May 26, 2008

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17th Annual Practice Education Seminar this Wednesday, in Augusta

Over 100 physicians, practice managers and guests are expected to be at the Augusta Civic Center on Wednesday for the Association's 17th Annual Practice Education Seminar.  Featuring the theme of preventing prescription drug abuse and diversion, the day-long program also includes presentations on the quality improvement initiatives currently active in the state and a dozen break-out sessions in the afternoon.  A nationally known speaker will discuss the healthcare workforce shortage.  Persons interested may still register on line at  Walk-ins are also welcome. 

The program begins at 8:30am on Wednesday, May 28, at the Augusta Civic Center.  The first presentation is a keynote talk by the Honorable Paula Silsby, U.S. Attorney for the District of Maine.  Entitled, "Prescription Drug Abuse:  Today's Epidemic", this talk with highlight the current problems in the state and what the medical community can do about it.   Joining her will be Marcella Sorg, PhD, of the Margaret Chase Smith Center and the author of the most recent study of deaths by drug overdose in Maine.  The afternoon breakouts sessions include two talks on this general subject matter as well, including an update on the state's Prescription Monitoring Program.

The morning plenary sessions also feature a panel discussion on "Transparency and Accountability:  A summary of Projects in Maine".  Moderated by MMA President William Strassberg, M.D., the session will provide updates on several performance improvement initiatives in the state including, Pathways to Excellence, Quality Counts, Maine Quality Forum, Chartered Value Exchange and the MMA's Voluntary Practice Assessment Initiative.  The two Robert Wood Johnson funded programs, Aligning Forces for Quality and Regional Quality Strategy also will be discussed.

Completing the morning program is a presentation on the impact on medical practices in the state of the healthcare workforce shortage.  This presentation will be by Kurt Mosely of the MHA Group.  Mosely is the author of the publication entitled, "Will the Last Physician in American Please Turn out the Lights", which is also the title of his talk.

At lunch, MaineCare Medical Director Rod Prior, M.D. will discuss current MaineCare issues, including the pending fee increase.

The afternoon breakout sessions are arranged around four educational tracks:  Technology, Practice Management, Compliance and Hot Topics.

Category One CME credit has been awarded to the educational programs.

As the MMA office has been experiencing phone difficulties, anyone with questions about the program should contact the Association's EVP Gordon Smith directly on his cell phone at 215-7461.


FEDERAL ALERT: June 30th Deadline for Latest Medicare Payment Cut Looming!

The 0.5% update in Medicare payment rates approved by Congress late last year will expire on June 30, 2008.  Unless Congress acts before that date, a 10.6% cut will become effective on July 1, 2008 and an additional 5% cut is projected for January 1, 2009.

OUR MESSAGE TO CONGRESS:  Act quickly to extend the current 0.5% update through the remainder of 2008 and provide a 2009 update that reflects the increase in medical practice costs to give Congress the time necessary to pave the way for longer-term reform of the Medicare “sustainable growth rate” (SGR) physician payment formula.

Impacts of the Medicare Payment Cuts in Maine

  • Maine physicians will lose $50 M for the care of elderly & disabled patients over the 18 months from July 2008 through December 2009 if projected cuts become effective.  On average, each Maine physician faces a Medicare cut of $13,000 during this period.  Also, the state’s physicians will lose $1 B for the care of elderly & disabled patients by 2016 because of nearly a decade of cuts for this important care.
  • 14,133 employees, 223,962 Medicare patients and 47,343 TRICARE patients in Maine will be affected by these cuts.
  • Compared to the rest of the country, Maine, at 17%, has an exceptionally high proportion of Medicare patients and, at 18 practicing physicians per 1000 beneficiaries, has a below-average ratio of physicians to Medicare beneficiaries, even before the cuts take effect.
  • 47% of Maine’s practicing physicians are older than 50, an age at which surveys show many physicians consider reducing their patient care activity.
  • In July 2008, physicians in Cumberland & York Counties face cuts of an additional 1.1% on top of the 10.6% cuts across the country and the rest of Maine faces additional cuts of 2.1%.  The 2003 Medicare law provided a temporary increase in geographic payment adjustments for certain geographic areas.  This increase also will expire on June 30, 2008 under current law.

