Take Action on Medicare Physician Payment (SGR) Problem!

As efforts continue in Washington to find a permanent solution to the Medicare payment/SGR problem, it is important for Maine physicians and their staffs to continue their advocacy by communicating with Maine's congressional delegation.  Medicare payment rates for physicians have increased 1% since 2001 while practice expenses have increased over 27%.  Don't stand for Congress continuing its month to month failure to address the long-term issue.  The 21.3% cut has been delayed only until May 31 and the current expectation is that the rampant partisanship in Congress will prevent legislators from fixing the problem before the temporary delay expires next month.  Physicians need to tell Congress that enough is enough.

In last week's Maine Medicine Weekly Update, we informed you of action in Washington, D.C. delaying the 21.3% Medicare payment cut until May 31st.  The MMA is working with the AMA and other state and national medical organizations to persuade Congress to find a permanent solution to the Medicare SGR problem.  MMA EVP Gordon Smith has accompanied Maine physicians to Washington this week for meetings with members of Maine's congressional delegation and their staffs during which they will emphasize the importance of this issue to Maine physicians.  The nationwide cut of 21.3% is even greater in Maine because of the geographic discrimination we suffer from.  The cut in Cumberland and York counties would be 22.5% and in the rest of the state it would be 23.5%, with the reductions in payment representing over $60 million dollars annually in Maine alone.

You can help this important effort as follows:

1.  Communicate with Maine's congressional delegation (Senators Snowe & Collins, in particular) through the AMA's grassroots action center:  http://www.ama-assn.org/ama/pub/health-system-reform/repeal-medicare-sgr.shtml.

2.  MMA is also participating in a petition drive initiated originally by the Texas Medical Association but now supported by all fifty state medical societies and several national specialty societies.  The goal is to deliver a petition with more than a million signatures to members of Congress stating support for a permanent solution to the SGR problem.  The petition is available for your signature on line at: http://www.ipetitions.com/petition/meltdown/.

We can't emphasize enough the importance of contacting our influential Senators and encouraging them to help bridge the partisan gap that is making this issue so difficult to resolve.

Governor issues Executive Order to Implement National Health Reform in Maine

On April 22, 2010, Governor John E. Baldacci issues an executive order to establish the Health Reform Implementation Steering Committee.  This committee is directed to conduct the following:

To assure ongoing coordination, the Governor’s Office of Health Policy and Finance (GOHPF) shall lead the executive branch working with the Health Reform Implementation Steering Committee to implement National Health Reform.

The Health Reform Implementation Steering Committee shall be comprised of the following permanent members.  The Director of the Governor’s Office of Health Policy and Finance shall serve as Chair of the Steering Committee.

•             Director, Governor’s Office of Health Policy & Finance – Trish Riley
•             Commissioner of the Department of Health and Human Services – Brenda Harvey
•             Commissioner of the Department of Professional and Financial Regulation – Anne Head
•             Superintendent of Insurance – Mila Kofman
•             Executive Director of the Dirigo Health Agenda – Karynlee Harrington

Other members of the administration may be invited to serve on an as-needed basis with respect to specific issues affecting their scope of responsibility.  The Steering Committee shall work with the GOHPF health policy committee of key state agencies to support its mission, and draw membership from any other agency or department of state government as needed.

The GOHPF with the Health Reform Implementation Steering Committee shall advise the Governor and provide coordination and leadership for implementation of federal health reform across all departments and agencies of the executive branch;

Assure on-going information sharing and coordination of efforts with the Legislative Joint Select Committee on Health Care Reform Opportunities and Implementation;

Assure broad stakeholder engagement by consulting the Advisory Council on Health Systems Development to ensure open dialogue and to further the success of health reform implementation; and

Ensure the State Health Plan is consistent with on-going implementation efforts, which must include a chapter outlining issues and options for National Health Reform Implementation.

