September 10, 2007

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MMA Concludes Successful Annual Meeting; Nine Resolutions Passed

Enjoying great weather, a beautiful location and the company of professional colleagues, MMA members and guests attending the Association's 154th Annual Session in Bar Harbor this past weekend  participated in a variety of activities and earned CME credit.  Over three hundred members, guests and exhibitors attended making it one of the most successful meetings in recent history.  Resolutions passed at the Saturday morning membership meeting included a resolve urging MaineCare to reach out to providers when contracting for and testing its new MECMS claim processing system (due Jan. 1, 2010) and several resolutions touching on public health issues.

On Saturday evening, Kevin Flanigan, M.D. of Pittsfield passed the Presidential gavel to William Strassberg, M.D. of Belfast and Bar Harbor who will lead the Association during the next twelve months.  Stephanie Lash, M.D. of Bangor was elected President-elect and David McDermott of Dover-Foxcroft elected to chair the Association's 28-member Executive Committee.

The nine resolutions were all adopted with minor amendments to two of them and are available on the Association's website at  Resolution nine, Supporting SCHIP Reauthorization and Medicare Payment Reform, was submitted by MMA's delegation to the AMA and called on MMA members to communicate with our United States Senators and call on them to take immediate action to ensure that any conference agreement on the SCHIP (State Children's Health Insurance Program) include at least two years of positive Medicare physician payment updates that do not increase the cost of a permanent solution. Failure of the Congress to act will result in reductions to Medicare payments to physicians ranging from 11% to 12.1% in Maine, effective Jan. 1, 2008.

Charles Baker, President and CEO of Harvard Pilgrim Health Care, presented the keynote address and speculated on what the healthcare delivery and financing system would like like in the year 2020.  Mr. Baker provided several different scenarios, but also predicted that the next ten years won't look much different than the past ten years, in terms of financing and reform of the health system.  Lacking consensus on a national level, he noted that it is difficult to accomplish significant change.

Baker spoke the day following the state's announcement that Harvard Pilgrim, the most significant non-profit health plan in the state, would be the state's partner in offering the Dirigo Health Program in 2008.  The previous day, the state and Anthem Blue Cross and Blue Shield had announced an ending to their three-year DirigoChoice contract at the end of 2007. ( See related article in this Update.)

Paul Harrington, EVP of the Vermont Medical Society and a former state legislator in that state, and Kelly Kenney, J.D. of the AMA's Advocacy Resource Center responded to Baker's talk, providing an overview of what other states were doing in the area of health system transformation.  The states of Massachusetts, Maine, Vermont and California continue to be looked at because of their efforts to cover more patients, improve quality and moderate cost increases.

The closing educational program on Sunday morning features the topic of professionalism, with James Herndon, M.D., past President of the American Academy of Orthopedic Surgeons giving the closing keynote address.  The panel was moderated by MMA President William Strassberg and included two well-known Maine internists, Edward Gilmore, M.D. and Richard Kahn, M.D.

Honors and Awards presented at Saturday night's banquet included the following:

  • Samuel Broaddus, M.D. a Portland urologist received the Mary Cushman Humanitarian Award (International) for his exceptional volunteer work in Haiti and other third-world nations around the globe.
  • Richard Evans, M.D. received the President's Award for Distinguished Service, recognizing his many roles in supporting MMA including his service as an AMA delegate and his editorship of Maine Medicine.
  • Peter Leadley, M.D., received a Special Recognition Award for his exemplary service as Chair of the Association's Committee on CME and Accreditation.
  • 50 yr. recognition pins were presented to Carl Brinkman, M.D., Alice Cunningham,M.D. and Einar Juhlin, M.D., all of whom graduated from medical school in 1957.

Watch for your next issue of Maine Medicine for more details on the Annual Meeting, as well as accessing the Association's website at

Harvard Pilgrim to Replace Anthem BCBS as State Partner in Offering DirigoChoice

Last Tuesday, the state and Anthem Blue Cross and Blue Shield announced they were ending their three-year DirigoChoice contract at the end of this year.  The following day, the state and Harvard Pilgrim Health Care announced that they would partner in offering the product beginning in 2008, thus assuring current members that they would continue to have coverage to the product.  DirigoChoice members will receive further information on transition plans in the coming days and may call the Dirigo Health Agency at (207) 287-9900 for more information. [return to top]

Invitation: Program on Substance Abuse Issues for Professional Women

The Women's Law Society, an association of female attorneys, invites interested female physicians to its fall program entitled, Depression and Substance Abuse affects Female Professionals, scheduled for November 1, 2007 at Bowdoin College in Brunswick.

The facts are undisputed:  Attorneys and other professionals have a high risk of suffering from depression or substance abuse during the course of their professional lives.

