February 9, 2009

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MMA Payor Liaison Committee Looks at Cash Only Practices Wednesday Night, Feb. 11

On Wednesday evening, February 11th, the Association's Payor Liaison Committee will meet with several physicians and physician groups who are practicing without health plan contracts.  As the primary purpose of the Payor Liaison Committee is to meet periodically with health plan representatives and to oversee MMA activities related to health plan operations and regulations, the subject matter is unusual for the committee.  But, committee members requested that such a session be held, believing that it is important to understand this trend.  Any MMA member or practice manager is invited to attend.

The meeting will begin at 6:30 pm at the Association offices in the Frank O. Stred Building in Manchester.  Dinner will be available beginning at 6:00 pm.  While any MMA member or practice manager is cordially invited to attend (whether on the Payor Liaison Committee or not), please let Diane McMahon at MMA know so we will be sure to have enough food and materials (622-3374, ext. 216 or dmcmahon@mainemed.com).

Among the presenters at the meeting will be three representatives of True North, a nonprofit 501(c)(3) health care practice and research organization devoted to integrating state of the art medical care with proven complementary therapies.

MMA's Payor Liaison Committee meets six times a year and is chaired by Nancy Cummings, M.D., an orthopedic surgeon practicing in Farmington, Maine.  Any MMA member or associated medical practice manager who is interested in serving on the committee should contact Gordon Smith, the Association's Executive Vice President at 622-3374, ext. 212 or via e-mail to gsmith@mainemed.com.


Senate Succeeds in Cloture Vote on Stimulus Bill

Late this afternoon, the U.S. Senate reached the 60 votes necessary to close debate on the proposed economic stimulus package.  The final vote was 61-39 with Maine's two Senators and Pennsylvania's Arlen Specter joining majority Democrats in supporting the $827 billion Senate version of the plan.  The House bill costs about $819 billion.  No Republicans in the House voted for the bill and Republicans have been putting significant pressure on Senators Specter, Snowe, & Collins.  The Senate is expected to vote on the package again tomorrow and then it will go to a House/Senate conference committee.  President Obama hopes to sign the bill on Presidents' Day next week.   [return to top]

President Signs SCHIP Legislation; Calls it "Down Payment"

On February 4, 2009, President Obama signed H.R. 2, the 4.5-year, $32.8 billion reauthorization and expansion of the State Children's Health Insurance Program (SCHIP) established in 1997.  The bill maintains coverage for 7 million uninsured children and expands coverage to an additional 4 million.  During a signing ceremony, the President called the bill a "down payment" on his pledge to provide health insurance coverage to all Americans.  The bill makes families with incomes up to 300% of the federal poverty level eligible for the program and permits states to eliminate a 5-year waiting period for legal immigrant children and pregnant women who seek public coverage. [return to top]

CMS Moves Ahead with Recovery Audit Contractors (RAC)

In a move strongly opposed by the AMA and other medical organizations, the Centers for Medicare and Medicaid Services (CMS) announced on Friday, February 6th the award of contracts to four national recovery audit contractors, or RAC's.  These contracts were previously awarded but had been the subject of protests from competitors and a stop order was put in place.  Consequently, the implementation of the national RAC programs was put on hold until the protests over the awarding of the contracts could be resolved.  

The protests were resolved on February 6, 2009.   The settlement of the protests means that CMS will now continue with the implementation of the unpopular national RAC program.  As mandated by section 302 of the Tax Relief and Health Care Act of 2006, CMS will implement a permanent and national RAC program by January 1, 2010.

In our region, Diversified Collection Services (DCS) of Livermore, California was awarded the contract and will work in Region A consisting of Maine, N.H., Vermont, Massachusetts, R.I., and New York.  PRG-Schultz will be a subcontractor on the contract.

Medicare providers will not begin receiving correspondence from a RAC until the RAC and CMS have completed provider outreach in the Region.

The national Recovery Audit Contract program is the outgrowth of what CMS declared a successful demonstration program that used RAC's to identify Medicare overpayments and underpayments to health care providers and suppliers in California, Florida, N.Y., Massachusetts, S.C., and Arizona.

The program has been widely criticized by medical groups because  the contractors are allowed to receive fees based upon a percentage of the recovery, thus providing an inappropriate incentive.  In Maine, the MaineCare program tried a similar effort a few years ago which was so unpopular that the legislature, at MMA's urging, ultimately passed a law prohibiting the awarding of such contracts on a percentage/contingent fee basis.

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Looking for Physicians Interested in Maine's Outdoor Heritage

The Sportsmen's Alliance of Maine (SAM), a non-profit membership organization of Mainers who enjoy hunting, fishing, and other outdoor pursuits, is looking for physicians who enjoy the state's outdoor heritage.  Through the leadership of several Maine physicians including Lee Thibodeau, M.D. and Andy Iverson, M.D., SAM is undertaking an initiative that involves physicians and other health care professionals.  Any physician interested in assisting Dr. Thibodeau with this initiative should contact Gordon Smith, EVP of MMA at 622-3374, ext. 212 or via e-mail to gsmith@mainemed.com.