This steering committee will immediately begin to conduct an in-depth analysis of the new federal legislation, identify the steps necessary to produce an implementation plan, develop a plan to pursue funds pursuant to the national temporary high-risk pool to maximize affordable coverage options for Maine citizens, plan for the creation of the State Health Exchange and plan for the implementation of all other components of the National Health Reform, including specific action steps, timelines, and assignment of lead responsibility.

The Advisory Council on Health Systems Development will serve as the advisory stakeholder group to the Steering Committee and shall assist in developing the analysis and implementation process. 

The text of the executive order is as follows:

12 FY 10/11

April 22, 2010

AN ORDER IMPLEMENTING NATIONAL HEALTH REFORM IN MAINE

WHEREAS, President Barack Obama signed the historic Patient Protection and Affordable Care Act on March 23, 2010 and the Health Care and Education Reconciliation Act of 2010 on March 30, 2010; and

WHEREAS, under National Health Reform up to 37,000 Maine small businesses will qualify for tax credits to help make coverage more affordable, provide affordable coverage options for 125,000 Mainers who are uninsured and 40,000 Mainers who purchase health insurance through the individual market; and

WHEREAS, states have an important role to implement many components of National Health Reform, including certain immediate reforms; and

WHEREAS, Maine is uniquely situated to implement National Health Reform due to its history of insurance reform and Dirigo Health Reform efforts in Maine including expanding access to health insurance, improving quality of care, strengthening public health, and reducing cost growth; and

WHEREAS, a coordinated response by the executive branch is important to ensure timely and successful implementation of National Health Reform across all departments and agencies; and

WHEREAS, the Governor’s Office of Health Policy and Finance (GOHPF) was established in January, 2003 by Executive Order 06 FY 02/03 to serve as a focal point on health policy and assure coherent, collaborative cross agency state health policy, maximize Medicaid and other federal programs, and chair the Cabinet Council on Health representing all agencies in state government with health-related responsibilities to assure coordinated policy;

NOW, THEREFORE, I, John E. Baldacci, Governor of the State of Maine, do hereby establish the Health Reform Implementation Steering Committee and direct the following:

To assure ongoing coordination, the GOHPF shall lead the executive branch working with the Health Reform Implementation Steering Committee to implement National Health Reform.

Membership

The Health Reform Implementation Steering Committee shall be comprised of the following permanent members. The Director of the Governor’s Office of Health Policy and Finance shall serve as Chair of the Steering Committee.

• Director, Governor’s Office of Health Policy & Finance

• Commissioner of the Department of Health and Human Services

• Commissioner of the Department of Professional and Financial Regulation

• Superintendent of Insurance

• Executive Director of the Dirigo Health Agency

Other members of the administration may be invited to serve on an as-needed basis with respect to specific issues affecting their scope of responsibility. The Steering Committee shall work with the GOHPF health policy committee of key state agencies to support its mission, and draw membership from any other agency or department of state government as needed.

Duties

The Governor’s Office of Health Policy and Finance, with the Steering Committee, shall work collaboratively with tribal, local and federal governments. The GOHPF will serve as the state liaison with the federal government for health reform implementation.

The Governor’s Office of Health Policy and Finance, with the Health Reform Implementation Steering Committee, shall:

• Advise the Governor and provide coordination and leadership for implementation of federal health reform across all departments and agencies of the executive branch;

• Assure on-going information sharing and coordination of efforts with the Legislative Joint Select Committee on Health Care Reform Opportunities and Implementation;

• Assure broad stakeholder engagement by consulting the Advisory Council on Health Systems Development to ensure open dialogue and to further the success of health reform implementation; and

• Ensure the State Health Plan is consistent with on-going implementation efforts, which must include a chapter outlining issues and options for National Health Reform implementation.

