October 15, 2007

 
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Prescribing Data Restriction Law, Effective 10/1/07, is Held Up By Lawsuit

Physicians and other prescribers expecting in October to receive a packet of information on the new law allowing a state specific opt-out of the practice of data mining of prescribing information will have to wait.  State agencies expected to set up the program have delayed implementation pending the results of a court challenge to the law.  The data-mining companies challenging the law have asked for an injunction against its implementation which will be argued in the federal courts in late November.  MMA will keep members informed of the court case and the law through this Weekly Update and through the pages of Maine Medicine.

The October 1, 2007 issue of American Medical News contains an article on the Maine law and a similar law in Vermont and the court challenges.  Entitled, Drug info firms target prescriber data laws, the article appears on page 10 of the AMA's weekly publication. 

The same data-mining companies challenged the law enacted two years ago in New Hampshire which dealt with the same issue, but that law imposed an absolute ban on the use of such data, while the Maine law allows a physician (or any person with prescription privileges) to opt out thereby making their data private.  The Vermont law prohibits the use of such information unless the prescriber opts in thereby specifically giving his or her permission to have the data utilized for marketing purposes.

The firms challenging the law are IMS Health Inc., Verispan LLC, and Source Healthcare Analytics Inc.  The complaints argue that they violate the U.S. Constitution's 1st and 14th Amendments as well as the Commerce Clause.

In the A.M.News article, IMS spokesman Randy Frankel stated, "The problem with the Maine and Vermont laws is that they create an entirely new and unprecedented privacy right for physicians in their professional conduct.  Improving our health care system depends on access to more information, not less."

The article notes that both the Maine Medical Association and the Vermont Medical Society support their respective state laws but that neither society is expected to participate in the litigation.  The AMA also has chosen not to file an amicus brief in the federal court action.

MMA Group Health Plan to Experience 3.2% Decrease in Premium in 2008

Because of a very favorable loss ratio this year in the range of 60%, Anthem Blue Cross Blue Shield of Maine will reduce premiums across the board for the Association's group health plan available to its members and their families and staff.  It is the first reduction in premium in several years and will help to bring the rates to a point similar to the community rate.  The decrease in premium will be 3.2% for all of the options in the plan, including the carve-out option for retirees who rely on Medicare for their primary coverage.  The decrease is effective February 1, 2008, which is the traditional renewal date for the plan.

"We are not naive about how unusual a decrease is in the current environment.  We are simply pleased to accept the modest decrease and hope that the lower rates will attract more members to the Plan," noted Gordon H. Smith, MMA EVP.

Members or staff wishing to receive a quote to join the plan should contact Judy Conley at HRH New England at 1-800-464-1203, ext. 1103.  HRH New England is the exclusive broker for the MMA Group Health Plan.

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123rd Maine Legislature Publishes Bill Requests for Second Regular Session

Members of the 123rd Maine Legislature were required to file new bill requests for the Second Regular Session scheduled to begin just after the New Year by October 3, 2007.  The list of bills filed by legislators & by state agencies is on the legislature's web site at:  http://janus.state.me.us/legis/lio/publications.htm.  See the top 2 items.

During the Second Regular Session, legislators are supposed to consider only bills of a fiscal or "emergency" nature.  In practice, this means that a bill must receive a majority vote of the 10-member Legislative Council (the legislative leadership) to be admitted.

The MMA Legislative Committee is scheduled to meet from 5:30 to 7:00 p.m. on Wednesday, December 5, 2007 to review the bills admitted for consideration during the Second Regular Session & to review the Committee's administrative process for the new session.  All members are welcome.  For more information, please contact Charyl Malik, Legislative Assistant, at 622-3374, ext. 211 or cmalik@mainemed.com.


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New Hampshire Screening Panel Law Focuses Attention on Maine's Panel System

Enactment of a medical malpractice screening panel law modeled on Maine's successful law in 2006 has led to recent media and public attention on both statutes.  Yesterday's (Oct. 14, 2007) article in the Maine Sunday Telegram entitled, New Hampshire law backfires, slows malpractice suits, as well as associated articles in some of the daily papers may, unfortunately, lead to increased scrutiny of Maine's law.  You can find the article on the web at:  http://pressherald.mainetoday.com/story.php?id=140443&ac=PHnws.

The content in the article is not as damaging as the headline and contains comments supportive of the panel system from Terry Sheehan, M.D. and Mick McCall from Medical Mutual Insurance Company of Maine and Gordon Smith, MMA EVP. 

