March 9, 2009

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HHS Committee Forms Subcommittee to Review Hospital Cuts in Biennial Budget

The Legislature's Health & Human Services Committee has formed a subcommittee to make recommendations to the Appropriations Committee regarding the Governor's proposed reductions in the hospital payments in the biennial budget.  The agreements previously reached at the time of closing the supplemental budget (L.D. 45) are unraveling and MMA is concerned about the cuts to Critical Access hospitals and further concerned about the previous agreements reached on provider-based reimbursement.

Members of the subcommittee are Senator Peter Mills (R-Somerset), Sen. Lisa Marrache, M.D. (D-Kennebec), Rep. Sally Lewis (R-Elliot), Rep. Anne Perry (D-Calais), Rep. Linda Sanborn, M.D. (D-Gorham).  The subcommittee and the full HHS Committee are expected to complete their work on the recommendations this coming week.  The subcommittee meets again on Wednesday, March 11th.

MMA opposes the cuts to Critical Access Hospitals, believing that these institutions in the rural parts of the state are an important part of the primary care network across Maine.  While these hospitals escaped the cuts proposed in the recent supplemental budget, the Governor has included the cut again in the biennial budget.

Relative to provider-based reimbursement, MMA supports the agreement reached during the debate on the supplemental budget.  At that time, the State agreed to mitigate the reduction in provider-based reimbursement by increasing the MaineCare fee schedule to approximate 70% of Medicare reimbursement rates.  Currently, the fee schedule approximates, on average, 57% of Medicare rates and remains one of the lowest Medicaid fee schedules in the country.  If this agreement is carried over to the supplemental budget, an increase of more than $13 million would be achieved in the fee schedule. 

In addition, MMA continues to advocate for the use of the Medicaid funds coming to Maine through the stimulus bill to pay the debt owed to Maine's hospitals for the care of MaineCare patients in 2005 and 2006. 

The MMA urges physicians to contact members of the HHS Committee and their own legislators to oppose the Critical Access Hospital and hospital-based physician cuts.

You can find your own legislators on the web at:

You can find members of the HHS Committee and their contact information on the web at:

You can call toll-free and leave a message at the State House for any legislator as follows:

  • Senators:  1-800-423-6900
  • Representatives:  1-800-423-2900

White House Issues Town Hall Report

On March 5, 2009, the Obama Administration issued a report summarizing the information obtained from many town-hall style meetings hosted by many, including the MMA, around the country during December 2008.  The report is entitled, Americans Speak on Health Reform:  Report on Health Care Community Discussions is now posted on a new White House web site dedicated to health care reform,

The report includes feedback from more than 30,000 participants.  The top concerns cited by respondents included:

  • the cost of care (55%);
  • lack of preventive care (20%);
  • pre-existing conditions limiting insurance access (13%); and
  • concerns about the quality of care (12%).

Participants expressed support for a system that is:

  • fair (36%);
  • patient-centered (19%);
  • simple & efficient (17%); and
  • comprehensive (15%).

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Report on MMA Executive Committee meeting, March 4, 2009

The 28-member MMA Executive Committee held its regularly scheduled meeting on this past Wednesday, March 4.  The priority topic was continued review of the membership survey conducted in November-December of 2008.  In addition to completing review of member responses to the survey, committee members discussed how to make the responses available to members and to the public.  Watch for this information in the coming weeks, both via e-mail and in press releases to the public.  At some point this month, the complete results will be available to MMA members on the member's only section of the MMA website at

Committee members also heard of proposed changes to the Annual Meeting being held September 11-13, 2009 in Bar Harbor.  This year's CME programming will include some sessions at the Jackson Lab.  Registration materials for the meeting will be available in May.

Membership was reported to be at the highest level ever, with 3123 members as of the end of February.  Dues income is running about $10,000 ahead of the prior year.

Preliminary budget results from 2008 were presented by Treasurer Michael Parker, M.D. and Finance Director Heidi Lukas, CPA.  MMA had an operating loss of approximately $54,000 for the year.  Like most organizations and individuals, the MMA's investments took a significant hit from the bear market.

Other reports from staff included an update on the contract with the State on academic detailing, the provisions in the federal stimulus bill relative to health IT and comparative effectiveness, and current legislative proposals pending in Augusta.