The Governor’s Office of Health Policy and Finance, with the Health Reform Implementation Steering Committee, shall immediately:

• Conduct an in-depth analysis of the new federal legislation;

• Identify the steps necessary to produce an implementation plan;

• Develop a plan to pursue funds pursuant to the national temporary high risk pool to maximize affordable coverage options for Maine citizens;

• Plan for the creation of the State Health Exchange; and

• Plan for the implementation of all other components of National Health Reform, including specific action steps, timelines, and assignment of lead responsibility.

The Advisory Council on Health Systems Development will serve as the advisory stakeholder group to the Steering Committee and shall assist in developing the analysis and implementation process required by this Executive Order.

The GOHPF may seek external funding and the aid of advisory panels as appropriate.

Reporting

The Governor’s Office of Health Policy and Finance shall report monthly to the Governor on the Steering Committee’s implementation efforts beginning May, 2010.

Effective Date

The effective date of this Executive Order is April 22, 2010.

John E. Baldacci, Governor

Towards the end of the session, the legislature passed an order creating a similar committee:

Joint Order Establishing a Joint Select Committee on Health Care Reform Opportunities and Implementation

ORDERED, the Senate concurring, that the Joint Select Committee on Health Care Reform Opportunities and Implementation is established as follows.

1. Joint Select Committee on Health Care Reform Opportunities and Implementation established. The Joint Select Committee on Health Care Reform Opportunities and Implementation, referred to in this order as "the committee," is established.

2. Membership. Notwithstanding Joint Rule 353, section 5, the committee consists of 17 members, appointed as follows:

A. Five members of the Senate appointed by the President of the Senate, including members from each of the 2 parties holding the largest number of seats in the Legislature and with preference to members of the Joint Standing Committee on Insurance and Financial Services, Joint Standing Committee on Health and Human Services and Joint Standing Committee on Appropriations and Financial Affairs; and

B. Twelve members of the House of Representatives appointed by the Speaker of the House, including members from each of the 2 parties holding the largest number of seats in the Legislature and with preference to members of the Joint Standing Committee on Insurance and Financial Services, Joint Standing Committee on Health and Human Services and Joint Standing Committee on Appropriations and Financial Affairs.

3. Committee chairs. The first-named Senator is the Senate chair of the committee and the first-named member of the House is the House chair of the committee.

4. Appointments; convening of committee. All appointments must be made by May 20, 2010. The appointing authorities shall notify the Executive Director of the Legislative Council once all appointments have been made. When the appointment of all members has been completed, the chairs of the committee shall call and convene the first meeting of the committee, which may not be held before May 20, 2010. If by May 20, 2010 a majority but not all appointments have been made, the chairs may request authority and the Legislative Council may grant authority for the committee to meet and conduct its business.

5. Duties. The committee shall study any federal health care reform legislation enacted by the United States Congress and determine the State's opportunities for health care reform and the State's role in implementation of federal legislation. In examining these issues, the committee shall consider:

A. The impact of federal legislation on existing state law and programs that provide access to health care to residents of this State;

B. The role of the State in the implementation and oversight of a health insurance exchange;

C. The opportunity for the State to conduct pilot projects, including, but not limited to, pilot projects related to cost containment, payment reform, use of health care technology or health care coverage, with federal funding;

D. The impact of federal legislation on the State's MaineCare program;

E. How federal legislation affects the ability of the State to adopt a system of universal health care through a single-payer plan or other mechanism, including the use of Medicare, MaineCare and other state money to provide funding for universal health care in the State; and

F. Any other issue related to implementation of the federal legislation.

If federal legislation is not enacted, the committee shall consider any other issue related to the State's options for health care reform.

6. Consultation with stakeholders. The committee shall consult with stakeholders including the Governor's Office of Health Policy and Finance; the Department of Health and Human Services; the Department of Professional and Financial Regulation, Bureau of Insurance; health insurance companies; hospitals; health care providers; business and labor representatives; and advocates for health care reform.

