April 7, 2008

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Invitation to Hear Jeff Goldsmith, PhD at MMA on Friday Morning (April 11)

Members, practice managers and hospital administrators are reminded of the opportunity to hear from health care futurist Jeff Goldsmith, PhD, at MMA offices in Manchester on this coming Friday morning, April 11 from 9:00 to noon.  There is no cost for the program which will focus on the topic of "The Changing of the Guard; Generational Transition in Medicine." discussing the challenges of providing care to baby boomers given the changes in the workforce.  The program is limited to fifty persons so call MMA at 622-3374 to reserve a slot.

Dr. Goldsmith is one of the nation's leading healthcare futurists.  He has spoken in Maine frequently over the past few years and is well acquainted with the challenges of Maine's marketplace.  Last Fall, Dr. Goldsmith presented to a group of nearly 400 persons at the Hanley Leadership Dinner in South Portland.

Dr. Goldsmith is President of Health Futures, Inc. and also serves as Associate Professor of Public Health Sciences at the University of Virginia.  From 1982 to 1994, he served as National Advisor for Healthcare for the firm of Ernst and Young and provided strategy consultation to a wide variety of healthcare systems, health plans, supply and technology firms.  Prior to 1982, he was Director of Planning and Government Affairs at the University of Chicago Medical Center and Special Assistant to the Dean of the Pritzker School of Medicine.

Dr. Goldsmith earned his doctorate in Sociology from the University of Chicago in 1973, studying complex organizations, sociology of the professions, and politics of developing nations.  He was the recipient of the Corning Award for excellence in health planning from the AHA's Society for Healthcare Planning in 1990, and has received the Dean Conley Award for best healthcare article three times from the American College of Healthcare Executives.  He has written extensively for the Harvard Business Review and has been a source for articles on medical technology and health services for the Wall Street Journal, the New York Times, Business Week, Time and other publications.  He is a member of the editorial board of Health Affairs.

This special "Second Fridays" presentation offers a unique opportunity to hear from Dr. Goldsmith in a small setting, with ample time for questions and discussion.

There is no cost to attend but please call MMA at 622-3374 to reserve a spot.

Comments Sought by State on End-Of Life Care Issues

Following up on a series of public forums last fall sponsored by the Maine Hospice Council and the Maine Attorney General's Office, state officials are seeking public comment on end-of-life care issues including personal experiences and perspectives.  Over two hundred individuals attended the programs, but the comment period was extended to the end of April, 2008.

Commentors are encouraged to provide perspectives on issues such as advanced directives, pain management, grief counseling, hospice services and related issues.  A report will be presented to the Legislature later in the year.

Written comments may be submitted to Laurie Simpson, Office of the Attorney General, 6 State House Station, Augusta, Maine 04333. [return to top]

Medicare Fee Fix the Primary Topic at AMA Advocacy Conference

The impending July 1, 2008 reduction in physician fees paid by Medicare was the primary topic of interest at the annual AMA Advocacy conference in Washington D.C. this past week.  The reduction averages 10.6% but in Maine the cut is deeper, 11.7 % in Cumberland and York counties and 12.8% in the remainder of the state. 

S. 2785, introduced by Michigan Senator Debbie Stabenow (D.) would restore the cut and continue with the 0.5% increase July 1 followed by an 1.8% increase in January, 2009.  The legislation would cover an 18 month period, but would not permanently change the sustainable growth rate (SGR) formula.  It is hoped that the 18 month fix will provide time for the Congress to permanently eliminate the SGR methodology and place it with a methodology that would recognize a yearly increase in practice costs.

MMA leadership and staff met with all four members of the Maine Congressional delegation and all are committed to avoiding the July 1 cut.  Senator Collins has already signed on to the Stabenow bill, being the second Republican member of the Senate to do so, the first having been Kay Bailey Hutchinson (R, Texas).

The Congress has limited time to act in order to avoid the cut, but it is hoped that the Senate Finance Committee will move a solution onto the Senate floor.  The House passed a fix last year, only to have it removed by the Senate.  So the House is waiting for the Senate to take the first step.

MMA will keep members and staff aware of the attempts to deal with this important issue through the Weekly Update. 

