February 8, 2010

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MaineCare Physician Fee Increase to Take Effect March 1, 2010

Despite the significant state budget shortfall, the State will meet its commitment to Maine physicians by increasing the MaineCare physician fee schedule on March 1.  Fees will increase from the current 57% of Medicare to 70% of Medicare, a significant increase providing nearly $8 million annually to the fee schedule.  Although the conversion of MECMS to MHIMS will not take place until April 1, 2010 at the earliest, the fee increase, enacted by the legislature in 2009, will take place as scheduled.

Although the vast majority of physicians will see an increase in MaineCare payment at the time of the increase, a few physicians, who provide services within a hospital setting, will receive a decrease in reimbursement if they have been paid the full Medicare rate previously for services provided in the the office despite providing the service in the hospital.  On March 1, 2010, such physicians will receive the Medicare fee for the professional component of the fee but will no longer be paid the total fee that assumed that the service was provided in the office and thus included the cost of the facility in the physician fee.

MMA representatives met with MaineCare officials on this past Thursday to discuss the fee increase and the implications of the reduction in fees for procedures performed in the hospital.

Questions about the increase can be directed to MMA EVP Gordon Smith, Esq. at 622-3374, ext. 212 or via e-mail to gsmith@mainemed.com.



Medicare Physician Payment Issue Addressed in Obama Budget Proposal; Short Term Fix May be in Jobs Bill

President Obama released his $3.8 trillion budget proposal for FY 2011 for Congress' consideration on February 1st.  The budget proposal assumes passage of health care reform and includes an average of spending reductions in the House and Senate reform bills.  Those bills would reduce Medicare and Medicaid spending by about $500 billion over 10 years.  The budget proposal also would ensure flat funding of Medicare physician payment rates (avoiding planned cuts according to the SGR formula) for the next 10 years at a cost of $371 billion.  The bill would provide a 6-month increase in federal matching rates for state Medicaid programs at a cost of $25.5 billion.  Congress of course may accept all, some, or none of the President's recommendations. 

Late last week, Senate Finance Committee Chairman Max Baucus (D-MT) said that a short-term reversal of the 21% Medicare payment cut scheduled for March 1st may be included in a jobs bill expected to be on the Senate floor this week.  

You will find an American Medical News story on the President's budget proposal on the web at:   http://www.ama-assn.org/amednews/2010/02/08/gvl10208.htm. [return to top]

President Encourages Congress to Keep at Health Care Reform Work; Suggests Summit

In his public appearances during the last several days, President Obama continued to urge Congressional Democrats to continue searching for common ground to move health care reform forward this year.  He also urged Republicans to bring their ideas forward and to move beyond simply saying "no" to any aspect of health care reform.  During the Super Bowl pre-game show last night, he went so far as to offer the White House as a venue for a bipartisan half-day summit on health care reform to be televised live during the month of February.  Though a gamble, this offer follows his recent meeting with House Republicans that many observers believe was successful for the President.

The President concluded his interview before the Super Bowl by saying despite the challenges of the health care reform debate, it's still the right thing to do for the American people. [return to top]

Stephen Sears, M.D., M.P.H. Named State Epidemiologist

Dr. Stephen Sears is our new State Epidemiologist!

The Maine CDC is extremely pleased to announce the arrival of Dr. Stephen Sears as the new State Epidemiologist.  A well-known infectious disease physician with a masters degree in public health, Dr. Sears is from Maine and comes to us after a career that involves hospital administration (MaineGeneral and Mercy Hospitals), as well as infectious disease and public health work.  More information can be found at:  http://www.maine.gov/tools/whatsnew/index.php?topic=DHS+Press+Releases&id=90686&v=cdc_article

Dr. Sears is a long-term member of the Maine Medical Association and we wish him all the best as he embarks on this next phase of his professional career.


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MMA's Public Health Committee To Meet this Wednesday, February 10th

The latest MMA Public Health Committee meeting is scheduled for this Wednesday, February 10, 2010 from 4:00 pm - 6:00 pm at the Maine Medical Association office.  All members and interested non-members are welcome to attend.  This meeting is now accessible by Webinar via your laptop for your convenience.  Please follow the instructions below.  It would be best for you to connect in via the instructions below for "the On-line Meeting."  The Dana Center (Maine Medical Center) will no longer be used for video-conferencing of the Public Health Committee meetings because of the new Webinar capabilities.