7. Staff assistance. The Legislative Council shall provide necessary staffing services to the committee.

8. Report. No later than November 3, 2010, the committee shall submit a report that includes its findings and recommendations, including suggested legislation, to the First Regular Session of the 125th Legislature.

It is expected that the executive and legislative groups will work collaboratively on this significant implementation effort. [return to top]

AMA and MMA Collaborate on Climate Change and Human Health for Clinicians on May 20th

Public Health Forum on Climate Change and Human Health For Clinicians

May 20th                                                                                                                                                                                   8:30am-11:30am                                                                                                                                                                   Holiday Inn by the Bay, Portland, Maine                                                                                                                         Limited to 50 attendees  (There is no registration fee)                             

The earth's climate is in the midst of significant change and with it comes the impact upon human health.  Increased respiratory allergies, asthma attacks, days lost from work due to respiratory disease, emergency room visits, hospitalization rates, and mortality are all symptoms of climate changes.

Physicians, Physician Assistants, Nurse Practitioners and Nurses are being called upon to increase their involvement in educational efforts on the impending health problems due to climate change and the adaptive and mitigating actions that can be taken in the public health policy arena. 

A limited number of seats (50) are available for clinicians to attend this forum that will address the scientific underpinnings of climate change and identify human health effects and implications for public health.

Expert Faculty to include:

Paul R. Epstein, MD, MPH, Associate Director Harvard Center for Global Health and the Environment.  Dr. Epstein received recognition for his contributions on the work of the Intergovernmental Panel on Climate Change (IPCC), awarded the Nobel Peace Prize in 2007.

Paul A. Mayewski, PhD, Explorer and Scientist Director & Professor, The Climate Change Institute, University of Maine.  Dr. Mayewski has developed integrated understanding of multiple controls on climate and unique role of human impact, demonstrated associations between climate and disruptions to civilization.

The program will conclude with a reactor panel of experts to facilitate an in-depth discussion with attendees.

To register, email kmiller@mainemed.com and indicate in the subject line that you would like to register for the Climate Change Forum on May 20th.  When your registration is received, a detailed agenda with directions will be sent to you via email prior to the forum.

This forum will provide 2.0 hours of CME and CEU credits.

The American Medical Association is sponsoring only three Climate Change forums across the country on Climate Change and this program is one of the three. [return to top]

MMA Presents 19th Annual Practice Education Seminar on May 19, in Augusta

MMA will present its 19th Annual Practice Education Seminar on Wednesday, May 19th at the Augusta Civic Cemter.  The program runs from 8:30am to 4:15pm  and is designed to prepare practice managers and physicians for the challenges ahead and to inform them of the major issues and trends in practice in the state.  This year, there are three panels addressing the question of what is expected today of physicians, from the viewpoint of patients, seniors, regulators, legislators and employers/businesses.  David Howes, M.D., President of Martin's Point Health Care will present the keynote address and Kurt Mosely of Merritt Hawkins will discuss the recent nationwide survey of physicians.  Breakout sessions will include the topics of the new medicinal marijuana law and other legislative highlights from the 124th Legislature, recently adjourned.  There will also be updates from MaineCare and Medicare.  Finally, a luncheon program will feature an explanation of those aspects of the new federal reform law that will impact most significantly on Maine physicians.

Registration is available on the MMA website at www.mainemed.com,  For further information or to receive the brochure containing the updated schedule of talks, call the MMA office at 622-3374 and ask for Maureen  (ext. 219) or Gail Begin (ext. 210) or e-mail Gail at gbegin@mainemed.com.

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Medical Mutual Insurance Company of Maine Announces Favorable Rate Adjustments

Medical Mutual Insurance Company of Maine President & CEO Terrance J. Sheehan, M.D. recently has sent a letter to the company's insureds announcing rate adjustments approved by the Maine Bureau of Insurance effective June 1, 2010.  The new rates include a base rate reduction of 5%.  With the addition of a 7% credit derived from a recent dividend, most MMICOM-insured physicians should see an approximate 12% reduction in premium.  The company cited continued favorable loss trends attributable at least in part to physicians' commitment to "sound risk management principles" and "best practices every day."

