May 7, 2007

 
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New Hampshire Federal Court Strikes Down Ban on Purchase of Physician Data

Following the New Hampshire legislature's passage of a prescriber data confidentiality bill last session, state legislatures around the country are considering similar bills and more litigation is likely.  The Vermont legislature is considering similar legislation and the Maine legislature had three such bills before it this session.  On Friday, the Health & Human Services Committee voted by a 12 - 1 margin to recommend passage of a statute permitting all health care practitioners with prescribing privileges to prohibit the commercial use of their prescribing data through an "opt out" system based upon the licensing boards.  The bill is L.D. 4, An Act Protecting the Confidentiality of Prescription Information.  IMS Health, one of the leading health information companies, likely will challenge Maine's law in the courts.

The U.S. District Court in New Hampshire found that the state did not have the same interest in protecting the confidentiality of prescriber data as patients' personal data and found that the New Hampshire law infringed upon the health information companies' commercial speech rights protected by the First Amendment to the U.S. Constitution. 

Despite court ruling, doctors can still restrict the use of their prescribing data.  In the wake of this ruling, the AMA reminds all physicians that they can still elect to prevent pharmaceutical sales representatives from accessing their data through the AMA Physician Data Restriction Program (PDRP).  The PDRP empowers physicians to opt out of sharing prescribing data with pharmaceutical sales representatives.  But, it keeps the data available for researchers to advance important public health benefits, such as timely and appropriate communication about drug recalls and evidence-based medical research.  The AMA does not collect, sell or have access to prescribing data, but rather provides a way for doctors to determine how their data will be used.  All physicians, whether AMA members or not, are eligible for the PDRP.

During the debate on L.D. 4 and related bills, the AMA and the MMA promoted the PDRP as a reasonable alternative to this approach that uses state resources to establish a single state program that duplicates the intent of the PDRP.  At the work session last Friday afternoon, the MMA presented a proposed committee amendment to the bill that would have directed the AMA and the MMA to further publicize the PDRP, required the AMA to enhance the protections in the PDRP, and developed an "opt out" process for non-physician prescribers.  The HHS Committee expressed no interest in this approach.

Dirigo 2.0 Details Announced

The Governor’s new health care bill has been sent back from the revisers’ office and sponsored by Majority Leader Hannah Pingree of North Haven and cosponsored by Senate President Beth Edmonds of Freeport. Click here for a summary of the bill [pdf].  A public hearing will be held on the proposal on this coming Friday, May 11 at 1:00pm before the Committee on Insurance and Financial Affairs.  Association representatives will attend to present the MMA testimony.

Entitled, "An Act To Make Health Care Affordable, Accessible and Effective for All,", L.D. 1890 has thirteen different sections amending a number of existing laws and creating some news one.  Of particular interest to MMA is Part I, which establishes a health care shared responsibility program to require certain employers and individuals who do not offer or take up health insurance to pay a fee toward coverage of the uninsured. This section directs Dirigo Health, in consultation with representatives from the business, labor, economic development, taxation, consumer, insurance and health care communities along with other interested stakeholders, to adopt major substantive rules to implement this program and to address the concerns for affordability and fairness and the impact on the business climate.

The Maine Medical Association has endorsed the concept of an individual health insurance mandate since 2003 when it issued its white paper on Health System Reform.  The AMA also endorses an individual mandate for individuals earning over 500% of the federal poverty level. [return to top]

Hanley Center for Health Leadership Announces Statewide Health Leadership Development Program

The Daniel Hanley Center for Health Leadership and the Institute for Civic Leadership (ICL) are pleased to announce the establishment of a major new statewide Health Leadership Development (HLD) program!
25-30 emerging and evolving healthcare leaders from across Maine will be selected for the inaugural class that will be assembled this fall for a 14-day multi-month program that will take place in central Maine.
Participants will develop a wide range of core leadership competencies and build their knowledge of key issues, trends and public policy through case studies, speakers and readings.

WHO SHOULD APPLY ? Each year's HLD class will include a diverse mix of clinicians, administrators, public health leaders, government officials and policymakers, educators, payers, volunteers, employers, consumers, attorneys and others. 

WHY HAS THIS PROGRAM BEEN DEVELOPED? Maine's healthcare environment is becoming more complex and competitive than ever before. Maine needs more leaders with the vision, skills and relationships to effectively tackle complex issues and build a strong health delivery and coverage system for the future.

WHO HAS DEVELOPED THE PROGRAM? The HLD program has been developed with the active involvement of an Advisory Committee that includes a wide range of stakeholders from throughout Maine.

