June 1, 2009

 
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Still TIme to Register for 18th Annual Practice Education Seminar this Wednesday, June 3rd

There is still time to register for the Association's Annual Practice Education Seminar being held at the Augusta Civic Center this Wednesday, June 3, 2009 from 8:30 am to 4:30 pm.  Attorney General Janet Mills and Insurance Superintendent Mila Kofman, Esq. are the keynote presenters.  A dozen breakout sessions are available in the afternoon, including topics such as the new FTC rules to prevent identity theft ("red flag" rule) and the new HIPAA changes included in the federal stimulus bill.

Registration is available on the MMA website at www.mainemed.com or by calling Maureen Elwell at the MMA office at 622-3374, ext. 219. 

"This annual program gives MMA an opportunity to provide information on a number of topics that are important to the practices and to discuss with them the trends in medical practice in Maine.  This year there is a focus on technology, compliance, and quality improvement," noted Gordon Smith, Esq., Executive Vice President of MMA.  "The day also gives us an opportunity to showcase some of our new initiatives such as the academic detailing program as well as reminding members of the existence of established programs such as The Coding Center and the Chronic Pain Consultation Program."

More than 100 physicians and practice managers are expected to attend the seminar that also will feature nearly a dozen exhibitors.

 

Maine Chapter, America College of Surgeons Concludes 59th Annual Meeting in Bar Harbor

The Maine Chapter of the American College of Surgeons held its 59th Annual Meeting this past weekend at the Harborside Hotel in Bar Harbor.  A seminar on Health Care Policy in Maine and the Nation started off the meeting on Friday morning, followed by an afternoon devoted to practical lessons regarding medical malpractice.  Mark Lavoie, Esq. and Julian "Jay" Sweet, Esq. presented three cases, in a panel discussion moderated by MMA EVP Gordon Smith, Esq.  Before the discussion was a presentation by F. Dean Griffen, M.D., FACS on the ACS Closed Malpractice Claims Study.  The need for liability protection in an age of evidence-based guidelines was a constant theme during the discussion.

In the Friday morning session, MEDPAC member Karen Borman, M.D., FACS detailed the Commission's recommendations to Congress and highlighted the issues facing the Congress currently as it works on comprehensive health care reform.

Saturday and Sunday morning sessions focused on clinical presentations and Maine author Kate Braestrup, Chaplain of the Maine Warden Service was the keynote speaker at the Banquet on Saturday evening.

In Chapter business, Rod Lahren, M.D. succeeds G. Tom Marshall, M.D. as President of the Maine Chapter.  M. Parker Roberts, M.D. succeeds Joel Lafleur, M.D as Secretary-Treasurer of the Chapter and Dr. Lafleur succeeds Charles "Tom" McHugh, M.D. as Governor for the College. [return to top]

Leonard Keilson, M.D., M.P.H. 1947-2009

The Maine Medical Association was sorry to learn last week of the death of one of our strongest members and supporters, Leonard Keilson, M.D., M.P.H. of Portland.  Dr. Keilson died unexpectedly on May 25, 2009.  The MMA staff got to know Dr. Keilson in connection with his role as Governor for the State of Maine for the Maine Chapter of the American College of Physicians, a position he held from 1997 to 2002.  In 2004, he founded the Maine Center for Lipids and Cardiovascular Health, a practice for preventive cardiology.  He led many trials in lipids research and published scientific papers that were presented both in the United States and around the world.

Dr. Keilson received his medical degree from the Albert Einstein College of Medicine and was a Robert Wood Johnson Clinical Scholar at Johns Hopkins where he completed his internal medicine residency and earned a master's degree in Public Health. 

 He is survived by his wife Bobbie Keilson and his daughter Ana Isabel Keilson of New York City.  Our condolences go out to his family and his many friends and professional colleagues.  [return to top]

Topics in Gastroenterology 2009 Update

This year’s "Topics in Gastroenterology" course again looks to be an exciting educational opportunity for the many providers in our region.  The topics are current, including a symposium on colon cancer, nutrition, IBD, and case presentations.  We hope you can join us again this year or if you have not yet come to our conference, please consider joining us.  The Hilton Garden Inn offers a fantastic venue for our conference.  The faculty and organizers work very hard to ensure an outstanding educational experience. 

On behalf of the Maine Gastroenterology Society we hope to see you in Freeport! 

Below is the agenda for the conference.  Please contact Gail Begin to register at 207-622-3374 or email at gbegin@mainemed.com.  Hope to see you there!

8:00 am Registration/continental breakfast

8:30 Opening remarks- Jay Bosco, M.D. & Andreas Stefan, M.D.

Session I- Colon Cancer Symposium- Moderator: Andreas Stefan, M.D.

8:40 Colon Cancer Introduction, Demographics and Risk Factors Mark Lena, M.D.

9:10 Genetic Testing in Colon Cancer Karen Rasmussen, Ph.D.