MMA exclusively endorses Medical Mutual as the medical liability insurance carrier of choice for its members. [return to top]

AMA Meets with Secretary Sebelius on EHR Incentive Program

The AMA recently met with DHHS Secretary Kathleen Sebelius to make her personally aware of the significant  concerns physicians have with eligibility requirements CMS is proposing for incentives to purchase and use EHRs.  David Blumenthal, M.D., Director of the Office of the National Coordinator (ONC), and Marilyn Tavenner, CMS' new Principal Deputy Administrator, also participated in the meeting.  During the meeting, Joseph Heyman, M.D., the AMA's Immediate Past Chairman of the Board, reiterated the AMA's support for wide-spread health IT adoption.  He explained, however, that the AMA is deeply concerned that the pending CMS meaningful use regulation will set the bar too high for the initial stage of the incentive program, which could deter many physicians from participating and hamper the launch of the program.  AMA representatives highlighted several specific concerns raised in a comment letter signed by the AMA and 95 state and specialty medical societies. 

For more details on the AMA's advocacy efforts on health IT issues, please visit http://www.ama-assn.org/ama/pub/advocacy/current-topics-advocacy/practice-management/medicare-physician-payment-reform-regulatory-relief/federal-reg-advocacy-efforts.shtml.  Select "Health IT/EHR Incentives." [return to top]

Medicare Advantage Fraud Training Requirement Lifted

In response to a joint comment letter from the AMA and state medical societies, CMS has agreed to lift the requirement that physicians and suppliers enrolled in the Medicare program obtain fraud, waste, and abuse compliance training from Medicare Advantage plans.  The regulatory change was included in a final regulation on Medicare Advantage and Part D that was published in the April 15th Federal Register.  The final rule modifies some of the requirements for Medicare Advantage and Part D prescription drug plans that will be offered in the 2011 plan year. [return to top]

AMA Describes Taxes & Credits in Health Care Reform Law

The Patient Protection and Affordable Care Act—health system reform legislation signed into law by President Obama on March 23—contains a number of key provisions for you and your patients. Some provisions may have an immediate impact on your practice and patients, while others will not take effect for some time.

Given the new direction for the nation's health system, the AMA has developed Health System Reform Insight to help you understand the new law and how it will affect you, when certain provisions are scheduled to take effect, how you can be ready when the regulations go into effect and what your patients need to know.

Past editions have explained how health system reform will affect physician practices, your patients (PDF) and average Medicare payment rates (PDF), and provided descriptions of Medicare savings (PDF) under health reform legislation for different provider category groups. Today we'll explain key provisions in the new health reform law, including tax credits and changes (PDF), that may affect physicians and their practices.

Taxes and credits in the health system reform law
The Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, is paid for through taxes and fees on the health care sector and employers, as well as through additional taxes on upper-income individuals. These and other tax changes, including tax credits for small business owners, will affect physicians as employers and as individual taxpayers. Below is a snapshot of key provisions in the new law that may affect physicians and their practices.

