January 1, 2007

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Best Wishes for a Healthy and Prosperous New Year from the Maine Medical Association

Happy New Year.  Please click below for a brief holiday message from your Association staff.  We wish you all the best for a healthy and prosperous 2007.  Thanks for all you do for the patients of Maine.

As 2006 draws to a close, the staff here at the Maine Medical Association thanks all of you readers, whether members, practice managers, corporate affiliates or friends for your support over the past year and pauses to wish you a very healthy and prosperous New Year.

It was a very busy and successful year for MMA and that would not have been possible without the strong support of all of you.  We look forward to 2007 and we count our blessings, among them being the knowledge that we represent over 2700 Maine physicians, residents and students who everyday are providing compassionate and quality care to the citizens of our state.  Thank you for all you do all year long.

We have one last wish for 2006.  We wish that every reader of the Weekly Update would take the time (it takes just a moment) to go to the MMA website at www.mainemed.com and register for access to the member's only website.  This will help ensure that you have access to the information you need on a timely basis for the coming year and beyond.

The office will be closed Monday, Jan. 1 for the New Year's Holiday but will re-open at 7:00am on Tuesday.  Happy New Year!

The Coding Center Presents Major 2007 Changes in CPT, January 4, 2007

The Coding Center's Coding Roundtable Conference Call

Major 2007 changes in CPT and YOUR questions answered!

2.5 CEUs available.
The cost is $100 for Maine, New Hampshire, and Vermont medical society member physicians and their staff, and $125 for non-members. Please have 2007 CPT books during the call.
Conference call information will be sent to registrants following receipt of registration form.
Don’t miss it!

One phone call* from your own office allows your entire staff to listen in. 

  • No travel expense
  • No time away from the office!
  • Q & A will follow presentation.

*Fee allows for one phone line per registration.  Additional phone lines require additional fee.

 Register today!
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People: Kellie Miller moves from MOA to MPCA; Judith Chamberlain, M.D. to run for AAFP President Elect

Kellie Miller, Executive Director of the Maine Osteopathic Association for the past 12 years has announced her resignation from that position, effective Dec. 22, 2006.   Kellie will be assuming a position at the Maine Primary Care Association where she will be responsible for the development and implementation of the Association's efforts regarding community planning for response to public health emergencies, with emphasis on pandemic influenza preparedness, as well as community health center preparedness.  MMA staff and officers have worked closely with Kellie over the past 12 years and wish her well in her new position.

Judith Chamberlain, M.D., Medical Director at Bowdoin Medical Group in Brunswick, has announced her candidacy for President Elect of the American Academy of Family Physicians, an organization she has been involved with for many years.  The election will take place in 2007.  MMA wishes Dr. Chamberlain well in her campaign.  During her distinquished career in both Brunswick and previously in Piscataquis County,  Dr. Chamberlain has been a tireless advocate for primary care, public health and quality improvement. [return to top]

Dirigo Health Agency Assesses $34.3 Million Savings Offset Payment

The Directors of the Dirigo Health Agency voted Thursday, Dec. 28 to proceed with collecting the $34.3 million savings offset payment (SOP) from health insurance companies and self-insured groups in order to fund the Dirigo Agency activities, including providing subsidies for the DirigoChoice product, for the coming year.

Under the Dirigo legislation enacted in 2003, the Agency is permitted to calculate annually the savings estimated to have been achieved as a result of various Dirigo initiatives.  

The Directors had delayed the assessment pending the recommendations of a Blue Ribbon Commission which was established by the Governor to study alternative means of financing the Dirigo initiatives.  The Commission made its recommendations to fund the Agency through support of the general fund enhanced by various "sin" taxes on items associated with ill health such as tobacco, alcohol and sweetened beverages.  The fact that the Agency chose to assess the full amount of the allowable SOP may be an indication of a perceived lack of support in the Governor's office or in the Legislture for the committee's recommendations.

The insurance community and the Maine State Chamber of Commerce last year filed a lawsuit contesting the legality of the assessment of the SOP and that lawsuit is still pending in the superior court.  In the meantime, the SOP for the past year is being collected. 