Attorneys have the highest rate of depression among any profession and women generally have twice the depression rate of men.  Attorneys have twice the substance abuse rates of the general population and alcohol abuse affects women in physiologically different ways than men.  But most lawyers know very little about the symptoms of these diseases or the successful treatments available to address these problems and so, all too frequently lawyers remain untreated, trudging alone through a most difficult illness.  The WLS Fall Program will increase your awareness of these illnesses, educate you to your ethical obligations with respect to impaired attorneys and open a discussion of how we as women professionals can help support each other.

Our special guest speaker is Dr. Susan Blank, a board certified psychiatrist specializing in addiction medicine, who has extensive experience with the treatment of impaired professionals.  Dr. Blank is the Executive Director of Psychiatric and Psychological Services at the Caron Center in Pennsylvannia, one of the leading treatment centers in America.

Dr. Blank was awarded her medical degree at the Medical College of Georgia in 1985, receiving both the awards for “Best Psychiatry Student” and “Top 5 Surgical Students.”  Following her four year residency, Dr. Blank was employed by several prestigious medical facilities, including the Talbott Recovery Center which specializes in the treatment of impaired professionals as well as achieving post graduate certification in Advanced Forensics and addiction medicine.  Not only are her paper credentials outstanding, but Dr. Blank’s combination of professional experience with a family life is a story we as women professionals will find inspiring.  Susan grew up in Idaho, has four children: 2 children born during undergraduate school, one baby in medical school and the final baby during her residency ( exhausted yet?).  In her “spare” time, Susan is a huge sports fan and loves hockey, football, baseball, soccer, and has even been known to watch sport fishing on TV.

The ethics component of the program will be provided by Louise Thomas, Esq., an attorney at Pierce Atwood, who has done significant lecturing on the problems of attorney impairment both in Maine and nationally.   Louise was just appointed to the ABA Standing Committee on Substance Abuse.

For more information, please contact Melinda J. "Mindy" Caterine, Esq. with Moss Shapiro at 775-6001 or






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Primary Care Study Commission to Convene on Friday, September 14th

The Commission to Study Primary Care Medical Practice established by the 123rd Maine Legislature during its First Regular Session (S.P. 732) has scheduled its first meeting for this Friday, September 14, 2007 in Room 209 of the Cross State Office Building (the HHS Committee room).

The Committee members are:


Sen. Lisa T. Marrache, M.D. (D-Kennebec), Chair

Sen. Joseph Brannigan (D-Cumberland) 

Sen. Kevin L. Raye (R-Washington)

House Members

Rep. Gary A. Connor (D-Kennebunk), Chair

Rep. Marilyn E. Canavan (D-Waterville) 

Rep. Anne C. Perry (D-Calais)

Rep. Sarah O. Lewin (R-Eliot)

Rep. Donna W. Finley (R-Skowhegan)

Public Members

Ann Woloson, Executive Director, Prescription Policy Choices

David A. Peterson, President & CEO, The Aroostook Medical Center

John H. Irwin, D.O., Medical Service, Internal Medicine

Jeffrey Aalberg, M.D., Maine Medical Center, Family Practice Center

Kevin S. Flanigan, M.D., Sebasticook Valley Primary Care

The duties of the Commission are:

 A.                 Identify causes of the loss of independent ownership of primary care medical practices due to financial, regulatory or business-related reasons. B.                 Seek input from independent primary care physicians (PCP) on payor mix, reimbursement and Medicaid regulatory changes and the effects on their ability to practice medicine in Maine. C.                 Determine the effect that hospital control of primary care offices and physicians has on health care costs, access to health care and medical treatment.  D.                 Review how comparable states manage physician-hospital relationships with respect to health care cost, patient advocacy and access to health care.

E.                  Report findings and recommendations, including suggested legislation, to the Joint Standing Committee on Health and Human Services by December 5, 2007.  The Joint Standing Committee may introduce a bill related to the study.

The agenda for the first meeting is:

September 14, 2007 FOCUS: Gathering Information on Primary Care Practice in Maine   10:00 a.m.        Introduction/Study Overview §         Opening Remarks §         Commission Members’ Introductions §         Review Charge of Joint Order   10:30 a.m.       Presentation - Overview of Primary Care Practice in Maine §         Overview of Background Packet/Research §         Department of Health and Human Services   12:00 p.m.       Lunch Break   1:00 p.m.         Panel Discussion - Challenges for Primary Care Practices – Current             state of primary care practices in Maine §         Maine Primary Care Association §         Maine Hospital Association §         Maine Academy of Family Physicians §         Maine Medical Association §         Maine Osteopathic Association §         Independent Primary Care Physicians   3:00 p.m.         Public Comment/Testimony                 3:30 p.m.         Commission Discussion §         What we learned §         Additional information needed §         Next steps   4:00 p.m.         Adjourn

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Victoria Wallack Receives MMA's First Annual Journalism Award

During the General Membership meeting on Saturday morning, September 8, 2007, MMA President Kevin S. Flanigan, M.D. presented the MMA's first annual Award for Excellence in Healthcare Reporting to Victoria Wallack of Mount Vernon. 