Provisions affecting the health care sector

• 40 percent excise tax ("Cadillac" tax) on high-cost health plans—Beginning in 2018, an excise tax will be imposed on the coverage provider (i.e., insurer, plan administrator or employer depending on the type of coverage) of high-cost employer-sponsored health plans with aggregate values exceeding $10,200 for individual coverage and $27,500 for family coverage. The tax is equal to 40 percent of the value of the plan that exceeds these threshold amounts. For insured plans, the coverage provider will be the health insurance issuer; for self-insured plans, the coverage provider will generally be the plan administrator. Employers that make contributions to a health savings account (HSA) or medical savings account (MSA) must pay the excise tax if those contributions exceed the thresholds. The tax is not imposed on the individual enrollee. The dollar thresholds are indexed to inflation.
• Annual fee on health insurance providers—Beginning in 2014, a fee will be applied on net premiums of all health insurers based on their market share. For non-profit insurers, only 50 percent of net premiums will be taken into account in calculating the fee. Exemptions are granted for: non-profit plans that receive more than 80 percent of their income from government programs targeting low-income or elderly populations, or people with disabilities; voluntary employees' beneficiary associations (VEBAs) not established by an employer; certain nonprofit insurers with medical loss ratios within specific limits; and self-insured plans and federal, state or other government entities. (The fee does apply to companies that underwrite government-funded insurance, such as Medicaid managed care plans and the Federal Employee Health Benefits Program.)
• Annual fee on pharmaceutical companies and medical device manufacturers—New annual fees on certain manufacturers and importers of branded prescription drugs (including biological products, but excluding orphan drugs) would be imposed beginning in 2011 based on annual sales and set to reach a certain revenue target each year. Beginning in 2013, an annual excise tax of 2.3 percent will also be imposed on the sale of Class I medical devices by manufacturers, producers or importers. Class I includes the vast majority of orthotics and prosthetics, as well as durable medical equipment. Exemptions are provided for eyeglasses, contact lenses, hearing aids and any device that is generally purchased at retail for individual use.
• Excise tax on indoor tanning services—Effective July 1, 2010, an excise tax of 10 percent will be imposed on the amount paid for indoor tanning services.

Provisions affecting employers

Employer penalties and subsidies

• Penalties on larger employers—Employers with more than 50 full-time employees that do not offer coverage and have at least one full-time employee who obtains coverage through an exchange and qualifies for an individual premium tax credit or cost-sharing subsidy (e.g., individuals with income between 100 percent and 400 percent of the federal poverty level; the poverty level in 2010 is $18,310 for a family of three) will be assessed penalties beginning in 2014. The penalty amounts to $2,000 multiplied by the number of full-time employees in excess of 30. If an employer offers coverage but has at least one employee who is entitled to a premium tax credit because the employer's plan is too costly, the penalty is $3,000 for each employee receiving a credit or $2,000 for each full-time employee, whichever is less. Employers of 50 or less, which include the vast majority of physician practices, are exempt from the requirement to provide coverage.
• Subsidies for small businesses—Small business tax credits will be available to employers with 25 or fewer employees with average annual wages below $50,000 if they purchase health insurance for their employees. (This tax credit is separate and distinct from the individual tax credit that low-income individuals may be eligible to receive if they purchase insurance through an exchange.) For tax years 2010 through 2013, the tax credit can be up to 35 percent of the employer's contribution toward the premium, provided the employer contributes at least 50 percent of the total premium cost. The full 35 percent credit will be available to employers of 10 or less with average annual wages below $25,000. The credit phases out as firm size and average wage increase. In tax years 2014 and later, for eligible small businesses purchasing coverage through the state exchanges, the tax credit increases to 50 percent of the employer's contribution toward the premium, provided it is at least 50 percent of the total premium cost. The credit will be available for two years. The full credit will be available to employers of 10 or fewer with average annual wages of less than $25,000. According to the IRS, the wages and hours of physician business owners and partners will not be counted in calculating either the number of full-time employees or the average annual wages.

Limitations on employer deductions

• Expenses allocable to Medicare Part D subsidy—Effective 2013, employers that currently sponsor retiree prescription drug plans will no longer be able to deduct amounts contributed to them. However, future Medicare Part D subsidies will continue to be tax-free to the employer.
• Limitation on excessive health insurance company compensation—Effective 2013, the deduction for executive and employee compensation for health insurance providers is limited to $500,000 per applicable individual. The limit applies to all officers, employees, directors and other workers.

