July 16, 2007

 
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AMA National "House Call" Comes to Portland Tomorrow

The American Medical Association President-elect Nancy Nielsen, M.D. will be in Portland on Tuesday to advocate for congressional action fixing the flawed Medicare payment formula based upon the sustainable growth rate (SGR).  Without such action, physician payment for treating Medicare payments will be reduced another 10% effective Jan. 1, 2008.  Joining Dr. Nielsen at a 10:30am press conference will be MMA President Kevin Flanigan, M.D., So. Portland internist Thomas Claffey, M.D. and AMA Delegate David Simmons, M.D. of Calais.

"Given that Maine has the oldest population in the country and 17% more Medicare recipients per capita than other states, fixing the Medicare payment formula is essential to preserving access to care for Maine's vulnerable Medicare population," stated Dr. Flanigan, who is an internist and pediatrician in private practice in Pittsfield.

The press conference will be held at the administrative offices of Intermed at 100 Foden Road in South Portland (West Building, 2nd floor conference room).

Also on the agenda for the House Call is a meeting with the editorial board of the Portland Press Herald (Blethen Newspapers) at 3:00pm. 

A survey released by the AMA in June showed that 60% of America's physicians would be forced to limit the number of new Medicare patients they will be able to care for next year if the payment cut is implemented.

Congress' own advisory committee on Medicare, MedPAC, has recommended that Congress stop next year's 10% cut and update payments 1.7%, in line with practice cost increases.  The AMA is now urging the Congress to enact legislation that will replace the looming cuts with Medicare payment updates based on practice costs.

Next year's 10% reduction is just the tip of the iceberg.  Over nine years, the cuts total about 40%, while the government estimates that the cost of caring for patients will increase 20%.  Over the life of the cuts, 77 percent of physicians say they will be forced to limit the number of new Medicare patients they treat.  In April/May of 2007, the AMA conducted the on-line survey of nearly 9,000 physicians to determine their reactions to the proposed cuts.

The AMA is helping patients share their concerns about the Medicare cuts with a Web site www.patientsactionnetwork.org and phone number 1-888-434-6200 that puts patients in touch with their senators and congressional representatives.

The impact of the cuts will reverberate beyond seniors who rely on Medicare.  America's military families will also be hurt, as the military health insurance program, TRICARE, faces the same physician payment cuts as Medicare. 

 

NPI - July 16 Deadline

The NPI is here.  The NPI is now.  Are you using it?

Reminder – July 16 is the Deadlineby which Updates/Changes/Deletions Must Be Submitted to NPPES in Order to be Reflected in Initial Downloadable File

In order for providers’ updates, changes, and deletions to be reflected in the initial downloadable file of NPPES data, providers must ensure that their updates, changes, and deletions are submitted to NPPES no later than July 16, 2007.  To ensure the inclusion of updates, changes, and deletions in the initial downloadable file,  July 16 is the last date on which they may be submitted via the web-based process, and is the last date by which the NPI Enumerator can receive them on the paper NPI Application/Update form (CMS-10114).[1]

The document is entitled, “National Plan and Provider Enumeration System (NPPES) Data Elements – Data Dissemination – Information for Providers” and is available at http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/NPPES_FOIA_Data%20Elements_062007.pdf on the NPI website.  We strongly recommend that providers read this document as soon as possible. 

Updates, changes, and deletions that are submitted after July 16 will be reflected in the appropriate monthly update file, also downloadable from the Internet.  For example, an update submitted on July 26 would be effective after the creation of the initial downloadable file and thus would be reflected in the first update file (to be created 1 month after the creation of the initial downloadable file); an update submitted on August 30 would be effective after the creation of the first update file and thus would be reflected in the second update file (to be created 1 month after the creation of the first monthly update file). 

After the initial downloadable file is made available, an update file will be available each month thereafter at the same Internet location.  All of the files (the initial file and the update files) will remain available for download at that Internet location.

The NPI Registry will operate in a real-time environment.  Updates, changes, and deletions will be reflected in the NPI Registry at the same time they are reflected in NPPES.  Therefore, the July 16 date is insignificant with respect to the data in the NPI Registry.

Still Confused?

Not sure what an NPI is and how you can get it, share it and use it?  As always, more information and education on the NPI can be found at the CMS NPI page www.cms.hhs.gov/NationalProvIdentStand on the CMS website.  Providers can apply for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203. 

Getting an NPI is free - not having one can be costly. 

