September 21, 2009

 
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Sen. Baucus Presents Health System Reform Bill for Mark-Up This Week

Sen. Max Baucus (D-Montana) last Wednesday released his proposal for comprehensive health system reform as Chairman of the powerful Senate Finance Committee.  The proposal carries a price tag of $856 billion over ten years and to date lacks any Republican support.  The Finance Committee is to meet this coming week to vote on the plan which could result in a vote on reform in the full Senate in October.  On the House side, Speaker Nancy Pelosi has been waiting to see the Senate Finance Committee proposal before proceeding further in the House.

President Obama on Sunday appeared on all three network Sunday morning shows and reiterated his resolve to sign comprehensive health care reform before the end of the year.  He noted that he had made some substantial changes in his approach, including his willingness to support a mandate requiring individuals to purchase health insurance which he had opposed during the election campaign.  He also noted his willingness to compromise with Republicans on liability reform, noting that he realized it was a very important issue to providers of care. 

In emphasizing his belief that the current course of health care was unsustainable, the President noted that 130% increase in the cost of health insurance for individuals over the past decade.  The cost to employers increased even more, a whooping 166%.  Even in 2008, when general inflation was negative due to the recession, health care costs increased by 5.5%.  Costs are expected to increase over 10% in the coming year.

The President stated that he believed that about 80% of the issues were agreed to and that it was the remaining 20% where differences would have to be narrowed.  But he also indicated that if a reform reached his desk that he did not believe was good for the American people, he would not sign it.

The President noted that two-thirds of the revenue needed to fund the Baucus proposal over ten years would come from savings within the system, with one-third coming from reduced payments to Medicare Advantage Plans, fees on drug and device manufacturers, health insurers and clinical laboratories.  In addition, $215 million would come from an excise tax of 35 percent on insurance plans valued at more than $8,000 per individual or $21,000 per family. This excise tax is opposed by many Democrats and Republicans, but was actually first proposed during the campaign by Sen. John McCain.

As the health care reform debate heads into October, there does seem to be widespread agreement on some key issues, including protecting persons with pre-existing conditions and significantly reforming health insurance. But there is widespread opposition to many of the other proposals and it remains to be seen whether a truly comprehensive bill can ultimately pass.

Maine Senator Olympia Snowe continues to be in the forefront of the debate.  Last week, she released a statement opposing the Baucus proposal, citing concerns over how the reform package would be funded.  The Senator has also said she would not support a public health insurance option, but was still interested in a "trigger" option that would kick in should the cost of health care continue to increase. She also indicated an intent to continue to meet with the bi-partisan group of six Senators (including Senator Baucus) toward the goal of crafting a bill that could attract her support and that of other Republicans on the Senate Finance Committee. 

Senator Susan Collins also expressed concern about the cost and scope of the Baucus proposal, but expressed a willingness to continue to work toward a bill that could attract some Republican votes. 

MMA will continue to advocate for provisions which are consistent with the principles included in the White Paper on Health System Reform, reaffirmed on July 15 by the MMA Executive Committee.  This week will included some op-ed pieces and a presentation by EVP Gordon Smith to the Portland Rotary Club on Friday.  This past week included a forum sponsored by the Androscoggin County Medical Society featuring a panel of Robert McAfee, M.D., Gordon Smith, Esq. and Nicolle Witherbee, Phd.  Dr. Witherbee is a federal budget analyst with the Maine Center for Economic Policy.

Check the MMA website at www.mainemed.com for updates on reform  To receive the AMA's weekly e-mail newsletter, Health System Reform Bulletin, so to www.ama-assn.org/go/hsrbulletin.  

Catch Up on Those Pesky New Laws and Regulations: MMA, Oct. 9, 2009

MMA's Popular "First Fridays" educational seminars resume on Friday, Oct. 9 with a program introducing the 2009-2010 Physician's Guide to Maine Law.  In addition to presenting highlights of the new publication, MMA lawyers Andrew MacLean and Gordon Smith will also present the legislative and regulatory highlights from the first regular session of the Legislature. 

