May 31, 2010

 
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House Passes Short-Term SGR Relief; Senate Recessed Prior to House Action; CMS to Hold Claims Again

On Friday afternoon, May 28th, the House passed an amended version of H.R. 4213, the American Jobs & Closing Tax Loopholes Act of 2010, which includes provisions to suspend Medicare physician payment cuts according to the sustainable growth rate (SGR) formula for 19 months.  In place of the 21% cut originally scheduled for 2010, the House proposal would implement a 2.2% payment update for the remainder of this year, and a 1% payment update for 2011.  In 2012,  the SGR formula will resume, with an estimated 33% payment cut effective in that year.  The SGR provisions were voted on separately from the rest of the legislation, passing on a bipartisan vote of 245 to 171.  Both Congressman Michaud and Congresswoman Pingree voted for the the measure. 

The overall price tag for the House bill was reduced in response to concerns expressed by members of the Blue Dog Coalition, who objected to federal deficit increases that would have been produced by previous versions of the bill. 

With respect to the Senate, Majority Leader Harry Reid announced last Thursday night that there would be insufficient time following House action on H.R. 4213 to complete Senate consideration of the bill before Memorial Day.  As a result, the Senate adjourned and the 21% Medicare physician payment cut scheduled for 2010, which has been postponed three times already, will technically take effect on June 1.  The Centers for Medicare & Medicaid Services (CMS) already issued instructions to its contractors to postpone processing claims for Medicare physician services provided on or after June 1 for 10 days to provide time for Congress to complete its action and overturn the scheduled cut retroactive to June 1.  The Senate will have to act some time between its return from the recess on June 7th and the end of the CMS claims hold on June 14th.

Following is a press statement issued by Dr. Rohack after the Senate announcement.

 

FOR IMMEDIATE RELEASE                                            May 27, 2010

SENATE TURNS ITS BACK ON SENIORS AND MILITARY FAMILIES

Senators Leave for Vacation, Allowing Medicare Meltdown to Begin June 1

Statement Attributable to:       J. James Rohack, M.D.

                                                President, American Medical Association

The Senate has turned its back on seniors, and America’s physicians are outraged that Congress has deserted patients by failing to address this year’s Medicare cut before the June 1 deadline.  Senators are more interested in heading home for the holiday than in preventing a Medicare meltdown for seniors.  The 21 percent Medicare physician payment cut has been looming all year, and yet all Congress has managed to do is repeated short-term delays.  This is complete mismanagement of a health care program that America’s seniors and the disabled rely on.  Already, about one in four Medicare patients looking for a new primary care physician have trouble finding one, and congressional inaction will make it much worse.

“It is sad and ironic as we enter the Memorial Day holiday that Congress’ inaction on the 21 percent cut puts health care for America’s military heroes and their families at risk. TRICARE, the health care program for military families ties its payment rates to Medicare.

“Enough is enough: nine times in eight years Congress has delayed the cut and not fixed the problem.  Congress needs to buckle down, stop growing the problem and fix it once and for all to save the Medicare and TRICARE programs for America’s seniors and military families.” 

Physicians and patients must let their Representatives and Senators know that enough is enough—Congress is wreaking havoc on the Medicare program and physician practices across the country!   Make your voice heard during the Memorial Day Recess! 

You can help with 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/.

Also, the AMA is conducting a survey on the SGR problem and the MMA encourages you to follow this link for more information about the survey and how to access it:  http://www.ama-assn.org/ama/pub/advocacy/current-topics-advocacy/practice-management/medicare-physician-payment-reform-regulatory-relief/medicare-sgr-survey.shtml.

 

 

Once Again, FTC Delays "Red Flags" Rule Compliance Deadline - now to 12/31/10

At the request of several members of Congress, the Federal Trade Commission (FTC) has delayed the compliance deadline for its controversial "red flags" rule on identity theft until December 31, 2010.  The delay will give Congress time to consider legislation on the entities subject to the rule.  The FTC has delayed the compliance deadline several times from the original November 1, 2008 deadline.  You can read the FTC's announcement on the web at:  http://www.ftc.gov/opa/2010/05/redflags.shtm.

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Robert McAfee, M.D. to be Honored Wednesday Night as Recipient of Annual Edmund S. Muskie Justice Award

Former MMA and AMA President Robert E. McAfee, M.D. of Portland will be honored this coming Wednesday evening at the annual Edmund S. Muskie Justice Award Dinner at the Holiday Inn by the Bay in Portland.  Dr. McAfee is being recognized for his tireless efforts to combat family violence.  Over four hundred persons are expected to attend the event the proceeds of which will benefit six legal aid organizations in the state.