The reduction in July would cost Maine physicians over $50 million over the 18 month period. [return to top]

MMA Legislative Committee Schedules 1st District Congressional Candidate Visit for Second Forum

The MMA Legislative Committee and the Trustees of the Maine Physicians Action Fund (MPAF) have scheduled the second forum of the year for Tuesday, May 13, 2008 from 5:30 to 8:00 p.m. at the MMA office in Manchester.  This event will be a candidate forum with the Republican and Democratic candidates for Maine's First Congressional District.  While we have not yet heard from all the candidates, we do expect Steve Meister, M.D., Adam Cote, Senator Ethan Strimling, former state Senator Mike Brennan, and Dean Scontras. 

Legislative Committee Chair Katherine Pope, M.D., Vice Chair Sam Solish, M.D., and PAC Chair John Makin, Jr., M.D. invite any interested member to join us for this event.  Please RSVP to Lisa Dennison at ldennison@mainemed.com or 622-3374. [return to top]

Political Pulse: Supplemental Budget Enacted/"Lay Midwives" Licensing Bill Up for Debate Soon

1.  Direct entry or "lay" midwife licensing
Although legislative scheduling is always difficult to predict, MMA expects L.D. 2253 regarding lay midwives to be voted on in the House and Senate this coming week.  The bill has appeared in the "Notice" section of the House calendar, meaning that it could appear on a calendar supplement as early as today.  The bill, that would license lay midwives, creating a false sense of the safety of home births and leading to confusion with the role of nurse midwives (CNM's), received a 7 to 6 divided report from the Committee on Business, Research & Economic Development.  While the narrow majority favored licensing midwives under the existing board of Complementary Health Care Providers, 6 members on the committee voted to allow access to a short list of medication for home births but to reject licensing.

MMA opposes licensing and is joined in that opposition by the specialty societies representing obstetricians, family physicians, pediatricians, emergency physicians, psychiatrists, the Maine Osteopathic Association,  the Maine Association of Nurse Practitioners, and the March of Dimes.

MMA members and their staffs are encouraged to call their legislators urging opposition to the majority report.  

You may leave a message at the State House asking a member to call you back as follows: You may leave a message at the State House asking a member to call you back as follows:

                                      Senators:  1-800-423-6900
                                      Representatives:  1-800-423-2900

You can find your own legislators on the web at:  http://janus.state.me.us/house/townlist.htm  

If you have further questions or comments about this effort, please contact Gordon Smith, EVP at gsmith@mainemed.com or 622-3374, ext. 212 or Andrew MacLean, Deputy EVP at amaclean@mainemed.com or 622-3374, ext. 214.

2.  State FY 2008-2009 Supplemental Budget (L.D. 2289) 
After a period of intense negotiations, the Legislature finally enacted a supplemental budget late last Monday evening, March 31, 2008.  The Governor signed the bill (P.L. 2007, Chapter 539) and the Legislature adjourned the Second Regular Session sine die just before midnight.  The bill, passed by votes of 82-52 in the House and 24-11 in the Senate, covers a gap of $190 million without new broad-based tax increases.  While the $20 million cut to hospital-based physicians was included in the budget, the legislature enacted a separate bill, L.D. 2290, to address the cut through a rebasing of the current hospital tax from 2004 to 2006.  Representative Janet Mills (D-Farmington) was the prime sponsor of L.D. 2290, An Act to Protect Access to Health Care.  The MMA assisted with the budget lobbying, but the principal credit goes to Mary Mayhew, the Maine Hospital Association, and Representative Mills. 

You can read the Governor's statement upon signing the budget on the web at:  http://www.maine.gov/tools/whatsnew/index.php?topic=Portal+News&id=53142&v=Article-2006.  The 123rd Maine Legislature began its First Special Session on Tuesday, April 1st and it is expected that it will complete its work by Wednesday, April 16, 2008.

3.  Bill Banning Smoking in Cars Scheduled for Ceremonial Bill Signing on Thursday, April 10th 
The House and Senate enacted L.D. 2012, An Act to Protect Children in Vehicles from Secondhand Smoke on April 1st and 2nd respectfully and Governor Baldacci has scheduled a bill signing ceremony for Thursday, April 10th.  MMA EVP Gordon Smith gave the lead testimony on the bill on behalf of the MMA and Health Policy Partners of Maine and the MMA will participate in the signing ceremony.  Maine becomes the latest to enact such legislation following 3 other states and the province of Nova Scotia.

4.  Toxics Bill Appears on House Calendar 
The Natural Resources Committee's 9-4 "ought to pass as amended" report on L.D. 2048, An Act to Protect Children's Health & the Environment from Toxic Chemicals in Toys and Children's Products appears on today's House calendar. 