As the New Hampshire system begins its implementation, only eight panel hearings have been held out of 131 cases filed since the law was enacted.  The article discusses the concerns that the New Hampshire trial bar has with the law, with the personal injury attorneys claiming that the new system makes it more expensive to bring a case.  The trial lawyers in New Hampshire have bitterly opposed the statute from its inception.  In Maine, the Maine Trial Lawyers Association and the Maine State Bar Association joined MMA, Medical Mutual, and the Maine Hospital Association in developing the legislation in 1986, although a number of prominent Maine trial lawyers have expressed concern with the statute since.  MMA and other tort reform supporters have had to fight off a number of trial-lawyer inspired attempts to amend or eliminate the system in the past fifteen years.

Independent studies of the Maine system, conducted on behalf of the Maine Bureau of Insurance, have concluded that the panel system has been successful in meeting its goal of weeding out frivolous cases and expediting settlements in meritorious cases.  The panel system appears to be the major factor in Maine's medical liability premiums being lower than New Hampshire's and being the second lowest in New England.  Medical Mutual recently announced a dividend for Maine's insureds based upon favorable claims experience.

This past week, MMA Deputy EVP Andrew MacLean and the President of the Maine Trial Lawyers Association, Donald Briggs, Esq., met with the Chief Justice of the Maine Superior Court, Thomas Humphrey, to discuss the status of Maine's system.  Justice Humphrey is the administrator of the system under the law.  Justice Humphrey has devoted substantial time to collecting technical, procedural data on the panel proceedings and to training both judicial personnel and panel chairs on the process to ensure timeliness as often as possible.  The statute provides that cases are to be reviewed by the panel within 6 months of assignment.  While Justice Humphrey acknowledged that this might not be realistic, most panel proceedings should be completed within one year, the outer limit in the statute.  Justice Humphrey is trying to standardize the administration of the panels across panel chairs and Superior Court locations.  Participation as a panel member by physicians is very important to the success of the process, so the MMA urges you to participate when asked or to help a panel chair to locate a physician in the appropriate specialty who is available to serve.

Currently there are no proposals pending in the legislature to review or amend Maine's law, although such an examination has been recommended by the Chief Justice of the Maine Supreme Judicial Court, based upon her concern in one case reviewed on appeal which involved technical interpretations of how split decisions in a panel proceeding are presented to the jury. [return to top]

SCHIP Veto Override Vote Scheduled for Thursday, 10/18; AMA & AARP Urge Override

The U.S. House of Representatives has scheduled Thursday, October 18, 2007 for a vote to override the President's veto of the $35 billion SCHIP reauthorization bill.  On September 25, 2007, the House passed H.R. 976 by a vote of 265-159, about 2 dozen votes shy of the number needed to override the veto.  Both of Maine's House members, Tom Allen (D-1st District) & Mike Michaud (D-2nd District), voted with majority Democrats for the bill.  On October 10, 2007, the AMA & AARP sent a joint letter to members of the House urging them to override the President's veto of the SCHIP bill. 

The letter closes as follows:  "When 47 million Americans are already uninsured, this is not the time to jeopardize the coverage of our children."  You can find the joint letter & other advocacy materials on the web at:  http://www.ama-assn.org/ama/pub/category/18040.html.

The AMA & AARP also are working together on advocacy in favor of the Medicare payment fix.  The 2 organizations have developed a TV ad campaign urging the Congress to address the 10% + cut scheduled to take effect on January 1, 2008.  Senate Finance Committee Chair Max Baucus (D-MT) has stated that his committee will address the Medicare SGR problem & other Medicare policy issues before the end of the year.
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Maine CDC Proposes to Create Eight Public Health Districts in the State

Public meetings around the state will begin this week on the state's proposal to divide Maine into eight public health districts.  As part of the proposal,  some staff would be re-located from Augusta to other communities in order to make them more accessible to both citizens and health professions.

The proposal in some ways is reminiscent of the practice in the 19th century to have local health officials in each community.

"The whole mission is to make Maine's public health system more effective and more efficient," said Dora Anne Mills, M.D., MPH, Director of the Maine Center for Disease Control and Prevention.  The proposal was prepared by the so-called Public Health Working Group which has been working for two years on the proposal.

The first of the public forums will be held at Governor's restaurant in Waterville at 12:30 pm on Monday (10/15).  The proposal is part of the broader effort to update the state's biennial State Health Plan.  You can find information about these public forums & the schedule on the web at:  http://www.maine.gov/dhhs/boh/october_district_health_forum.htm.