Dr. McAfee, a retired general surgeon and a native of Portland, has been involved in a host of public health activities in the state over the past five decades.  From 2003 until this past Spring, he chaired the Board of the Dirigo Health Agency.  He has also been extensively involved in tobacco control efforts, cancer prevention, and handgun control. 

Dr. McAfee is a graduate of Bates College and Tufts University School of Medicine.  He and his wife, Doris, are the parents of four adult children.  MMA congratulates Dr. McAfee on this unique honor. [return to top]

MMA, MHA, & MOA Join Forces to Present Third Annual Quality Symposium on June 10

The Maine Osteopathic Association, the Maine Medical Association, and the Maine Hospital Association on June 10, 2010 will present the Third Annual Statewide Quality Symposium.  The theme this year is, Using Health Information Technology to Advance Quality:  Through Meaningful Use to Meaningful Improvement

The Symposium this year will precede the MOA's annual meeting at the Samoset Resort in Rockport.  Registration for the Symposium will begin at 8:00 a.m. on the 10th with the program beginning at 8:30 a.m. and concluding at 3:30 p.m.  The Keynote Speaker will be Joshua J. Seidman, Ph.D., Acting Director, Meaningful Use Division, Office of Provider Adoption Support, HHS/ONC.  Also presenting is Don Wright, M.D., M.P.H., Deputy Assistant Secretary for Healthcare Quality.  Dr. Wright will provide an overview of the newly created Office of Healthcare Quality within the federal Department of Health & Human Services.

This year's symposium would be an excellent opportunity for any medical practice that is anticipating moving toward an electronic medical record system in order to receive the financial benefits offered by the federal law.

For more information, contact Angela Westhoff, Executive Director of MOA at 623-1101.  There is a $75 registration fee which covers lunch breaks and all materials.  5.5 hours of CME have been sought for the program.

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June 4th "First Fridays" Program Features Minors' Rights to Health Care Treatment

The MMA's next First Fridays seminar is scheduled for Friday, June 4th from 9:00 a.m. to noon at the MMA office in Manchester and is entitled, Treating Minors in a Primary Care Setting.  The subject of minors' rights to confidential health care treatment is one of the most common areas of question and concern for physicians and their office staff.  The faculty for the program are:

  • Kenneth Lehman, Esq., Chair of the Health Law Practice Group at Bernstein, Shur, Sawyer & Nelson
  • Carol Mansfield, M.D., a physician with Winthrop Pediatrics
  • Andrew MacLean, J.D., Deputy EVP, MMA

This program, which is approved for three hours of category one CME, is designed to provide practical advice for any medical office which provides care to children under the age of 18.  Among the topics explored are the instances in which minors can give consent for their own care and whether full confidentiality can be provided in such instances. 

You can find more information about the program and you may register online on the MMA web site:  http://www.mainemed.com/calendar/details.php?IDMeet=946.  For more information, please contact Maureen Elwell at melwell@mainemed.comor 622-3374, ext. 219.  Registrants for the program can attend in person at the MMA offices in Manchester or participate through webex from their office or home. [return to top]

Draft State Health Plan Released; Public Hearings Scheduled

The draft of the 2010-2012 State Health Plan targets efforts to improve health and health status through expanded primary care and prevention while producing savings by eliminating waste and inefficiency.

“It links evidence-based public health strategies with measurable outcomes to lower the trajectory of health care costs,” according to the plan’s introduction.  “Importantly, it lays out a path and identifies the policy choices now provided Maine through newly enacted national health reform law.”

The plan notes the progress that has been made, since the state started releasing the state health plan, including:

  • Maine improved from the 16th healthiest state in 2003 to the 9th healthiest in 2009.
  • Maine improved from 19th among states in covering the uninsured in 2003, to 6th in 2009.
  • Costs for health insurance premiums have grown more slowly in Maine than in the rest of the United States.
  • In 2003, Maine ranked 12th in the percent of surgical patients receiving the appropriate care to prevent complications; by 2007, Maine ranked 1st.

The plan suggests:

  • Reducing inefficient practices and waste, including:
  • Reducing preventable hospitalizations, emergency room admissions and unnecessary care;
  • Reducing duplicative and unnecessary laboratory tests and advanced imaging;
  • Increasing the number of Maine citizens with a stable relationship with primary care practice;
  • Reducing health care-associated infections; and
  • Improving access to specialist consultations through telemedicine.
  • Strengthening community-based public health and prevention;
  • Paying for what matters, in other words, payment reform;
  • Aligning policies and practices to support primary care and prevention;
  • Guiding the Certificate of Need program to support priority goals.

The plan also discusses workforce challenges, the importance of data and electronic medical records.   

