July 17, 2006

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MMA Executive Committee to Meet on July 26

The 28 member MMA Executive Committee will meet next week, on July 26, to review a number of items relating to the 153rd Annual Session, being held this year Sept. 8-10 in St. Andrews-by-the-Sea, New Brunswick, Canada.  Included on the agenda is the first review of a proposed budget for 2007, a report from the nominating committee, and a review of anticipated resolutions to be considered at the Annual Meeting.  Also on-tap is a discussion of the need to review contemporary governance processes in determining whether to continue to enlarge membership on the Executive Committee.  Members may register for the meeting online at the MMA website at www.mainemed.com


The educational component of this year's Annual Session is entitled, "Medicine in Extreme Environments" and features keynote presentations by NASA Astronaut and surgeon Story Musgrave, M.D. and Donald Palmisano, M.D., J.D.  Dr. Palmisano is a former President of the American Medical Association.  Six and one-half hours of CME is available. The meeting will be held September 8-10, 2006, at the Fairmont Algonquin in St. Andrews, New Brunswick.

Brochures containing registration materials have been mailed to each MMA member.  Register today by going online to www.mainemed.com

The Executive Committee is chaired by William Strassberg, M.D., an orthopedic surgeon practicing in Ellsworth.

Report on Maine Quality Forum Advisory Committee Meeting

The Maine Quality Forum Advisory Committee met on Friday (July 14) and considered several issues of interest to physicians.  Much of the meeting consisted of a discussion of the assessment of progress on the MQF Five Year Goals.  The goals include publishing provider specific quality data that supports:

  • Informed Patient Choice
  • Provider competition on quality
  • Compliance with best practices
  • Information for Pay for Performance by others
  • Useful feedback to providers to support QI efforts
  • Identification of best providers
  • Longitudinal analysis

Other goals include publishing data describing Mainer's health status, maintaining a public interaction program through establishment of an interactive website and implementing the sharing of health information among unallied providers.

Council members heard a presentation on rebuilding the current website and using AHRQ data to provide state snapshots comparing Maine's hospital quality performance with the other New England states.

The Council also heard an update on the MQF "In A Heartbeat" Project.  The goals of the Project are to improve the care, quality of life and survival of people in Maine who experience Acute Myocardial Infarction.  Each patient in Maine suspected of having an acute myocardial infarction, will receive necessary care, at the right time, given Maine's limitations of geography, healthcare infrastructure and transportation.  All providers of care will follow an agreed upon flexible system of care - to maximize the effectiveness of each patient's treatment through minimization of time to treatment and maximization of appropriateness of treatment.  The purpose of the project is to develop metrics of process and outcome that support evidence of achievement of common goals regardless of local chain of care decisions.  Indicators of process and outcome will be followed sufficiently to continually maximize the quality (safe, timely, effective, efficient, equitable, and patient-centered) of the process.  Gus Lambrew, M.D., of Portland is the Medical Director of the Project.

The Council will meet next on Friday, Sept. 8 in Augusta.  Rebecca Colwell chairs the Council and Robert Keller, M.D. is the Vice-Chair. [return to top]

Avian & Pandemic Flu Newsline Available Now
The latest issue of the Maine CDC's Avian & Pandemic Flu Newsline is available online now. Go to www.maineflu.gov and click on Latest Flu-Related News. [return to top]

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Let's Talk About Drugs: OMS Pharmacy Division Wants to Hear from You

Let’s Talk About Drugs

This fall, Office of MaineCare Services (OMS) Pharmacy Division will tour the state to hear from you about . . .

  • MaineCare pharmacy benefits,
  • Discount prescription drug programs sponsored by the state,
  • Prior Authorization,
  • Preferred Drug List (PDL), 
  • Medicare D, and, 
  • Whatever else is on your mind about MaineCare and drugs. 

OMS can add or delete topics to focus on your interests and priorities.  OMS’s goal is to get your feedback for future improvements.  On Prior Authorization, OMS will summarize recent trends and listen to your experiences getting drugs approved.  They will explain the PDL and how it is developed.  They will also discuss how the state works with Medicare D plans, including how and who qualifies for the State’s wrap-around drug programs. 

There will also be time for open discussion of other issues.  The entire presentation will take less than an hour. 