Senator Debbie Stabenow (D-MI) has submitted S. 2785, the Save Medicare Act of 2008 as a vehicle to provide an 18-month “fix” for this problem & Senator Stabenow has attracted 18 co-sponsors for the bill, including Maine’s junior Senator Susan Collins.

While all 4 members of Maine’s Congressional delegation have historically been supportive of organized medicine’s position on this Medicare payment issue, it is important that you contact them to reiterate how important a Medicare payment fix is to your ability to continue providing care to Medicare beneficiaries & to thank them for their continuing support!

Contact Senator Olympia J. Snowe (R):  202-224-5344;

Contact Senator Susan Collins (R):  202-224-2523;

Contact Representative Tom Allen (D, 1st District):  202-225-6116;

Contact Representative Mike Michaud (D, 2nd District):  202-225-6306;

You can find more information about the Medicare physician payment campaign, including a link to the “grassroots action center” where you can send a message to members of Congress, on the AMA web site at: [return to top]

MMA to Oppose People's Veto Effort to Halt Increased Health Care Coverage

This past week saw the initial efforts of the beverage industry, funded by out-of-state interests, to halt the law passed by the legislature that provided alternative funds for the Dirigo Health Agency through increased taxes on beer, wine and sugared syrup.  The law also established a 1.8% assessment on health insurance premiums, which is a decrease from the amount assessed under the previous methodology (utilizing the savings offset payment).

The so-called "People's Veto", organized by a group now known as "Fed Up with Taxes" (FUWT), is attempting to gather the 55,000 signatures needed by July 17 to stop the law from taking effect.  If they are successful and the signatures are certified by the Secretary of State's office by August 17, the issue would be placed on the November general election ballot.

MMA supported the original legislation, believing that taxing products that lead to increased health care costs and using the revenue to increase health care coverage for Mainer's is an appropriate strategy as efforts to cover the more than 140,000 Mainers who are currently uninsured continue.  MMA was also represented on the Blue Ribbon Commission that met in 2006 and recommended this approach.

MMA is participating with many other healthcare and consumer groups to encourage Maine citizens not to sign the petitions and to oppose this effort to help Mainers have more affordable coverage.  Other organizations participating include the Maine divisions of the Cancer and Heart Associations, the AARP, the Maine State Employees Association, Consumers for Affordable Healthcare, The Maine Equal Justice Project and the Maine Primary Care Association.

Talking points developed in opposition to the effort to halt the law follow:


Health Coverage for Maine

Supporting reasonable solutions to the health care crisis

Say ‘No Thanks’ to the “beverage petition” to veto health coverage


    • Taking away health insurance from Maine kids and hard-working adults isn’t what Maine’s all about.  Maine people care about our neighbors and our communities.


    • A petition supported by the big national beverage companies could cause 18,000 Maine children, families, and small businesses to lose their health coverage. Another 40,000 could see their premiums become unaffordable.


    • We’re all worried about the economy, but putting kids, families, and small businesses at risk of losing their health insurance is not the solution. 


    • A few extra pennies on beer, wine, and soda is a reasonable solution that will allow 18,000 Maine kids and hard-working adults to keep their health insurance, while making coverage affordable for an additional 40,000 who are not able to get insurance through their employers.


    • Groups behind the “beverage petition” have deep pockets and the support of the big national beverage companies.  They are spending hundreds of thousands of dollars hiring an out-of-state signature-gathering firm while putting health insurance for Maine kids and hard-working adults in extreme jeopardy.


    • We believe most Maine people will say “no thanks” to signing this “beverage petition” because the health of Maine kids is worth more than a few pennies on beer, wine, and soda.


