April 13, 2009

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Twenty-seven Organizations Present at Listening Session with Senator Snowe

The Maine Medical Association was pleased to co-host a successful "Listening Session" with Maine's Senior Senator Olympia J. Snowe on April 7.  Twenty-seven organizations representing health professionals, consumers, hospitals, employers, health plans and government presented their respective ideas on health system reform to the Senator who is on the influential Senate Finance Committee which will begin hearings soon.

Jo Linder, M.D., Chair of MMA's Executive Committee, presented the Association's testimony which can be viewed on in its entirety on the MMA website at www.mainemed.com.  Noted in MMA's statement was the need for better support for primary care, coverage for the uninsured, and MMA's support for an individual health insurance mandate.  MMA first proposed a mandate for persons to purchase coverage, with appropriate subsidies for those persons unable to afford coverage, in its White Paper on Health System Reform in 2003.

A second "Listening Session" with Senator Snowe was held in Bangor on Wednesday, April 8.  At the Bangor event, MMA President Stephanie Lash, M.D. presented MMA's testimony.

Both events were covered extensively by the media.  The Portland session was moderated by MMA EVP Gordon Smith and Mary Mayhew, Vice President for Governmental Affairs for the Maine Hospital Association.

Senator Snowe is expected to be a major player in the Congressional debate over health care reform.  Accompanying her at the sessions were her chief health staffer, William Pewen, PhD, MPH.  Dr. Pewen has been with the Senator's staff for six years and was recently named by Roll Call magazine one of the ten most influential health staffers on capital hill.

MMA Executive Committee to Meet on Wednesday, April 15

MMA's twenty-eight (28) member Executive Committee will meet this coming Wednesday (April 15) at the Association's offices in the Frank O. Stred Building in Manchester.  Chaired by Jo Linder, M.D., the Committee will discuss the prospects for health system reform and followup on some of the work that was done on worksite wellness at the Committee retreat in January.  The full agenda for the committee may be viewed in the member's only section of the Association's website at www.mainemed.com.

Current legislative issues, including the state budget, will also be discussed. 

All MMA committee's are open to any MMA member whether on the committee or not. [return to top]

MMA Annual Benefit Golf Tournament, Monday, June 22 at Augusta Country Club

MMA's Annual Golf Tournament will be held on Monday, June 22 at the Augusta Country Club.  The event will begin with lunch on the deck at 11:00am with a shot-gun start at noon.  A traditional "scramble" format will be followed.  Brian Jumper, M.D. will chair the tournament again this year. The net proceeds from the tournament will benefit the Medical Professionals Health Program.

Registration materials for the event and sponsorship opportunities will be mailed to all prior participants and all corporate affiliates this coming week.  Watch for these materials in your mail.

Any questions may be directed to Gail Begin at MMA (622-3374 ext 210 or via email to gbegin@mainemed.com). [return to top]

Political Pulse: Legislative Highlights of the Week


Again last week, the Appropriations Committee continued its caucuses and work sessions on the FY 2010-2011 budget (L.D. 353) with the hospital reimbursement issues at the forefront of the discussions.  Current financial forecasts suggest that the projected gap in the biennial budget may have grown by $300 million or more.  The next state revenue reprojection is expected in early May.


A large crowd turned out last Monday for the Criminal Justice & Public Safety Committee's public hearings on the following four bills dealing with gun control:

  • L.D. 726, An Act to Improve the Process for Issuing Concealed Weapons Permits;
  • L.D. 814, An Act Regarding the Sale of Weapons at Gun Shows;
  • L.D. 985, An Act to Increase Public Safety by Requiring a Federally Licensed Firearms Dealer to Facilitate the Transfer of Firearms; and
  • L.D. 1138, Resolve, to Provide Assistance to Private Sellers of Firearms.

Former AMA and MMA President Robert McAfee, M.D., a longstanding advocate for gun safety, testified in favor of the bills as did other representatives of Maine Citizens Against Handgun Violence, including the parent of one of the students killed at Columbine High School in Colorado.  The MMA provided the AMA's standing policies on gun control as well as several resolutions adopted by the MMA membership during the past decade, particularly one addressing the so-called "gun show loophole."  

The bills faced strong opposition from the National Rifle Association, the Sportmen's Alliance of Maine, and other gun owners' rights organizations.


On Thursday, April 9, 2009, the BRED Committee held a public hearing on L.D. 1223, An Act to Allow Pharmacists to Administer Certain Medications, a bill advanced by Hannaford, Rite Aid, and the National Association of Chain Drug Stores because Maine is one of only a handful (or less) of states that do not permit pharmacists to administer at least the flu vaccine to adults.  The MMA has been in negotiation for months with the bill's proponents in an effort to reach a compromise.  While the MMA testified "neither for nor against" the bill, the Maine Academy of Family Physicians (MAFP) and the Maine Chapter of the American Academy of Pediatrics (Maine Chapter, AAP) testified in opposition to the bill.  Larry Losey, M.D., a pediatrician from Brunswick, testified on behalf of the Maine Chapter, AAP.