The majority report authorizes the DEP  to include on a list of chemicals of high concern chemicals identified by specific entities.  Prior to designating priority chemicals, the DEP is required to consult with affected industries, independent experts, and other interested parties and with the Maine CDC.  It authorizes the BEP to adopt rules restricting the sale of children's products  containing priority chemicals if safer alternatives are available.  It authorizes DEP to designate mercury or a mercury compound as a priority chemical for the purpose of adopting rules to prohibit the sale of a mercury-added product that is not currently regulated. 

The minority report recommends a Resolve directing the DEP to work with the Maine CDC to develop a list of chemicals of high concern and to convene a stakeholder group to gather recommendations on the list.  It also requires the 2 state agencies to consult with various federal agencies to help identify areas where state action is practical and necessary.  Finally, it requires the 2 agencies to report back to the legislature on their efforts.

The MMA Public Health Committee has been actively engaged in supporting this bill.

5.  Legislative Committee Conference Call 
The next Legislative Committee conference call is scheduled for tomorrow evening, April 8th at 7 p.m.  The conference call number is 1-800-989-2842 and the access code is 6223374#.

6.  Legislative Schedule and Other Resources  
The Legislature's statutory adjournment deadline is Wednesday, April 16, 2008.

You can find more legislative information on the Maine State Legislature's web site:  http://janus.state.me.us/legis.   

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MMA Senior Section Luncheon, April 30

A Senior Section luncheon will be held on April 30th from 11:30 to 2:00 pm. at the Maine Osteopathic Association in Manchester. Guest speakers will be Michael Tesoro, MD from the Connecticut Medical Society and also Robert Bing-You, MD, Director of Medical Education at the Maine Medical Center.  Dr. Tesoro will present on his experiences establishing a Senior Section in Connecticut, and Dr. Bing-You will present on the mentoring program at Maine Medical Center.

For more information, please contact Lisa Martin at lmartin@mainemed.com or call 622-3374 x 221. [return to top]

Dahl-Chase Seeks Executive Vice President

A successful, large, private, pathology group in Maine is seeking a qualified, highly motivated individual to fill the position of Executive Vice-President of its anatomic pathology laboratory and courier service.  The position requires strong leadership qualities and an MBA degree with expertise in finance and business management.  Knowledge and experience in medical science and healthcare re-imbursement are desirable.  Facility with human resource-related issues and personnel management is also desirable.  The position will require close interaction with the President and Vice-President of the pathology group, Laboratory Manager and key personnel in the business and IT divisions.  Forward and innovative thinking related to improvement of pathology services and increasing business opportunities will be highly valued. 

The salary structure is highly competitive and commensurate with experience with a generous benefits package and the opportunity to benefit from the company’s growth.

Qualified individuals may submit letters of interest and résumés to:

George Eyerer, M.D.          
President, Dahl-Chase Pathology Associates                                                                   
417 State Street, Suite 541, Bangor, Maine 04401                                                
(207) 941-8200


 Mark Illingworth, MBA, MT (ASCP)
 President, Dahl-Chase Diagnostic Services            
 417 State Street, Suite 541                     
  Bangor, Maine 04401
  (207) 941-8200
  www.dahlchase.com [return to top]

WellPoint: 11 Errors Off-Limits

Indianapolis Star, April 2, 2008
The nation’s largest health insurer announced that it is halting reimbursement payments to physicians and hospitals for 11 medical errors. WellPoint, Inc. will no longer provide payment for errors deemed preventable by the Centers for Medicare and Medicaid Services and the National Quality Forum. The policy change, which is expected to be rolled out nationwide this year, also states that patients will not be billed for the treatments received in error.  [return to top]

MeGMA Offers Presents Medical Practice Budgeting and How to Market Your Medical Practice, April 30 in Lewiston

The Maine Medical Group Management Association presents Medical Practice Budgeting and Improving Key Financial Benchmark Performance & How to Market Your Medical Practice Plus Round Table Discussions and Networking, April 30, 3008 at the LePage Conference Center in Lewiston.  The speakers will be Douglas R. Miller, M.E.d., M.B.A., and Sam Surprise.