Provisions affecting individuals

• Tax penalties for failure to obtain health insurance coverage—Individuals must obtain minimum essential coverage for themselves and their dependents, effective 2014, with certain exemptions (i.e., hardship, religious reasons). Those without coverage will pay a tax penalty of the greater of $695 per year up to a maximum of three times that amount ($2,085) per family, or 2.5 percent of household income. The penalty will be phased in according to the following schedule: $95 in 2014, $325 in 2015, and $695 in 2016 for the flat fee; or 1.0 percent of taxable income in 2014, 2.0 percent in 2015, and 2.5 percent in 2016.
• Medicare payroll tax—Effective 2013, the hospital insurance (Medicare Part A) payroll tax will increase by 0.9 percent on high-income workers earning more than $200,000 and joint filers earning more than $250,000. In addition, a 3.8 percent Medicare tax will be imposed on net investment income from interest, dividends, annuities, royalties, rents and taxable net gain for these same individuals. This tax is not indexed for inflation.
• Itemized deductions for medical expenses—Effective 2013, the threshold for claiming the itemized tax deduction for unreimbursed medical expenses will increase from 7.5 percent to 10 percent for taxpayers under 65. The increased threshold applies to individuals 65 years and older in 2017.
• Flexible savings accounts (FSAs)—Effective 2013, contributions to FSAs are capped at $2,500.
• HSAs—Effective 2011, the tax on distributions from an HSA or Archer MSA that are not used for qualified medical expenses is raised to 20 percent. Also effective 2011, the cost of over-the-counter medicines may not be reimbursed through an FSA, HSA, Archer MSA, or Health Reimbursement Arrangements, unless obtained with a prescription.
• Health professionals state loan repayment tax relief—Payments made under any state loan repayment or loan forgiveness program that is intended to provide for the increased availability of health care services in underserved or health professional shortage areas will be excluded from gross income.

Governor Issues Executive Order Establishing Office of the State Coordinator for HIT

On April 6th, Governor Baldacci signed an Executive Order creating the Office of the State Coordinator for Health Information Technology (OSC) within the Governor's Office of Health Policy & Finance and the Health Information Technology Steering Committee.  The Steering Committee will serve in an advisory role as the State pursues compliance with federal HIT compliance requirements.  You can find the Executive Order on the web at:  http://www.maine.gov/tools/whatsnew/index.php?topic=Portal+News&id=95308&v=article-2008.  Jim Leonard is the Director of the Office of the State Coordinator for HIT. 

Also, a working group involving the Governor's Office of Health Policy & Finance, the OSC, HealthInfoNet, and consultants has drafted and submitted to the Office of the National Coordinator, the Maine Statewide Health Information Exchange Strategic & Operational Plans.  This document is required for states to obtain certain HIT funding and Maine apparently is one of the first states to submit it.  You can find the plan on the Governor's Office of Health Policy & Finance web site:  http://www.maine.gov/governor/baldacci/cabinet/health_policy.html.

On Thursday, April 22nd, the OSC hosted a meeting of HIT stakeholders to discuss the latest developments in these HIT efforts and to solicit public comment on the HIT plan.  All participants acknowledged that the plan will continue to evolve and public comment is welcome throughout the implementation process.  If you do review the plan and would like to provide feedback, please contact Gordon Smith, EVP (gsmith@mainemed.com; 622-3374, ext. 212) or Andrew MacLean, Deputy EVP (amaclean@mainemed.com; 622-3374, ext. 214). [return to top]

Advisory Council on Health Systems Development Discusses National Health Care Reform's initial assessment of impact and opportunities for Maine

On Friday, April 23^rd the Advisory Council on Health Systems Development discussed the federal healthcare reform law  and assessed its initial impact on the state and the potential opportunities it presents.

