December 8, 2008

 
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Update on MMA Executive Committee Meeting 12/3

MMA's 28-member Executive Committee met last Wednesday, December 3, 2008 and considered a number of issues.  Primary topics for the meeting included e-prescribing and a preview of the upcoming legislative session.  Budget issues are certain to dominate the session, with the anticipated deficit for the biennial budget now greater than $800 million.

Daniel Mingle, M.D. and Paul Klainer, M.D. joined the Committee for the discussion of e-prescribing that  focused on the actions MMA could take to assist members who are interested in getting started with e-prescribing.  The Medicare payment of an additional 2% compensation in 2009 for e-prescribing has sparked a lot of interest around the state.  MMA will share a list of potential vendors with members and share copies of the new manual on the topic prepared by the AMA.

Other action taken by the Committee included the following:

  • Affirmed the Operations Committee invitation to the Executive Committee of the Maine Osteopathic Association for two joint committee meetings in 2009.

  • Supported the EVP's joining the minority opinion on a portion of the report being prepared by the HealthInfoNet Stakeholders Group.  The position of the minority of the Group is that increasing fees or taxes can not be ruled out in providing the $2 million needed from the state to fund one-third of the costs of HealthInfoNet that represents the public benefit portion of the project.

  • Following a preliminary report by the Ad Hoc Committee on Annual Session, voted to accept a recommendation that one day be cut from the 2009 Annual Session that will begin on Friday, September 11, 2009.  The meeting will be held at the Harborside Hotel and Marina in downtown Bar Harbor.

  • Accepted a report by EVP Gordon Smith summarizing the Association's activities in connection with Ballot Question One.

The Committee will hold a weekend retreat in January that will feature consideration of a long-term development plan and a session on worksite wellness.  The results of the membership survey currently being offered to members also will be considered.

Jo Linder, M.D., an emergency physician from Falmouth, chairs the Committee.

MMA Payor Liaison Committee to Meet with Anthem Officials Wednesday

MMA's Payor Liaison Committee will meet on Wednesday evening December 10, 2009 at the MMA offices in Manchester.  Guests for the evening will be from Anthem, including Provider Network Manager Vincent Liscomb, Medical Director Jeff Holmstrom, D.O., and Martha Ridge.  One of the topics will be Anthem's pay-for-performance program.  The meeting will begin at 6:30 pm.

The Committee meets with different payors throughout the year.  Meetings are open to any MMA member, but let us know if you are planning to attend as dinner is available beginning at 6:00 pm.  You may RSVP to Diane McMahon at 622-3374, ext. 216 or via e-mail to dmcmahon@mainemed.com.

The Committee is chaired by Nancy Cummings, M.D., an orthopedic surgeon from Farmington. [return to top]

Data Suggest Physician Shortage Could Exceed 124,000 by 2025

CQ (11/27, Reichard) reported, "The nation's health system will have to rely on nurse practitioners and physician assistants to cope with a shortage of doctors that will climb to 124,000 physicians by the year 2025, according to new projections [released] by a medical school lobby."  In fact, the Association of American Medical Colleges warns that "a 30 percent expansion in medical-school enrollment and an increase in graduate medical-education positions will not eliminate the projected shortage, only moderate it."  This "estimated shortage of 124,000 doctors assumes that medical resources will be used at current levels, but the report says that 'practice and utilization patterns in the future are very unlikely to be the same as today.'"  Thus, the authors projected that "the shortage in 2025 would reach 159,300 rather than 124,000.  The higher projection assumes continued increases in the level of medical resources people consume, and younger doctors working fewer hours, among other factors."

[return to top]

CMS Begins 2009 Medicare Contractor Provider Satisfaction Survey

The Centers for Medicare & Medicaid Services (CMS) will be administering the 2009 Medicare Contractor Provider Satisfaction Survey (MCPSS) beginning in December 2008.  The MCPSS is designed to measure provider satisfaction with and perceptions about the services contractors provide to Medicare providers and suppliers.

The MCPSS will give providers/suppliers the opportunity to rate their contractor(s) on various business functions.   Should you receive it, please take a few moments to complete the survey and return it.  For more information, please visit the MCPSS web page at: www.cms.hhs.gov/mcpss , and  www.MCPSStudy.org . [return to top]

CMS Announces Influenza Pandemic Policies

The Centers for Medicare and Medicaid Services has developed certain emergency policies and procedures that may be implemented in the event of an influenza pandemic.
Providers should monitor the NHIC, Corp. Web site, www.medicarenhic.com , in the event of an influenza pandemic in order to determine the policies being implemented and when and where such policies are applicable.  You should also monitor the CMS Web site at http://www.cms.hhs.gov/Emergency/10_PandemicFlu.asp.