    • Health insurance coverage is an essential building block of a strong economy.  When kids get preventative care to make them healthier, and when businesses can count on healthy employees, Maine’s economy will be in a position to thrive.


    • Coverage is the key.  The best way to reduce health costs and make sure the health system works for everyone is to get all Maine children and adults covered by health insurance.


    • Maine’s efforts are working.  Maine is one of the few states that has reduced its number of uninsured citizens in recent years.  We need to build on that success and work together to find creative ways to get more people covered by health insurance.


    • This petition drive could jeopardize insurance coverage and affordability for over 50,000 children and hard-working adults in our communities – that’s more than the populations of Bangor and Saco combined.


    • If you’re asked to sign the “beverage petition”, please say, “No thanks, we want health coverage for Maine.”


    • Join us in telling the beverage companies, “No thanks, to the veto of health coverage for Maine.”

  [return to top]

New Hospital Patient Survey Data Posted on

The Centers for Medicare and Medicaid Services (CMS) began last week running advertisements in Maine newspapers promoting its public website,  The site permits patients to compare and research hospitals on a state by state basis.

"Twenty, thirty years ago, physicians drove all the decisions in health care," said Charlotte Yeh, M.D., the regional administrator of CMS.  "Now patients can use the Web sites to compare patient satisfaction and performance rates."   Dr. Yeh contacted MMA staff prior to the advertisements running in Maine to give us a heads up and to answer any questions.  Prior to accepting her federal position, Dr. Yeh was a practicing emergency physician in Massachusetts and was active in the Massachusetts Medical Society and the New England AMA delegation.

Other websites in Maine that provide comparative information include the Maine Health Management Coalition site at and the Maine Quality Forum Site.

Nationally, the commercial site,  rates hospitals  on a variety of factors. [return to top]

Downeast Association of Physician Assistants (DEAPA) Recognizes David McDermott, MD , MPH as the 2008 Physician of the Year

The Physician of the Year Award, presented annually to a Maine physician who has

demonstrated outstanding support of Physician Assistants and the PA profession by

precepting, educating, and legislating; or by exemplifying the PA/physician

team approach to medicine has been awarded to David B. McDermott, MD, MPH.  He graciously received his award this past week in the presence of his colleagues at Mayo Regional Hospital medical staff meeting, where William Bisbee, PA-C., incoming DEAPA President presented him with his award.


 Dr. McDermott  is a graduate of the University of Rochester and the University of Vermont School of Medicine and completed his residency in Family Practice at Maine Medical Center in Portland.  Following residency Dave became a member of the US Air Force Active Reserves, serving time at MacDill AFB in Florida in the Department of Emergency Services and a six month tour in Iraq during Desert Shield and Desert Storm.  In July 1993, he left the service and moved his family to Dover-Foxcroft, where he assumed the role of staff physician and Medical Director of Dover-Foxcroft Family Medicine, a position he holds today.  Additional duties have included Medical Staff President at Mayo Regional Hospital,

Medical Director of the Foxcroft Academy Student Health Center, Medical Director of the Hibbard Nursing Home, and Medical Director of Emergency Services at Mayo Regional Hospital. 


During his medical career, Dr. McDermott has worked with many PAs and continues to advocate for the utilization of physician assistants as vital members of the health care team.  The PAs who have worked side by side with him are not infrequently asked for their opinions on medical issues.  He encourages PAs to take an active role in hospital committees and to participate in all aspects of medical care. 


MMA congratulates Dr. McDermott on receipt of this award. We also appreciate his exceptional voluntary activities in the MMA exemplified by his current positions as chairmen of the Committee on Physician Quality, the Operations Committee and the Executive Committee. He is a candidate for President-elect, a position that will be filled at the Association's Annual Meeting, Sept. 6, at the Samoset. 