If you plan to attend the meeting, please email Kellie Slate Miller, Director of Public Health Policy at kmiller@mainemed.com.  Thank you, and we look forward to your involvement.

The PHC meeting packet (agenda and supporting materials and the 2009 Passed Resolutions) can be accessed at the Maine Medical Association's website at http://www.mainemed.com/calendar/programs/2010/021010_PHCAgendaMaterials.pdf.

Topic: Public Health Committee

Date: Wednesday, February 10, 2010

Time: 4:00 pm, Eastern Standard Time (New York, GMT-05:00)

Meeting Number: 732 422 072

Meeting Password: 1234

To join the online meeting (Now from iPhones too!)
1. Go to https://mainemed.webex.com/mainemed/j.php?ED=132014027&UID=914378867&PW=NZjQyYzQ2NDc0&RT=MiMxMQ%3D%3D
2. Enter your name and email address.
3. Enter the meeting password: 1234
4. Click "Join Now".

To view in other time zones or languages, please click the link:

To join the audio conference only
To receive a call back, provide your phone number when you join the meeting, or call the number below and enter the access code.
Call-in toll-free number (US/Canada): 1-877-669-3239
Call-in toll number (US/Canada): +1-408-600-3600
Global call-in numbers: https://mainemed.webex.com/mainemed/globalcallin.php?serviceType=MC&ED=132014027&tollFree=1
Toll-free dialing restrictions: http://www.webex.com/pdf/tollfree_restrictions.pdf

Access code:732 422 072

For assistance
1. Go to https://mainemed.webex.com/mainemed/mc
2. On the left navigation bar, click "Support".

You can contact me at:

To add this meeting to your calendar program (for example Microsoft Outlook), click this link:

The playback of UCF (Universal Communications Format) rich media files requires appropriate players. To view this type of rich media files in the meeting, please check whether you have the players installed on your computer by going to https://mainemed.webex.com/mainemed/systemdiagnosis.php

Sign up for a free trial of WebEx


IMPORTANT NOTICE: This WebEx service includes a feature that allows audio and any documents and other materials exchanged or viewed during the session to be recorded. By joining this session, you automatically consent to such recordings. If you do not consent to the recording, do not join the session. [return to top]

MUA's 2010 Annual Winter CME Conference This Weekend Will Highlight "Robotic Partial Nephrectomy"

The Maine Urological Association's 2010 CME Conference occurs this weekend at Sugarloaf, February 12-14, showcasing Lisa T. Beaule, M.D.'s technique on "The role of Robotic Partial Nephrectomy."  With the recently published AUA Guidelines on management of small renal masses, the role of minimally-invasive nephron-sparing surgery has taken center stage and should be considered as part of the practicing urologist's surgical repertoire.  Other speakers include:  Ted Roth, M.D speaking on "Interstem Devices," Andrew MacLean, MMA Deputyr EVP addressing "Legal Aspects of Preventing Prescription Drug Diversion/Abuse in Maine," along with Marek Skacel, M.D. discussing "Pathology Case Studies," Terrance Sheehan, M.D. with Medical Mutual Insurance Company of Maine highlighting urology cases in Maine, and Molly Schwenn, M.D. discussing the "New England Bladder Cancer Research Findings."

This year's conference is sponsored by Maine Medical Partners-Urology, a MaineHealth Member.  For more information, go to www.mmc.org.

Interested physicians and mid-levels who are interested in attending this CME conference may contact Kellie Slate Miller at kmiller@mainemed.com or call 207-622-3374, ext. 229 prior to February 11th. [return to top]

MSA Welcomes National Anesthesiologist Group's President to Maine this Weekend

The Maine Society of Anesthesiologists (MSA) holds its winter meeting at the Grand Summit Hotel at Sugarloaf this weekend, February 13th & 14th.  MSA members will welcome as guests, Alex Hannenberg, M.D., President of the American Society of Anesthesiologists (ASA) and the group's general counsel and director of the Washington, D.C. office Ronald Szabat, J.D., LL.M.  The MSA meeting begins at 3 p.m. on Saturday, February 13th.