Providers must await guidance from NHIC, Corp. and CMS before considering any pandemic policy to be operationally effective. 

For the quickest notification method, we strongly encourage you to join NHIC's electronic listserv, via the Web site home page at  http://www.medicarenhic.com/   It is fast and very easy to sign up! [return to top]

MMA Members: LAST WEEK to Complete Membership Survey

All MMA active members should have recently received a survey from Enetrix , a survey research firm recently puchased by the Gallup organization.  The survey is intended to provide MMA with important information regarding its member services and member priorities.  The survey can be completed online or by paper copy.

Please take the five to ten minutes it will take to complete the survey.  MMA cannot represent your interests effectively if we don't hear from you on a regular basis.

If you are an active MMA member and have not received the survey or an email message directing you to the website, please contact Gordon Smith, MMA EVP at gsmith@mainemed.com. [return to top]

AMA Offers PQRI Webinar, December 17

Get up to speed right now!

 

Physicians      CPT advisors     Practice managers and coders

 

Sign up for this timely PQRI 2009 webinar today!

 

Wednesday, December 17, 2008

1 – 2:30 p.m. EST

 

Changes in the Centers for Medicare and Medicaid Services (CMS) 2009 Physician Quality Reporting Initiative (PQRI) program will become effective on January 1. Be informed by attending this timely webinar, hosted by the American Medical Association (AMA)—convener of the Physician Consortium for Performance Improvement®, the measure developer of 112 of the 153 measures in PQRI 2009. Don’t miss this important opportunity to learn about the measures included in the 2009 PQRI program and how your practice can prepare to report through claims for the 2009 reporting year. 

 

Hear from leading experts

 

Susan Nedza, MD, MBA, Vice President, Clinical Quality and Patient Safety, AMA

Dr. Nedza brings the experience she gained during her work at CMS on the PQRI program together with her knowledge of the performance measures and CPT Category II Coding. 

Kendra Hanley, MS, Senior Policy Analyst, Clinical Performance Evaluation, AMA

Ms. Hanley leads the development and maintenance of the PCPI measure specifications, including the PQRI program, and advises on CPT Category II code development for clinical performance measures.   

Samantha Tierney, MPH, Senior Policy Analyst, Clinical Performance Evaluation, AMA

Ms. Tierney leads the development of the AMA-developed PQRI tools for individual performance measures and measures groups.

 

Learn the latest developments

 

  • New options for claims reporting in 2009—individual measures or measures groups
  • How to determine which measures apply to your practice
  • Key elements of 2009 PQRI performance measures and specifications—what has changed and what is new
  • Tips to facilitate more accurate reporting
  • New implementation tools developed by the American Medical Association for PQRI 2009, including tools for reporting measures groups

Don’t miss this important opportunity. If you submit Medicare Part B claims and plan to participate in the 2009 PQRI program, you should register today.

 

Registration fee, $160-AMA Members; $185 Non-members

REGISTER HERE [return to top]

HHS Announces Medicaid, SCHIP Matching Rates for FY 2010

The U.S. Department of Health & Human Services published a notice in the November 26, 2008 Federal Register establishing the federal medical assistance percentages (FMAP) for Medicaid programs and the enhanced FMAP percentages used for the SCHIP program and some Medicaid populations.  The FMAP percentages range from 50% to a high of 75.67 in Mississippi.  The enhanced FMAP percentages range from 65% to 82.97%. 

Maine's percentages are the highest in New England with the FMAP rate at 64.99% and the enhanced FMAP rate at 75.49%.  The other New England states' rates are:

  •  MA:  50%/65%
  • NH:  50%/65%
  • VT:  58.73%/71.11%
  • CT:  50%/65%
  • RI:  52.63%/66.84%

These rates will be effective for the period from October 1, 2009 through September 30, 2010.

Through the National Governors Association (NGA) and the National Conference of State Legislatures (NCSL), the states have been lobbying Congress for an increase in Medicaid spending as part of an economic stimulus package.  The states last received additional Medicaid assistance in 2003 when Maine received a $53 million payment that was used to begin the Dirigo Health Program.  [return to top]

New Guidance on Relationship Between Medical & Education Privacy Laws

On November 25, 2008, the U.S. Departments of Education and HHS jointly released new guidance on the relationship between the Family Educational Rights & Privacy Act (FERPA) and the HIPAA privacy rule.  The agencies developed the guidance following concerns raised in the aftermath of the shootings at Virginia Tech when health care practitioners, education officials, and law enforcement authorities misunderstood when information could be shared.  The guidance makes it clear that both FERPA and the HIPAA privacy rule permit disclosure of health care information without consent to law enforcement authorities, family members, and other appropriate individuals when necessary to protect the health and welfare of the patient or student or other individuals.