 

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Dirigo Health Agency Announces Year 3 Dirigo-related Savings

In early July, the Dirigo Health Agency released its analysis of the aggregate measurable cost savings associated with the Dirigo Health program for its third year of operation.  In the report, the agency states the amount of the savings to be approximately $93 million.  About $4 million is claimed to be created as a result of the MaineCare physician fee increase included in the Dirigo legislation and about $74 million is claimed to be created by Maine hospitals meeting the voluntary caps on consolidated operating margins. 

The report now goes to public hearing before the Dirigo Health Agency Board of Directors later this month.  Various interveners have filed to be participating parties at the hearing.  Once the Board makes its final determination, the findings are then sent to the acting Superintendent of Insurance Eric Cioppa who has the final say on the matter, subject to court appeals.  [return to top]

Next "First Fridays" Program: Collaboration Skills for HealthCare Professionals

MMA's popular "First Fridays" CME programs return from a summer break on Friday, Sept. 7, 2007 with a program entitled, "Collaboration Skills for Healthcare Professionals."   This fast-paced, interactive workshop examines the essential building blocks that are required for building healthy teamwork and delivering safe, quality healthcare.  The instructor is Beth Boynton, RN, MS, who is an independent organizational development consultant specializing in building collaboration skills as a coach, trainer, faciliator and teacher.  Ms. Boynton provides organizational development services for healthcare organizations in Maine with a specialty in teambuilding for physicians, nurses and allied healthcare professionals.

The program will be held from 9:00am to noon at the offices of the Maine Medical Association in Manchester. 

Reigstration is available on the MMA website at www.mainemed.com.  Registration materials will also be included with the July-August issue of Maine Medicine, which should arrive in member's mail boxes the second week of August.  [return to top]

MMA PAC, MPAF, Invites You to Portland Area State Legislative Fundraisers

Fundraising events for the Maine Senate Republicans, Senate Democrats, & House Democrats are scheduled in the greater Portland area this week.  The MMA's political action committee, the Maine Physicians Action Fund, has committed to sponsor each of these events & interested physicians are welcome to join MMA EVP Gordon Smith at the events.  While no additional contribution is necessary, the caucuses certainly would appreciate personal contributions of any amount.

The schedule of events is:

Tuesday, July 17, 2007, 5:30 - 7:30 p.m., Saltwater Grille, South Portland, Senate Republicans

Wednesday, July 18, 2007, 6:00 - 8:00 p.m., DiMillo's Floating Restaurant, Portland, House Democrats

Wednesday, July 18, 2007, 7:00 - 8:00 p.m., Saltwater Grille, South Portland, Senate Democrats

If you have questions about these events, please contact Charyl Smith, Legislative Assistant, at csmith@mainemed.com or 622-3374, ext. 210.
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Surgeon General Candidate Has Nomination Hearing

With outgoing Surgeon General Richard Carmona's public comments about Bush Administration political pressure in the job at the top of the news headlines, Surgeon General nominee James Holsinger, Jr., M.D., Ph.D. testified at his nomination hearing before the Senate Health, Education, Labor, & Pensions Committee on Thursday, July 12, 2007.

Dr. Holsinger told committee members that he would defend the scientific integrity of the office against political & ideological pressure.  He said that the following initiatives would be his priorities:

  • fighting childhood obesity;
  • curtailing tobacco use;
  • disaster preparedness for U.S. physicians.
Also, in his remarks Dr. Holsinger:
  • defended President Bush's policy on stem cell research;
  • said he would work to ban direct-to-consumer drug advertising;
  • said he would promote all forms of contraceptives to all segments of society, including high school students.
Responding to inquiries about his 1991 paper suggesting that male homosexuality was unnatural, he said that he prepared the paper at the request of a non-scientific church group within the parameters set by it.  Dr. Holsinger currently is the President of the United Methodist Church's Judicial Council.  Dr. Holsinger's comments suggest that guarding against undue political influence does not mean that moral & ethical issues would not influence his decisions.

The Senate HELP Committee is expected to complete review of his nomination before the August recess.
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Senate Finance Committee Reaches Tenative Agreement on SCHIP Reauthorization

Last week, the Senate Finance Committee reached a tentative bipartisan agreement on a $35 billion reauthorization of the State Children's Health Insurance Program (SCHIP) to be funded by a $0.61 increase in the federal tobacco tax.  This amount would cover those currently enrolled in the program, as well as 2 million of the 6 million individuals eligible but not enrolled.

President Bush has said that he would support only a $5 billion increase over 5 years for a total of $30 million.  The House Democrats would add $50 billion over 5 years for a total of $75 billion.