The OMS Pharmacy Division staff can be part of one of your regularly scheduled meetings, or can host a special meeting.  If you would like to have OMS at your meeting, please contact Bruce McClenahan at 287-4018 or by e-mail Bruce.McClenahan@Maine.gov <mailto:Bruce.McClenahan@Maine.gov>.  [return to top]

Senate Approves Prescription Drug Import Plan

The U.S. Senate has approved (in a 68-32 vote) a proposal to allow Americans to import prescription drugs from Canada. However, according to the New York Times, the proposal will probably be rejected when the House-Senate conference committee negotiates the final version of the Department of Homeland Security $31.7 billion budget for next year. Besides posing possible consumer safety issues, opponents are concerned about the risk of terrorism. For more information:
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The Coding Center's Coding Tip of the Week

Chief Complaint -- Every Evaluation and Management encounter must include a chief complaint.  This includes inpatient hospital and nursing facility services.  If the chief complaint is not documented or is unclear, your service cannot be coded or billed. Be specific; a chief complaint of “follow-up” is not sufficient however “Follow-up for Hypertension” is acceptable.

Questions? Call the Coding Center: 1-888-889-6597 [return to top]

Update on Voluntary Practice Assessment Project

The MMA/MOA Voluntary Self-Assessment Project now has both a physician consultant and a Project Director.  Lisa Letourneau, M.D., MPH is the physician consultant to the project and Jean Eichenbaum of Portland has been named the Project Director.  Ms. Eichenbaum will also serve as staff to the Learning Network established by Quality Counts!  She has previously held positions at the Portland Press Herald and Mercy Hospital where she remains a Board member.  She is currently pursuing a Master's Degree in Health Administration from the Universityof North Carolina.

The purpose of the Project, funded by the Maine Quality Forum, is to offer a confidential assessment of the quality of care provided in fifty or more primary care practices.  The quality metrics to be used will be determined at an upcoming meeting of the Committee on Quality Improvement and Peer Review but is likely to involve looking at diabetes care and CVD for adults and asthma and vaccinations for children.

The Project is particularly interested in assisting practices which are privately owned and not associated with an existing PHO.  But all requests will be considered and any practice interested in participating should contact MMA for more information and an application form.  Call 622-3374 and press 0 to talk to Gordon Smith, Andy MacLean or Warene Eldridge.
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CMS Announces Payment Hold on Medicare Claims

The Centers for Medicare & Medicaid Services (CMS) has announced a Medicare payment hold for claims during the last 9 days of the federal fiscal year, September 22 through September 30. All claims held will be paid on October 2. Interest will not be accrued and late penalties will not be paid to an organization or individual as a result of this one-time hold on payments. The hold policy applies only to claims subject to payment, not to full denials, no-pay claims, and other non-claim payments, such as periodic interim payments, home health requests for anticipated payments, and cost report settlements. The CMS payment delay is mandated by section 5203 of the Deficit Reduction Act of 2005. For more information, please view the MLN Matters Article at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5047.pdf .
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Maine AAP Fall Educational Conference and Open Forum on Early Childhood: From Risk to Resilience to Practice, November 4, 2006
November 4, 2006
Black Bear Inn, Orono, ME

Maine AAP Fall Educational Conference and Open Forum on Early Childhood: From Risk to Resilience to Practice
Featured Topics and Speakers:

Adverse Childhood Experiences (ACES): Dr. Vincent Felitti, MD, nationally known for his work on the Adverse Childhood Experiences Study, will discuss the link between early childhood traumas and adult health outcomes.  

Resilience and Protective Factors: Emmy Werner, PhD, nationally known for her 40-plus years of experience studying  reproductive and environmental risk factors as well as resilience and recovery protective factors in the entire birth cohort for the year 1955 on the Hawaiian island of Kauai.

Interactive discussions with other experts in the fields of pediatrics, family medicine, child development, mental health, public health, parent advocacy, legislation, politics, and early childhood services will provide participants with better understanding and skills to help create protective households  and communities for the children of Maine. 

Invited Audience: pediatricians, family physicians, other health professionals, early childhood development experts, early childhood service providers, parents, mental health providers, legislators, child and family advocates...Anyone wishing to make change towards a humane and culturally competent early childhood system for Maine.

Co-Sponsored by: Maine Early Childhood Initiative and Maternal and Child Health Program (Maine Center for Disease Control and Prevention, Department of Health and Human Services).

For more information: Aubrie Entwood, Executive Director, Maine AAP,
207-685-9358 or agridleyentwood@aap.net.      www.maineaap.org      [return to top]

Dr. Paul Klainer Honored for Service to the Knox County Health Clinic

Dr. Paul Klainer was recently honored by the New England Patriots Charitable Foundation for his work with the Mid-Coast Health Net and the Knox County Health Clinic where he is the medical director. The clinic operates under the auspices of Mid-Coast Health Net, a non-profit organization.