You can find the guidance document on the web at:  http://www.hhs.gov/ocr/hipaa/HIPAAFERPAjointguide.pdf. [return to top]

IOM Issues New Report on Resident Working Hours

On December 2, 2008, the Institute of Medicine (IOM), released a report entitled, Resident Duty Hours:  Enhancing Sleep, Supervision, and Safety.  The IOM report retains the 2003 recommendation of the ACGME to limit resident duty hours to 80 hours per week, averaged over a 4-week period.  The report goes on to recommend that a continuous shift not exceed 16 hours unless a 5-hour sleep break is included in a shift that may last up to 30 hours.  It also recommends better scheduling of shift changes to allow for adequate handover of patients, better error reporting by residents, and better ACGME oversight, including whistleblower processes.  The IOM produced the report at the request of Congress in 2007.  The AMA applauded the recommendations, but the consumer advocacy organization Public Citizen found the recommendations inadequate.

You can find more information about the report on the web at:  http://www.iom.edu/CMS/3809/48553/60449.aspx.  [return to top]

Maine Drops 2 Places in "America's Health Rankings"

In the recently released America's Health Rankings 2008 by the United Health Foundation, Maine dropped to 9th place from 7th place in 2007.  The following strengths were identified:

  • Low violent crime rate
  • Low incidence of infectious disease
  • Low rate of uninsured population
  • Low geographic disparity within the state

The report identified 2 principal challenges:

  • Low immunization coverage
  • High rate of cancer deaths

Finally, the report found these significant changes from last year:

  • In the past year, the prevalence of obesity increased by 9%
  • In the past year, the percentage of children in poverty increased by 9%
  • In the past 5 years, the rate of uninsured population decreased by 15%
  • Since 1990, the rate of deaths from cardiovascular disease decreased by 35%

You can find more on the rankings, including the ranking of the U.S. in the world, on the web at:  http://www.americashealthrankings.org/2008/index.html. [return to top]

Maine CDC Seeks Input on New Electronic Death Registration System

The Maine Center for Disease Control and Prevention is conducting this survey of potential users of a new Electronic Death Registration (EDR) online system for Maine, in order to understand your technical capabilities for participation. Your responses to the questions will help us develop a system that will work for you!

Please take a moment to participate in the survey by following the link below:

http://www.surveymonkey.com/s.aspx?sm=Y0FGOjHmbQj9LaYgpLIbBQ_3d_3d [return to top]

Medical Care Development Inc. Announces New President, CEO

Medical Care Development, Inc., is proud to announce that Mark E. Battista, MD, JD, has been chosen to become its President and CEO.  He will replace John A. LaCasse, Eng.Sc.D., who has served as MCD’s President since 1981.

Dr. Battista is a resident of Portland, Maine.  He received his medical training at Queen’s University, Kingston, Canada, and is a 1981 graduate of Boston University School of Law.  He was employed by Unum from 1985 to 1999 and recently served as a Vice President of Planning, Program Development and Project Management at Pen Bay Healthcare.  Dr. Battista is married to Jennifer Andrews and they have one son, Nicholas.

“I am honored the Board has placed their faith in me to become their next President and CEO,” states Dr. Battista.  “It is a once in a lifetime opportunity to join an organization that does such worthy work for our neighbors in Maine and those in need abroad.  Medical Care Development is truly a Maine jewel that has quietly worked for over forty years to improve the health and well-being of people both at home and abroad.  I am looking forward to working with my new colleagues, MCD partners and the Board in developing new programs and businesses and to helping to continue MCD’s record of success.”

Dr. LaCasse said, “I have been with Medical Care Development for 40 years.  It is with a heavy heart I leave behind an organization that has meant so much not just to me, but for the people of Maine and around the globe whose lives we have improved.  I cannot think of a more fulfilling career.  I am extremely proud of MCD’s exceptional staff and all they have achieved and cannot wait to see Dr. Battista fulfill that mission into the future.”

MCD’s projects in Maine address prevention and awareness building around a myriad of public health issues including youth suicide, cardiovascular health, diabetes, HIV/AIDS, school-based health programs, access to dental health, training and support for people with mental illness, reducing youth access to alcohol, smoking and obesity reduction, and workplace health.  MCD also operates supported living programs for elderly and disabled clients through the state.

Internationally, MCD is working to build better systems for malaria prevention, health services planning and management, rehabilitation for war victims, improving children’s health, and family planning.  This work is done in developing countries such as Equatorial Guinea, Lesotho, Madagascar, Sudan, Benin, Haiti, and South Africa. [return to top]

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