Seminar Schedule:

  • Registration and Continental Breakfast is from 7:30 AM to 8:30 AM
  • The first session will begin at 8:30 AM.
  • 8:30 AM to 11:30 AM Douglas Miller, M.Ed., M.B.A., will present "Medical Practice Budgeting and Improving Key Financial Benchmark Performance"
  • 11:30 AM to 12:30 PM - Lunch
  • 12:30 PM to 2:30 PM - Sam Surprise will present “Marketing Your Medical Practice”
  • 2:30 PM to 4:00 PM Round Table Discussions

Click here for more information [pdf] [return to top]

Governor's 11th Annual Health Summit, June 4, at Hilton Garden Riverwatch in Auburn

“Achieving Higher Performance in Primary Care:  The Patient Centered Medical Home” is the theme of the Governor’s 11th Annual Health Summit, to be held on June 4, 2008 at the Hilton Garden Riverwatch in Auburn, Maine.

Understand the key principles of the Patient-Centered Medical Home and learn from the expert panel of leaders who have experience in office practice transformation into medical homes.  Learn how to qualify for NCQA recognition.  Presenters will describe challenges for implementation and simple strategies to transform an office practice and breathe life into the principles of the medical home such as: pre-appointment preparation, empowered nursing, prescription management, rapid access scheduling, patient portals, patient engagement, and incorporating an EHR in supporting innovation.  
 Attendees will learn how to modify their practices into medical homes, becoming the basis of a systemic approach to improving access to care, improving quality, and controlling cost.  The agenda includes nationally known speakers:

• Melinda Abrams, Director of The Commonwealth Fund’s Patient-Centered Primary Care Program
• Xavier Sevilla, MD, FAAP, Chief of Pediatrics, Manatee County Rural Health Services, Inc., and Steering Committee on Quality Improvement and Management, American Academy of Pediatrics
• Christine A. Sinsky, MD; Thomas A. Sinsky, MD, Medical Associates Clinic and Health Plans, Dubuque, Iowa
• David Loxterkamp, MD, Seaport Family Practice, PA, Belfast, Maine
• Elizabeth Pearson, Dartmouth Medical School; Toni G. Wall, Maine Center for Disease Control and Prevention
• Josh Cutler, MD, Director, Maine Quality Forum; Jeff Holmstrom, DO, Medical Director, Anthem; What’s Happening in Maine— Update on the All Payor Pilot Initiative

Online registration is available at http://www.mcdregistration.org/.  If you would like to receive a brochure, please contact dianec@mcd.org. [return to top]

Update on Tamper-Proof Prescriptions for MaineCare

As you may remember, a new federal requirement for tamper-proof prescriptions for the Medicaid program was delayed from October 1, 2007 to April 1, 2008.  The Maine DHHS pharmacy program has provided the following update on its efforts to comply with the new federal requirement. 

In response to the amendment in Section 7002(b) - U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act, the State of Maine has put into place a tool to assist you during this change. The tool is a web site; http://mainecarepdl.org/index.pl/home/tamper-resistant-prescription-pads this site contains mailings that have been sent out to providers to ensure their compliance with the new requirements of the act, information about the law and links to vendors that supply tamper resistant prescription pads.

We have also put into place an audit procedure. Starting today, April 7, 2008, the Pharmacy Help Desk will be contacting pharmacies and asking for copies of ten random prescriptions, if the script is compliant then further information will not be needed. However, if the pharmacy helpdesk determines the script is not compliant then additional information or contact may be needed. Prescriptions found non-compliant are subject to reversal.

Exceptions to section 1972(k) (2) are provided in section 1972(k) (3) of the act. These exceptions include drugs provided in nursing facilities, intermediate care facilities for the mentally retarded, and other specified institutional and clinical settings. The tamper-resistant pad requirement does not apply to refills of written prescriptions presented at a pharmacy before April 1, 2008. It does not apply to e-prescriptions, faxed prescriptions, or prescriptions communicated to the pharmacy by telephone.

To be considered tamper resistant on April 1, 2008, a prescription pad must contain at least one of the following three characteristics:

  1. one or more industry-recognized features designed to prevent unauthorized copying of completed or blank prescription form;
  2. one or more industry-recognized features designed to prevent the erasure or modification of information written on the prescription by the prescriber;
  3. one or more industry-recognized features designed to prevent the use of counterfeit prescription forms.

By October 1, 2008, a prescription pad must contain all three to be considered tamper resistant. Please refer to www.mainecarepdl.org for more information on Tamper resistant pads and vendors that supply the pads.

If you have any questions or concerns please feel free to contact the Pharmacy Help Desk at 1-888-420-9711 or Jennifer Cook at 207-287-2705 and email Jennifer.Cook@Maine.gov.

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