June 28, 2009

 
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MMA/MHA to Host "Listening Session" with U.S. Rep. Chellie Pingree on July 2

MMA and the Maine Hospital Association will co-host a "Listening Session" with U.S. Representative Chellie Pingree this week on Thursday, July 2 from noon to 2:00pm at the MMA offices in the Frank O. Stred Building in Manchester.  This session follows a very successful listening session with Sen. Olympia Snowe earlier this year. Nearly thirty stakeholder organizations have been invited to present their current thinking about health system reform at the session.

Congresswoman Pingree was first elected to represent Maine's First Congressional District last November and her two-year term began in January,   She will be accompanied at the Session by staff members Jackie Potter and Jennifer Taylor.  Ms. Taylor is the health staffer in Washington for Rep. Pingree.

Each of the organizations invited to present will be expected to highlight their highest priorities for consideration in the current discussion of reforms.  Because of the number of presenters, each group will have approximately 3 minutes to present their case.  Following the conclusion on the Listening Session at 2:00pm, participants are invited to stay for an additional hour to discuss further opportunities to work together in promoting health system reform.

Any MMA member is welcome to attend and observe the session, but please RSVP to Diane McMahon at 622-3374 ext. 216 (or via e-mail to dmcmahon@mainemed.com) so that we can be sure to have enough lunches for everyone.

MMA is committed to continuing a dialogue with Maine's Congressional delegation as the Congress continues to work on comprehensive health system reform.

 

National HIT Chief David Blumenthal, M.D. to address Hanley Forum on July 31, 2009

 Join Health & Healthcare Leaders From Across Maine At The

7th Annual Hanley Leadership Forum 

"Breaking Through...

Making The Effective, Widespread & Integrated Use of Health IT That Improves Health and HealthCare A Reality for Maine"

Friday, July 31, Portland

Mark Your Calendars!

 

Hanley Leadership Forum 

8:30 a.m. to 4 p.m. Friday, July 31, Holiday Inn by the Bay, Portland (registration and continental breakfast begin at 7:45 .m. 

 

Register Today!

 

Click here to register for the Hanley Forum. 

 

Deadline is July 21. 

 

Seating is limited, so register today!

 

Discounted tickets are available to individuals who are unable to afford a full price ticket. Contact the Hanley Center for more details.
Email: jharnar@maine.rr.c
m

 

 

 

Hanley Logo

Keynote Speaker

 

David Blumenthal, M.D., M.P.P.

 

National Coordinator

Office of the National Coordinator of Health IT, Department of Health & Human Services

 

 Dr Blumenthal Photo

 

 

Dr. Blumenthal   is leading the Obama Administration's ambitious implementation of a nationwide interoperable, privacy-protected health information technology infrastructure---one of the cornerstones of key health reform proposals and a major funding priority in the American Recovery and Reinvestment Act (ARRA).

Before being named to his post earlier this year, Dr. Blumenthal served as a physician and as the director of the Institute for Health Policy at The Massachusetts General Hospital/Partners HealthCare System in Boston, Massachusetts.  He was also the Samuel O. Thier Professor of Medicine and Professor of Health Care Policy at Harvard Medical School.

From 1987-1991 he was Senior Vice President at Boston's Brigham and Women's Hospital, a 720-bed Harvard teaching hospital.  From 1981 to 1987 he was Executive Director of the Center for Health Policy and Management and Lecturer on Public Policy at the John F. Kennedy School of Government at Harvard.  

 

Other Featured Presentations At This Summer's  Hanley Leadership Forum

 

A full day of presentations, panel discussions and other sessions is now being finalize by a Planning Committee co-chaired by Dr. Lisa Letourneau of Quality Counts and Dr. Josh Cutler of the Maine Quality Forum.  The Forum's lead off speaker will be Dr. Robert  Berenson,  FACP, Institute Fellow at the Washington, D.C.-based  Urban Institute. Dr. Berenson, who keynoted the 2008 Hanley Forum, will return to offer a clinician's view of the emerging  health reform package now being developed in Congress. Dr. Berenson was a member of the Obama Administration transition team and recently was appointed as a commissioner on the Medicare Payment Advisory Commission.