9:40 Pathologic Findings in the Colon Hagen Blazyk, M.D.

10:10 Break/visit exhibits

10:30 Surgical Approaches to Colon Cancer Parker Roberts, M.D.

11:00 Medical Oncology in Colon Cancer Elizabeth Connelly, D.O.

11:30 MGS State of the Art Lecture: IBD The Role of Biological Therapy in Clinical Practice
Amy Barto, M.D., Lahey Clinic

12:15 pm Lunch break/visit exhibits

Session II -Nutritional GI issues- Moderator: James Morse, M.D.

1:00 Non-Alcohol Steatohepatitis—Diagnosis and Treatment Scott Stern, D.O.

1:30 Pre and Pro Biotics—Ready for Primetime? Jay Bosco, M.D.

2:00 Obesity-Bariatric Surgical Update Renee Wolff, M.D.

2:30 Nutriceuticals—Ready for Primetime? James Morse, M.D.

3:00-3:15 break/visit exhibits

Session III- Case Presentations – Moderators: Jay Bosco, M.D. & Andreas Stefan, M.D.

3:15 Case #1 32 y/o female with Crohn’s disease with a positive pregnancy test
Discussant: Amy Barto, M.D.

3:30 Case #2 76 y/o female with acute pancreatitis complicated by a pseudocyst
Discussant: Andreas Stefan, M.D.

3:45 Case #3 58 y/o male actively drinking alcohol presents to ER with jaundice
Discussant: Scott Stern, D.O.

4:00 Closing remarks- Jay Bosco, M.D. & Andreas Stefan, M.D.

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Fee Increase for Physicians Who Bill for MaineCare Services Under Section 90

In the June 1st payment cycle, MaineCare will pay the new higher rates on claims for dates of service July 1, 2008 through December 24, 2008.  The rate increase was retroactive to July 1, 2008, and the claims system started paying the new rate on December 24, 2008.  This payment will apply the rate increase to the remaining claims that qualify for it.  This is a retrospective adjustment for a MaineCare fee increase authorized by the previous legislature that raised MaineCare rates from approximately 53% of Medicare rates to approximately 57% of Medicare rates.  The legislature's action in the current biennial budget in the 124th Legislature (covered in the Political Pulse artice in this newsletter) will raise MaineCare rates to approximately 70% of Medicare rates effective February 1, 2010.

The adjustment will appear on the June 17, 2009 Remittance Advice Statement.  Providers do not need to contact MaineCare or re-file claims.

MaineCare's Online Procedure Code Lookup lists the rates and other coverage details.  MaineCare Claims Adjustment Staff are also available to answer questions.

For general billing questions, please contact the Billing & Information line at 1-800-321-5557 Option #8. [return to top]

Senate Finance Chairman Says Public Plan Likely in Committee Reform Plan

In comments following the release of a policy options paper released on May 11, 2009, Senate Finance Committee Chairman Max Baucus (D-MT) has said it is likely that the health care reform plan being drafted in his committee likely will include a public plan option and he believes he can win some Republican support for it.  However, he also said that a true single payer plan is "off the table" and that the public plan option could go in any number of directions, including:

  • one based on Medicare, paying Medicare rates;
  • one administered by private third-party administrators;
  • one administered by the states; or
  • one offered as a fall back option like the Medicare prescription drug law.

The Senate Finance Committee is expected to begin work on health care reform this month and hopes to offer a reform plan by the August recess.

The AMA continues to update its web site with information about the health care reform debate in Washington, D.C. at:  http://www.ama-assn.org/.
[return to top]

Single-Payer Advocates and Opponents to Public Plans Hold Opposing Rallies in Augusta

In addition to an increasing number of television spots by various groups advocating for comprehensive health care reform, last week single-payer advocates and their opponents staged rallies in Augusta on Saturday.  Organizers of the Single-Payer rally included the Maine State Nurses Association, the Maine AFL-CIO, Veterans for Peace, the Maine Green Independent Party, and various peace and justice groups in the state.  The Maine Heritage Policy Center also held an opposing rally, holding up signs indicating that private health care should be preferred over any public plan.  About 200 people rallied for a single payer system while about 40 turned out on behalf of the Maine Heritage Policy Center.  The single-payer rally was led by former Green Party gubernatorial candidate Pat LaMarche.

Also appearing at the single-payer rally was Dr. William Clark, a retired member of the Harvard Medical School faculty. 

According to media reports, both sides acknowledged that the current system is broken, but there is very deep disagreement about how to fix it.  Both sides advocated for their supporters to communicate with the Maine Congressional delegation as deliberations continue in the coming weeks about how to fix the existing system.