Dr. Klainer was awarded the grand prize of $10,000 by Robert Kraft, chief executive officer and chairman of the Patriots, during the Community MVP Awards program at Gillette Stadium in Boston. The award acknowledges individuals who have demonstrated extraordinary dedication, leadership and commitment to their communities. "I am both honored and grateful to be selected as your 2006 Community MVP," said Klainer as he was presented with the award. "But I really need to accept this on behalf of all the other volunteers who have made this possible."

Dr. Klainer was the driving force behind the founding of the Mid-Coast Health Net in 1999. After retiring from a 20-year practice in emergency and internal medicine in Massachusetts, Dr. Klainer recognized the need for a free clinic and prescription program in the midcoast area. After training 30 volunteers, he opened the Knox County Health Clinic. While serving as the medical director and president of the board of directors of the organization—both volunteer positions—Dr. Klainer continues to be the primary care provider, and is also readily available for medical questions from patients during non-clinic hours.

In 2001, the clinic's dental program was started and has since logged 690 dental visits and over 725 visits with the staff hygienist. In 2003, the Prescription Assistance Program, which helps patients who cannot afford their medications, was initiated. To date, the clinic has saved 269 patients $785,105 on 2,454 prescriptions. The clinic hopes to exceed $1,000,000 in savings by the end of 2006.

"The Mid-Coast Health Net is a grass roots organization and I was fortunate to arrive in Rockland at the right time to be the catalyst," said Klainer. "It is truly my privilege to bring the dedicated volunteers together to provide healthcare access and needed medications for those that otherwise would have none. We are a Band-Aid on a much larger medical care access problem, but we do what we can to improve the quality of life in the midcoast."

"We are thrilled Dr. Klainer has won this award," said Bentley Snow Davis, Director, Knox County Health Clinic. "Because of his initiative, hundreds of lower-income, uninsured neighbors have quality healthcare. I am certain that if everyone had that same sense of community involvement and spirit of volunteerism as Dr. Klainer, the world would be a better place."

Dr. Klainer is a graduate of Colby College and Tufts University School of Medicine. He completed his residency in Internal Medicine at the University of Massachusetts Medical Center in Worcester, Massachusetts. He practiced emergency medicine for 18 years while serving on numerous state committees and boards concerning emergency medical services and access to medical care. Dr. Klainer and his wife, Jeanne, live in Owls Head, Maine. Their daughter, Suzanne, graduated from medical school this year.

For additional information about the Knox County Health Clinic and to volunteer or to make donations, please call Bentley Snow Davis at 594-6996.

Courtesy Pen Bay Healthcare [return to top]

DHHS To Hold Informational Sessions on Managed Care Initiative

The Maine Department of Health and Human Services is planning a series of meetings around the State to talk with consumers and families about its plans for implementing managed care for mental health and substance abuse treatment services. We would appreciate it if you would encourage the consumers with whom you work to attend one of these sessions. While the intended audience of these meetings is consumers and families, you are most welcome to attend.

For each day listed below, they will hold two meetings. Each meeting will cover the same information. Each day will have a meeting at 2:30 to 4:30 pm and then again from 6:00 to 8:00 pm. Here is the schedule:

Monday, July 24, 2006

Rockland DHHS Office, Conference Rooms A & B
91 Camden Street, Suite 103
Rockland, ME 04841

Portland DHHS Office, Conference Rooms A & B
161 Marginal Way
Portland, ME 04104

Sanford DHHS Office, Conference Rooms A & B
890 Main Street
Sanford, ME 04073

Biddeford DHHS Office, Conference Rooms A & B
208 Graham Street
Biddeford, ME 04005

Bangor DHHS Office, Pooler Pavilion, 2nd floor
176 Hogan Road
Bangor, ME 04401

Wednesday, July 26, 2006

South Paris DHHS Office, Conference Room near Reception
243 Main Street, Suite 6
South Paris, ME 04281

Farmington DHHS Office, Conference Room B
114 Corn Shop Lane
Farmington, ME 04938

Lewiston DHHS Office, Conference Rooms A & B
200 Main Street
Lewiston, ME 04240

Augusta DHHS Office, Conference Rooms C & D
35 Anthony Avenue
Augusta, ME 04330

Skowhegan DHHS Office, Large Conference Room
98 North Avenue, Suite 10
Skowhegan, ME 04976

Caribou DHHS Office, Conference Rooms A & B
30 Skyway Drive, Unit 100
Caribou, ME 04736

Dover-Foxcroft DHHS Office, Sebec and Borestone Rooms
125 Summer Street
Dover-Foxcroft, ME 04426

Thursday, July 27, 2006

Ellsworth DHHS Office, Conference Room A
17 Eastward Lane
Ellsworth, ME 04605

Machias DHHS Office, Conference Room 1A
13 Prescott Drive
Machias, ME 04654 [return to top]

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