The Physician's Guide to Maine Law has been updated to be current through the completion date of the Legislature last June.  Attendees will receive an updated copy of the Guide (thumb drive or three-ring binder) and walked through the on-line version as well. 

The three-hour program presented at the MMA offices in Manchester will begin at 9:00am, with a continental breakfast being available beginning at 8:30am.   The registration fee for this particular program is $75 and you may register online at www.mainemed.com or by calling the MMA office at 622-3374 ext. 219.

On Friday, Nov. 6, MMA will present a three hour program on the topic of supervising and delegating to Mid-level Providers, Medical Assistans and Office Staff.  The program will focus on the laws, regulations and customs in Maine impacting on physician supervision and delegation.  Faculty will include licensing board representatives, health lawyers and risk managers.  Watch for a flyer on this program in your Sept. - Oct. issue of Maine Medicine which should arrive on your desks by Oct. 5.  Or you may register now on-line at www.mainemed.com.

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Report on Maine Quality Forum Advisory Council Meeting, Sept. 18

The Maine Quality Forum Advisory Council, created in the 2003 legislation establishing the Dirigo Health Agency, met for its bi-monthly meeting this past Friday.  The Council is chaired by Robert Keller, M.D. and staffed by Josh Cutler, M.D. and James Leonard of the Maine Quality Forum. Other physicians on the Council include Jan Wnek, M.D., W. Stephen Gefvert, D.O. and Jeff Holmstrom, D.O.

Karynlee Harrington, Director of the Dirigo Health Agency presented an update of agency activities, focusing primarily on the Board's deliberations regarding changes to the Dirigo Choice product.  The Board of the Agency, chaired by Robert McAfee, M.D., proposes to increase enrollment by 30 to 40%, by reducing current expenses to add to the revenues generated by the action of the legislature in enacting a 2.4% assessment on health insurance claims to replace to previous savings offset payment.    A Request for Proposals will go to insurers later this Fall and the DirigoChoice product will look differently than it does today.  The RFP will have a target cost, rather than having the Agency sharing risk with whatever health plan might be willing to partner with the sate on the new product.  In re-designing the benefit, more cost sharing with insureds is expected, while preventive services will continue to be favored and promoted.  Relative to eligibilities for subsidies, an asset test will be applied for the first time, in addition to looking at an enrollee's income.

Ms. Harrington also provided details of the recent federal grant received by the Governor's Office of Health Policy and Finance in order to provide health insurance coverage to more part-time workers, including seasonal employees.  The product will launch on July 1, 2010.

Following Ms. Harrington's report, Committee members heard the following presentations:

  • Patient Centered Medical Home Pilot:  Practice Transformation Update:  Sue Butts-Dion
  • Health Care Disparities Analysis Using MaineCare Data   Ted Rooney, RN, MPH
  • Heart Failure Discharge Planning and Readmission Project    Deb Mattin, RN and Susan Schow, MHDO

Josh Cutler, M.D. provided updates to members on the following MQF projects:

  1. Hospital Acquired Infections
  2. ARRA
  3. Claims Analysis Phase II
  4. Nursing Sensitive Indicators

The Committee meets again on Friday, Nov. 13, 2009 at 9:00am at the Dirigo Health Agency (Board Room)

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Report on Meeting of MMA's Committee on Physician Quality, Sept. 17

MMA's Committee on Physician Quality met on September 17 and addressed a full agenda of items. David Hallbert, M.D., an internist practicing in Bangor with Martin's Point Healthcare, accepted the chairmanship of the committee, succeeding David McDermott, M.D., MPH who is now serving as MMA's President.  Dr. McDermott was thanked for his three year's service as Chair of the Committee. 