Tarren Bragdon, Executive Director of the Maine Heritage Policy Center stated that the Center was very concerned about a government takeover of health care.  "We firmly believe everyone should have access to high quality private insurance," he said.  "I work too hard to force my family onto government health care." [return to top]

MMA Executive Committee to Meet on Wednesday, June 3, 2009

The Association's twenty-eight member Executive Committee will meet on this coming Wednesday, June 3rd at the Association offices in Manchester, Maine.  The meeting begins at 2:00 pm and, as with all MMA Committee meetings, any MMA member is welcome to attend.

Priority items for the meeting include review of the member comments on the all-member survey conducted late in 2008, MMA's role in national health system reform, and a discussion of the possibility of the Medical Professionals Health Program contracting with the Maine State Board of Nursing to provide services to nurses in need of recovery and advocacy.  A review of the last month of the legislative session will also be provided by Deputy EVP Andrew MacLean, Esq.

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

  [return to top]

POLITICAL PULSE: Governor Signs $5.8 Billion Biennial Budget

FY 2010-2011 BIENNIAL BUDGET (L.D. 353) BECOMES LAW

Concluding work that began in early February, the 124th Maine Legislature enacted the $5.8 billion two-year budget for state services beginning July 1, 2009 on Wednesday, May 27, 2009 by votes of 119-26 in the House and 33-2 in the Senate.  Governor Baldacci signed the bill the next day.  Cuts to health care and social service programs were mitigated by federal stimulus funds.  The budget includes $9 million in General Fund cuts to reimbursement for hospitals, but includes funding to bring past due hospital settlements up to some point in 2007.  It also includes funds to increase the MaineCare fee schedule for physicians and other individual practitioners from approximately 57% of Medicare rates to approximately 70% of Medicare rates effective February 1, 2010.

You can read the Governor's statement on the budget on the web at:  http://www.maine.gov/tools/whatsnew/index.php?topic=Portal+News&id=73898&v=article-2008.

MENU LABELING BILL LIKELY UP FOR DEBATE IN THE HOUSE TOMORROW/TAKE ACTION NOW!

The Speaker's Office has notified MMA that the House is likely to debate L.D. 1259, An Act to Increase Access to Nutrition Infomation, an 11-3 "ought to pass" report from the Health & Human Services Committee tomorrow.  The Governor has indicated his support for the measure and the bill has received considerable editorial support in the last week.  However, your contact with your own member of the House and Senate before tomorrow's debate would be helpful.

Here is the link to the summary page for the bill on the legislature's web site:  http://janus.state.me.us/legis/LawMakerWeb/summary.asp?ID=280032306.

You can find your own member of the House and Senate on the web at:  http://www.maine.gov/legis/house/townlist.htm.

You can leave a message at the State House for your legislators by calling toll free as follows:

Representatives:  1-800-423-2900

Senators:  1-800-423-6900

Talking Points

  • There is a strong link between obesity and eating out - people eat large quantities of higher calorie food than they do when dining at home;
  • In order for people to take personal responsibility, they must have information at the point of purchase;
  • Chains already have done the caloric analysis in other states and municipalities, so accessing this information shouldn't be an added burden for businesses;
  • In fact, the bill has been amended to make it much easier to comply with as it is phased in in the region (Massachusetts just passed a similar bill) and menus and menu boards don't need to be customized for Maine;
  • This bill gives chain restaurants until February 1, 2011 to comply with this requirement.  Massachusetts is requiring the posting effective November 1, 2010 and California is requiring the posting effective January 1, 2011.  That is plenty of time for restaurants to phase this in as they replace or update their materials and many chains will have compliant menu materials designed and readily available by that time.
  • This bill focuses on chains of 20+ because they have standardized menus and train employees to replicate a menu item in a standardized manner; however, the bill does allow for human error and exempts custom or special orders.
  • "Mom & Pop" restaurants have a far greater degree of variation in food preparation from day to day and order to order, so this does not apply to them.

TWO BILLS FROM INSURANCE COMMITTEE ALSO APPEAR ON HOUSE CALENDAR

Two other divided reports from the Insurance & Financial Services Committee of interest to MMA have appeared on the House calendar:  L.D. 1205, An Act to Establish a Health Care Bill of Rights and L.D. 1206, An Act to Fund the Dirigo Health Program through a High-Risk Pool.   The MMA supports L.D. 1205 and opposes L.D. 1206.  Both bills are divided along party lines with 9 Democrats favoring passage of 1205 but defeat of 1206 and the Committee's 4 Republicans in the opposite position.  Of particular importance to the MMA in L.D. 1205 are some due process protections for physicians in health plan profiling and tiering programs.



 



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REMINDER: Legislative Committee Conference Call this Thursday at 8:30 p.m.

The next regular Legislative Committee conference call will be this Thursday, June 4, 2009 at 8:30 p.m.  The conference call number is 800-989-2842 and the access code is 6223374#.  There are no new bills for review this week, but the MMA staff will provide an update on floor action in the House and Senate as the legislature approaches adjournment anticipated in the next couple of weeks. [return to top]

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