The Committee is chaired this year by Jo Linder, M.D., an emergency physician from Falmouth.

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Health Effects of Wind Turbines Forum Scheduled for March 25th

The MMA’s Public Health Committee meeting, scheduled for 4 to 6 p.m. on March 25, 2009 at the MMA, will provide a forum on the health effects of wind turbines.  Opposing viewpoints will be presented and discussed based on the current scientific studies and available data regarding possible health effects, such as sleep deprivation and stress. 

Presenters include:

  • Dora Anne Mills, MD, MPH, Director, Maine Centers for Disease Control & Prevention, DHHS
  • Albert Aniel, MD, Internal Medicine, Rumford, Maine
  • Michael Nissenbaum, MD, Northern Maine Medical Center
  • Angus King, Independence Wind, LLC, former Governor of Maine

 The meeting will begin at 4 pm and light refreshments will be available. 

Please RSVP your attendance plans to by March 20th, and indicate whether you will be joining the meeting in person, by conference call, or by video-conferencing at the MMC Dana Center, Classroom #2, in Portland, Maine.

The conference call number is:  1-800-989-2842, Passcode:  6223374# [return to top]

First Stakeholder Meeting Held to Determine Protocol for Designation of Priority Chemicals

The first of three stakeholder meetings was held on Friday, March 6, 2009 on the Protocol for Designation of Priority Chemicals from the preliminary draft of DEP Rule Chapter 880 based upon the 123rd Legislature's LD 2048, An Act to Protect Children’s Health and the Environment from Toxic Chemicals in Toys and Children’s Products.  DEP Rule Chapter 880, Regulation of Chemical Use in Children’s Products, sets forth the process by which the Board of Environmental Protection may designate a chemical for regulatory scrutiny as authorized under Title 38, chapter 16-D, subsection 1691-1699-B of the Maine Revised Statutes.

Approximateli 30 stakeholders convened including representatives from Maine Medical Association, Maine Women’s Lobby, The Alliance for a Clean and Healthy Maine, Natural Resources Council of Maine, the Toy Industry and the American Chemistry Council, along with three independent experts and several members of the Maine Department of Environmental Protection staff began the difficult process of providing input to the Commissioner.  Currently, there are 1800 high concern chemicals and the DEP will be working to designate 2 “priority” chemicals.

The meeting was convened by an outside meeting facilitato to gain feedback on 1) the protocols for designation, 2) fees and definitions, and 3) logistics issues.  After lengthy comments by the Toy and Chemical Industry representatives, who were quite opinionated about the process and stated that there was too much to discuss over a three meeting time frame indicated that they would prefer to allow the use of “weight of evidence approach” to designation and had immense concerns about disclosure of information regarding the priority chemicals process.  They also expressed the belief that there was a lack of resources at the DEP to implement the law.

Despite this set back, the stakeholder group was able to move forward on the list of stakeholder issues of concern, such as:

  • requesting legal staff to discuss the disclosure/confidentiality requirements;
  • the economic cost of inaction;
  • incentives for green chemistry;
  • allowing DEP to designate more than minimum of priority chemicals by law;
  • the process around public disclosure; and
  • the process for the  designation of priority chemicals.  

Much discussion centered on recommendations for designation, including:  risk-based, including use/exposure to chemicals that particularly affect infants and unborn children, prioritize based on bio-monitoring in cord/blood, on list for developmental concerns, such as endocrine disrupters and carcinogens and incidence of disease.

Minutes of the March 6th meeting will be posted on DEP’s safer chemical website at:  The next stakeholder meeting is scheduled for March 27th from 10:00 am – 3:00 pm at the DEP Response Building Training Room, East Side AMHI Campus. [return to top]

Let MMA Do Your HIPAA Staff Training on April 3, 2009

The federal HIPAA privacy and security rules require your new staff to be trained in HIPAA and encourage annual HIPAA training for your existing staff.  On Friday, April 3, 2009, for  MMA will host its initial First Friday educational program for 2009, the Annual HIPAA Update:  Privacy and Security.  The three-hour program will begin at 9:00 a.m. and will feature three experts on the HIPAA privacy and security regulations and state confidentiality laws.  The program is intended to meet the requirements for annual HIPAA training.  The program will be held at the Association offices in the Frank O. Stred Building in Manchester.

