October 1, 2007

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Congress Acts to Delay Medicaid Requirement for Tamper Resistant Prescription Pads

President Bush this weekend signed legislation that will delay the Oct. 1, 2007 requirement that most prescriptions for Medicaid (in Maine, MaineCare) patients be written on tamper resistant prescription pads.  The six-month delay will help ensure that Medicaid patients are not delayed in their access to necessary medications.  Physician and pharmacy associations had been advocating for the delay ever since the requirement had been contained in legislation authorizing more funding for the war in Iraq a few months ago.

The House passed H.R. 3668 on September 26, 2007 & the Senate followed suit on September 27, 2007.  H.R. 3668 is legislation to extend a number of health care provisions set to expire on October 1, 2007.  Maine law for several years has required tamper resistant prescription pads for Schedule II medications in order to decrease the risk of illegal diversion.  However, many observers believed that the new federal requirment for all Medicaid drugs was overly broad and would result in delays in Medicaid patients obtaining necessary medications.  Maine's 1st District Congressman Tom Allen was particularly helpful in obtaining congressional relief from the requirement for the next six months.  It is hoped that the Congress, during the period of the delay, may limit the requirement to Schedule II scripts consistent with the existing Maine law.  You can find MDEA Rule Chapter 1, Requirements for Written Prescriptions of Schedule II Drugs on the web at:  http://www.maine.gov/sos/cec/rules/16/chaps16.htm.



New England AMA Delegation meets in Waltham, MA

On this past Saturday (Sept. 29), the New England AMA delegation met in Waltham, MA at the offices of the Massachusetts Medical Society for its Fall meeting.   Preparing for the interim meeting of the AMA in November, delegates and alternate delegates from the six New England states heard reports from each state and considered a half-dozen resolutions for possible introduction  to the AMA House of Delegates on behalf of the New England delegation.

A resolution from the Connecticut delegation calling for the Congress to fix the Medicare payment problem and to reauthorize the State Children's Health Insurance Program (SCHIP) was tabled in order for the sponsors to rewrite the resolution in order to bring it up to date, given the Congressional action last week resulting in passage of the SCHIP expansion without any Medicare payment reform.  

The MMA's senior AMA delegate, David J. Simmons, M.D., of Calais attended the meeting and presented the report from Maine.  Among other items, Dr. Simmons brought the delegation up to date on the Maine law allowing physicians and other prescribers to opt out of sharing their prescribing data.  The law is being challenged in the federal courts by the data mining companies. [return to top]

One Hundred Twenty-five Ophthalmologists Converge on Bar Harbor for DOS

The Sixth Annual Downeast Ophthalmology Symposium was held this past weekend in Bar Harbor with more than 140 attendees from more than 30 states and South Africa.  This popular CME meeting, organized by the Maine Society of Physicians and Surgeons (MSEPS), brings together an excellent faculty and participants from across the country.  The program is directed by course director Sam Solish, M.D. who practices in Portland.

On Friday morning, The Society held its Fall Business Meeting, chaired by MSEPS President Peter Kohler, M.D. of Waterville.  MMA EVP Gordon Smith was the featured speaker at the meeting.  Mr. Smith touched on the following issues during a legislative and regulatory update:

  • The trend toward tranparency and the use of the all-payor claims data base
  • Scope of Practice issues, incuding the current effort by lay midwives to be licensed and to prescribe
  • Medical Liability and the current status of Maine's pre-litigation screening panels
  • Certificate of Need
  • Medicaid reimbursement and the claims processing situation
  • Medicare payment reform

Congratulations to MSEPS and its officers and staff for a successful meeting and symposium.


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5th Annual Maine Benzodiazepine Study Group Conference and Unused Drug Return Conference

The University of Maine Center on Aging in partnership with the Maine Benzodiazepine Study Group, in cooperation with Cary Medical Center, and with support from the American Pharmacists Association, the Bingham Group, and the Maine Health Access Foundation, announces the opening of registration for its fall conference, "Improving Patient Safety through Informed Medication Prescribing and Disposal Practices."   This event marks the 5th Annual Maine Benzodiazepine Study Group Conference & 4th Annual Unused Drug Return Conference.  This international gathering of clinicians, researchers, policymakers, drug enforcement officials, environmentalists, and health care providers is being held at the Holiday Inn by the Bay in Portland, Maine on Oct. 31 & Nov. 1.  Conference registration information and materials and the advance program may be accessed at: http://www.mainebenzo.org/2007conference.htm.  For more information, contact Jason Charland, Conference Coordinator, at 207-262-7928 or jason.charland@umit.maine.edu. [return to top]

"Health, Culture and Literacy: Solutions for Clear Health Communications," Friday, Oct. 26 in Freeport

MaineHealth Learning Resource Centers will host "Health, Culture and Literacy:  Solutions for Clear Health Communications" on Friday, Oct. 26th 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.