Attending the meeting were two guests and observers from the American Medical Association.  Susan Nedza, M.D. and Cheryl Irmiter, PhD are completing an environmental scan of medical societies' capacity to move quality improvement initiatives forward.  They are seeking to gain an understanding of the role each organization plays and the challenges physicians face in providing care.  The project is funded by the Robert Woods Johnson Foundation (RWJ) and centers around the 15 communities across the country which are the recipients of an Aligning Forces for Quality (AF4Q) grant.  In these communities (Maine is one), the project seeks to improve the quality of health and health care by teaming up with those who get care, give care, and pay for care.  That is, the AF4Q is aligning key stakeholders in local communities to improve their own ability to deliver quality care as well as measure and publicly report their performance.

The AMA's Advancing Ambulatory Quality Improvement (AAQI) Project is targeting the state and county medical societies in which the AF4Q project is located and engaging the societies in conversation regarding the current challenges and opportunities in their communities regarding the following:  quality improvement (QI) efforts, leadership, health information technology, practice management, and education.  This environmental scan seeks to highlight the differences among medical societies' resources for supporting practice managers and others in undertaking these efforts and the key aspects to prepare medical societies to support their membership.

The results will be shared with the participants in order to foster a dialogue about opportunities to assist  members as they strive to provide the best possible care in a rapidly evolving practice environment.  The results of the inquiry will be aggregated in order to identify best practices by these organizations.  The AMA hopes to complete a template for best practices used to implement ambulatory QI programs.  The results will also be shared with the Robert Woods Johnson Foundation staff.

More information on the AAQI can be obtained from AAQI@ama-assn.org.

The CPQ meeting included updates on the following MMA projects:

  • Academic Detailing
  • DocSite Registry grant
  • Aligning Forces for Quality
  • Patient Centered Medical Home
  • Office-based QI Program
  • BOLIM funded Consultation Project on Prescribing for Chronic Pain

Pines Health Services, an affiliate of Cary Medical Center was accepted into the Office-based QI program, with some suggestions for its Annual QA plan. 

The 2010 Quality Summit, to be presented Thursday, June 10 in conjunction with the Maine Osteopathic Association Annual Meeting, was discussed and volunteers sought for the planning committee.  This will be the third year a Quality Summit has been presented jointly by MMA, MHA and MOA.  No theme has yet been selected for the Summit.

The Nov. 12th Quality Symposium in Freeport, presented by the MMC PHO was noted.

Potential agenda items for future meetings include:

  • Josh Cutler, M.D. of the Maine Quality Forum on the MQF cost variation study
  • Douglas Salvadore, M.D. on the Maine Infection Collaborative
  • Larry Hopperstead, M.D. on NSQIP
  • Janet Smith, RN from the MaineHealth Center for Quality and Safety
  • EMHS collaborative on chronic disease care

The MMA Committee on Physician Quality will meet next on Nov. 12, from 4:000pm to 6:00pm at the MMA offices in the Frank O. Stred Building in Manchester.  Any MMA members wishing to serve on the committee should contact MMA EVP Gordon Smith at gsmith@mainemed.com.

 

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Report on Coalition for the Advancement of Primary Care, Sept. 16

The Coalition for the Advancement of Primary Care, chaired by Elizabeth Fowlie Mock, M.D., met at the MMA offices this past Wednesday (Sept. 16).  Coalition members heard updates on the following projects/issues:

  • Patient Centered Medical Home Pilot      Lisa Letourneau, M.D., MPH
  • Primary Care Workforce/Pipeline            Charles Dwyer and Kevin Lewis
  • Oral Health/Dental Care:  Workforce Issues    Frances Miliano, Maine Dental Assocaition

Charles Dwyer presented information on the Health Workforce Forum established in 2005 by the 122nd Maine Legislature.  The law established the Health Occupations Report, to be complied by the Department of Labor, in conjunction with the Office of Health Data and Program Management's Office of Data, Research and Vital Statistics, and the Health Workforce Forum.

The Forum was established to coordinate the information and stakeholders needed to assess current and projected shortages in a number of health occupations and to make policy recommendations.  Participants include representatives of health professional associations, licensing boards, employers, education programs, Maine Department of Health and Human Services, Center for Disease Control and Prevention and the Maine Department of Labor.

