September 5, 2005

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Hurricane Katrina Relief Efforts Continue: How You Can Help!
The federal Dept. of Health and Human Services is mobilizing health care professionals and relief personnel to assist in Hurricane Katrina relief efforts. Physicians and other medical professionals with any state license who can commit to short-term, long-term or rotating coverage are urgently needed in Louisiana, Mississippi, Alabama, Florida and Texas.
Visit the HHS Health Care Professionals and Relief Personnel Volunteer Page at to sign up. You may also call the Hurricane Katrina Volunteer Call Center at 866-528-6334.

Physicians and medical societies all over the country are concerned and anxious to assist.  MMA first broadcast its Special Alert to members on Wednesday, August 31, directing them at that time to contact the Maine Emergency Management Agency at 207-624-4400 or 1-800-452-8735 to volunteer.  The AMA has been in contact with the Emergency Operations Centers at the Dept. of Health and Human Services, the Centers for Disease Control and Prevention, and other agencies to assist with a coordinated medical response.  The AMA and MMA are also in contact with the state medical societies in the affected states to see how we can be helpful.

Members who are unable to volunteer but wish to assist in other ways, may donate to one of the following voluntary organizations designated by the Federal Emergency Management Agency.

  • American Red Cross 800-435-7669 (or
  • Salvation Army 800-725-2769

Because the President has declared a state of emergency, your Maine medical license is valid in the state you volunteer to practice in.  The situation is still very fluid and if additional information becomes available, we will share it with you through Maine Medicine Weekly Update or through a Special Alert such as that sent out last week.

MMA President Lawrence Mutty, M.D., MPH has advocated for physician volunteerism throughout his term as President.   At the conclusion of his term, it now appears that the need is truly greater than ever.  Please do whatever you can, in whatever way you can,  to assist in the relief effort.

Senator Susan M. Collins at MMA Annual Session in Bar Harbor this Weekend!
United States Senator Susan Collins will attend the opening reception at MMA's 152nd Annual Session this weekend.  The reception will be held from 6:00pm to 7:30pm on Friday, Sept. 9 at the Harborside Hotel and Marina.  The Senator will speak at approximately 6:30 p.m.  In addition to briefing attendees on the attempt by Congress to fix the Medicare payment problem, the Senator will, no doubt, want to talk some about the hurricane relief effort and her role as the Chairman of the Homeland Security and Governmental Affairs Committee which has jurisdiction over the Department.  She has already called for an investigation into the matter.

Senator Collins also serves on the Armed Services Committee and the Special Committee on Aging.  Previously, she served for six years on the Committee on Health, Education, Labor and Pensions.

Senator Collins was elected to represent the State of Maine in the United States Senate in 1996 and was re-elected to a second term in 2002.  She is a native of Caribou and is a 1975 graduate (magna cum laude) of St. Lawrence University.  Prior to seeking office herself, she worked for Senator William S. Cohen and Governor John R. McKernan in a variety of capacities.

As previously announced, Governor John E. Baldacci will speak at the meeting on Saturday morning at approximately 11:30 a.m.  Prior to the opening of the membership meeting on Saturday morning, DHHS Commissioner John Nicholas will present an update on MaineCare.

While most rooms in the Harborside Hotel are sold out, additional members and guests can be accommodated at the nearly Regency Hotel (with complementary shuttle service to the meeting site).  If you are interested in attending any portion of the meeting, including the 11 hour CME program on emerging infectious diseases,  call Diane McMahon at MMA today (622-3374) and she will assist you.  Don't miss this once-a-year opportunity to find out what is going on in Maine medicine and what you can do about it. [return to top]

MECMS Claims Update
DHHS Commissioner Jack Nicholas and Deputy Commissioner Mike Hall both communicated with MMA staff last week to comment on last week's report on the current status of the MECMS system.  Specifically, the Commissioner has promised to have the troublesome crossover claims processed before the end of the year (Feb. had been noted in last week's report).  The Commissioner stated that he would give a more specific date when reporting to MMA members at the Annual Meeting this Saturday. (8:30 a.m)

MMA appreciates the Commissioner and Deputy Commissioner taking the time to attend the Annual Session and appreciate their personal efforts in trying to fix the system and to be as responsive as possible.  It was through their efforts, and MMA advocacy, that interim payments were established for many physician offices (originally, physician offices were not on the list for prospective interim payments).  It was also through their efforts, and that of Medical Director Laureen Biczak, D.O. that the 15% physician fee increase, effective July 1, 2005 came to pass.