In the interest of full disclosure, Gordon's brother George is the long-term Executive Director of SAM. [return to top]

Political Pulse: Legislative Highlights of the Week

With the supplemental budget (L.D. 45) now passed and public hearings on the biennial budget (L.D. 353) starting today, the pace of work at the State House is picking up.  Last week was the first of the session in which there was substantial activity on bills in most committees.  The MMA and medical specialty organizations were involved in the following bills of interest.

The Education & Cultural Affairs Committee held a public hearing on L.D. 98, Resolve, to Direct the Department of Education and the Department of Health & Human Services to Require the Teaching of Mental Health Awareness in Middle Schools Based on a National Curriculum.  The MMA and the Maine Association of Psychiatric Physicians supported the bill.  The Committee also held a public hearing on L.D. 136, An Act to Require the Provision of Unstructured Recess Time for Elementary School Students.  The MMA and the Maine Chapter of the American Academy of Pediatrics supported the bill.

The Health & Human Services Committee held public hearings on L.D. 67, An Act to Protect Beaches in Maine's State Parks and L.D. 99, An Act to Allow Authorization for the Release of HIV Information on a General Medical Information Release Form.  The MMA and the Maine Chapter of the American Academy of Pediatrics supported L.D. 67, a bill that the pediatricians have cited as one of their top legislative priorities for the 124th Maine Legislature.  The bill had no opposition, but the Committee has decided to delay a work session on the bill until it hears a related bill, L.D. 155, An Act to Ban Smoking on Public Beaches and in Public Parks.  L.D. 99 received support only from an individual with a particular interpretation of the interplay between the state HIV statutes and the state and federal health information privacy laws.  The HIV Advisory Committee, the Maine Civil Liberties Union, the Maine CDC, and the MMA all expressed concerns about the bill.  At a work session last week, the Committee unanimously voted to kill the bill.

The Business, Research & Economic Development Committee held public hearings on two bills of interest to the MMA, L.D. 89, An Act to Amend the Laws Concerning Informal Conferences as Part of the Board of Licensure in Medicine's Disciplinary Proceedings and L.D. 94, An Act to Authorize the State Board of Nursing to Request Mental and Physical Examinations and to Establish a Nurse Health Program.  The MMA spoke in favor of both bills. The committee has scheduled work sessions on the bills for this week.

You can find more information about these bills, including the text of each, by using the "Bill Status Search" function of the Maine legislature's web site, http://janus.state.me.us/legis/LawMakerWeb/search.asp.
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MMA's Senior Section to Look at Hospice Volunteering on Wednesday

MMA's Senior Section, consisting of our retired members, will hold its next luncheon meeting on this coming Wednesday, February 11th at 11:30 am.  The program will be held at the association offices at the Frank O. Stred Building in Manchester.  The program on Wednesday will consist of presentations from various hospice programs around the state and from physicians who volunteer at these facilities.

Any person wishing to attend is welcome but please RSVP to Lisa Martin at 622-3374 ext. 221 or via e-mail to lmartin@mainemed.com.

The Senior Section was established in 2008 and is chaired by Buell Miller, M.D.  For further information, contact Dr. Miller at 622-3374, ext. 228 or via e-mail to bmiller@mainemed.com.

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Maine Urological Association Starts 2009 with Successful Winter CME Meeting!

The Maine Urological Association's 2009 Annual Winter Meeting was well attended with 13 urologists, 11 exhibitors, and nine speakers capping off the weekend at Sugarloaf.  Joining the group this year was well known Peter Albertsen, MD from the University of Connecticut, Division of Urology who spoke on "PSA Testing:  What Have We Learned in the Past 20 Years?"  The Maine Medical Center Cancer Institute was the major corporate sponsor and is very supportive of the Maine Urological Association's endeavors.  The members will be working on new initiatives throughout 2009 to increase communication among the New England Urology Residency programs - Lahey Clinic, Boston University, Harvard, Mass General, UVM, Dartmouth Hitchcock, University of Connecticut, and Maine Medical Center.

The 2010 Maine Urological Association's Annual Winter Meeting has been scheduled for February 12-14 at the Grand Summit Hotel at Sugarloaf and the leadership is already working on the CME program agenda for the 7 CME hour Conference.  For more information, please contact Kellie Miller, staff for the Maine Urological Association at 207-622-3374, ext. 229 or kmiller@mainemed.com. [return to top]

Public Health Committee Meeting Dates Confirmed for 2009 - February 24th set for First Meeting

The MMA Public Health Committee meeting dates have been confirmed for 2009 and February 24th, 4pm - 6pm at the MMA office has been confirmed as the next meeting.  Through the assistance of Dr. Jim Schneid, we now have access to the Maine Medical Center's, Dana Center Video-Conferencing to allow our physicians in southern Maine to connect into the meeting.  If you have agenda items to be considered by our Chair, Charles Danielson, MD, please send them to Kellie Miller, Director of Public Health Policy at kmiller@mainemed.com.  Our February 24th meeting will provide an update on the status of public health legislative bills, updates on our strategic initiatives in healthy weight, childhood immunization and pediatric environmental health, and other issues.