Gordon Smith, Esq., the Association's Executive Vice President and a frequent lecturer to medical groups, Kenneth Lehman, Esq., of the Portland law firm of Bernstein, Shur, Sawyer & Nelson, and John Coolong, of Systems Engineering make up the faculty for this program.

The program will also update attendees on the changes in the HIPAA regulations that were included in the recent federal stimulus legislation.  These changes deal primarily with accounting for inadvertent disclosures and other aspects of enforcement. 

To register, call 622-3374, ext. 219 or go to the MMA website at  There is a $60 fee which covers breakfast and all course materials.  For physicians attending, three hours of category one credit are available. [return to top]

Invitation to Annual Corporate Affiliate Breakfast, April 15, 2009 at Portland Country Club

Representatives of MMA's Corporate Affiliates are invited to attend the annual Corporate Affiliate Breakfast, being held this year at the Portland Country Club in Falmouth on Wednesday morning, April 15, 2009.  There is no cost to attend the event that begins at 7:30 a.m.  The presenter this year is Kim Block, WGME News 13's Healthy Living reporter and the most popular and most recognized TV anchor in Maine according to recent surveys.

Invitations will be mailed later this week, but if you would like to register early, call Lisa Martin at MMA (622-3374, ext. 221 or via e-mail to  and let her know that you would like to attend.

The annual breakfast gives MMA an opportunity once a year to thank our corporate affiliates for their support of MMA and for the services they provide to MMA members, their families, and staffs.

Members of the MMA's Executive Committee and Committee on Membership and Member Benefits have also been invited to attend.

Last year, nearly a hundred people attended the breakfast and heard a talk by Joshua Daniel Sparling, M.D., who spoke of his experiences in Iraq in 2007 in support of Operation Iraqi Freedom. [return to top]

Be Prepared for the HITECH Act: 8 Tips for Successful EHR Adoption

Join athenahealth for a live webinar on Wednesday, March 25th at 12:15 p.m. ET as it shares how you can plan correctly for and then select the right EHR vendor for success.

The Obama Administration has made electronic health record (EHR) adoption a major health policy objective. With the new Health Information Technology for Economic and Clinical Health (HITECH) Act, the goal is for all physicians to begin using EHRs in the next decade.

But, many physician practices are troubled by the huge up front costs many EHRs require - hardware, software, interfaces, and IT support - without a clear return on investment (ROI).  Practices also worry about disruption during EHR implementation.

A successful EHR can dramatically improve patient care, profit, and workflow.  What’s more, EHR implementation can be a smooth (and practice-strengthening) process.

In this Webinar, learn how to:  1) plan correctly, and 2) choose the right vendor for success with an EHR.  Get clear guidance on…

Doing the right planning:

• Assess your practice’s readiness for an EHR

• Establish an appropriate budget and team for EHR implementation

• Manage change to ensure EHR optimization

• Redesign workflow to streamline operations and accommodate the EHR

Choosing the right vendor:

• Select the right partner for long-term success

• Understand key advantages to a network-based solutions (instead of traditional software-only systems)

• Evaluate vendors’ ability to help your practice stay on top of issues such as P4P, the HITECH Act, and the complex, changing reimbursement environment

• Get the best of both worlds with an integrated practice management and EHR

 REGISTER NOW [return to top]

Save the Date: Maine Chapter AAP Spring Conference, May 2-3, 2009

The Maine Chapter of the American Academy of Pediatrics presents its spring conference, May 2-3, 2009 at Sunday River.  This year's theme is Alternative and Complementary Pediatric Medicine.  As patients request more complementary medicine, physicians find themselves needing to keep up-to-date on what is out there, especially on what is evidence-based.  This conference will provide you with the opportunity to hear from the experts and take home methods for integrating CAM into your practice.

Given the feedback from last Spring, there will not have a formal lecture during lunch but will allow you to network and continue growing your CAM knowledgebase by having access to speakers.