NOMINATE A COLLEAGUE FOR THE HLD PROGRAM---OR APPLY YOURSELF: Use the Nomination Form [pdf] to list the names of colleagues are poised to take on increased leadership responsibility in the months and years ahead.  Individuals nominated for the program will receive a letter inviting them to apply. They will also receive a program calendar, tuition and scholarship information and more background.  Email, fax or mail your completed nomination forms today to Jim Harnar at jharnar@maine.rr.com so that prospective candidates receive their invitations right away!

DEADLINE: Deadline for Applications is May 20, 2007

FOR MORE INFORMATION:  Visit our the Daniel Hanley Center for Health Leadership website or contact Jim Harnar at jharnar@maine.rr.com [return to top]

4th Annual Corporate Affiliate Breakfast a Success

Over 90 MMA corporate affiliates and physician members gathered at the Portland Country Club April 26th for MMA's 4th Annual Corporate Affiliate Breakfast. The featured speaker for the morning was MMA's own best-selling author, Tess Gerritsen, who regaled the group with tales from the fore of the publishing industry and tips for aspiring writers. At least 30% of Americans "believe they've got a book in them," she said, and from the number of slightly sheepish expressions around the room, that was a lowball figure. 

MMA's corporate affiliate program, founded just 8 years ago, has grown to a robust 100, encompassing firms providing everything from Audio/Visual Support to Travel.To learn more about MMA's Corporate Affiliates and the services they provide, check out mainemed.com and click on Corporate Affiliates at the top of the page. [return to top]

Quality Counts! Seeks Administrative Assistant

“Quality Counts” is committed to working together across organizations and across communities, to improve healthcare systems and outcomes with the people of Maine. Quality Counts will work to coordinate existing but disparate efforts across the state that support local, patient-centered, and coordinated systems of care AND the resources that support them.  Its goals are to improve health status; promote consistent delivery of high quality care; improve access to healthcare; and contain healthcare costs.

Position:  Administrative Assistant

Vision for this position:  Quality Counts seeks a mature, responsible person who is interested in healthcare, ideally in the overall improvement of healthcare delivery in Maine.  This person will be able to begin working with us on a part-time basis in our offices at the Maine Medical Association building at 30 Association Drive in Manchester, ME.  Over time, this person will have the opportunity to grow with our organization, in terms of knowledge and experience, increased hours and benefits, and income.  We seek a person who can interact with the many constituents Quality Counts will deal with, both within the healthcare community in Maine and in all other sectors of the Maine environment (the employer community, all levels of government within the state, community organizations, and other professional groups.)

Requirements:  The ideal candidate will possess strong people skills and strong Microsoft Office skills; be very organized and thorough; present a professional and courteous demeanor; and, must be able to function fairly autonomously with a team containing members who work on-site or remotely.

Our Commitment:  This position will never be dull and routine!  Quality Counts will offer a supportive, professional yet down-to-earth team environment.  There will always be room for learning and growth, as we facilitate the growth of a learning environment throughout the state of Maine.

Salary:  To be determined.

If interested, please contact John Barry, Executive Director of Quality Counts, at jbarry2040@gmail.com or (207) 332-8284. [return to top]

Update on MMA Legislative Communications Process

Because of resource considerations and based upon feedback from members, MMA Legislative Committee Chair Katherine Pope, M.D., Vice Chair Sam Solish, and Deputy EVP Andrew MacLean plan to merge the Maine Medicine Political Pulse with the Maine Medicine Weekly Update so that you will receive one weekly electronic newsletter that will address general matters of interest to the membership and legislative and regulatory matters.  If the Legislative Committee wishes to issue a legislative alert or call to action, it will do so through the Weekly Update unless the timing requires a special newsletter.  In that case, it will continue to use the Political Pulse template.  You can continue to access the MMA web site, www.mainemed.com, and look under Legislative & Regulatory matters for the bill tracking forum and general information about the Maine legislative process.  You will find highlights of the previous week and a preview of the week to come in the Weekly Update

The Legislative Committee will hold a weekly conference call on Thursdays at 7:30 p.m.  Any member may participate.  The conference call number is 1-800-989-2842 and the code is 6223374#.  These calls will not have a formal agenda.  Mr. MacLean and/or Mr. Smith will provide an update on current advocacy activities and participants are welcome to pose questions or make comments about any bill being tracked by the MMA.  The calls usually will take about a half hour, though some will be shorter.  The call ended in about 15 minutes last week.   