As has been widely reported in the media,  the patience of MaineCare providers is wearing thin.  More resources need to be dedicated to the effort to fix the claims payment system and to restore a culture of customer service within the Office of MaineCare Services. 

The Provider Advisory Committee meets again this Thursday, Sept. 8, to receive an update from the Department.  The results of this meeting and the substance of the Commissioner's remarks in Bar Harbor will be shared in next week's Update.

In the meantime, it goes without saying, that both the State and MMA appreciate the hundreds of physicians who continue to see MaineCare patients under these difficult circumstances.  We certainly believe that relief is on the way.

As has been previously noted in this publication, MMA can frequently intervene with DHHS to help a particular office.  Please let us know if we can be helpful in any way, by sending an e-mail to Gordon Smith at [return to top]

Program on Impaired Professionals to be Held on Thursday, Sept. 8 in Bar Harbor
Nearly one hundred attendees are now expected for Thursday's "Protecting the Public/Restoring the Professional," a CME program (7 hours of category one credit available) sponsored by:

  • The Maine Medical Association
  • The Maine Physician Health Program
  • The Maine Assistance Program for Lawyers
  • The Maine Board of Licensure in Medicine
  • The Maine Board of Osteopathic Licensure and
  • The Maine Office of Substance Abuse (OSA)

The Program will be held at the Bar Harbor Club at the Harborside Hotel and Marina in downtown Bar Harbor, beginning with a continental breakfast at 8:15 a.m.  The first Plenary session, entitled, "Pathophysiology of Substance Abuse Disorders,"  will be presented by Michael Gendel, M.D., Clinical Director of the Colorado Physician Health Program.  Dr. Gendel is currently serving as President of the Federation of State Physician Health Programs.

The afternoon Plenary Presentation will be on "Outcomes Research,", given by Michael Sweeny, J.D. who directs the Oregon Lawyers' Assistance Program.  The day concludes with all the Plenary speakers discussing , "What Should the Future Hold,", moderated by David Simmons, M.D. and David Kee, J.D.  Dr. Simmons and Attorney Kee direct the impairment programs in Maine for physicians and lawyers, respectively.

It is not too late to register for the program, and the registration fee is only $50 which includes breakfast, lunch and all materials.  Call Diane McMahon at 622-3374 to register.  You can just show up, but an addition $15 will be charged. [return to top]

MaineCare Drug Utilization Review Committee to Meet Tuesday, Sept. 13, 2005
The MaineCare Drug Utilization Review Committee will meet on Tuesday, Sept. 13, 2005 in Conference Room 1A&B at the Department of Health and Human Services/ Office of MaineCare Services, 442 Civic Center Drive, Augusta from 6:00 to 8:00 p.m.  The public comment period will begin at 6:00 p.m.

The agenda includes an update on the Adderall mailing and the Thiazolidinedione/CHF mailing, the situation with the Atypicals and New Business, including:

  • Asmanex
  • Atrovent HFA
  • Byetta
  • Symlin
  • Equetro
  • Niravam
  • Aptivus
  • Revatio
  • Ventavis
  • Levaquin
  • BC patch
  • Aldara/5FU skin cancers -SR accepted
  • Suboxone/subutex and ongoing narcotic use - PA implemented
  • Formulary - preliminary discussion.
[return to top]

First of "First Fridays" CME Programs a Success; Next Program, Oct. 7, 2005
With good support from local practices, the MMA's attempt to establish a series of  educational programs to be held at MMA on the first Friday of each month was very successful.   This past Friday, Sept. 2, nearly 40 attendees heard attorneys Ken Lehman, Andrew MacLean and Gordon Smith discuss, "Minors' Healthcare;  Rights, Responsibilities and Consent."

The next program will be on Friday morning, Oct. 7 and the topic is Preventing Prescription Drug Abuse.  Among the talks will be a presentation on the state's new prescription monitoring program and how it can be used to help your practice.  Maine DEA Chief Roy McKinney will also provide an update on what the current status is of prescription drug abuse in Maine.  Gordon Smith will offer practical tips on preventing diversion, through the use of narcotic contracts and other techniques.  Registration is only $60 which includes breakfast and all program materials.  Register now with Chandra Leister at or you may call her at 622-3374.

Don't delay as the room can only comfortably seat 40 persons, classroom style. [return to top]

Shopping for an EMR System? We Can Help on Sept. 28
The Maine Medical Group Management Association and MMA team up on Wednesday, Sept. 28, 2005 to present "Tech Talks" at the Augusta Civic Center.  Part trade show, part education presentation, part conference, this dynamic, day-long event is designed with the small and medium size medical practice in mind.  Intended to provide physicians and practice managers with a "hands -on" experience, the presenters are primarily practicing physicians who have successfully implemented a technology project in their offices. 