 On Saturday, July 14, 2007, the President indicated that he would veto the proposal.  He believes that the program should cover only children up to 200% of the FPL & that the government should help the rest of the uninsured by changing the tax treatment of health benefits & perhaps providing tax credits to help individuals purchase coverage.

Senator Olympia J. Snowe, a member of the Senate Finance Committee, said that the SCHIP proposal would receive a "strong vote" in the Finance Committee, "despite some misgivings" about the tobacco tax increase.

The Finance Committee could begin mark up of the bill as early as this week.  The SCHIP program is due to expire on September 30, 2007.
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MMA's Coding Center Offers Two Certification Courses Beginning in July

MMA's Coding Center, directed by Jana Purrell, CPC, will offer two 15 week certification courses beginning in July.  The courses will be offered in Lewiston and in Dover-Foxcroft.  This 15 week course, developed by the American Academy of Professional Coders (AAPC) will take students through the 2007 Current Procedural Terminology (CPT), International Classification of Disease (ICD-9), and HCPCS books to address proper coding in physician practices.  The class is intended to educate students on proper techniques and rules of coding and will also prepare them to sit for the AAPC Certified Professional Coder (CPC) exam.  Both programs begin the last week of July.  For more information or for registration materials, call the MMA office at 622-3374.

The cost of the course is $1600, which includes all course materials, the cost of the CPC exam and a one year membership in the AAPC.  The course in Dover-Foxcroft will be offered  weekly at Mayo Regional Hospital from 1:00pm to 5:00pm on Tuesday afternoons, beginning on July 24.  The course in Lewiston will be offered on Thursdays at St. Mary's Regional Medical Center from 3:00pm to 7:00pm, beginning  on July 26.  The test to achieve certification at both locations will be held the week of Nov. 5, 2007. 

These course offerings present a unique opportunity for coding personnel in the Lewiston and Piscataquis County areas to get certified.  These opportunities don't come along very often.  Hospitals, medical practices or individual coders interested may receive more information or may register by calling MMA at 622-3374 (Press 0 and ask for Lisa Dennison). 

As coding and reimbursement issues become more prominent and complex, having certified coders is one of the most effective means of reducing risk to a medical practice.

Both courses will be taught by Jana Purrell, CPC, the Director of The Coding Center.   Jana continues to be one of the most popular and respected coding instructors in the country. [return to top]

MMA First Yard Sale Saturday, July 21

MMA's offices at the Frank O. Stred Building located just off busy Route 202 in Manchester present an ideal location for a weekend yard sale.  In order to eliminate some excess office equipment and furnishings, MMA will take advantage of this location and conduct a yard sale on Saturday, July 21.  Offerings from MMA will include some office chairs, file cabinets and office equipment.  MMA staff and members may contribute materials for the sale, either as a donation or on a commission basis.  Call Gordon Smith at MMA if you have something to contribute to the sale (622-3374 or via e-mail to gsmith@mainemed.com.  Proceeds will benefit MMA.

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Upcoming Events Around the State

MaineHealth Learning Resource Centers will host “Health, Culture and Literacy:  Solutions for Clear Health Communications” on Friday, Oct. 26 at the Hilton Garden Inn in Freeport.  The program will feature Ann Fadiman, author of “The Spirit Catches You and You Fall Down.”  The conference will also discuss the latest research on adult literacy in the United States.  Participants will gain skills needed to improve patient and client outcomes.  For more information and the preliminary agenda, go to www.healthliteracyinmaine.org...

Fadiman will also speak at the Maine Humanities Council’s conference “Caring for the Caregiver: Perspectives on Literature and Medicine” November 9 and 10 in Manchester, NH.  This conference, part of the council’s Literature & Medicine: Humanities at the Heart of Health Care®.  The conference will survey the wide range of innovative programs that support health care professionals through the use of literature and writing.  It will focus on one particular feature of the literature and medicine movement: its ability to renew and energize health care professionals’ connection to their work.  For more information, visit http://www.mainehumanities.org or call 1-888-MEReader.

Save the date for Quality Counts! Part 5:  Aligning Partners for Quality on December 7 at the Augusta Civic Center.  Sign up information is available at www.mcdregistration.org/signup.asp?ID=21 [return to top]

Kennebec County Healthcare Practitioner Fundraiser for Susan Collins, Friday July 21

As you know, the MMA encourages its members to participate in political campaigns for the candidates of their choosing. MMA leadership has been asked to participate in an upcoming Kennebec County healthcare practitioner fundraising event for the Susan Collins campaign. If you are interested in attending, please see this invitation [pdf link] for further details and RSVP information.