The program is presented in collaboration with the Maine Medical Association and more than a dozen other healthcare organizations. 

Seven breakout sessions will be presented, including one entitled "Getting Started for Physicians," featuring Terry Davis, PhD, Professor of Medicine and Pediatrics, Lousiana State University Health Sciences Center.  MMA EVP Gordon Smith will introduce Mary Ann Abrams, MD, MPH from Iowa, who will present two workshops entitled, "Transforming Patient-Provider Communication - The Iowa Health System Approach."

Maine Medical Center designates this educational activity for a maximum of 5.75 AMA PRA Category I credits.  Physicians should only claim credit commensurate with the extent of their participation in the activity.  The cost is $75 for physicians. [return to top]

Maine Society of Anesthesiologists Holds Fall Meeting at MMA

This past Wednesday evening (Sept. 26), members of the Maine Society of Anesthesiologists held their Fall meeting at the offices of MMA in Manchester.  Speakers included Norman Curtis, Director of Customer Service for MaineCare, and representatives of EDS, one of four potential bidders for the new MaineCare claims processing system.

Mr. Curtis was accompanied by billing personnel who presented detailed information on some of the claims processing problems impacting uniquely on anesthesia.  Many of these problems have been continual since January of 2006 when the MECMS system was first turned on.

Gordon Smith, Esq., presented a legislative and regulatory report.

The Society will meet next on Feb. 9 and 10 at Sugarloaf. [return to top]

Unused Drug Disposal Program Receives Initial Funding

Following up on landmark legislation introduced by Sen. Lynn Bromley (D-Cumberland) at the request of the Maine Medical Association and the Maine Association of Psychiatric Physicians, the University of Maine's Center on Aging will launch a program this fall to help consumers dispose properly of unused prescription drugs in a safe and environmentally responsible manner.

The program aims to have patients put unused prescriptions or over-the-counter drugs in pre-addressed, postage-paid pouches and mail them to the Maine Drug Enforcement Agency for disposal, most likely through incineration.  The mailing pouches will be available through Maine pharmacies.

The program is targeted primarily at seniors and their caregivers and is the first of its type in the nation.  It will launch first in four counties:  Penobscot, Cumberland, Kennebec, and Aroostook, but it could be expanded to additional counties eventually.


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MMA EVP Gordon Smith on Three Month Sabbatical

Beginning Oct. 8, MMA EVP Gordon Smith will be on a three month sabbatical, returning to work on January 18, 2008 when the MMA Executive Committee begins a weekend retreat in New Hampshire.  During this time, Deputy EVP Andrew MacLean will serve as Acting EVP, directing activities of the 13 member staff as well as continuing his advocacy activities at the State House and before the regulatory agencies.

"After 28 years with MMA, I am looking forward to a brief break to clear my head and recharge my batteries," said Smith, who began work for MMA in the Fall of  l979 while still with a private law firm in Augusta.  He began full-time with the Association in January 1981. 

In addition to Mr. MacLean, MMA has made arragements with private attorneys to continue its contract review service for members, continuing the same reasonable price ($250).  This service can be accessed by communicating with Mr. MacLean at 622-3374, ext. 214 or via e-mail to amaclean@mainemed.com.

The MMA Executive Committee and staff wish Gordon all the best during his sabbatical.  [return to top]

Congress Passes $35 Billion SCHIP Bill; President Still Promises Veto

On September 25, 2007, the U.S. House passed H.R. 976, the Children's Health Insurance Program Reauthorization Act by a vote of 265-159, short of the 2/3 majority needed to override the President's threatened veto.  The bill would provide the program with $35 billion in funding over 5 years in addition to the $25 billion already in the budget.  This funding would extend coverage to an additional 4 million children in addition to the 6.6 million currently covered.  To reach these children, the bill provides for $100 million in grants for new outreach efforts.  The bill also will provide dental coverage to all SCHIP children.  On September 27, 2007, the Senate enacted this measure by a vote of 67-29.