In defending the action of the directors in assessing the SOP for the coming year, Board Chair Robert McAfee, M.D. noted that the Agency has existing funds that will last only through March of 2007.  Although the legislature may well enact the tax increases recommended by the Blue Ribbon Commission, that action may not come soon enough to provide continued funding for the Agency operations, including the DirigoChoice product, Dr. McAfee said. [return to top]

Joint Commission Establishes Implementation Plan on Core Measure Sets

New core measure and measure set implementation timelines have been established for the Joint Commission's ORYX initiative. As a reminder, all but one (pregnancy and related conditions) of the Joint Commission's measure sets are Hospital Quality Measures, which the Joint Commission has in common with the Centers for Medicare and Medicaid Services and are endorsed by the the National Quality Forum and used for the Hospital Quality Alliance initiative. This facilitates data collection and reporting. Some timeframes rely on future NQF endorsement and HQA approval (caveats are noted).

  •  Surgical Care Improvement Project:
    • Two venous thromboembolism measures - Effective with January 1, 2007 discharges.
    • Three additional infection measures - HQA approved; implementation date is pending NQF endorsement
    • One cardiac measure - HQA approved; implementation date is pending NQF endorsement
  • Three children's asthma care measures - Effective with April 1, 2007 discharges. Two measures are NQF endorsed and one is pending NQF endorsement.
  • Critical care measure set - Effective with January 1, 2008 discharges, pending NQF endorsement.
  • Hospital-based inpatient psychiatric measure set - Will be tested in 2007 and then submitted to NQF for consideration of endorsement; an implementation date would be announced pending that endorsement.
At a later date, the following two measure sets may be reported by the Joint Commission on Quality Check pending CMS implementation and an agreement between CMS and the Joint Commission for receipt of the data from CMS. While the data would be posted to Quality Check, it will not, at this time, be used as part of the priority focus process.
  • H-CAHPS (Hospitals-Consumer Assessment of Healthcare Providers and Systems)
  • 30-day mortality measures for acute myocardial infarction and heart failure
  • 30-day pneumonia, pending NQF endorsement
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Save the Date! Annual Practice Education Seminar in Auburn on Wednesday, June 20

The Association's 17th Annual Practice Education Seminar, formerly called the Physician Survival Program, will be held on Wednesday, June 20, 2007 at the Hilton Garden Inn at Great Falls Plaza in Auburn.  This day long seminar will feature plenary sessions in the morning and twelve breakout sessions in the afternoon.  Featured topics will include pay for performance programs, quality improvement, updates on MaineCare and Medicare (including details on how to participate in the Medicare Voluntary Reporting Program effective July 1, 2007) and tiered networks.

This annual program presents MMA with its best opportunity to share relevant information and to look to the future of medical practice in Maine.

Registration materials will be included in the next three issues of Maine Medicine but you may reserve a seat by calling Gail Begin at MMA at 622-3374 ext. 210 or by e-mailing her at gbegin@mainemed.com.  You will also be able to register on-line at the MMA website at www.mainemed.com although that feature for this program will not be available until mid-January. [return to top]

Influenza Arrives in Maine

The Maine CDC announced on Friday (Dec. 29) that cases of both influenza A and influenza B among Maine residents have now been confirmed by laboratory diagnostic testing in several communities, marking the beginning of the Maine influenza season.

The following are excerpts from the Center's announcement, which was released by Dora Anne Mills, M.D., M.P.H., Public Health Director.

    "Clinicians should consider influenza in the differential diagnosis of febrile respiratory illnesses in patients of any age, encourage their high risk patients to be immunized against influenza if they have not already done so, and review updated recommendations on the use of antiviral medications for influenza prophylaxis and treatment.

  • Vaccine supply is still plentiful and high-risk patients should be vaccinated as soon as possible.  Contact the Maine Immunization Program at 287-3746 if you have questions about obtaining vaccine.
  • The ACIP has recommended that neither amantadine or rimantidine be used for treatment/prophylaxis of influenza A or influenza B during the season.  Detailed recommendations on use of oseltamivir (Tamiflu) and zanamivir (Relenza) for both treatment and prophylaxis of influenza A and influenza B are available through the link below. 
  • When influenza is first detected in an community by use of rapid diagnostic testing, consider sending some specimens to the Maine Health and Environmental Testing Laboratory for culture confirmation (for more information contact Anne Sites at 1-800-821-5821)."

For focused, up-to-date information/recommendations on influenza for health professionals, go to http://www.cdc.gov/flu/professionals/ [return to top]

Maine One of Three States Adequately Funding Tobacco Prevention Programs

Nearly all states have faltered badly when it comes to using their l998 tobacco settlement money to fund smoking prevention programs, according to a new report, "A Broken Promise to Our Children: The l998 State Tobacco Settlement Eight Years Later."   The report was released by the Campaign for Tobacco-Free Kids, the American Heart Association, the American Cancer Society and the American Lung Association.