 

Maine To Become Nation's 2nd Statewide Health Information Exchange


The Hanley Leadership  Forum will coincide with a major announcement that same day by Maine's statewide health information exchange, HealthInfoNet, which is about to become the second statewide system of its kind.

Join These Organizations By Becoming A  Corporate Sponsor of  

 The 2009 Hanley Leadership Forum

 

3M

Orion

AARP

 

Contact

Jim Harnar at jharnar@maine.rr.com

or call 207-807-6646 

 

 

For more information about the 2009 Leadership Forum please visit www.hanleyleadership.org or  contact Jim Harnar at jharnar@maine.rr.com or 207-523-1501

 

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MMA/Quality Counts Partner to Make Docsite Licenses Available to Maine Physicians

Ever thought about having your practice participate in the CMS Physician Quality Reporting Initiative (PQRI) but didn't know where to start?  The Maine Medical Association has partnered with Quality Counts to offer primary care practices a new option for participating in the PQRI program using using the "DocSite" registry. Using free coupons for the DocSite PQRI reporting tool, available from the MMA through a Physicians Foundation grant, interested practices can use the PQRI "Alternative Reporting Methods and Criteria", which allows physicians to track and report data for 30 consecutive patients with one of seven conditions, including Diabetes, Back Pain, Prevention, Chronic Kidney Disease, and Rheumatoid Arthritis. 

Any practice can participate (you do not have to be a current DocSite user).  For more information, see http://www.mainequalitycounts.org/library/2009-6216005705.pdf.  To obtain a free coupon from the MMA to use the DocSite PQRI reporting tool, contact Lisa Letourneau MD at letourneau.lisa@gmail.com, or Gordon Smith, gsmith@mainemed.com, 207-622-3374 x212 [return to top]

Dirigo Health Agency Board Looks Ahead

The Dirigo Health Agency Board of Directors met for three hours on Friday, June 19 and began a discussion as to what the DirigoChoice health insurance product might look like in the future.  With the Legislature having enacted legislation establishing an alternative funding source to the controversial "Savings Offset Payment", the Agency is now able to look ahead to a more positive future for its DirigoChoice product.  The product is now offered through Harvard-Pilgrim Health Care under a contract which expires in 2010.  The Agency is expected by Fall to put together a Request for Proposals to send to potential partners.  The alternative funding is a straight 2.14% assessment on paid claims, assessed to insurers and third-party administrators.  Under the original Dirigo legislation enacted in 2003, the assessment could be as much as 4% of paid claims, with the yearly assessmet based upon a formula set by the Board but approved ultimately by the Superintendent of Insurance.  Each year, the assessment (Savings Offset Payment) was challenged by business and insurance interests.  At least one year's assessment is still in the courts.

With future funding ensured, the Agency can now make plans to pay back the state some funds borrowed because of cash flow issues caused by the timing of the SOP payments, and also can anticipate some modest growth in enrollees in 2010.  Enrollment has been frozen for over a year and a waiting list exists for those individuals, small businesses and sole proprietorships interested in buying the product.

The Dirigo Board and staff discussed potential benefit designs to the product and even suggested the possibility of using a voucher system.  Such a system would likely take the state subsidy paid now to Harvard Pilgrim and pay it to the enrollee, thus allowing the enrollee to purchase from a choice of products.  Such a system would likely be similar to the current process used in Massachusetts.

Certainly the future of DirigoChoice may also be impacted by whatever health system reforms may be enacted in Washington.  With most proposals seeking to advance the goal of universal access to insurance coverage (public or private), state efforts such as Dirigo and the Massachusett's health connector will be examined closely.