The Forum meets regularly to review health workforce information, to draft recommendations based on its analysis, and to provide leadership and support for health workforce development initiatives in the state.  Meeting information and reports are submitted to the Director of the Maine Center for Disease Control/Office of Public Health and shared with the Department of HHS and the State Health Plan Advisory Council on Health Systems Development.

The major themes for the Forum's work include:  Leadership, Data, Collaboration, Planning Strategy, and Communications.

The Forum will submit a Fall 2009 report to the Department of HHS, Center for Disease Control, Office of Rural Health and Primary Care and the State Health Plan Advisory Council on Health System Development.  This work will involve:

  • Providing the leadership around how Maine can best address its health workforce shortages
  • The collection and analysis of available workforce data.
  • Bring stakeholders together, such as the community colleges and universities, the employers, the professional associations, and facilitate and promote collaboration and partnerships across different sectors.
  • Identify strategies that meet immediate and long-term needs.
  • Raising awareness.

The Coalition meets next on Wednesday, Nov. 18 at 9:00am at the MMA offices in Manchester. [return to top]

Work to Begin on Revisions to Physician-Attorney Code of Cooperation

The existing Medical-Legal Code of Cooperation, last updated in 2000 by the Maine Medical Association, the Maine Bar Association and the Maine Osteopathic Association will be the subject of revisions and updating by a committee appointed by the organizations and convening today (Sept. 21).  Augusta attorney Sumner Lipman will represent the Maine State Bar Association, Derry Rundlett, Esq. will represent the Maine Trial Lawyers Association and MMA attorneys Gordon Smith and Andrew MacLean will represent MMA.  The Maine Chiropractic Association will participate as well, as there is also an existing Code between chiropractors and attorneys.

The Code applies only in civil proceedings and deals with issues such as depositions, furnishing of medical records and court testimony.

Drafts of any revisions will be shared with appropriate MMA committees.  Any member wishing to have input into the revisions or who has suggestions for the Code should contact either Gordon or Andy at MMA (amaclean@mainemed.com; gsmith@mainemed.com).

Several meetings throughout the Fall and early Winter are anticipated. [return to top]

How to Get Paid for Administering H1N1 Vaccine and Additional Information

How to Get Paid for Administering H1N1 Vaccine and Additional Information

Brief Summaries on the following are below:

-        Billing for H1N1 Vaccine from the AAFP, Medicare and MaineCare, links provided

-        Availability for health care provider to register to receive H1N1 Vaccine

-        Anticipated first large shipments due to arrive in mid-October

-        New H1N1 School-Located Vaccine (SLV) Clinic information

-        Updated Interim Recommendations (9-18-09) for H1N1 Treatment of Pregnant Women can be found at: http://www.cdc.gov/H1N1flu/pregnancy/antiviral_messages.htm

-        H1N1 Residential School and H1N1 Vaccine Availability

-        Two Email Addresses for H1N1 Questions and Reporting

-        Keep Informed!

http://www.aafp.org/online/en/home/publications/news/news-now/practice-management/20090916h1n1-paymt.html

  

Medicare Billing Info for H1N1 Vaccine

http://www.cms.hhs.gov/MLNMattersArticles/downloads/se0920.pdf

MaineCare Roster Billing for H1N1 and Seasonal Vaccine for Schools (similar info for home health agencies forthcoming)

http://www.maine.gov/dhhs/oms/providerfiles/billing_instructions.html

The FDA's approval of four vaccines against the novel influenza A (H1N1) virus is official. Now, physicians in private practice need details from health insurance companies about how to code and bill payers for administering the vaccine to receive timely payment for this service.

CMS has created a unique health care common procedure coding system, or HCPCS, code -- G9141 -- specifically to cover administration of the H1N1 vaccine, although private insurers are not required to use the G code.

The AAFP has confirmed the following instructions from the country's largest private health insurers and Medicare.