Only three states - Colorado, Delaware and Maine - currently are funding tobacco prevention programs at minimum levels set by the Centers for Disease Control and Prevention, according to the report.

The American Medical Association expressed concern at the report's findings. "Particularly alarming, despite the intent of the tobacco settlement agreement, is that most states are diverting these funds to non tobacco-related programs,"  said current AMA President William G. Plested, III, M.D.

MMA Executive Vice President Gordon Smith noted the extraordinary advocacy of Maine CDC Director Dora Anne Mills and the strong support of both Governor King and Governor Baldacci in insisting that the majority of the funds be used in smoking cessation and prevention.  He also praised the work of the major voluntary health organizations (lung, cancer, heart), MMA, MHA and Blue Cross Blue Shield of Maine in establishing the Maine Coalition on Smoking OR Health in l980.  "The twenty six year history of our coalition demonstrates probably the most successful advocacy on this issue in the country.  The fact that Maine has the toughest anti-tobacco laws in the country and nearly the highest cigarette tax in the country is directly attributable to the work of the coalition, its founders and volunteers.," Smith said. [return to top]

Maine Medical Association Top 10 Legislative Successes of 122nd Maine Legislature

  1. Secured a $3 million General Fund increase in MaineCare (Medicaid) reimbursement for physicians and other individual practitioners, infusing approximately $8.3 million in state and federal dollars into the fee schedule and bringing MaineCare rates up to approximately 53% of Medicare rates.
  2. Negotiated interim payments from the Department of Health & Human Services to assist practices experiencing cash flow problems because of the MaineCare Claims Management System (MECMS) conversion and obtained $1 million to reimburse practitioners for interest costs incurred on lines-of-credit because of problems with the MECMS conversion.
  3. Raised the cigarette excise tax by $1.00 to a total of $2.00 per pack to avoid cuts in state health care programs and to discourage Mainers from smoking.
  4. Enhanced Maine’s medical liability laws by enacting a so-called I’m sorry provision prohibiting a practitioner’s statement of apology or sympathy to a patient who has experienced an unanticipated outcome of a medical service from being admitted as evidence of liability in a civil action.
  5. Established a process to ensure the accuracy and credibility of physician-specific quality data before its release to the public by the Maine Health Data Organization (MHDO) or the Maine Quality Forum (MQF).
  6. Maintained a provision of the Dirigo Health Program law setting aside 12.5% of the Capital Investment Fund (CIF), the annual cap on spending for health care projects subject to certificate-of-need (CON) review, for non-hospital projects.
  7. Established a maternal and infant death review process so that Maine has a multidisciplinary effort to reduce the rate of maternal and infant death.
  8. Pursued amendments to the MaineCare drug management program to promote the quality of care and reduce the administrative burdens in the prior authorization process.
  9. Protected physicians’ interests in the implementation of the access, cost containment, and quality improvement provisions of the Dirigo Health Program.
  10. Increased the upper limit available per physician from $10,000 to $15,000 for medical liability insurance premiums through the Rural Medical Access Program, a state effort to maintain obstetric services in rural areas of Maine.
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123rd Legislature Re-Convenes on Wednesday, Jan. 3, Followed by Governor's Inauguration

The 123rd Maine Legislature re-convenes on Wednesday for a 4:00pm session.  The unusual timing of the session is due to the inauguration of Governor Baldacci later that evening in a ceremony at the Augusta Civic Center.  An Inaugural Celebration will be held the next evening, Jan. 4, also at the Augusta Civic Center.

The First Regular Session formally began in early December but the session was recessed for the holidays.  Over 2400 pieces of legislation have been submitted and a list of all the bills by title and brief description should be available later this week.  MMA's POLITICAL PULSE, which presents weekly information on the status of bills of interest to physicians, will be published each Friday during the session, beginning later this month.  If you would like to receive it, send a message to Charyl Smith at csmith@mainemed.com or to Andrew MacLean at amaclean@mainemed.com.

The session is expected to last well into June.  Don't forget Physician's Day at the Legislature on Thursday, March 29th.  It presents an opportunity for Maine's medical community to meet with legislators and helps to develop a better understanding of the legislative process.

MMA has a very pro-active legislative strategy for the session and has drafted six bills for consideration.  The Legislative Committee, chaired by Katherine Pope, M.D. and co-chaired by Sam Solish, M.D. will meet during the session to oversee the progress on these bills and to help determine appropriate positions on the many other bills of interest. [return to top]

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