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Coding Center to Offer CPC Coding Course in Lewiston

The Coding Center, a subsidiary of the Maine Medical Association, will present a eighteen-week coding course, qualifying a student to then sit for the AAPC exam, beginning in Lewiston in August.  The classes will be held at Central Maine Medical Center's Conference Room and will be taught by Gina Hobert, CPC-I, CPC, CPC-H.

This 18-week course, developed by the American Academy of Professional Coders (AAPC), will take students through the 2009 Current Procedural Terminology (CPT), International Classification of Disease (ICD-9), and HCPCS books to address proper coding in physician practices. This class is intended to educate students on proper techniques and rules of coding and will also prepare them to sit for the AAPC Certified Professional Coder (CPC) exam.

The Program includes the following:
- One year membership in the  AAPC
- Student workbooks
- CPC exam
- Group discussion and networking opportunities

Prerequisites: Two years coding experience, understanding of anatomy and medical terminology is strongly recommended

Course Requirements:
- 2009 Current Procedural Terminology (CPT) Book  (Professional Edition strongly recommended)
- 2009 ICD-9-CM Book
- 2009 HCPCS Book

Cost:
$1650 MMA members & affiliates
$1750 non-MMA members

For more information on the course, please contact Maureen Elwell at 622-3374 Ext. 219 or via e-mail to melwell@mainemed.com, or click here for a registration form .[pdf] [return to top]

Get Ready for FTC "Red Flags Rule" Deadline, August 1, 2009

Last fall, the Federal Trade Commission (FTC) ruled that if physicians defer payment for services, they become"creditors" simply by billing patients after their services are completed.  Accordingly, physician practices are required to implement identity theft prevention programs that comply with a regulation known as the Red Flags Rule.  The FTC has twice delayed the implementation of the Rule to give practices more time to comply, but it is unlikely that the upcoming August 1, 2009 deadline will be extended further.

"MMA members should continue to assume that this new rule applies to physician offices and take steps to achieve compliance by the new deadline,"  said Andrew MacLean, Esq., General Counsel and Deputy EVP at MMA.

In order to assist members in complying with the new rule, MMA published an article in the May-June issue of Maine Medicine, authored by Attorney Brettt Witham of Verrill & Dana.  Attorney Witham also presented on the topic at the June 3rd Annual Physician Education Seminar in Augusta.  Past issues of Maine Medicine can be found on the MMA website at www.mainemed.com.

In the way of background, multiple federal agencies jointly issued the Red Flag regulations in compliance with the Fair and Accurate Credit Transactions (FACT) Act of 2003.  The regulations require financial institutions and creditors to develop and implement written Red Flag/Identity Theft Prevention Programs.  The specific regulations (16 C.F.R. section 681) that affect health care providers are those of the FTC, the federal agency responsible for enforcement in the health care industry.  The FTC defines Red Flags as those events that should alert you to the possible existence of identity theft.  According to the regulations, a creditor includes any person or entity that "regularly extends, renews, or continues credit..."  The FTC considers a medical practice to be a creditor when the practice submits claims to insurance companies and defers a patient's payment of the balance. 

The regulations require development and implementation of a written compliance program with reasonable policies and procedures for:

  • Identifying patterns, practices, and specific forms of activity that signal red flags and incorporate them in the program
  • Detecting red flags incorporated in the program
  • Responding appropriately to any detected red flags to prevent and mitigate identity theft
  • Updating the program periodically to reflect changes in risk

In addition, policies and procedures must cover how the practice will administer the program, including obtaining approval of the program from the Board of Directors, staff training, and monitoring of service providers.

The regulations do provide a degree of flexibility, stating that the program "must be appropriate to the size and complexity " of the creditor and the nature and scope of its activities.  In a modest size office,  compliance should not be difficult.  Requiring a patient to furnish a photo id and maintaining a photo in the patient's record would be a reasonable way to begin. [return to top]

Mercy Recovery Center Medical Director is MHA Caregiver of the Year

Mark Publicker, MD, medical director of the Mercy Recovery Center part of the Mercy Health System in Portland, is the 2009 Maine Hospital Association Caregiver of the Year.