Robert Seifert, Center for Health Law & Economics, University of Massachusetts Medical School, and Trish Riley presented information on the initial assessment of impact and opportunities for Maine.  They presented key aspects of the law, starting out with the comparison of ME health care today and in 2014; how health reform is funded; enhanced federal support to ME through health reform, along with the chronology of implementation, the implementation process and the integration with the state of Maine’s State Health Plan.  They quickly indicated that Maine’s implementation infrastructure is already in place with the Governor’s Office of Health Policy & Finance, the implementation of the Steering Committee, the Health Policy Committee and state agencies, the Advisory Council on Health Systems Development and stakeholders, through Dirigo and the subsidies & HRSA Voucher program and also working with the newly enacted Joint Select Committee on Health Reform Opportunities and Implementation.  For more information, go to http://www.mainelegislature.org/legis/bills/display_ps.asp?snum=124&paper=HP1262&PID=1456

For a copy of the powerpoint presentation, download a copy at www.maine.gov/gohpf.   Council members expressed an interest to work with the appropriate team to develop a tool to assist all stakeholders in navigating the new health care reform legislation, the implementation timelines, understanding the roles of the State Exchange for purchase of coverage for individuals and small businesses.  The Maine Medical Association was represented at the meeting by Council Members Lani Graham, MD and Maroulla Gleaton, MD

The impact of the new law on physician practices in Maine will also be one of the primary topics at the upcoming Practice Education Seminar on May 19th at the Augusta Civic Center (see article in this issue of the Update giving more details on the Seminar).  . [return to top]

First Fridays Program on May 7th Features Risk Management

The next MMA First Fridays seminar on Friday, May 7th from 9:00 a.m. to noon features two experienced risk managers from Medical Mutual Insurance Company of Maine speaking about two important aspects of risk management in the physician office. 

• Sue Boisvert, B.S.N., M.H.S.A., Senior Risk Manager will offer a presentation entitled, Workplace Violence:  Are You Prepared? 
• Nancy Brandow, M.S., Senior Risk Manager will follow with a presentation entitled, Telephone Triage Tips to Reduce Risk and Improve Patient Safety.

Registration is available on the MMA web site at:  http://www.mainemed.com/.

You also may participate by WebEx.

For more information, please contact Maureen Elwell at MMA by phone at 622-3374, ext. 219 or by email at melwell@mainemed.com. [return to top]

REMINDER: Your Participation in MaineCare Survey Critical to HIT Incentives

The ARRA Health Information Technology Act (HITECH) provides Medicaid incentive funding for providers adopting, implementing, or updating electronic health records and health information technology.

Physicians, physician organizations, and qualified professionals may be eligible for funding up to $63,750 per professional over a five year period.  Ongoing funding requires that providers demonstrate “meaningful use” of HIT as defined by CMS.  Physicians may be eligible for either Medicare or Medicaid funding but may not participate in both.  Hospitals are also eligible for Medicaid HIT funding but hospital employed physicians are not.  The pertinent CMS rulemaking can be found at http://www.cms.hhs.gov/Recovery/Downloads/CMS-2009-0117-0002.pdf.  Physician practice organizations are eligible for funding for up to ten providers.

Similar incentives will be administered by Medicare.  Hospitals are eligible to receive both Medicare and Medicaid funding, while physicians eligible for both Medicare and Medicaid funding must choose which program to participate in. 

MaineCare is in the planning phase of HIT incentives.  CMS requires Medicaid agencies to assess the current state of technology development in the provider community and to create a vision for the future (2015) state of HIT/HIE in Maine.  The State will use an electronic survey tool administered by the Muskie Institute to compile the assessment of current technology.

It is very important that every physician, whether eligible or not, participates in the survey.  The survey is not an application for funding, but a tool to assess the “as is” state as required by CMS. 

Funding to providers will begin in January of 2011.  The implementation phase of the project including provider funding applications begins next fall.

By now, you should have received an email containing the survey link.

We look forward to working with you on the HITECH funding.

If you have any questions, please contact Dawn Gallagher by phone at (207)287-9366 or by email at dawn.r.gallagher@maine.gov.

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