October 6, 2008

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"No on One" Campaign Formally Launches Today; Opposition Releases Economic Impact Study

Physicians are featured prominently in successful press conferences in Portland and Bangor today to formally launch the campaign against Ballot Question 1, the Dirigo Health Program funding/insurance market reform  initiative.  The MMA is among many health care and social service advocacy organizations making up Health Coverage for Maine, the coalition working against Question 1.  The group favoring Question 1, Fed Up With Taxes, orchestrated the release today of a report entitled, Fiscal and Economic Impacts of Beverage Excise Taxes Imposed by Maine Public Law 629.  Both events received substantial coverage by the print and broadcast media.

Health Coverage for Maine conducted its press conference in Portland at 10:00 a.m. today at the corner of West Street and the Western Promenade in the city's West End.  Lisa Letourneau, M.D., M.P.H. and Lani Graham, M.D., M.P.H. both spoke at the event.  At the Bangor event hosted by Neurology Associates of Eastern Maine, MMA President Stephanie Lash, M.D. and Executive Committee member Kenneth Christian, M.D. both spoke.  Charles Pattavina, M.D., an emergency physician with EMMC also attended.  The MMA thanks these physicians for taking the time to participate in these aspects of the MMA's advocacy.  Campaign Coordinator Edie Smith reported that all major TV stations and print journalists in each market attended the events.

Speakers emphasized the campaign's messages that this debate is about preserving the landmark Dirigo Health Program with its important quality improvement, cost containment, and DirigoChoice access initiatives. The Program is improving Maine's health care system and is covering thousands of Maine citizens.  It is one reason that Maine is in the top tier of states in percentage of the population with health insurance coverage.  You can find more talking points on the web at:  http://www.healthcoveragemaine.org/.

Also today, the University of Maine at Orono press office released a report on the tax and job impacts of the new beverage taxes in P.L. 2007, Chapter 629 written by UMO economist Todd Gabe.   

The press release follows:

News release – Oct. 6, 2008
Contacts: Todd Gabe, 581-3307; George Manlove, 581-3756

UMaine Economist Calculates Tax and Job Impacts of New Beverage Taxes

ORONO – Maine’s new beverage taxes, at the heart of Question 1 on this November’s ballot, will cost Maine businesses and households as much as $40.7 million annually in higher taxes on beer, wine and nonalcoholic beverages, according to new research
by University of Maine economist Todd Gabe.

These taxes, imposed by Public Law 629, also would result in the reduction of $17.5 million in beer, wine and soft drink net sales revenue. Including multiplier effects, the total economic impacts are an estimated reduction in sales revenue of $26.3
million statewide, with a loss of 395 full- and part-time jobs that provide about $8.8 million in income, according to Gabe.

“These total impacts are spread across the entire Maine economy, but concentrated in restaurants and bars, retail stores and other companies that sell and distribute beverages,” he says.

“Many people might be tempted to combine the $40.7 million in additional taxes and the $26.3 million in reduced sales revenue into a single impact figure. But that would be comparing apples and oranges,” Gabe said. “They are different types of
impacts, but the bottom line is an increase in the price of beverages and a loss of sales revenue to the beverage industry.”

Gabe’s study on the fiscal and economic impacts of the beverage tax was commissioned by “Fed Up With Taxes,” a coalition of businesses and individuals, and several associations representing stakeholders.  

The report does not take a position on Question 1, Gabe says. “It simply estimates the effects of the new law on beverage taxes, as well as the economic impacts of the statewide reduction in beverage sales revenues associated with the tax hike,” he
says. “Other aspects of the law need to be considered to make a judgment about whether Public Law 629 is ‘good’ or ‘bad’ for Maine.”

The intent of the study is to inform the debate on Question 1 – the repeal question – on the upcoming ballot, Gabe says.

“This kind of information is important for voters to consider,” he says. “It’s a lengthy report, but the majority of it is about how the numbers were generated.”

Gabe can be reached for comment at (207) 581-3307.


Health Coverage for Maine will critique Gabe's analysis, but the campaign's initial reaction was skepticism about its credibility because it was commissioned by Fed Up With Taxes and based upon data supplied by the industry.

 MMA EVP Gordon Smith will participate in MPBN's MaineWatch program with Newell Augur of Fed Up With Taxes this Thursday evening.