He was nominated by Mercy Health System President and CEO Eileen Skinner who called him “a model physician and caregiver” who, in addition to his work with patients, trains other clinicians in addiction medicine.

Eighty babies have been born healthy and at full term with no major withdrawal symptoms, thanks to a program Dr. Publicker founded called MOMS, (Mothers on Maintenance Subutex).  MOMS is designed to help addicts who are pregnant or have recently given birth—an extremely vulnerable and growing population.  The women are treated with Subutex, also known as buprenorphine, an alternative to methadone. 

But it’s the personal relationships Dr. Publicker develops with the patients that allow for the success of the program.  Dr. Publicker’s wife has designed and created hand-made diaper bags, sweaters and baby blankets for the MOMS group members. 

Dr. Publicker’s advocacy for his patients recently took him to the United States Congress, where, after two years of working with Sen. Susan Collins (R-Maine), he helped write a new law.  In December of 2006, Congress passed a bill that more than triples the number of people who can be treated for opiate addiction with buprenorphine.  The drug had been approved for use in 2002, but was restricted to only 30 patients per physician practice.  Thanks to the new law, that number is now 100 per physician. 

In November, Dr. Publicker was credited in the Journal of the American Medical Association for his work on the first major national study of a new treatment of opiate addiction in adolescents.  As part of the study, Suboxone, an alternative to methadone, was given to 30 adolescent patients at the Mercy Recovery Center for up to three months.  Those patients saw a dramatically reduced rate of relapse both in the short and long terms. [return to top]

CMS Announces 2009 PQRI registries

On June 16, CMS announced qualified registries for the 2009 Physician Quality Reporting Initiative (PQRI). For 2009, there are 74 qualified registries, 42 more than last year. A list of qualified registries can be accessed under the "Reporting" section page on the CMS website at http://www.cms.hhs.gov/PQRI. Each of the registries listed has gone through a vetting process. CMS believes that it is highly likely each of these registries will be successful in their data submission for the PQRI program. In addition, the agency plans to archive 2007 PQRI feedback reports on June 30. These reports have been posted since July 2008 on http://www.qualitynet.org/pqri. [return to top]

Maine CDC Sends Alert to Provide Guidance on the Diagnosis and Management of PG Women During the H1N1 Novel Virus Outbreak

The Maine Health Alert Network sent an advisory out to healthcare professionals to provide guidance for the diagnosis and management of pregnant women with influenza like illness (ILI) during the current outbreak of novel influenza A H1N1 in Maine.

Pregnant women are known to be at higher risk for complications from infection with seasonal influenza viruses, and severe disease among pregnant women was reported during past pandemics. An excess of influenza-associated deaths among pregnant women was reported during the pandemics of 1918-1919 and 1957-1958.

Adverse pregnancy outcomes have been reported following previous influenza pandemics, with increased rates of spontaneous abortion and preterm birth reported, especially among women with pneumonia. Case reports and several epidemiologic studies conducted during inter-pandemic periods also indicate that pregnancy increases the risk for influenza complications for the mother and might increase the risk for adverse perinatal outcomes or delivery complications.

Given the prevalence of circulating influenza A H1N1 virus, pregnant women presenting with signs and symptoms consistent with ILI (fever and respiratory symptoms, including cough or sore throat) should receive prompt empiric antiviral treatment for influenza A H1N1. Treatment should not be delayed awaiting confirmatory results of H1N1 virus testing. In particular, due to the varying sensitivity of rapid influenza tests, pregnant women with ILI should be treated presumptively even if rapid influenza tests are negative and should continue treatment unless more sensitive tests for influenza A H1N1 are specifically negative or until recommended treatment course is completed. A full version of this advisory may be downloaded from the Maine CDC website as a Microsoft Word or Adobe PDF by clicking on the hyperlink at the bottom of this message.

www.maine.gov/dhhs/boh/index.shtml [return to top]

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