For more information, and to register, go to

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MMC 7th Annual Perinatal Conference, April 28

Maine Medical Center's 7th Annual Perinatal Conference will be April 28, 2009 and is intended for health care providers who care for pregnant women.  This year's focus is on pregnancies with risk factors and the continuum of care.  The program is approved for both nursing contact hours and continuing medical education hours. 

Click here for the conference brochure. To register or for questions and further information, please contact Beth Turner at [return to top]

Steve Meister, MD, FAAP, New MCH Medical Director for Maine CDC

Maine CDC is very pleased to announce that Steve Meister, MD, FAAP will start as the new Maternal & Child Health Medical Director for Maine CDC on Tuesday, March 31st.  Steve is a pediatrician with more than 25 years experience in primary care pediatrics in a variety of settings, the last 13 years at Kennebec Pediatrics in Augusta.  He lives in Winthrop and is married to Dr. Dervilla McCann, a cardiologist, and has two grown children.

His particular clinical interests have been in the areas of preventive care, developmental delays and autism, behavorial health, and the health needs of children in foster care.  He has also been very involved in state level health policy issues, including his current chairmanship of the Maine Child Death & Serious Injury Review Panel.  Steve's education includes undergraduate studies at Brown and Columbia Universities, medical education at Tufts University School of Medicine, internship and residency in pediatrics at Columbia University, and a masters in health services from George Washington University. [return to top]

New Bills for Your Review & Comment/Reminder of Legislative Committee Conference Call

The following are bills of interest to the physician community printed and referred to committees last week for your review and consideration.  Please note that clicking on the highlighted "LD XXX" will take you to a PDF version of the bill.

LD 794, Resolve, To Adjust Copayment Rules To Ensure Access to Home-based Care Services (monitor)

LD 795, Resolve, To Enhance Public Information about the MaineCare Program (monitor)

LD 802, An Act To Require Reporting on Medical Services or Treatment Provided to Minors without Parental Consent (oppose; pediatricians; OB/GYNs; Public Health Committee)

LD 803, An Act To Authorize an Active Retired Justice or Judge To Conduct Arbitration and Chair Medical Malpractice Screening Panels (support)

LD 809, An Act To Preserve the Viability of Services to Maine's Citizens with Mental Retardation (monitor;psychiatrists)

LD 814, An Act Regarding the Sale of Weapons at Gun Shows (support; Public Health Committee)

LD 819,  An Act To Encourage Transparency in Disclosing the Ingredients in Vaccinations for Children to Parents and Guardians (oppose; pediatricians; Public Health Committee)

LD 820, An Act To Limit Smoking in Outdoor Dining Areas (support; Public Health Committee)

LD 821, An Act To Support Collection and Proper Disposal of Unwanted Drugs (support; Public Health Committee; psychiatrists)

LD 825, An Act To Allow the Consecutive Purchase of 6-month Health Insurance Policies (monitor)

LD 833, An Act To Distribute Funds Received from the Racino in Bangor to the Department of Health and Human Services, Office of Substance Abuse (monitor or support; Public Health Committee; psychiatrists)

LD 853, An Act To Encourage Maine Residents To Attend Medical School and Practice in Maine (support; Committee on Loan & Trust Administration)

LD 854, Resolve, Directing the Department of Health and Human Services To Create a New Health Care Internet Infrastructure (monitor)

LD 859, An Act To Control Premium Costs in the Small Group Health Insurance Market (support)

LD 865, An Act To Change the Maine HIV Advisory Committee (support; Public Health Committee)

LD 866, Resolve, To Examine Data Discrepancies and Adequately Identify and Serve Children with Brain Injuries (monitor or support; pediatricians)

LD 877, An Act To Amend the Laws Governing the Reporting of Crimes on the Maine Registry of Certified Nursing Assistants (support)

LD 881, Resolve, To Ensure the Health of Maine Children by Requiring a Certain Vaccination (support; pediatricians; Public Health Committee)

LD 909, An Act To Authorize a General Fund Bond Issue To Fund Research and Development for Cancer (support; Public Health Committee)

The next MMA Legislative Committee conference call is scheduled for 8:30 p.m. on Thursday, March 12, 2009.  The conference call number is 800-989-2842 and the access code is 6223374#.  Any MMA member or specialty society representative is welcome to join the discussion of bills listed above and other legislative highlights.



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