·                         UnitedHealthcare is asking physicians to submit the CPT vaccine administration code appropriate to patient age, route of administration and number of vaccines administered. In addition, physicians must submit CPT code 90663 for the vaccine itself and indicate an amount of $0.01. The federal government is providing the vaccine free of charge, but some claims clearinghouse systems will reject CPT codes with a $0 charge.

·                         CIGNA is asking physicians to bill for the administration of H1N1 flu vaccines using the new G9141 HCPCS code.

·                         Aetna wants physicians to use age-appropriate CPT codes -- 90465-90468 for children or 90471-90474 for adults. Use of the G9141 HCPCS code also is permissible.

·                         Humana prefers that physicians use the HCPCS G9141 code when filing a claim for administration of the H1N1 vaccine.

·                         Because of the large number of Blue Cross Blue Shield companies, the AAFP cannot give definitive instructions for these payers. If physicians have questions about H1N1 vaccine administration payment, they should contact their local BCBS plan.

·                         WellPoint and Wellpoint's subsidiary, Anthem, have not released instructions to physicians regarding administration of the H1N1 vaccine.

·                         Medicare wants physicians to bill for administration of the H1N1 vaccine using the HCPCS G9141 code. Payment will be the same as for administration of the seasonal influenza vaccine. More information about CMS' H1N1 vaccine payments is available in a recent MLN Matters.

Availability for health care provider to register to receive H1N1 Vaccine

(Go to http://www.maine.gov/tools/whatsnew/attach.php?id=79438&an=2  for more information)

This health alert is to update health care providers on the availability of the ability to order H1N1 vaccine.  As you may know, pregnant women, children and young adults are being disproportionately affected by novel H1N1 influenza virus (“swine flu”).  We expect to start receiving H1N1 vaccine in Maine by mid-October.  If you are a health care provider licensed to administer vaccine, we ask that you consider registering to receive the H1N1 vaccine. 

SCHOOL-LOCATED VACCINE CLINICS

We also encourage you to become involved with the initiative to offer all children seasonal and H1N1 vaccines in Maine schools.  This will assure all Maine children are offered vaccine as quickly and as efficiently as possible while also not overburdening the health care system.  If you are interested in becoming involved, please contact your local schools, or call the Maine CDC at 1-888-257-0990, or check the school-located vaccine website at www.maineflu.gov.  Thank you ahead of time for your consideration in this important public health effort to keep our communities and schools healthy! 

REGISTRATION TO RECEIVE H1N1 VACCINE

Even if you already receive vaccine from Maine CDC, you need to register separately to receive H1N1 vaccine.  

To register, fill out and submit the H1N1 Provider Agreement for H1N1 Vaccine, which can be found at:  http://www.maine.gov/dhhs/boh/maineflu/h1n1/provider-agreement-2009-2010.shtml

For questions regarding H1N1 influenza vaccine ordering see the FAQ in this document.  For other questions: 

H1N1 vaccine will only be available through state health departments (Maine CDC/DHHS in Maine), and will not be available for private purchase from manufacturers.

Anyone interested in offering H1N1 vaccine must complete and submit the H1N1 Provider Agreement.  Even those who are already registered Maine Immunization Program providers and who have already completed paperwork to offer seasonal flu vaccine must submit this form. 

There are two important requirements for the receiving end of H1N1 vaccine. 

·       ·        The vaccine must be placed into a working refrigerator that is dedicated to storing vaccine and can maintain the vaccine’s temperature of 35.6 to 46.4 degrees Fahrenheit (2 to 8 degrees Celsius).  The vaccine must NOT be exposed to freezing temperatures.  A “dorm” style refrigerator in which the freezer and refrigerator share an exterior door is not appropriate. For further details on handling: http://www.cdc.gov/h1n1flu/vaccination

·       ·        A physician or nurse practitioner with an active Maine license should be on record to be providing oversight for the vaccine. 

