of medical technologies and therapies on health care. A similar version of the bill was approved by the House Energy and Commerce Commission earlier this week. Observers expect  the House to vote next week on this legislation and  MMA will provide an analysis of the final language negotiated between the two Chambers in the August 1, Maine Medicine Weekly Update.  For more information, enter S 544 ES at: http://thomas.loc.gov/
[return to top]

PhRMA Drafts Preliminary DTC Drug Advertising Guidelines
The Pharmaceutical Research and Manufacturers of America (PhRMA) Board of Directors last week gave preliminary approval to draft guidelines regarding direct-to-consumer (DTC) advertising of drugs. PhRMA is still working on the final details, specific language and a mechanism for dealing with complaints from consumers and health care professionals. When the guidelines are finished, they will go before each PhRMA member company for its consideration, voluntary adoption and implementation. The preliminary guidelines endorse informing physicians about new drugs before running DTC ads, although they don't set a time span between a drug's release and the beginning of ads. The preliminary guidelines also endorse targeting ads to age-appropriate audiences; including information about the drug risks along with the benefits; and not making false or misleading claims. Claims that are made should have substantial evidence to back them up. The guidelines encourage drug companies to promote health and disease awareness as part of their advertising, and to include information about assistance programs for uninsured and low-income consumers. Two leading consumer advocate groups have already criticized the guidelines for not going far enough. For more information:
http://www.usatoday.com/money/industries/health/2005-07-21-drug-ads-usat_x.htm?csp=34 [return to top]

CMS to Offer Physicians Free Software for EMR Systems

The Centers for Medicare & Medicaid Services (CMS) plan to give physicians free software to computerize their medical practices, the New York Times reported. The program will begin next month and offer Vista software, a well-proven electronic medical record (EMR) system that has been used for two decades by hospitals, doctors and clinics with the Department of Veterans Affairs. CMS will also provide a list of companies that have been trained to install and maintain the system. Although the software has a reputation for being difficult to install and use, CMS has been working hard to simplify it and make it easier to use. Many physicians currently use computers to file health insurance claims, but only 20 percent to 25 percent of the nation's 650,000 licenses physicians outside the military and the Department of Veterans Affairs are using EMRs. Many physicians have hesitated to install EMR systems because they are expensive and physicians worry that the companies selling them and providing support will go out of business. For more information:

http://www.nytimes.com/2005/07/21/health/21records.html [return to top]

"Protecting the Public/Restoring the Professional" Sept. 8, 2005 in Bar Harbor
The Maine Physician Health Program and the Maine Assistance Program for Lawyers team up on Sept. 8, 2005 to present a unique educational seminar on the challenges involved in balancing the needs of impaired colleagues with the public interest. Plenary sessions include talks on the pathophysiology of substance abuse disorders, protecting the public-the regulatory charge and the results of treatment in professionals with substance abuse.  The program is being held at the Harborside Hotel and Marina in Bar Harbor.

Registration is only $50 per person which includes lunch and all course materials.  The program goes from 8:45am to 5:00pm and 7 hours of CME are available.  Registration materials are available from Diane McMahon at MMA (dmcmahon@mainemed.com).

The program is co-sponsored by the Maine Board of Licensure in Medicine, the Maine Board of Osteopathic Licensure and the Maine Office of Substance Abuse. [return to top]

"Emerging Threats in Infectious Disease" Topic of 152nd MMA Annual Session
MMA is proud to present the topic of "Emerging Threats in Infectious Disease" as the theme for the upcoming Annual Session in Bar Harbor,  Sept. 9-11.  Watch for a registration brochure in your mail but if you are anxious to get registered, contact MMA at 622-3374 or via e-mail to dmcmahon@mainemed.com and a packet will be sent to you.  You may also register on-line at www.mainemed.com.  11 hours of CME are available at the meeting.

This year's Annual Session promises to be one of the best in a proud 152 year tradition.  Register now before all the good rooms are gone! [return to top]

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