Ms. Wallack has been the owner of and reporter for Maine Statehouse News since April 2004, a political news service covering the Maine State House and government agencies that provides copy to more than a dozen Maine newspapers with a combined circulation of more than 80,000.

In his presentation of the award, Dr. Flanigan highlighted Ms. Wallack's coverage of the state budget process and the MaineCare claims management system issues.

Ms. Wallack received her bachelor's degree in journalism from The Ohio State University and has 30 years of experience in newspaper management, writing, recruitment, staff training, budgeting, marketing, and public relations.
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Deadline for SCHIP Reauthorization Looming

U.S. House & Senate leaders are trying to reach a compromise on SCHIP legislation between bills passed by each body prior to the August recess before the program expires on September 30th.  The Senate bill's funding level is $35 billion & it includes no Medicare payment policy, such as the physician payment fix.  The House bill's funding level is $50 billion & it includes a number of Medicare payment policy provisions including the physician payment fix.  The President still threatens a veto of either version. 

House Majority Leader Steny H. Hoyer (D-Maryland) said last week that it may be necessary to enact a funding extension to give the two sides more time to work on a compromise.  According to a Congressional Research Service report entitled, What Happens if SCHIP is Not "Reauthorized,"  12 states including Maine will run out of funding in their SCHIP programs on October 1, if Congress does not reauthorize the program.  DHHS could redistribute $93 million in leftover funding for the program, but that would cover only about 2 weeks of the 12 states' projected FY 2008 SCHIP spending.
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US DHHS Official Describes HIPAA Privacy Rule Enforcement Actions

Speaking at a privacy symposium at Harvard University in late August, Linda Sanches, a senior advisor in the HHS Office of Civil Rights said that her agency had received 29,000 complaints in the last 4 years & that 1/3 of them have resulted in formal investigations.

The major categories of complaints are:

  • unauthorized use & disclosure of protected health information;
  • lack of safeguards; &
  • failure to provide access to one's own medical records.
About 7000 cases have been resolved with 2/3 resulting in corrective action agreements & 1/3 resulting in a finding of no violation.  About 6000 cases are pending & 410 cases have been referred to the Justice Department for possible criminal investigation.

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US Census Bureau Reports Increase in Uninsured

The U.S. Census Bureau recently has released a report, Income, Poverty, & Health Insurance Coverage in the United States:  2006, concluding that the nation's uninsured rate grew from 44.8 million in 2005 to 47 million in 2006.  This represents an increase in the percentage of uninsured from 15.3% in 2005 to 15.8% in 2006.

Those with private insurance coverage through their employers decreased from 60.2% in 2005 to 59.7% in 2006.  Those with government-sponsored health coverage also dropped from 27.3% in 2005 to 27% in 2006.

Texas had the highest uninsured rate at 24.1%.  Minnesota had the lowest uninsured rate at 8.5%  Hawaii, Iowa, Wisconsin, & Maine were the only other states with uninsured rates under 10%.
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Public Citizen Compares Medicaid & Medicare Payment Rates

In a report entitled, Equal Pay for Equal Work?  Not for Medicaid Doctors, released September 5, 2007, Public Citizen found that in 2003 the Medicaid program on average paid physicians $0.69 for every $1 paid by Medicare for the same care. 

Using 2007 data, the pay disparity is most significant in New York where Medicaid pays 29 cents for every Medicare dollar.  In New England, the Rhode Island program pays 40 cents for every Medicare dollar.  Not all state Medicaid programs pay less than Medicare.  In Arizona & Delaware the rates are nearly the same.  Alaska ($1.38) & Wyoming ($1.25) pay more for Medicaid services than Medicare pays.

Maine's Medicaid program now pays approximately 53% of Medicare rates following the fee increase enacted by the 122nd Maine Legislature.  This does not include the fee increase scheduled for July 1, 2008 enacted by the 123rd Maine Legislature.
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Physicians Move Up in Compensation Rankings According to Labor Department

On August 29, 2007, the U.S. Labor Department's Bureau of Labor Statistics released, Changes in Occupational Ranking and Hourly Earnings, 1997 - 2005, a report based upon salary information from the National Compensation Survey.  Twelve of the 20 highest paying occupations on the 1997 list also were on the 2005 list.  Physicians moved up from 12th place in 1997 to 4th place in 2005, the largest upward trend in the study.