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Calling Physicians Interested in Serving on Legislature's Primary Care Study Group

Near the end of the First Regular Session of the 123rd Legislature, members enacted a Joint Order creating a Commission to Study Primary Care Medical Practice and to report its findings and recommendations by December 2007 for consideration by the Joint Standing Committee on Health & Human Services in 2008. 

Among the 13 members of the Commission are:

  • Two independent primary care physicians, one of whom is appointed by the President of the Senate and one of whom is appointed by the Speaker of the House; and
  • One member of an organization representing physicians in the State, appointed by the Speaker of the House.

The Commission has the following duties:

  • Identify the causes of the loss of independent ownership of primary care medical practices due to financial, regulatory or business-related reasons;
  • Seek input from independent primary care physicians on payor mix, reimbursement and Medicaid regulatory changes and the effects of such factors on the ability of independent primary care physicians to practice medicine in Maine;
  • Seek to determine the effect of hospital control of primary care medical offices or primary care physicians on health care costs, access to health care and medical treatment of Maine's citizens; and
  • Review how comparable states manage physician-hospital relationships with respect to health care costs, patient advocacy and access to health care.

To the best of our knowledge, this initiative had its genesis within the legislature and not in an advocacy organization.

If you are interested in serving in one of the 3 physician positions specified in the Joint Order, please contact Andrew MacLean, Deputy EVP, at amaclean@mainemed.com or 622-3374, ext. 214. [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 by approved medical schools.  The MMEF Committee on Loan and Trust Administration met on Thursday, June 14, 2007 to review 41 loan applications.  Listed below are the students who will be receiving loans from the MMEF this year.  Congratulations!

 

MMEF APPLICANT

 

SCHOOL

 

APPROVED

 

Alto, Letizia

 

UVM

 

25,000.00

 

Ashcroft, Jonathan

 

St Georges University

 

10,000.00

 

Aslam, Jessica

 

Sabo University

 

25,000.00

 

Avener, Catherine

 

UVM

 

20,000.00

 

Barus, Carl

 

UVM

 

25,000.00

 

Barus, Kathryn

 

UNE

 

10,000.00

 

Bloomberg, Christopher

 

UNE

 

10,000.00

 

Bowley, Michael Patrick

 

Boston Univ School of Med

 

25,000.00

 

Brown, Jodi

 

Midwestern Univ.

 

5,000.00

 

Christian, Kenneth

 

UVM

 

20,000.00

 

Crothers, Jacob

 

Tufts

 

10,000.00

 

Deane, Jessica

 

UVM

 

20,000.00

 

Demmons, William

 

Sabo University

 

25,000.00

 

Duquete, Adam

 

UNE

 

5,000.00

 

Elsaesser, Theodore

 

Georgetown Univ School of Med

 

10,000.00

 

Emery, Kendra

 

UNE

 

10,000.00

 

Giberson, Mellory

 

UVM

 

20,000.00

 

Greenleaf, Megan

 

UVM

 

10,000.00

 

Griffin, Judith

 

Columbia University

 

10,000.00

 

Hiendlmayr, Brett

 

Ross University School of Med

 

10,000.00

 

Hunt, Edward

 

UNE

 

5,000.00

 

Libby, Brandon

 

Dartmouth

 

10,000.00

 

Liberatore, Anna

 

UVM

 

20,000.00

 

Malek, Matthew

 

Univ of Rochester School of Med

 

20,000.00

 

Martel, John

 

UVM

 

20,000.00

 

Morgan, Matthew

 

UNE

 

5,000.00

 

Mosher, Michelle

 

UNE

 

5,000.00

 

Parent, Emily

 

UNE

 

10,000.00

 

Park, Margaret

 

UNE

 

5,000.00

 

Parker, Laurel

 

Tufts

 

15,000.00

 

Poisson, Glen

 

St Matthew's University

 

10,000.00

 

Pringle, Dwight

 

Thomas Jefferson Med College

 

20,000.00

 

Robbins, Heather

 

Tufts

 

25,000.00

 

Sanders, Abigail

 

Dartmouth

 

20,000.00

 

Silver, Jeremy

 

UVM

 

10,000.00

 

Stinson, Jacob

 

UNE

 

10,000.00

 

Sweeney, Christopher

 

UVM

 

10,000.00

 

Szela, Craig

 

Harvard Medical School

 

20,000.00

 

Walmer, Scott

 

UNE

 

5,000.00

 

Weinstein, Maria

 

UNE

 

5,000.00

 

Wendell, Lauren

 

UVM

 

10,000.00

 

 

 

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.  While funds are limited consideration will be given to late applicants.  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 or visit our website at www.mainemed.com

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