Presenters include Drs. Daniel Mingle, Michael Parker, Daniel Friedland and Joel LaFleur.  These physicians have either successfully put an electronic medical records system into an office setting or are currently in the process of doing so.

Confirmed vendors at the event include eClinicalWorks, Healthvision, Network Systems, Northern Data Systems and the Record Management Center.  NextGen and Allscripts have been invited and are hoped to be heard from shortly.

The program begins with an overview of how to choose a vendor, followed by a talk on the linkages between technology and "pay for Performance."  At 2:00 p.m., Dr. Lawrence Rammunno, M.D., M.P.H. , Clinical Coordinator for the Northeast Health Care Quality Foundation will present on "DOQ-IT", the physician office quality improvement initiative of CMS and the Foundation.

Additional talks include,"Legal Issues with Electronic Medical Records," (Mike Duddy, Esq.) and a presentation on Ergonomics.

Registration is only $40 for the day which includes breakfast, lunch and all program materials.  Call 622-3374 for a registration packet today! [return to top]

CMS to Host National HIPAA National Provider Identifier Roundtable Conf. Call
CMS will host a National Provider Identifier (NPI) Roundtable conference call on Sept. 14, 2005 at 2:00 PM ET.  The call in number is 1-877-203-0044 and the identification number is 5580762.  There is no cost or registration required.

The identifier numbers are now available for application by all physicians who conduct electronic transactions, as well as by other HIPAA "covered entities."  After May 23, 2007, all healthcare providers and plans will be required to use and accept only NPIs in standard transactions (small health plans will have one extra year).  By replacing the various unique identifiers currently used by physicians when dealing with different payers, the NPI works toward fulfilling HIPAA's administration simplification goals.

Application for an NPI can be accomplished online at, by requesting a paper application to the same web site or by calling 800-465-3203.

Group practices should decide ahead of time whether physicians will file for NPI's individually or as a group this Fall.

Upon receiving a NPI, physicians should abstain from using the number when transacting with a particular health plan until that plan notifies the physician that it can accept the NPI.

Between May 23, 2005 and Jan. 2, 2006, Medicare claims processing systems will accept an existing legacy Medicare number and reject as unprocessable any claim that includes only an NPI.  Beginning Jan. 3, 2006, and through Oct. 1, 2006, Medicare will accept an existing legacy number or an NPI as long as it is accompanied by an existing legacy number.  Beginning Oct. 2, 2006 and through May 22, 2007, Medicare systems will accept an existing legacy claim and/or an NPI.  After May 23, 2007, only an NPI will be accepted by the Medicare program. [return to top]

Maine Primary Care Association 2005 Annual Conference and Clinical Symposium, Oct. 5-7, So. Portland
"Innovations in Quality Care:  Advancing Access for All In Maine," is the theme of this year's Annual Conference and Clinical Symposium sponsored by the Maine Primary Care Association.  The program will be held Oct. 5-7 at the Marriott in South Portland. 23 CME credits have been applied for with subjects ranging from improving quality through systems design to treatment of pediatric asthma.

Contact the Maine Primary Care Association, 73 Winthrop St., Augusta, Maine 04330 for registration materials.

The Maine Primary Care Association represents the interests of 18 federally qualified rural health centers in the state. [return to top]

Advanced Directives/DNR Orders the Subject of Legislative Inquiry
The hearing room usually reserved for the legislature's Joint Standing Committee on the Judiciary was the site August 22 of a meeting of  several parties called together to discuss the current Maine laws regarding advanced directives and DNR orders.

The meeting was requested by the Judiciary Committee after it received a communication from a legislator who had a constituent who felt that Maine's laws were either inadequate or that the public needed to be better educated about the relationship between an Advanced Directive and a Do Not Resuscitate Order.

Among the attendees, which included Gordon Smith from MMA, was EMS Office Director Jay Bradshaw who described the process that EMS personnel use when confronted by an advanced directive but no DNR.  In such a circumstance, the EMS personnel do attempt to resuscitate the patient.  Only when the so-called "orange form" or orange bracelet is utilized will EMS not attempt to resuscitate.

The attendees had a long discussion of the impact of the existing law and the need for public and provider education. The possibility of using a universal form such as has been attempted in Oregon was discussed.   Another meeting is anticipated for October. [return to top]

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