Aligning Forces for Quality Baseline Physician Survey Please Help!

A team conducting the national evaluation for the Aligning Forces for Quality (AF4Q) initiative is conducting a national telephone survey focusing on small and medium-sized physician in Maine.  Policymakers have sometimes concluded that large groups deliver better care, in part because so little information exists about smaller practices. This survey will help provide more information on this issue.  It explores several topics, including how practices provide preventive care and care for patients with chronic disease. The survey is part of a study, which is funded by the Robert Wood Johnson Foundation and the Commonwealth Fund, and is a successor to an earlier study of large medical groups; the previous study, which resulted in an article in JAMA (January 22/29 2003 – Volume 289, no.4, pp 434-441) and 14 additional articles in peer-reviewed journals, has been widely influential.

The American College of Physicians, American Academy of Family Physicians, American College of Cardiology, Medical Group Management Association, Quality Counts, and Maine Quality Forum encourage physicians or their chief administrators to participate in this study, which involves responding to survey questions via telephone.  The survey, which is being conducted by PRS (a national survey research firm) under the direction of Lawrence Casalino, MD, PhD, at the University of Chicago, takes approximately 30 minutes and is scheduled at the respondent’s convenience – times before or after office hours can be scheduled.  As a token of appreciation a check for $175 will be sent to the physician/administrator or the practice organization after the call is completed.

Additionally, once data collection is complete, participating practices will receive a summary of the results, enabling them to make comparisons between their practice and overall averages in their market, state, and the country at large. For further information, contact Lawrence Casalino, MD, 773-834-4865 or lcasalin@uchicago.edu or Robin Gillies, PhD, 510-643-8063 or gillies@berkeley.edu. [return to top]

DHHS Office of Inspector General Issues FY 2009 Work Plan

On October 1, 2009, the DHHS, Office of the Inspector General (OIG) issued its 2009 plan of work, including a focus on auditing and evaluating the Medicare Part D drug program and other Medicare benefit provisions, such as DME.  The work plan also includes a review of serious medical errors, or "never events," in hospitals.  The work plan may be found on the web at:  http://www.oig.hhs.gov/publications/docs/workplan/2009/WorkPlanFY2009.pdf. [return to top]

Health insurance costs grow 5% in '08

USA Today, September 25, 2008
A recent study released by the Kaiser Family Foundation and the Health Research and Educational Trust found that health insurance premiums rose 5% this year, an increase comparable to last year’s increase and considered relatively low.  However, the study shows that in order to slow the costs of health insurance, many companies, specifically small businesses, are now offering high-deductible plans.  In fact, in a single year, the percentage of workers enrolled in insurance plans with deductibles of $1,000 or more jumped nearly 6%, to 18% nationwide.  Opponents of such plans have expressed concern that the growing popularity of these high-deductible plans is simply shifting healthcare costs to consumers. [return to top]

Earn a 4% Bonus by Putting Medicare's Physician Quality Reporting Initiatives (PQRI) and E-prescribing Into Practice

Physicians may increase their overall Medicare reimbursement by 4 percent by successfully e-prescribing and reporting Physician Quality Reporting Initiative (PQRI) measures.  In 2009 and 2010, physicians who successfully e-prescribe may receive a bonus payment of 2 percent of their overall Medicare reimbursement. In addition, physicians who successfully report measures (one of which addresses e-prescribing) in the PQRI may receive a 2 percent bonus in 2009.

In conjunction with the Vermont Medical Society, MMA is offering two educational sessions on Vermont Interactive Television (VIT) to help practices prepare to implement this program.

Thursday, October 16th, 4:45 p.m. to 6:15 p.m.
Speakers: Andy Finnegan, Centers for Medicare and Medicaid Services; and
Paul Harrington, EVP, Vermont Medical Society

Tuesday, October 21st, 12:45 to 2:15 p.m.
Speakers: William Kassler, M.D., Centers for Medicare and Medicaid Services; and Paul Harrington, EVP, Vermont Medical Society

Educational sessions will be presented on VIT at the MMA's office in Manchester. Both sessions will include plenty of time for questions and answers. Please forward this announcement to colleagues and staff who may be interested in attending. There is no charge to attend these events. [return to top]

DHHS Seeks Public Health Physician

The Department of Health and Human Services (DHHS) is driven by its vision of Maine people living safe, healthy and productive lives.  Its goal is to assist the people of Maine in meeting their own needs, as well as the developmental, health and safety needs of their children.  It serves the public in an environment that reflects a caring, responsive and well-managed organization.  The Maine Center for Disease Control & Prevention (Maine CDC), Division of Family Health develops and implements health promotion and disease prevention programs to reduce morbidity and mortality and directs interventions to address specific identified health issues among the maternal child health (MCH) population.