The report is available on the web at:
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Annual Maine Pain Initiative Symposium "Pain Management at the End of Life", Sept. 18-19

Register now for the Annual Maine Pain Initiative Symposium “Pain Management at the End of Life”

September 18 & 19, 2007
Samoset Resort on the Ocean, Rockport, Maine

or copy this URL to your browser:

*   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *  

Tuesday, September 18, 2007, 3:00 p.m. to 6:30 p.m. (includes dinner)
Pain Management at the End-of-Life
A 2-hour workshop for physicians based on the recently published Physician Self-Study Packet

Tuesday, September 18, 2007, 5:00 p.m. to 8:30 p.m. (includes dinner)
Medicare Hospice Access and Utilization:
Final report from Muskie School of Public Service from Phase One of “Collaborating for the Future”

*   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *   *  

Wednesday, September 19, 2007, 8:00 a.m. to 4:00 p.m.
Pain Management at the End of Life

Two morning plenary sessions:
“Must Dying be Painful? What Have We Learned After 35 Years?”
And:  “Methadone Madness”
Richard C. Stephenson, MD, VP Hospice and Palliative Care Center, Winston-Salem, NC

An afternoon plenary session:
“Finding Peace from the Pain: PTSD Near the End of Life”
Thomas E. Edes, MD, Director, Home & Community Based Care, VACO

And panel presentation:
“Finding Peace from the Pain: PTSD in the Life of the Veteran”

Facilitated by
Patrick Daly, MD, Palliative Care Team Coordinator, Togus VAMC
and representatives from Togus VA Medical Center, and Maine Veterans Homes

Concurrent sessions by:
Craig Hurwitz, MD; 
Elizabeth Hart, MD;
Janice Reynolds, RN, BC, OCN, CHPN;
Steven D’Amato, RPh, BCOP


Continuing Education:

Tuesday, September 18 “Pain Management at the End of Life”
Maine Medical Education Trust has designated this educational activity for a maximum of 2.0 Category 1 credits towards the AMA Physicians Recognition Award. Maine Medical Education Trust is accredited by the Maine Medical Association’s Committee on Continuing Medical Education to provide Continuing Medical Education (CME) to practicing physicians.
This program has been reviewed and is acceptable for 2.5 AOA - 2A credit Hours ~ Plus 3 additional for Self-Study Pack Completion for 9/18/07 American Osteopathic Association

Wednesday, September 19 “Maine Pain Initiative Symposium”
Maine Medical Education Trust has designated this educational activity for a maximum of 5.5 Category 1 credits towards the AMA Physicians Recognition Award. Maine Medical Education Trust is accredited by the Maine Medical Association’s Committee on Continuing Medical Education to provide Continuing Medical Education (CME) to practicing physicians. 
This program has been reviewed and is acceptable for 5.5 AOA - 2A credit Hours American Osteopathic Association

This continuing nursing education activity was approved by ANA-Maine, an accredited approver by the American Nurses Credentialing Center's Commission on accreditation, and approved for 5.5 (60 minute) contact hours.  Activity #07-040-I

The Board of Pharmacy has approved this program for 5.5 CEUs -- program #1409

The Board of Examiners of Psychologists has approved this program for 5.5 CEUs -- program # 1193

* Concurrent session faculty and sessions are tentative. Please check the website for confirmed faculty and presentations.

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"Using Data to Improve Quality and Public Reporting" First Fridays, Oct 5, 2007

Don't miss the next-to-last First Friday session of 2007: Using Data to Improve Quality and Public Reporting, October 5, 2007. Register online today!

Be proactive and learn how to collect and use your own practice (clinical) data to:

  • Improve quality
  • Market your practice
  • Prevent errors
  • Successfully compete with competitors
  • Enhance revenue by participating in Pay for Performance programs

The Maine Legislature at the behest of the Maine Quality Forum and the Maine Health Data Organization (MHDO), has authorized the release from the all-claims database of physician-identifiable data, subject to a set of rules and safeguards. Among the safeguards are the ability of the physician to see and review his or her data prior to publication.

This three- hour program will prepare you for the fast approaching release date onto the Maine Quality Forum website.

Register online today!


  • Joshua Cutler, MD, Director, Maine Quality Forum
  • Ted Rooney, RN, Consultant to Pathways to Excellence, a project of the Maine Health Management Coalition
  • Alan Prysunka, Executive Director, Maine Health Data Organization
  • William Perry, Maine Health Information Center
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For more information or to contact us directly, please visit l ©2003, Maine Medical Association