June 2, 2008

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MaineCare Physician Fee Increase Effective July 1, 2008

At the Association's Annual Practice Education Seminar this past Wednesday, MaineCare Medical Director Rod Prior, M.D. confirmed that the anticipated physician fee increase scheduled for July 1, 2008 will occur, but that because of delays in necessary rule-making, the payments may not be received until August.  The proposed rules propose an increase from 53 percent of Medicare to 61.7 percent of Medicare.  In addition, an increase in the Primary Care Case Management fee from $2.50 to $3.50 per member per month is proposed.

The fee increase is occurring because of legislative action during the first session of the 123rd Legislature that added $3 million of state dollars to the physician fee schedule, effective July 1, 2008.  This appropriation, when combined with the federal Medicaid match, totals more than $8 million and will take the fees to the stated level of Medicare.  Obtaining the increase and then preserving it through the state's budget crisis was MMA's highest legislative priority this past year.

In addition, the proposed rules increase the categories of Mainecare enrollees eligible to participate in the Case Management system. 

The rules and related rulemaking documents may be viewed on at:  http://mainegov-images.informe.org/bms/rules/downloads/c_ii_iii_s_90_p_05_21_08.pdf.

DHHS Certificate of Need Unit Recommends Denial of Projects in Lewiston (2) and Bangor (1)

The State's Certificate of Need Unit has recommended that the Commissioner reject CON applications of both Lewiston hospitals and Eastern Maine Medical Center in Bangor.  The hospitals have an opportunity until June 11 to respond to questions raised by the staff before Commissioner Brenda Harvey makes a final decision.

In Lewiston, Central Maine Medical Center (CMMC) is seeking to expand its emergency department and laboratory.  St Mary's is seeking to expand its operating rooms, laboratory and pharmacy.  Eastern Maine Medical Center in Bangor filed its application to expand its inpatient facility.

State officials stated that although there were unique issues involved with each project, all three hospitals failed to show a need and that the proposed projects were too expensive, causing health insurance premiums to rise.

The project at CMMC was more than $47 million and the EMMC project was more than $262 million.

In all thee hospitals, officials stated last week that they intend to file more information with the CON unit in an effort to seek reversal of the recommendations. [return to top]

Medical Mutual Offers Risk Management Program at MMA this Friday, June 6

Medical Mutual's Risk Management Department offers a CME program entitled, "Patient Disclosure following an Unanticipated Outcome" this coming Friday morning, June 6 at the MMA offices in the Frank O. Stred Building in Manchester.  Three category 1 CME credits are available.  This program is offered as part of the Association's "First Fridays" seminar series offering a CME program the first Friday morning of each month.

Two years ago, the Maine legislature enacted legislation providing for inadmissibility of certain comments made after an adverse event when the comments express empathy but do not concede liability.  This law and the programs around the country promoting "I'm sorry" approaches to medical errors will be discussed by an experienced group of risk managers:

  • Jackie Mador, RN, MHA, CEN, CCRN

  • Cheryl L. Peaslee RD, BSN, MBA, CPHQ

  • Nancy R. Brandow, MS

Review of case studies will walk program participants through actual patient disclosure discussions and allow ample opportunity for questions.  Physicians, Practice Managers, Risk Managers, and other office staff will benefit from this presentation.

The program begins at 9:00 am and concludes at noon.  The $60 registration fee includes breakfast and all the written materials.  You may register by calling MMA at 622-3374 ext. 219 or by registering on-line at www.mainemed.com.

There will be no "First Friday" presentation in July but programs will resume in August with Dr. Kenneth Hamilton presenting a program entitled, "Restoring the Care in Healthcare."

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Penobscot County Medical Society to Meet on Friday Evening, June 6 in Orono

The Penobscot County Medical Society will host a dinner meeting and program this coming Friday night, June 6th, at the Buchanan Alumni House at the University of Maine in Orono.  The event begins at 5:30 pm.  Members or guests interested in attending should e-mail Lisa Martin at MMA at lmartin@mainemed.com or call her at 622-3374, ext. 221.