As the MCH Public Health Physician in the Maine Center for Disease Control & Prevention, you will provide medical, clinical and epidemiologic consultation to Maine CDC staff whose work is focused upon the MCH population, assist with the development of short and long term MCH priorities, provide leadership on MCH policy issues in consultation with the Division of Family Health Director and Maine CDC Director, act as a liaison between Maine CDC and MCH related health professionals and health care providers, develop applications and provide oversight and management in the implementation of federally funded projects specific to MCH, and work with a diverse group of partners in accomplishing MCH and Maine CDC priorities to advance the health of the MCH population in Maine.   You will work collaboratively within the Division, across Maine CDC, DHHS and other Departments on MCH issues.

For more information, contact Virginia Roussel, (207)287-1873 [return to top]

Wall Street Bailout Bill Also Includes Mental Health Parity Provision

On October 3, 2008, President Bush signed the Wall Street relief bill (H.R. 1424) including compromise mental health parity legislation developed between the House and Senate in June.  Effective for the plan year on or after October 3, 2009, the bill amends ERISA and the Public Health Service Act to prohibit group health plans from including mental health treatment limitations, financial requirements, or out-of-network coverage limitations unless those limitations are applied to medical and surgical benefits.  The parity requirements apply to large groups of 50 or more.  The bill does not specify what conditions must be covered.  It does permit stronger state laws to prevail.  The Departments of HHS, Labor, and Treasury all have rulemaking authority under the bill.  

Before adjourning until after Election Day, the Congress enacted 3 other pieces of health care legislation.

  • The QI Program Supplemental Funding Act of 2008 (S. 3560) would increase funding for the program by $45 million.  The QI Program covers the Part B premium for individuals with incomes between 120% and 135% of the federal poverty level;
  • The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (H.R. 6353) is designed to stop internet pharmacies that sell controlled substances without a valid prescription while protecting the safety of consumers who fill legitimate prescriptions online.
  • The Stephanie Tubbs Jones Organ Transplant Act of 2008 (H.R. 6469) would increase funding for the Organ Procurement and Transplant Network from $2 million to $7 million, the first increase since 1984.
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CMS Expected to Renew Massachusetts' Medicaid Waiver for Health Care Reform Plan

On September 30, 2008, Massachusetts officials announced that CMS has preliminarily agreed to a 3-year extension of the Medicaid waiver on which its health care reform plan is based.  The agreement brings in a total of $21.2 billion over 3 years, a $4.3 billion increase from the $16.9 billion authorized under the previous waiver period.  The decision permits Massachusetts to spend $16.2 billion on Medicaid and $5 billion on health coverage expansion over 3 years, up from $12.9 billion and $4 billion during the past 3 years.  This will permit the Commonwealth to preserve all eligibility and benefit levels under the health care reform law, including subsidized coverage for those earning up to 300% of the federal poverty level.  The Massachusetts health care reform law, enacted in 2006, aims to provide universal coverage through a combination of Medicaid expansion, subsidized health plans for low-income individuals, creation of low-cost health coverage, and an individual mandate for health insurance coverage for most. [return to top]

Commonwealth Fund Assesses Presidential Candidates' Health Care Reform Proposals

The Commonwealth Fund on October 2, 2008 released The 2008 Presidential Candidates' Health Reform Proposals:  Choices for America, an analysis of the health care reform proposals of the candidates for President.  The report concludes that neither candidate's plan would achieve universal health care coverage principally because of the lack of an individual mandate for coverage.  The report concludes that the McCain plan would do little to reduce the ranks of the uninsured, while the Obama plan would cut the number of uninsured in half.  The cost of the Obama plan is estimated to be $1.6 billion from 2009 to 2018 and the McCain plan would cost about $1.3 billion.

 You can find the report on the web at:  http://www.commonwealthfund.org/.

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