November 10, 2008

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MMA Member Survey Now in the Field: Please Complete!

The MMA's membership survey, discussed in previous issues of Maine Medicine Weekly Update, is now available for members to complete.  Members for whom an e-mail address is available received the survey electronically this past week and other members should receive a paper copy of the survey shortly.  MMA appreciates members taking the ten minutes it takes to complete the survey so that we can be certain that the work we do is relevant to you and consistent with your interests.  The survey is being conducted by the national survey group Enetrix which was recently purchased by the Gallup organization.

The survey seeks to obtain information from the membership regarding the issues that are important to members in their daily practice.  The survey also compares the effectiveness of MMA to the AMA and other national and state medical associations.  The results will also be compared to the results of a similar survey provided to state medical society members in four other states last year (Maryland, Illinois, Tennesee,and Connecticut.)

The survey also contains four questions that relate to work with the pharmaceutical industry which is the funding source for the survey.

Thank you in advance to those members who have completed the survey or intend to do so.

Any questions or concerns about the survey may be directed to MMA EVP Gordon Smith, Esq. at

AMA Convenes for 2008 Interim Meeting

During a deeply emotional Opening Session on Saturday, November 8, 2008, the AMA House of Delegates remembered the life of AMA Immediate Past President Ronald M. Davis, M.D., M.P.H. who passed away Thursday after a courageous nine-month fight against pancreatic cancer.

Physicians paid a final tribute to Dr. Davis with Speaker Jeremy Lazarus A. Lazarus, MD reading a letter that Dr. Davis wrote to the House before he died, and Board Chair Joseph Heyman, M.D., introducing a poignant video tribute that included images of Dr. Davis throughout his career, from his time as a medical student member of the AMA to his stirring speech as in-coming President in June of last year.

Later in the opening session, AMA President Nancy H. Nielsen, M.D., Ph.D., urged physicians to continue to stand together despite the increased challenges the medical profession will face in the upcoming months.

Growing cuts to Medicare physician payments, a worsening economy, the rising rate of job losses, and 46 million uninsured Americans are a few reasons the stakes have risen.  Another is cost - something Dr. Nielsen pointed to as the driving factor behind the national health care debate.

"It is high time we do something about it," Dr. Nielsen said of the nation's broken health care system.  That something is "fundamental change - for ourselves, for our patients, for our nation," she said.

AMA Delegates and Alternate Delegates from Maine at the meeting include Richard Evans, M.D., Maroulla Gleaton, M.D., and John Makin, M.D.  Senior Delegate David Simmons is currently on medical leave and was unable to attend.

She challenged physicians to advocate for comparative effectiveness research, to work within specialty societies, and to develop appropriate measures for care.  Dr. Nielsen also pointed to returning to the core values and themes that brought physicians to medicine in the first place; serving humanity with humility, self-awareness, and a commitment to excellence.

"I believe that we can and should have the best health care system in the world," Dr. Nielsen said.  "I believe that we have the talent and dedication to build that health care system.  I believe we have the courage to do it now." [return to top]

REMINDER: Legislative Committee to Hold Organizational Meeting Next Week

Samuel P. Solish, M.D. and Lisa D. Ryan, D.O., chair and vice chair of the MMA Legislative Committee, invite Legislative Committee members, specialty society legislative liaisons and officers, and any interested member to the Committee's organizational meeting for the 124th Maine Legislature on Tuesday, November 18th from 6 to 9 p.m. at the MMA office in Manchester.  The agenda for this meeting will include:

  • a review of election results and the composition of the 124th Maine Legislature;
  • an overview of the Legislative Committee's process for the coming session;
  • a discussion of the MMA's legislative agenda for the 124th Maine Legislature;
  • a discussion of specialty society legislative priorities; and
  • a briefing on pharmacists' provision of vaccinations by pharmacy and pharmacist representatives with discussion to follow.

Maine medical specialty societies are strongly encouraged to send a representative to this important meeting.  Dinner will be available at 6 p.m.  Please RSVP to Andrew MacLean, Deputy EVP, at or 622-3374, ext. 214.

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Election 2008: Democrats Win Big in Washington & Augusta

In the week since the historic 2008 elections, the MMA has been assessing the political landscape for organized medicine in Washington, D.C. and Augusta for the next two years.  President-elect Barack Obama’s strong win combined with Democratic gains of at least 5 seats in the U.S. Senate and 18 seats in the U.S. House mean that Democratic leaders in Washington have the opportunity to make progress on the significant issues that confront our health care system.  The partisan composition of Maine’s congressional delegation remains the same with incumbent Senator Susan Collins (R) and 2nd District Congressman Mike Michaud (D) easily winning their re-election efforts and former Democratic State Senator Chellie Pingree defeating Republican Charlie Summers for the 1st District seat formerly held by Tom Allen (D).