The President supports an increase in SCHIP funding of $5 billion over 5 years in addition to the $25 billion baseline funding.  The President has threatened to veto the bill because of its cost, the $0.61 cents per pack increase in the cigarette tax, & his opinion that it would inappropriately increase the federal government's role in health care.  The Congressional Budget Office estimates that the President's proposal would force 1.4 million children off of the program.

At the end of last week, the Senate & House passed a temporary funding bill (H.R. 3668) that extends funding for the SCHIP while negotiations continue.  This is the same legislation that contains the 6-month delay in the requirement that tamper-resistant prescription pads be used for Medicaid beneficiaries.
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EMMC Nurses Issue Notice of One-Day Strike

Following the failure of negotiations between the hospital's administration & the Maine State Nurses Association & the expiration of the current labor agreement yesterday, the MSNA announced its intention to call a 1-day strike to take place after the 10-day notice required by law.  At issue between the 2 sides is the creation of & authority of a "professional practice committee" composed of direct-care staff nurses without nurse managers.  The nursing union wants this professional practice committee to have influence on major policy decisions affecting patient care, including nurse staffing levels.  Last year the MSNA established a relationship with the California Nurses Association & a CNA negotiator has been representing the MSNA in its negotiations with EMMC.

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Advisory Council on Health Systems Development Considers Expanded Role in Cost Containment

The 2003 Dirigo Health Program legislation created an Advisory Council on Health Systems Development to provide public input to the state health planning process & to provide advice on the State Health Plan & the certificate-of-need (CON) program.  Upon enactment of L.D. 1849, An Act to Protect Consumers from Rising Health Care Costs (P.L. 2007, Chapter 441) by the 123rd Legislature earlier this year, the Advisory Council has taken on an expanded role in the State's health care cost containment effort.  The Advisory Council, chaired by Brian Rines, Ph.D., held its first meeting since the effective date of the new law on Friday, September 28, 2007.  During this meeting, the Dirigo staff presented the Council with an extensive document entitled, ACHSD Data Book:  Investigating Maine's Health Care Cost Drivers.  The Council spent the day-long meeting reviewing its history, its new charge, & the Data Book & began its work plan to meet its deadline to make specific cost containment recommendations to the legislature beginning on March 1, 2008 & annually thereafter.

You can see the Council's new role in the legislation on the web at:  http://janus.state.me.us/legis/LawMakerWeb/externalsiteframe.asp?ID=280024978&LD=1849&Type=1&SessionID=7

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Bureau of Insurance Holds Public Hearing on Rule Chapter 850 "Consensus" Amendments to Geographic Access Standards

On Wednesday, September 26, 2007, the Bureau of Insurance held a public hearing on proposed amendments to the section of Rule Chapter 850, Health Plan Accountability, dealing with the controversial geographic access standards.  The proposed amendments are the recommendations of a "consensus-based" rulemaking group that included representatives of the MMA, the MHA, the Maine Association of Health Plans, the Maine State Chamber of Commerce, & consumer advocacy groups & are a modest effort, as permitted by statute, to permit health plans & employers to provide incentives to direct patients to providers & practitioners who meet certain quality standards.  One member of the public from Aroostook County spoke at the hearing & expressed concern about services in rural parts of Maine.  Most of the representatives who participated in the rulemaking group expressed comfort with the proposed recommendations, but the Maine Association of Health Plans said that they do not go far enough.  However, the amendments do go as far as permitted by the current statutory guidelines. 

The deadline for written comments is Tuesday, October 9, 2007 at 5 p.m.  You can find the proposed amendments to Rule Chapter 850 along with the Notice of Rulemaking containing the contact information for written comments on the web at:  http://www.maine.gov/pfr/insurance/rules/850.htm.

If you have further questions or comments about the proposed amendments, please contact Andrew MacLean, Deputy EVP, at amaclean@mainemed.com or 622-3374, ext. 214.
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For more information or to contact us directly, please visit www.mainemed.com l ©2003, Maine Medical Association