Completing the H1N1 Provider Agreement is your way of demonstrating interest. Each state is given a limit of the number of distribution sites, so we ask that health care providers consolidate their registrations.  For instance, we ask that outpatient practices with multiple health care providers submit one registration form

Once the designated H1N1 Vaccine Providers are identified, we will take orders for H1N1 vaccine. The H1N1 Vaccine Order Form is currently being developed and will be posted on our web site as soon as it is available. In the mean time, we suggest that you start assessing how many doses you will need so that you are ready to place your order as soon as we have the ordering process in place.

New H1N1 School-Located Vaccine (SLV) Clinic Information

New H1N1 School-Located Vaccine (SLV) Clinic Information is available from the Maine CDC to provide information for planning and conducting school-located 2009 H1N1 influenza vaccination clinics that target school-aged children enrolled in school and potentially other groups in the community.  SLV can be defined as vaccination that is: 

Administered on school grounds

Targets enrolled students and potentially others

Held before, during and/or after school hours

Typically involves collaboration between public health departments and public and private schools/school districts

For more information, go to the links provided below:

Maine CDC Flu School Vaccine Clinics Website

http://www.maine.gov/dhhs/boh/maineflu/schools/index.shtml

School Located Vaccination Information for Planners

http://www.cdc.gov/h1n1flu/vaccination/slv/planners.htm

School Located Vaccine Template Forms

http://www.cdc.gov/h1n1flu/vaccination/slv/relatedmaterials.htm

Residential School and H1N1 Vaccine Availability

The school must register in order to receive H1N1 vaccine.  Go to:  http://www.maine.gov/tools/whatsnew/attach.php?id=79438&an=2 for information on how to register.  The Maine CDC requests that if you are a residential school (college, university, boarding school, etc.) with the ability to vaccinate your students with a licensed health care provider, that you partner with a local health care provider, such as a hospital or health center to receive vaccine from them.  If you have a large student body (over 1,000 students) with an onsite health facility with the ability to meet the vaccine handling requirements, then consider registering to receive the H1N1 vaccine.  Maine CDC is limiting the number of vaccine distribution sites available in Maine, and want to make sure smaller schools start arranging for how they will receive vaccine, and larger schools register to receive it.  If anyone needs assistance n connecting with resources (vaccinators, etc.) the names and contact information is found at www.maineflu.gov) or call the Maine CDC at 1-888-257-0990 to request assistance.

Reporting outbreaks in schools:  Contact Maine CDC at 1-800-821-5821 or email:  disease.reporting@maine.gov   Infectious Disease Epidemiologists will respond and provide guidance on disease monitoring and control.  Schools are also asked to report when they are considering closing due to illness.  Epidemiologists will follow up on all reported outbreaks to provide guidance on the prevention and control of influenza and continued monitoring of students and staff for ILI (influenza Like Illness).  School health officials and Maine CDC epidemiologists will establish communication to share information and resources to better understand the outbreak and how it can be controlled.

The collective common goal is to prevent the spread of influenza and to reduce severe illness and death due to influenza. 

TWO EMAIL ADDRESSES FOR H1N1 QUESTIONS:

FLU.QUESTIONS@MAINE.GOV

In order to streamline communications, and to help us develop FAQs and other targeted communications, we have established an e-mail box called flu.questions@maine.gov.

This e-mail address is being posted for the public as well. To help us track questions, we ask that if you have a formal role with H1N1, that you identify that role, by for instance, submitting the source or target of the question in the subject line. For example: Phone Bank Question, VC Question, RRC Question, Field Epi Question, etc.

Tara Thomas will be monitoring this e-mail box, and will gather questions that need answering every morning at 9 am. If the question is forwarded, both the original questioner and the person forwarding the e-mail will be sent the reply.

DISEASE.REPORTING@MAINE.GOV
Medical and clinical questions related to influenza should be directed to disease.reporting@maine.gov.  These inquiries are triaged throughout the day by the Epidemiologist On Call, and typically are sent to a Field Epidemiologist for response.