All MMA members are welcome to join our public health committee meetings.  We look forward to everyone's participation in our work to ensure that our public health infrastructure in Maine continues to strengthen.

2009 Meeting dates:

  • February 24 (Dana Classroom - 7)
  • March 25 (Dana Classroom - 2)
  • May 20 (Dana Classroom - 4)
  • August 19 (Dana Classroom - 4)
  • October 21 (Dana Classroom - 4)
  • December 16 (Dana Classroom - 4)

Agenda and support materials will be emailed prior to each meeting, along with the conference call-in number.  Thank you and we look forward to your participation.

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Winter Break for Working Women - February 26 & 27 Conference

The Women Lawyers from the Maine Bar Association and Women Physicians from the Maine Medical Association have joined forces to fight back the blues of winter with a unique day and a half retreat of fun and continuing medical education credits and CLE credits.  Depression and substance abuse are diseases to which women professionals are vulnerable and the long cold Maine winter makes taking care of ourselves especially difficult.

Enjoy a relaxing mixture of education and fun with friends and colleagues at the Black Bear Inn in Orono.  The keynote educational speaker will be Dr. Susan Blank, an addiction psychiatrist.

But beyond education, take action to care for yourself, starting with an evening of laughter with attorney-comedienne Karen Morgan, and then during the day Friday, in addition to speaker Dr. Margaret J. Palmer, PhD, there will be breakout sessions for yoga, massage, acupuncture, and even how to dress to feel better!!!

For more information, contact Mara King at 207-777-4600 or mrk@andruckimitchell.com or go online at www.mainebar.org. [return to top]

New Issue of MaineCare Matters Available

A new issue of MaineCare Matters has been posted to the MaineCare web site.  This can be found at

http://www.maine.gov/dhhs/bms/member/innerthird/mainecare_matters.html. [return to top]

MMA Office Open on President's Day Holiday

The MMA office in Manchester will remain open on the President's Day holiday, Monday, February 16th to serve the needs and interests of MMA members.  Regular office hours of 7:00 am to 5:00 pm will be observed. [return to top]

New Bills for Your Review & Comment/Reminder of Legislative Committee Conference Calls on Thursday Evenings

The following bills of interest to physicians were printed and referred to committees last week.

 LD 281, An Act To Amend the Licensing Requirements for Speech-language Pathology Assistants (monitor)

LD 282, An Act Regarding the Requirement That the Treatment of a Gunshot Wound Be Reported (emergency physicians; monitor)

LD 290, An Act To Allow Maine Residents To Purchase Health Insurance from Out-of-state Insurers (monitor)

LD 297, An Act To Ensure That Medical Equipment Found in a Repossessed Vehicle Is Returned to the Owner (monitor)

LD 302, An Act To Require Review by the Joint Standing Committee on Appropriations and Financial Affairs of Transfers of MaineCare Funds (monitor)

LD 309, Resolve, To Direct the Emergency Medical Services' Board To Examine the Licensure Procedures for Emergency Medical Services Persons (emergency physicians; monitor)

LD 319, An Act To Track the Prevalence of Childhood Obesity in Maine (Public Health Committee, pediatricians, support)

LD 320, Resolve, Regarding the Use of MaineCare for Catastrophic Illness (monitor)

LD 322, An Act To Clarify the Prohibition on Payment for Health Care Facility Mistakes or Preventable Adverse Events (monitor)

LD 323, An Act To Improve Transparency in the Health Insurance Markets (monitor or support)

LD 337, An Act Regarding Emergency Involuntary Admission of a Participant in the Department of Health and Human Services' Progressive Treatment Program to a State Mental Institute (monitor; psychiatrists)

LD 340, An Act To Provide Greater Access to ATVs by Lowering the Minimum Operating Age (Public Health Committee, pediatricians, oppose)

LD 341, An Act To Amend the Department of Health and Human Services' Progressive Treatment Program (psychiatrists; support)

LD 343, An Act To Establish a Specialty License Plate To Increase Funding for Autism Programs (pediatricians; monitor)

LD 353, An Act Making Unified Appropriations and Allocations for the Expenditures of State Government, General Fund and Other Funds, and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Years Ending June 30, 2010 and June 30, 2011 (this is the FY 10/11 biennial budget; MMA will oppose parallel cuts in reimbursement for hospital-based physicians and critical access hospitals as in supplemental budget)

LD 359, An Act To Ensure That MaineCare Reimbursements to Hospitals Do Not Pay For Hospital Advertisements (monitor)

LD 362, An Act To Support New Mothers Who Are in Substance Abuse Treatment Programs (pediatricians; monitor)

LD 372, An Act To Authorize the Administration of Epinephrine Autoinjectors and Asthma Inhalers in Emergencies (pediatricians; monitor)

LD 392, An Act To Reduce Minimum Participation to 60% for Group Health Insurance (monitor)

LD 395, Resolve, To Further Regulate the Use of Tanning Booths by Minors (pediatricians; monitor or support)

The MMA Legislative Committee's weekly conference calls will take place every Thursday evening at 8:30 p.m. using the regular MMA conference call line:  800-989-2842; access code 6223374#.  Any member or specialty society representative is welcome to join the calls.  Please join us on February 12th!


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