The Committee also heard L.D. 1193, An Act to Establish Uniform Protocols for the Use of Controlled Substances, one of a number of bills sponsored by Senator Peter Mills (R-Somerset) to address the substantial prescription drug diversion issues in Maine.  The MMA opposed the bill as did the Board of Licensure in Medicine.


Also last Thursday, the Labor Committee heard L.D. 1167, An Act to Limit the Work Week of Doctors and Medical Residents, a bill that would limit any employed physician, whether in training or not, to 20 hours of overtime per week, meaning a total of 60 hours rather than the current 80-hour limit established for physicians in training by the ACGME.  The MMA, MHA, and residency program representatives all opposed the bill which had no supporters other than the sponsor.  Robert Bing-You, M.D. spoke against the bill on behalf of MaineHealth.  Based upon the questions and comments of Labor Committee members at the hearing, the bill has little chance of success.


The HHS Committee Chairs continue to schedule large numbers of bills for hearing on Monday and Tuesday, followed by work sessions on those bills on Wednesday and Thursday.  

On Monday, the Committee held hearings on the following 4 bills addressing prescription drug diversion:

  • L.D. 599, An Act to Allow Noninvasive Testing of Infants for the Presence of Drugs without a Parent's Consent;
  • L.D. 600, Resolve, to Encourage Physicians to Administer the Injectable Painkiller Toradol in Lieu of Other Opioids;
  • L.D. 623, An Act to Provide the Office of the Chief Medical Examiner Access to Controlled Substances Prescription Monitoring Program Data for the Purpose of Conducting Cause of Death Investigations; and
  • L.D. 738, An Act to Require Patients of Opioid Treatment Programs to Release Medical Information to a Designated Primary Care Physician

Senator Mills is the sponsor of L.D.s 599, 600, and 738.  He asked that the Committee kill L.D. 600 at the start of the hearing.  The MMA commented on its efforts in conjunction with other organizations to address the drug diversion problem in Maine.  The Committee endorsed passage of L.D. 623 without much debate.  After considerable discussion and with input from Augusta area OB/GYN Russ DeJong, M.D., the Committee voted 10-3 in favor of L.D. 599.  Finally, the Committee rejected L.D. 738, based largely on a concern that it conflicted with federal law.

The HHS Committee also held a lengthy public hearing and work session last week on 2 bills dealing with hospital-acquired infections:

  • L.D. 960, Resolve, Requiring Rulemaking by the Maine Quality Forum Regarding Clostridium Difficile and Methicillin-resistant Staphylococcus Aureus; and
  • L.D. 1038, An Act Regarding the Prevention and Reporting of Methicillin-resistant Staphylococcus Aureus

Members of the public related moving stories of family members experiences with HAIs while speaking in favor of the bills.  Consumer groups, nursing organizations, and organized labor also spoke strongly in favor of the bills.  The MHA, MMA, and infectious disease specialists spoke in opposition to the bills.  After several days of negotiations among interested parties, the Committee was able to reach agreement on amended language to both bills.

Finally, the Committee considered several bills dealing with transparency of health care organization finances and governance.  The MMA and MHA opposed L.D. 757, An Act to Improve the Transparency of Certain Hospitals, a bill that would make any organization receiving more than $250,000 per year in state funding subject to the Freedom of Information Act, the law requiring governmental agencies to conduct their business, with limited exceptions, in public.  Freshman Bangor Representative Adam Goode (D) submitted the bill at the request of his opponent, an accountant who was frustrated by being denied access to EMMC board meetings.  The MMA opposed the bill in particular because it would have applied to any private physician practice receiving more that $250,000 in Medicaid reimbursement each year.  [return to top]

National Healthcare Decisions Day is April 16

The Joint Commission encourages accredited hospitals and other health care organizations to promote the second annual National Healthcare Decisions Day on April 16.  This day supports end-of-life planning and organizations can plan activities that encourage patients to talk with their doctors and loved ones about advance directives.  There are a number of ways that organizations can promote National Healthcare Decision Day:

  • Publicize National Healthcare Decisions Day on the Website or in the organization's newsletter.
  • Provide members of the community with information on advance directives.
  • Have social workers or pastoral staff care staff available to provide guidance on how to start the discussion or complete advance directive forms.
  • Include a one-hour public seminar with a local attorney who is an expert on advance care planning.

MMA supports the encouragement of all patients to execute an advanced directive, providing direction to care givers which would be apply at any point if the patient were not competent to make their own decisions.

Advance Directive forms are available at the MMA office. [return to top]

Identity Theft Prevention Policies Mandated by Feds, Effective May 1

The Federal Trade Commission (FTC) has deemed physician practices that defer payment of patient debts as creditors."  Such practices must implement identity theft prevention programs that comply with a regulation known as the Red Flags Rule by May 1.  An article on the new requirements is on page 7 of the March-April Maine Medicine, prepared by attorney Brett Witham of Verrill Dana.  Mr. Witham will also present on the topic at the Association's 18th Annual Practice Education Seminar to be held at the Augusta Civic Center on Wednesday, June 3. 