 For more information, contact Anna Bragdon at abragdon@roadrunner.com or by phone at 441-5989. [return to top]

Motivational Interviewing (MI) for Clinicians to Promote Healthy Behavior and Health Weight Workshops in June 2010

Let's Go Healthcare (a statewide clinical initiative to improve the prevention, identification & treatment of childhood obesity) is committed to developing unique provider learning opportunities to help prevent, identify, and treat childhood overweight.  Motivational Interviewing (MI) Workshops have been scheduled in 3 convenient locations - Monday, June 7, 2010 at the United Way of Greater Portland; Tuesday, June 8, 2010 at the Senator Inn in Augusta; and Wednesday, June 9, 2010 at Eastern Maine Medical Center in Bangor.  The workshop runs from 8:00 a.m. to 3:00 p.m.  The fee to attend the conference is $95.

Let's Go has secured an exceptional and extremely knowledgeable speaker for this workshop:  Keri Bolton Oetzel, Ph.D., M.P.H., L.P.C. is a national expert on effective communication (Motivational Interviewing) with children and families around healthy behaviors/healthy weight.  She is a licensed clinical counselor who has worked with children, adolescents, and families for more than 10 years in New Mexico.

This workshop will focus on tools and hands-on activities for brief patient centered communications that result in a teaching framework for working with the "whole person/family."  Bonus opportunity includes follow-up coaching calls and skills webinar.  Participants will be required to complete a short on-line pre-workshop module before attending.  CME's are provided through the Maine Medical Association and the Maine Osteopathic Association.  Tory Rogers, M.D. stated, "this training is invaluable - not only to help in your obesity prevention work, but very applicable to other patient issues."

To register, go to www.letsgo.org or contact Jennifer Pelletier at pellej5@mmc.org or 207-662-6914.  Scholarship opportunities are available for residents. [return to top]

Quality Counts Board Holds Strategic Retreat

The Board of Directors of  Quality Counts! held a strategic retreat last Wednesday, February 3rd at the MMA offices in the Frank O. Sred Building in Manchester.  The five-hour retreat was facilitated by Paul Plsek who has previously been in the state to talk about the concept of change in complex adaptive systems.

After reviewing the existing Mission and Vision for the organization (stated below), board members provided input on what it meant for Quality Counts to lead, collaborate, and align, and then reviewed a document entitled, Simple Rules for Alignment.

Mission:  Quality Counts is transforming health and health care in Maine by leading, collaborating, and aligning improvement efforts.

Vision:  Through the active engagement and alignment of people, communities, and health care partners, every person in Maine will enjoy the best of health and have access to patient-centered care that is uniformly high quality, equitable, and efficient.

The Simple Rules of Engagement centered around the following three questions:

1.  How do we collectively move towards common goals?

2.  How do we access pools of resources for the common good?

3.  What are our "ground rules" of social order within an aligned system?

Much of the discussion centered on the concept of sharing resources, respecting and enhancing the capacity of partners, and being inclusive in all that is done, inclusion being defined as, to identify, inform, and engage partners that are engaged in similar activities, or may potentially have an interest in participating.  The rules also note the support and inclusion of consumers and the avoidance of duplicative activities.

The overarching goal is to improve health and health care for Maine people by promoting quality care that is safe, timely, effective, efficient, and patient-centered.

Board members also performed a traditional SWOT analysis by reviewing the organization's Strengths, Weaknesses, Opportunities, and Threats.

The retreat was felt to be a success by those members able to participate.  Along with the regular monthly board meetings, the organization will now be focused on the upcoming Quality Counts 7 program at the Augusta Civic Center on Friday, April 16th.

Quality Counts is directed by its Executive Director Lisa Letourneau, M.D., M.P.H. and Associate Director Dee Kerry deHaas.  Barbara Crowley, M.D. serves as the Chair of the Board and the Vice-Chair is MMA EVP Gordon Smith.  Its offices are co-located with the Maine Medical Association offices on Association Drive in Manchester.