If you have questions or comments about the Legislative Committee's communications process, please contact Andrew MacLean, Deputy EVP, at amaclean@mainemed.com.
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MeHAF Sponsors "Advancing Health Reform in Maine"

The Maine Health Access Foundation sponsored an all day conference at the Samoset Resort in Rockport this past Monday entitled, "Advancing Health Reform in Maine."  Keynoted by Stuart Altman, PhD, of the Heller School for Social Policy & Management at Brandeis University, the conference attracted over 200 attendees and showcased two new studies commissioned by MeHAF and prepared by the Urban Institute.

The first study examined the issue of health insurance in Maine.  The recently concluded work found that over 85% of uninsured Maine people come from a family with at least one employed worker.  In fact, working adults make up the majority of those who are uninsured.  Nearly half of Maine's uninsured workers come from low-income families and over half are employed by firms with fewer than 25 employees.  Nearly three-quarters of Maine people who are uninsured are young and middle aged adults.  With respect to children, over two-thirds of Maine's uninsured children come from families with annual incomes under $20,000 per year.  Adults who are not low-income make up 40% of Maine's uninsured. All told, there are estimated to be about 124,000 non-elderly Maine residents who lack health insurance.

The second study looked at what health insurance cost and how it is being paid for.  The study found that the household estimate of the costs of care to the uninsured in Maine in 2005 was $1292 per uninsured non-elderly resident, 51% of which was uncompensated.  37% represented out-of-pocket (cash) payments and 12 percent represented insurance payments (part-time coverage or workers' comp).  The total uncompensated care for the 124,000 Maine residents who are uninsured is $81 million.  The actual range of estimated costs of uninsured for 2005 was between $81 million and $138 million.  If the uninsured were insured, it is predicted that $175 million in new medical spending would result.

A third study by Critical Insights, also prepared for MeHAF, explored the topic of public perspectives on health care and insurance coverage in Maine.  After conducting focus groups of public citizens, the firm reached the following conclusions:

  • Residents without health insurance tend to be the most critical of the current system, and decry the high costs of care.
  • Mainers place significant value on access to affordable health care. 
  • While there was little consensus about how to approach expanding access to health care in Maine, people appear to be receptive to certain components of possible solutions.
  • Participants were generally concerned about the potentially adverse effect of adding new requirements on Maine business, and this tempered their enthusiasm about solutions rooted in the business community.
  • Most residents were receptive to the notion of having to make some trade-offs in order for all Maine residents to have some form of health coverage.  Participants gnenerally concurred they would be agreeable to having their personal physician changed or specified and/or having to wait for non-emergency care issues, such as routine screenings and check-ups, as long as they are able to have timely access to a physician in more critical and serious circumstances.
  • Regardless of the proposed approach, residents expressed a significant and overarching concern about the fairness of establishing guidelines for participation in a broad-based health reform plan that included coverage expansion.

In addition to hearing about these three new studies, participants also heard from panels discussing the topics of caring for the uninsured and asking the question, "How Can Maine's Existing Resources Be More Effectly Deployed to Advance Health Reform and Expand Access to Care." [return to top]

Appropriations Committee Continues Negotiations Towards 2/3 Vote

Work on the FY 2008-2009 biennial state budget continues during the fourth month since the bill, L.D. 499, was referred to the Appropriations Committee on the first of February.  Last week, the Democratic & Republican caucuses released their proposals.  The two plans, along with other budget materials, are posted on the web at:  http://www.maine.gov/legis/ofpr/afabiennialbudgetmaterials.html.  Fortunately, the $3 million General Fund increase in MaineCare reimbursement rates is included in both party plans.


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Governor Signs Primary Enforcement Seat Belt Bill
After several years of hard work by a coalition including the MMA, Maine finally has a primary enforcement seat belt law.  On April 30, 2007, Governor Baldacci signed L.D. 24, An Act to Make Failure to Wear a Seat Belt a Primary Offense as P.L. 2007, Chapter 60.  The Senate voted 19 - 15 and the House voted 76 - 61 on enactment.  The bill will become effective 90 days following adjournment of the legislature's First Regular Session in June.
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HHS Committee Again Rejects Restrictions on Vaccines Containing Thimerosal
Last week, the Health & Human Services Committee considered two bills that would have further limited the vaccine supply in Maine by restricting those containing the preservative thimerosal:  L.D. 1446, An Act to Protect Children from Mercury and Thimerosal Toxicity in Immunizing Agents and L.D. 1523, An Act Requiring Heavy Metal-free Immunizing Agents.  The 122nd Legislature also rejected two similar bills.  Maine CDC Director Dora A. Mills, M.D., M.P.H., the MMA, and the Maine Chapter of the AAP all testified against the bills.  The Committee unanimously voted against both bills, but did ask that the MMA use its newsletters and CME programs as opportunities to sensitize physicians and staffs to those families who have concerns about thimerosal.
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