  [return to top]

MMA Public Health Committee to Meet Wednesday, May 28, 2008

MMA Activities this week include a regularly scheduled meeting of the Committee on Public Health, which will convene at 4:00pm on Wednesday, May 28, at the Association offices in the Frank O. Stred Building in Manchester.   The committee is chaired by Waterville pediatrician Charles Danielson, M.D., and the primary staff is Kellie Miller, M.S. 

Wednesday's meeting will include initial consideration of public health oriented Resolutions to be introduced by the Committee to the 2008 Annual Session.  Other agenda items include the following:

  • Obesity/Weight Management Policy Issues
  • Immunizations Strategy Discussion for Action
  • Environment Health Update
  • Public Health Legislation Review for 2009

All MMA committee meetings are open to any MMA member interested in attending, in addition to the physicians who serve on the committee. [return to top]

Health Reform Effort of Former Majority Leaders, Including George Mitchell, Shows Promise

A positive buzz continues in Washington following the announcement last month of an effort by four former Senate majority leaders to propose recommendations to reform the nation's health care system.  George Mitchell, Bob Dole, Tom Daschle and Howard Baker are crafting a series of health policy recommendations that would be delivered in 2009 to a new president and Congress.  The former senators will each oversee forums on four key pillars for reform:  improving quality and value, improving access, ensuring a strong role for consumers, and finding a way to finance it.

The participants will get technical advice from Mark McClellan, M.D., former head of CMS in the Bush administration and Chris Jennings, former health policy adviser to President Clinton.

Despite the frustration of policy makers and the public regarding the cost of care and the increasing number of uninsureds, efforts to enact any significant reforms at the federal level have been repeatedly rebuffed, at least partially because of deep philosophical differences over the direction to take.

  [return to top]

Anthem to Provide Pricing Information to Members via Website

Anthem Blue Cross Blue Shield of Maine announced last Tuesday that its subscribers will have access to pricing for 39 medical procedures, including ancillary costs such as laboratory tests and hospital services.  Anthem has over five hundred thousand insureds in the state. The information will be made available on the Anthem website, and will be password protected for Anthem subscribers.

The "Care Companion Tool" also includes information on how frequently a facility does a procedure. [return to top]

Dirigo Health Board Meets to Consider Options

The Dirigo Health Agency Board of Directors, chaired by Robert McAfee, M.D., met on May 20 and considered its options in the face of a potential "People's Veto" of the legislation enacted by the legislature which provided for a funding source as an alternative to the existing savings offset payment and would have permitted a modest expansion of the DirigoChoice health insurance product.

If the coalition attempting to halt the law and place it on the ballot in November is successful in achieving the requisite number of certified signatures prior to July 18, the law will not take effect, pending the outcome of the vote.  If the vote is to overturn the law is successful, the Agency would be left with the exisiting savings offset payment as its primary funding source.  In order to prepare for that possibility, the Agency will hold an adjudicatory proceeding in July to determine the fourth year savings offset payment, in case it needs to be collected.

Should the petition drive fail or the ballot initiative be defeated in November, the taxes and premium assessment in the new legislation would be effective and the program could be opened up in October or early in 2009. [return to top]

Problems with MMA Phone Service

The MMA office has been experiencing some difficulties with the phone system.  While the system is still allowing a call to go directly to an extension, the option that is described in the voice mail as "press O for assistance" no longer operates and instead those calls get left in the general delivery mailbox.  While we access those messsages continually, we apologize that you can not reach a person in the office without dialing their direct extension.  We are in the process of evaluating proposals to repair the system or install a new one.  We appreciate your patience.

To assist you in this time of transition, the following are the current list of staff extensions:

(In alphabetical order)

John Barry  215

Gail Begin 210

Warene Chase-Eldridge 227

Lisa Dennison  219

Heidi Lukas  217

Andrew MacLean  214

Lisa Martin 221

Diane McMahon  216

Lauren Mier  223

Buell Miller  228

Kellie Miller  229

Marguerite Ridgway 218

Gordon Smith 212

Catherine Stratton 211 [return to top]

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