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AMA Joins Other Health Groups to Petition FTC on "Red Flags" Rule

In light of a recent federal court decision, four national organizations representing physicians, dentists, and veterinarians have called on the Federal Trade Commission (FTC) to exclude health professionals from the controversial "red flags" rule to combat identity theft.  In a letter sent to FTC Chairman Jon Leibowitz, AMA Executive Vice President and CEO Michael D. Maves, M.D., M.B.A. and leaders of the American Dental Association, the American Osteopathic Association, and the American Veterinary Medical Association asked the FTC to make it clear that the rule will not apply to their members given the result of recent litigation brought by the American Bar Association against the FTC.  In that case, the U.S. District Court for the District of Columbia ruled that lawyers should be excluded from the requirements imposed by the "red flags" rule.

 You can find a copy of the joint letter on the web at:  http://www.ama-assn.org/ama/pub/news/news/ftc-red-flags-rule.shtml. [return to top]

Update on Workers' Compensation System Facility Fee Schedule

As previously reported in the Maine Medicine Weekly Update, the deadline for the Workers' Compensation Board to vote on proposed amendments to Rule Chapter 5, instituting a fee schedule for health care facilities (primarily hospitals and ambulatory surgical facilities) has passed, and the Board will have to re-publish the rule and follow the Administrative Procedures Act (APA) process once again.  While the MMA and representatives of the state's ASCs urged the Board to proceed with the draft rule, the Board reacted to concerns raised by the business community that the draft rule didn't go far enough by re-engaging actuary Eric Anderson, an actuary with Ingenix who was the primary drafter of the proposed rule.  The MMA expects the rule to be published again later this Spring.  Until new rules go into effect, the W.C.B. General Counsel John Rohde said that the parties will be subject to whatever is currently in Appendix 3 of Chapter 5, the Medical Fee Schedule, with regard to the CPT codes in place for specific services.  There will be no Appendix 4 and 5, and the parties will have the option of a 5% discount for payment within 30 days. [return to top]

Legislative Committee Conference Call Information/Save the Date for a Forum on the State Budget

MMA Legislative Committee Chair Lisa Ryan, D.O. invites any interested physician or physician staff member to participate in the weekly conference call on Thursday, February 11, 2010 at 8:00 p.m. using the following toll-free call-in number and access code:  call 1-877-669-3239; access code 23045263.

There are no new bills for review this week, but the MMA staff will provide an update on legislative action of the week and will seek further input from physicians about bills scheduled for public hearing in the near future.

Also, the MMA Legislative Committee has planned a forum on the current state budget situation for Thursday, February 25, 2010 from 6 to 8 p.m. at the MMA office in Manchester.  The MMA will invite a bipartisan group of legislators and representatives of the executive branch to participate in a discussion of the the current budget priorities and implications for the future of health care in Maine.  We will reserve the first half hour for informal networking and will plan a program to last for approximately an hour to an hour and a half.  Any interested physician or practice staff member is welcome to attend, but we ask that you RSVP to Maureen Elwell, Legislative Assistant for our planning purposes.  Please contact Moe by email at melwell@mainemed.com. [return to top]


The HHS Committee made its report on the health & human services portions of the budget to the Appropriations Committee last week and the rest of the legislative committees will continue their reports this week.  Then, the Governor's supplemental budget, L.D. 1671, will be in the hands of the Appropriations Committee.  The Appropriations Committee likely will spend most of this month debating the details of the supplemental budget.  The other legislative committees have passed their deadlines for dealing with carry-over legislation and now are holding public hearings on new bills submitted during the second session.

Last week, the MMA testified on 2 bills in the Insurance & Financial Services Committee:  L.D. 1620, An Act to Protect Health Care Consumers from Catastrophic Debt and L.D. 1676, An Act to Protect Maine Citizens' Credit.  The MMA supported L.D. 1620, a bill that would prohibit annual and lifetime caps on health insurance coverage in Maine.  This is a key concern of health insurance customers today and is an aspect of the national health care reform debate about which there seems to be considerable bipartisan support.  Paul Liebow, M.D., a retired emergency physician from Bucksport spoke in favor of the bill.  The MMA opposed L.D. 1676 because of concern about its potential impact on the financial viability of physician practices.  L.D. 1676 is scheduled for a work session this week, but the first work session on L.D. 1620 has been deferred until Wednesday, February 17th.  

The HHS Committee's report back to the Appropriations Committee showed significant bipartisan concern about the Governor's proposed cuts in the health and human services area, but the reaction of some Appropriations Committee spokespeople was dismay at the HHS Committee's failure to tackle the difficult issues in this budget.

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