KEEP INFORMED

  • Stay Updated:
    • Check the Maine CDC H1N1 Website: www.maineflu.gov
    • Check the Weekly H1N1 Updates: Check the Thursday updates on H1N1 in Maine on Maine’s H1N1 website:  www.maineflu.gov.  You can subscribe to these updates via their RSS feed.
    • Sign Up to Receive Health Advisories:  Sign up to receive urgent updates from Maine CDC’s Health Alert Network (HAN).  The easiest and quickest way is to sign up is through the HAN Alert RSS feed at www.mainepublichealth.gov (midway down the center of the homepage). 

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Pediatric and Adult Immunization: Benefits, Safety, and Perceived Risks - National Speakers in Maine, September 29th!

SAVE THE DATE!

A Day Devoted to Immunizations (No Registration Fee)
September 29, 2009
Maple Hill Farm, Hallowell, Maine

Sponsored by the Maine Medical Association, American Academy of Pediatrics, Maine Chapter, and Maine Immunization Coalition

An entire day devoted to the topic of childhood Immunizations!  Join us in the morning to hear two national speakers discuss the benefits and safety of immunizations to assist physicians in responding to parents' questions. The day begins at 7:30 am with registration and Continental Breakfast.

8am – 11am Morning CME Program:

Pediatric and Adult Immunization:  Benefits, Safety and Perceived Risks: This program will provide education to physicians/mid-levels/nurses on vaccine benefits and safety so that they will be more comfortable handling questions from their patients on this currently controversial issue.  CME’s available for physicians and nurses.

Immunizations:  Vaccine Benefits

Iyabode Akinsanya-Beysolow, MD, MPH, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention

Immunizations:  Vaccine Safety and Perceived Risks

Gary Marshall, MD, Professor of Pediatrics and Chief Division of Pediatric Infectious Diseases, University of Louisville Medical School.

11:15am – 5:30 pm Immunization Congress (all morning CME attendees are invited to stay, but it is optional.  (Lunch to go is provided for all morning participants who opt not to attend the afternoon session.)

The afternoon is a working group session on financing immunizations in the state.  A diverse group of stakeholders will be invited to the afternoon session to discuss immunization financing issues in large and small groups and to work towards a plan for immunization financing for Maine.

It's Not too Late to register!  We still have a few more spaces!  To register for the morning CME and/or to express interest in the afternoon, and view the entire Agenda:  go to www.maineaap.org/conferences.htm  

http://www.maineaap.org/conference_agenda.htm   [return to top]

Medicare RAC Audit Webinar, October 19

 

 

Join us for a Webinar on October 19

 

 

Space is limited.
Reserve your Webinar seat now at:
https://www2.gotomeeting.com/register/541272939

 

On Monday, Oct. 19 at 12 noon, the six state medical societies of New England will sponsor a regional webinar to inform physicians and medical office staff about a national auditing program that will impact health care providers. This important session will describe the new national Recovery Audit Contractor (RAC) program, a component of the Tax Relief and Health Care Act of 2006.  

The goal of the RAC is to identify improper payments made on claims of health care services provided to Medicare beneficiaries.  Improper payments may be overpayments or underpayments.

• Overpayments can occur when health care providers submit claims that do not meet Medicare’s coding or medical necessity policies.

• Underpayments can occur when health care providers submit claims for a simple procedure but the medical record reveals that a more complicated procedure was actually performed.

Health care providers that might be reviewed include hospitals, physician practices, nursing homes, home health agencies, durable medical equipment suppliers and any other provider or supplier that bills Medicare Parts A and B.

Presenters will include representatives from the Centers for Medicare and Medicaid Services, and Diversified Collection Services Inc., the contractor for the RAC program in New England. Registrants are encouraged to submit questions by email in advance. Questions can
also be emailed during the Webinar, be sending messages to racwebinar@mms.org

 

Title:

 

Medicare RAC Audit Webinar

 

 

 

Date:

 

Monday, October 19, 2009

 

 

 

Time:

 

12:00 PM - 2:00 PM EDT

 

After registering you will receive a confirmation email containing information about joining the Webinar.