Following a reception and dinner, Marcella Sorg, PhD of the Margaret Chase Smith Center at the University will present recent data on the prevalence of deaths by drug overdose in the state.  Recently, the Office of the Chief Medical Examiner and Dr. Sorg collaborated on a study of these deaths. [return to top]

More than 100 People Attend 17th Annual Practice Education Seminar

More than 100 physicians, practice managers, and guests attended the Association's Annual Practice Education Seminar this past Wednesday at the Augusta Civic Center.  Featuring three topics at plenary sessions in the morning and a dozen break-out sessions in the afternoon, the day-long program presented updates on the following subjects:

  • Stark II and its Phase III regulations

  • Physician Profiling and Tiered Networks

  • Quality Improvement initiatives in the state, including updates on Pathways to Excellence, Quality Counts, Aligning Forces for Quality, the Voluntary Practice Assessment Initiative, and the Maine Quality Forum

  • Physician supply:  recruitment and retention issues

U.S. Attorney for the District of Maine, Paula Silsby, presented the Keynote talk, addressing the subject of the continuing problem of prescription drug abuse n the state.  Presenting with Attorney Silsby was Marcella Sorg, PhD of the Margaret Chase Smith Center at the Unviersity of Maine.

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Ground-Breaking New PBS Series Explores Causes, Seeks Solutions to American’s Health Crisis

A ground-breaking new documentary series crisscrosses the country exploring how the social conditions in which Americans are born, live, and work profoundly affect health and longevity - even more than medical care, behaviors, and genes.  This four-hour television and DVD series challenges fundamental beliefs about what makes Americans healthy – or sick – and offers new remedies for an ailing society.

UNNATURAL CAUSES:  Is Inequality Making Us Sick? Coincides with the intensifying presidential election year debates focusing on the estimated 47 million Americans lacking health coverage.  While embracing the essential need for universal health care, UNNATURAL CAUSES goes further, questioning what makes people ill in the first place, and probing why economic status, race, and zip code are more powerful predictors of health status and life expectancy than even smoking.

The documentary "Unnatural Causes: Are Inequalities Making Us Sick?" will be aired on the Maine Public Broadcasting Network (Channel 10):

- Parts 1 and 2 will air on Monday, June 2nd (9:00 - 11:00 pm)

- Parts 3 and 4 will air on Tuesday, June 3rd  (9:00 - 11:00 pm)

For More Information go to:  http://www.unnaturalcauses.org/

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To Help Guide Future Policy and Action around the Overweight/Obesity Epidemic – Complete on-line Survey

The Public Health Committee is collaborating with the Harvard School of Public Health, the New England Coalition for Health Promotion and Disease Prevention for the Regional Governor’s Conference, and the Maine Center for Public Health to assess the status of the New England states on a number of factors associated with overweight and obesity.  A set of indicators have been researched and created that illustrate the condition of populations within each state and the prevalence (or lack) of enabling factors that encourage or discourage people to eat well and stay fit.  There are many efforts underway to address this crisis, but more are needed and it will be difficult to devise successful strategies unless we keep track of current and changing conditions – not only of the health status of our population, but also of the “environmental factors” that facilitate or hinder people’s ability to make healthy choices. 

To help guide future policy and action around the overweight/obesity epidemic, the Maine Medical Association and the Maine Center for Public Health have partnered with the Harvard School of Public Health, and the New England Governors' Conference to collect data on member practices for a "Healthy Weight Trends Report."   This regional overview, to be issued bi-annually by the New England Coalition for Health Promotion and Disease Prevention (NECON), will be a powerful tool for local progress as well as a national model.

 We are asking for your participation in this important effort through completing an anonymous survey on your practices as a physician around healthy weight prevention and management.  The survey should take no more than 10 minutes to complete.  Please click here to complete the survey:


Thank you for your help in this important data collection effort.  Please contact Alison El Ayadi at the Harvard School of Public Health with any questions regarding the survey or project: aelayadi@hsph.harvard.edu or 617.877.7424, or you may contact Kellie Miller, Director of Public Health Policy at:  kmiller@mainemed.com or 207.622.3374, ext. 229 for information regarding our Maine overweight/obesity public health policy initiatives.


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MMA's Public Health Committee Focusing on Resolutions for Adoption

The MMA Public Health Committee met last week and first received brief presentations from Becky Smith, Executive Director for the Health Policy Partners of Maine and Dennise Whitley, Director of Advocacy & Communications, American Heart Association/Northeast Affiliate regarding overweight/obesity policy concepts for the 124th Legislature.  Next, Joan Orr, CHES from the Maine Center for Public Health provided an overview of the Healthy Weight Trends Report and the survey initiative occurring in June.  Very intense work is ahead for the PHC members in formulating our overweight/obesity policy initiatives.