In response to the mandate, a coalition led by the AMA, has corresponded with the FTC Chairman.  The letter:

  • Objects to the FTC's interpretation that physicians are creditors.
  • Expresses belief that the FTC failed to comply with the Administrative Procedure Act, which requires the FTC to explain its regulatory proposals and provide the public with notice and opportunity to comment.
  • Urges suspension of the Red Flags Rule as applied to physicians until the FTC complies with the Act.
  • Proposes that a new rule be published that allows a period of comment by the physician community.

Assuming that the FTC continues its movement toward this law, MMA has assembled some online resources to help members understand and comply with this directive. 

The Red Flags Rule:  What health care providers need to know...Go to www.ftc.gov, type "Red Flags Rule" in the upper right search window, then click on submit.  On the page that opens, click on above title.  Learn who must comply and how to comply and about administering your program and penalties for noncompliance.

Ref Flags checklist - Go to www.ftc.gov, type "Red Flags checklist" in the upper right search window, then click  on "submit".  Next scroll down the list of articles and click on "Identity Theft Red Flags and Address Discrepancies ..."  The checklist, found on pages 63773-63774, lists the issues you must consider in developing and maintaining your identity theft prevention program.

Email address for compliance questions - RedFlags@ftc.gov.  Send your questions about complying with the Red Flags Rule.

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Maine Lawmakers Pass Resolution on Single-Payer Health System

Maine lawmakers this past week passed a resolution calling on President Obama and Congress to establish a single-payer health system that covers all persons. The resolution cites the high cost of the present system and says managed care, HMO's and other reforms have failed to contain health costs.

Votes for the resolution ran along party lines, with the Democrats supporting the Resolution and Republicans opposing it.  The Senate vote was 10-15.  The House vote was 91-52.

The Resolution urged the Congress and the President to enact and sign legislation that is substantially similar to the United States National Health Insurance Act., H.R. 676, which was introduced in the 110th U.S. Congress.

Go to www.mainemed.com to view the full language of the Resolution. [return to top]

MMA's 18th Annual Practice Education Seminar to be held at Augusta Civic Center, June 3

MMA's 18th Annual Practice Education Seminar will be held on Wednesday, June 3, 2009 at the Augusta Civic Center.  The Program will run from 8:30am to 3:30pm and will focus on health system reform, technology (including disease registries, e-prescribing and EMR), quality improvement and health insurance issues.  Invited speakers include Attorney General Janet Mills and Insurance Superintendent Mila Koffman.  Other presenters include Lisa Letourneau, M.D. MPH, Josh Cutler, M.D., Gina Hobert, CPC, Noel Genova, PA-C, Vaughn Clark, Kenneth Lehman, Esq., Brett Witham, Esq. and Gordon Smith, Esq.  Other presenters will be announced soon.

This popular annual seminar is intended to inform physicians and practice managers of the major new laws and market trends impacting on Maine medicine.

Watch your mailbox and this newsletter for a full schedule and registrations materials in the coming days, but you may reserve your space today by contacting Maureen Elwell at MMA at 622-3374 ext. 212 or via email to melwell@mainemed.com [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 comment.  Please note that clicking on the highlighted "LD XXX" will take you to a PDF version of the bill.  For each bill, MMA Deputy EVP Andrew MacLean has proposed a position and any MMA committee or specialty society that might have a particular interest in the bill.  You are welcome to provide feedback about any of the bills and the proposed position by participating in the weekly conference call or by contacting Andy at amaclean@mainemed.com or 622-3374, ext. 214.

LD 1407, An Act To Implement the Recommendations of the PE4ME Planning and Oversight Team (support; Public Health Committee; pediatricians)

LD 1408, An Act To Establish the Universal Childhood Immunization Program (support; Public Health Committee; pediatricians)

LD 1411, Resolve, Regarding Legislative Review of Portions of Chapter 120: Release of Data to the Public, a Major Substantive Rule of the Maine Health Data Organization (monitor)

LD 1412, Resolve, Regarding Legislative Review of Portions of Chapter 101: MaineCare Benefits Manual, Chapter III, Section 21, Home and Community Benefits for Members with Mental Retardation or Autistic Disorder, a Major Substantive Rule of the Department of Health and Human Services, Office of MaineCare Services (monitor)

LD 1417, An Act To Add Unlicensed Assistive Persons with Notations to the Maine Registry of Certified Nursing Assistants (monitor)

LD 1423, An Act To Improve Toxics Use Reduction and Reduce Energy Costs by Maine Businesses (monitor; Public Health Committee)

LD 1429, An Act To Strengthen the Workplace Smoking Laws and Other Laws Governing Smoking (support; Public Health Committee)

LD 1433, An Act Regarding the Creation of Capitated Behavioral Health Pilot Programs (monitor; psychiatrists)

LD 1435, An Act To Amend Sentinel Events Reporting Laws To Reduce Medical Errors and Improve Patient Safety (develop position in conjunction with MHA; Committee on Physician Quality)

LD 1444, An Act To Protect Consumers and Small Business Owners from Rising Health Care Costs (support in concept)

The next MMA Legislative Committee conference call is scheduled for 8:30 p.m. on Thursday, April 16, 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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For more information or to contact us directly, please visit www.mainemed.com l ©2003, Maine Medical Association