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e-Health Initiative Releases "Blueprint" for Health Information Technology

On October 10, 2007, the e-Health Initiative, a coalition of almost 200 health care stakeholder organizations, released a "blueprint" describing the group's vision, principles, strategies, & actions for improving health & health care through the use of information technology.  The group has reached consensus on 3 principal recommendations:

  • Engage consumers in the drive for health information technology;
  • Transform health care delivery through health information technology; &
  • Improve population health using health information technology

The group has not achieved consensus on 2 of the most difficult issues in the debate:

  • The payment for & receipt of incentives to adopt health information technology; &
  • The privacy policies that will protect patients while permitting appropriate practitioner & researcher access to the health information.

The "blueprint" is available on the web at:  http://www.ehealthinitiative.org/blueprint/.
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Women's Law Society Invites Female Physicians to Fall Gathering on Depression & Substance Abuse

The Women's Law Society, a component of the Maine State Bar Association, invites female physicians to its Fall Gathering entitled, How Depression & Substance Abuse Affect Female Professionals, scheduled for the evening of Thursday, November 1, 2007 at Bowdoin College.

The schedule for the event is:

  • 5 p.m., Registration
  • 5:30 - 7:00 p.m., Presentation by Dr. Susan Blank & Louise Thomas, Esq.
  • 7:00 p.m., Buffet dinner

The location of the presentation is Thorne Hall & the location of the dinner is the Moulton Union.

The cost is $60 & the registration deadline is October 18, 2007.

For more information, please contact Cindy Swift with the Maine State Bar Association at 622-7523.
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Study Asserts that Nation's Children Receive Recommended Care only 46% of the Time

A study published last Thursday in the New England Journal of Medicine concludes that America's children received appropriate medical care only 46% of the time when they visited physicians and other health professionals.  The study was conducted by the RAND Corporation, the Seattle Children's Hospital Research Institute, and the University of Washington School of Medicine. 

The study reviewed health records associated with 1,536 children from twelve different metropolitan areas over a four-year period and compared the services provided with well-established care standards.  The study found that only 19% of ill infants with fevers had the recommended lab tests performed, only 44% of children with asthma were on the right medications, and only 38% of children were screened for anemia in their first two years of life.  Only 31% of children ages 3-6 have their weight measured in annual check-ups.

The majority of the children in the study were covered by health insurance.  [return to top]

First Friday CME Program Looks at Claims Database and Public Reporting

On October 5, 2007, the MMA presented as part of the First Friday's series of CME programs a program on the existing all-payor claims database and its potential use for public reporting of individual physician data.  Participating in the program were Alan Prysunka, Director of the Maine Health Data Organization, William Perry of the Maine Health Information Center, Ted Rooney, consultant to the Maine Health Management Coalition, and D. Joshua Cutler, M.D., Executive Director of the Maine Quality Forum.  The program was moderated by Andrew MacLean, Esq., Deputy EVP of MMA.

Extra copies of the materials from the program are available for $20 by contacting Gail Begin at MMA (gbegin@mainemed.com or call 622-3374, ext. 212).

A schedule of the 2008 First Friday presentations is included in your September-October copy of Maine Medicine and is located on the MMA website at www.mainemed.com. [return to top]

Leadership in Action Award Dinner to Feature Futurist Jeff Goldsmith, Nov 5, 2007

The Daniel Hanley Center for Health Leadership and The Institute for Civic Leadership hosts the Leadership in Action Award Dinner, featuring "A Look Over The Horizon: Maine, Health Care & Baby Boomers," November 5, 2007, 6:00-9:00 pm at the Portland Marriott at Sable Oaks.
 
Join healthcare leaders, employers and others for this special evening to recognize outstanding collaborative leadership in Maine's health sector and hear one of the nation's leading futurists, Jeff Goldsmith, describe what he sees on the health care horizon in Maine and throughout the nation.

Jeff Goldsmith is one of the nation's premier healthcare futurists. For more than 25 years he has studied major health care cost, quality and access trends and advised employers and healthcare leaders about how they can prepare for the challenges-and the opportunities---that will unfold in the years ahead. Jeff brings a national perspective as well as extensive knowledge of the Maine environment based on work he has done in this state.

His address will help you and your organization better understand and deal with the factors that will affect all of us as our population ages. Jeff will also offer insight into steps that leaders can take today to guide their organizations through the dynamic years that lie ahead.

Jeff's presentation will be of substantial interest to everyone who has a stake in the future of healthcare in Maine, including employers, providers and others who are struggling to provide high quality, affordable care and coverage for Maine people.

Register Today! Call Wayne Griffin at 207-773-3254 x100 or email wgriffin@civicleadership.org
$65 per person. Registration forms available at: http://www.hanleytrust.org/award/dinnerRSVP.pdf
Please register by October 29, 2007.  For more information, please contact Jim Harnar at jharnar@maine.rr.com or call 207-523-1501 [return to top]

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