The PHC members formulated their MMA Resolution Concepts in order to approve final drafts at the Committee's August meeting.  The three resolution concepts approved were:  1)  Immunizations – address the education issue and work with self-insurers, private insurers, etc.;  2) Environmental Health –  address the link of known and suspected medical consequences with an adequate chemical policy in Maine to safeguard human health and the environment;  and, 3) Overweight/Obesity Resolution – link efforts to the Health Policy Partners and others public policy strategies.  The committee also discussed the need to draft two additional resolutions on Domestic Violence Physician Education and another on Health Disparities.

The PHC committee will meet again August 27, 2008 from 4-6 pm at the MMA to finalize its resolution concepts, as well as to broaden its collective knowledge of health disparities.  All members are welcome to attend in person or via conference call at 1-800-989-2842; PassCode:  6223374.  For more information contact Kellie Miller at MMA at kmiller@mainemed.com or 622-3374, ext. 229.





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MMA Seeking Resident to Serve on Executive Committee

The Association is seeking a first or second-year resident to serve on its Executive Committee.  The Committee meets about every six weeks, usually on Wednesday afternoons at the Association offices in the Frank O. Stred Building in Manchester.  Any resident interested in representing the interests of residents should also be available to attend the Association's 155th Annual Meeting scheduled for September 4-7, 2008 at the Samoset Resort in Rockport.

Amy Madden, M.D., the first resident to ever serve on the Committee, completed her residency at the Maine-Dartmouth program recently and is no longer eligible to hold the position.  Her participation on the committee will be recognized at the Annual Executive Committee dinner on Sept. 4th in Rockland.

Any resident interested in the position should contact the Association's Executive Vice President Gordon Smith via e-mail to gsmith@mainemed.com

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MMA Executive Committee Meets on Wednesday, June 4

The MMA's 28-member Executive Committee will hold its next regularly scheduled meeting this coming Wednesday, June 4th at the Association offices in the Frank O. Stred building in Manchester.

Among the items on the agenda are the following:

  • A discussion of the Association's advocacy opposing the attempt by the "Fed Up With Taxes" Coalition to gather enough signatures of Maine citizens to place the potential repeal of the recently enacted funding package for the Dirigo Health program on the November ballot.

  • The efforts continuing in Congress to halt the July 1, 2008 Medicare physician fee cut of more than 11% in Maine (represents more than $50 million in Maine alone).

  • Announcement of the final plans for the Association's 155th Annual Session to be held Sept. 4-7, 2008 at the Samoset Resort in Rockport.

  • Report on the results of the 17th Annual Practice Education Seminar held this past Wednesday in Augusta.

The 2:00 pm meeting will be preceded by a meeting of the Operations Committee at 1:00 pm and followed by a meeting of the Budget & Investment Committee.

The Executive Committee will welcome a new member, Jenie Smith, M.D. of Lewiston.  Dr. Smith replaces Summit Kohli, M.D. who has moved out of state.  She is a nephrologist.

The Executive Committee is chaired by David McDermottt, M.D., MPH, a family physician practicing in Dover-Foxcroft.

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Schaller Anderson Seeks Contract Assistance with MaineCare Care Management Program

Schaller Anderson Medical Administrators, Inc. (SAMAI) is soliciting applications from clinical entities located and doing business in the State of Maine to contract with SAMAI for a period of not less than one (1) year in a community-based care management demonstration project for high-risk MaineCare members.  

Such clinical entities may include Physician Hospital Organizations (PHO), Federally Qualified Health Centers (FQHC), physician practices, or other clinical enterprises not associated with a PHO or FQHC engaged and participating in the care of MaineCare members.  Selected clinical entities will be expected to enter into a contract with SAMAI with an effective date of July 1, 2008.  The purposes of the contract are to support the implementation of community-based care management for high-risk, chronically ill MaineCare members residing in the State of Maine. 

Click here for a PowerPoint presentation that outlines the demonstration project expectations, and here for an application for participation in Microsoft Word format.  Please note the time lines and application requirements as described in the application document.  [return to top]

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