 

 

System Requirements
PC-based attendees
Required: Windows® 2000, XP Home, XP Pro, 2003 Server, Vista

 

Macintosh®-based attendees
Required: Mac OS® X 10.4 (Tiger®) or newer

 

 

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15th Annual Maine Pain Initiative Symposium, October 1

The Maine Hospice Council invites you to partici-pate in the Annual Maine Pain Initiative Symposium. The Council is pleased to have this year’s symposium at the Hilton Garden Inn in Freeport, Maine.

We are pleased to have Dr. Robert Twillman from the University of Kansas Cancer Center visit us. This year’s theme will highlight the importance of leadership and quality in pain management.

For more information, or to register, click here [pdf] [return to top]

All MaineCare Providers: MaineCare Re-enrollment for MIHMS is well underway for Cycle 1 Providers

Cycle 1 Providers:  The official deadline for re-enrollment is September 16, 2009.  However it is not too late for you to re-enroll.   Please follow this link https://mainecare.maine.gov to the Health PAS provider re-enrollment portal to complete your re-enrollment application as soon as possible.  It is important to the MIHMS implementation process that providers re-enroll in a timely manner according to their assigned cycle.  To begin the process, please click on the Provider Enrollment link in the middle of the left pane menu.

Please check this site to verify your assigned re-enrollment cycle http://www.maine.gov/dhhs/oms/pdfs_doc/fiscal_agent/prov_list.xls.  If you believe you are not assigned to the correct cycle, please contact us at MaineCare2010.dhhs@maine.gov

 

Re-enrollments have been staggered to allow for processing of all current MaineCare Providers in an efficient and timely manner.  Following this established schedule will allow for payments to be made in the first MIHMS financial cycle.  Providers who have not re-enrolled will experience delays in claims processing.

Please do not delay – get your application in now! 

The schedule for re-enrollment is:

Cycle 1:  August 19 through September 16

Cycle 2:  September 17 through October 14

Cycle 3:  October 15 through November 13

Cycle 2 Providers:  Re-enrollment begins Today!

When you enroll: Cycle 1 and 2 providers should click on the “In State Provider Enrollment” (please do not click on the “register”) link located in the left menu pane to begin the re-enrollment process. The “In-State Provider Enrollment” link currently reads “Provider Enrollment” but will be changed to “In State Provider Enrollment” in the next two weeks.

Do you know your NPI Type?  Providers should visit the NPI Registry at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do and conduct a search of their NPI number(s) to determine how they enumerated.  Knowing your NPI type is important when you re-enroll!  You need to verify if you are a Type 1 – individual or a Type 2 – Organization.

Please note:  Providers should not attempt to re-enroll prior to their assigned dates. 

The re-enrollment application is being updated to reflect policy revisions and attempting to re-enroll early will result in an inability to complete the re-enrollment application.

Questions regarding re-enrollment can be sent to MaineCare2010.DHHS@maine.gov [return to top]

MMA Corporate Affiliate Athenahealth Offers Federal Stimulus Bonus Payment Webinar, Sept. 24

There is a significant amount of stimulus money being offered by the government to physicians over the next few years. Join Athenahealth on Thursday, September 24th at 12:15 PM ET for a live Webinar to find the answers to some of your most pressing questions.

Both clients and non-clients can benefit from this 45 minute overview of the 2009 HITECH Act, and athenahealth’s Federal Stimulus Payment Guarantee. Some of the topics we’ll cover include:

  • What is the HITECH Act of 2009?
  • How is “meaningful use” of an EHR defined?
  • How can athenahealth guarantee their clients will receive stimulus payments?

Please join us for this presentation, and bring your own questions as we’ve set aside a lot of time for Q&A. Register today!  http://event.on24.com/r.htm?e=163743&s=1&k=E72B2EEBC0B0C10E130FBC3B2781BAA3&partnerref=mma.

For additional information, visit athenahealth [return to top]

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