Governor John Baldacci, midway through his second term, was not on the ballot this year and undoubtedly has spent much of the fall working on his last biennial budget proposal during a turbulent time for our economy that has resulted in a potential budget gap in the current fiscal year of approximately $110 million and in the next biennium of between $500 and $800 million. 

All 186 seats in the Maine legislature (151 in the House and 35 in the Senate) were on the ballot on Election Day.  While election results are not final and a number of recounts are likely, it appears that the Democrats will extend their 31 vote majority by 6 in the House (96 Democrats, 54 Republicans, 1 Unenrolled) and will extend their 1-vote margin in the Maine Senate by at least 4 (20 Democrats, 15 Republicans)  Senator Lisa T. Marrache, M.D., a family physician from Waterville and one of two physicians in the last legislature, appears to have retained her seat, but first term Republican House member Robert Walker, M.D., a radiologist from Lincolnville, appears to have lost his re-election bid.  Linda Sanborn, M.D., a family physician from Gorham, appears to be the winner in House District 130, a part of Gorham.

Although some legislative leadership races still are underway, Representative Hannah Pingree (D-North Haven) and Senator Libby Mitchell (D-Kennebec) have no opposition in their bids for Speaker of the House and President of the Senate respectively.

The 124th Maine Legislature will be inducted in early December and will begin its work during the week after New Year's Day.

Ballot Question 1, the “People’s Veto” of the alternative funding mechanism for the Dirigo Health Program (a 1.8% “health access surcharge” and modest tax increases on beer, wine, and flavored soft drinks) appears to have passed with a margin of 64% to 36%, so the Attorney General’s Office will defend the litigation challenging the constitutionality of the “savings offset payment” (SOP) while the new legislature again seeks a sustainable funding mechanism for the Program.

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Maine Health Management Coalition Recognized with Hanley Health Leadership Award

During an awards luncheon at Bowdoin College today, The Daniel Hanley Center for Health Leadership presented its 2008 Health Leadership Award to the Maine Health Management Coalition, a group of Maine businesses whose "value proposition" is "Safer, Higher Quality, More Efficient healthcare delivered to employees and dependents."  The Coalition has been working for more than a decade "to motivate market-driven improvements in quality and efficiency through the use of multistakeholder-endorsed, comparative performance information by employers and employees to make informed healthcare choices and decisions."  Maria Benoit Hanley, Chair Emeritus of the Hanley Center, presented the award along with keynote speaker John Wennberg, M.D., M.P.H.  Steve Gove, Chair of the MHMC Board of Directors, and Chris McCarthy, Chair of the MHMC Foundation Board of Directors, accepted the award on behalf of the Coalition.

The luncheon also was an opportunity to highlight the work of Dr. Wennberg, a pioneer in geographic variation analysis, to recognize inaugural Hanley leadership fellows Lisa Letourneau, M.D., M.P.H., Maureen Kenney, M.S.W., and Ned Claxton, M.D., M.P.H., and to encourage participation in the Hanley Health Leadership Development classes and other programs of the Center.  

The luncheon emcee duties were shared by Hanley Center Board Vice Chair Terry Sheehan, M.D. and Executive Director James Harnar. 

You can find more information about The Daniel Hanley Center for Health Leadership on the web at:
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Observers Speculate About Health Care Agenda in Washington

President-elect Barack Obama and the new Congress will have to deal with the economy and energy in early 2009, but health care likely will be high on the agenda as well.  Legislation to reauthorize the State Children's Health Insurance Program (SCHIP) could be the first health care matter addressed because the current 18-month extension expires on March 31, 2009.  The other priorities on the health care agenda could be:

  • Health care reform;
  • Medicare payment issues;
  • Information technology;
  • Quality and pay-for-performance;
  • Comparative effectiveness research;
  • Generic biologics;
  • Chronic disease management;
  • Health insurance regulatory reform; and
  • Regulation of FDA and prescription drugs.

Several people have been mentioned as possible HHS Secretary in the new administration including former Senate Majority Leader Tom Daschle (D, SD) and former Vermont Governor Howard Dean, M.D. (VT).  Elizabeth Fowler, the chief health counsel for Senate Finance Committee Chairman Max Baucus (D, MT) has been mentioned as a possible CMS Administrator. [return to top]

CMS Issues Final Rule on Physician Fee Schedule

On October 30, 2008, CMS released the final physician fee schedule rule for 2009, including the 1.1% payment increase authorized by the Medicare Improvements for Patients & Providers Act (MIPPA).  CMS also said that it would continue its work with the AMA's Relative Value Update Committee (RUC) and specialty societies to develop alternative approaches to identify misvalued codes.  It also will continue looking at services that could be bundled or subjected to a multiple procedure payment reduction.  The final rule also includes the 2% of total Medicare allowed charges incentive payments for electronic prescribing and for reporting under the Physician Quality Reporting Initiative (PQRI).  It adds 52 new quality measures to the PQRI for a total of 153.  

You can find the rule on the web at:[return to top]

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