The Advisory Council on Health Systems Development (ACHSD), the primary body advising the Governor's Office of Health Policy & Finance (GOHPF) on the state health plan, reviewed the draft at its meeting last Friday.  Public hearings are June 9th in the morning in Portland and in the afternoon in Augusta. [return to top]

MMA Executive Committee Meets on Wednesday, June 2nd

The MMA Executive Committee meets this coming Wednesday at 2:00 .pm. at the offices of the Association in the Frank O. Stred Building in Manchester.  Priority items for discussion at the meeting include:

  • MMA opportunities in connection with the federal Patient Protection and Affordable Care Act (PPACA). 
  • The failed efforts in the Congress to permanently repeal Medicare's SGR formula and the payment cut taking effect on June 1. 
  • The recently released State Health Plan and the opportunity to provide comments during the public comment period.
  • Resolutions to be considered at the upcoming AMA Annual Meeting in Chicago, June 12-15.

MMA EVP Gordon Smith will update committee members on the status of the efforts to transition the Coding Center activities to Baker, Newman & Noyes where two of the former Coding Center Directors work (Laurie Desjardins, CPC and Jana Purrell, CPC).  He will also update members on the ongoing work of the Medical Professionals Health Program.

MMA President-elect Jo Linder, M.D. will discuss plans for the 157th Annual Session which will be held in Bar Harbor September 10-12, 2010.

The Committee is chaired by Nancy Cummings, M.D., an orthopedic surgeon practicing in Farmington.  Any MMA member is welcome to attend any MMA committee meeting, whether they are a member of the committee or not. 

 

 

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MMA and OSA Team Up for Free CME in Wells on Friday, June 18

The Maine Medical Association and the State Office of Substance Abuse will present Comprehensive Management of Patients with Acute & Chronic Pain While Preventing Diversion, a three hour CME seminar in Wells on Friday, June 18th.  The program will be held from 9:00 a.m. to noon at the Village by the Sea on Rt. 1 (1373 Post Rd.) in Wells.  There is no cost for the program.

Faculty for the program include Mark Publicker, M.D., an addiction specialist and Director of the Recovery Center at Mercy Hospital, Daniel Eccher of the Office of Substance Abuse, and Gordon Smith, Esq., Executive Vice President of the Maine Medical Association.  Dr. Publicker will share best practices in the areas of pain control, addiction treatment, and prevention.  He will also discuss how to manage pain without causing addiction.

Registration materials are available from the MMA office (call 622-3374, ext. 219) or you may register on the MMA website at www.mainemed.com

The program is made possible through a grant by the Maine Office of Substance Abuse. [return to top]

Volunteers Needed for MMA Committees, 2010-2011

Watch for your May-June issue of Maine Medicine which will contain an insert listing the MMA committees and a request for volunteers.  The Committee on Nominations, chaired by Jo Linder, M.D., will be meeting this summer to prepare a report for the Annual Session being held in Bar Harbor September 10-12, 2010.   The Committee would welcome volunteers to serve on the following committees during the MMA election year which runs from September 2010 to September. 2011:

Committee on Legislation

Public Health Committee

Committee on Physician Quality

Committee on Membership and Member Benefits

Committee on Bylaws

Committee on Loan and Trust Administration

Committee on CME and Accreditation

Ad Hoc Committee on Technology

There also are vacancies currently on the Executive Committee from Oxford County, Lincoln-Sagadahoc Counties, and Waldo County. 

Any member interested on serving on a committee or desiring more information on a committee should contact EVP Gordon Smith at 622-3374, ext. 212 or via e-mail to gsmith@mainemed.com.

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MMA Offering CME Programs on HIPAA, the Federal Health Reform Bill (PPACA) and Medicinal Marijuana

MMA is now offering CME presentations on the following topics:

  • HIPAA Update;
  • Treating Chronic Pain While Preventing Diversion of Narcotics (offered in conjunction with the Maine Office of Substance Abuse);
  • Federal Health Care Reform Law
  • Medicinal Marijuana Law

MMA offers these programs to various audiences, including specialty societies, office staff, and other interested groups.  A fee of $200 is normally charged to cover travel and copying costs for the materials.  If your practice or group is interested in a presentation, contact Gail Begin at 622-3374, ext. 210 or via e-mail to gbegin@mainemed.com. [return to top]

Annual Golf Tournament June 7th to Benefit Medical Professionals Health Program

More than 100 golfers have registered to play in MMA's Annual Benefit Golf Tournament being held again this year at the Augusta Country Club in Manchester.  The event will be held on Monday, June 7th, with lunch on the deck beginning at 11:00 a.m. and the golf beginning promptly at noon (shotgun start).  The format for the tournament is a traditional four-person scramble.

Net proceeds from the event will be contributed to the Medical Professionals Health Program which assists physicians, dentists, pharmacists, PA's, and nurses in recovery from substance abuse.

With only a week to go, MMA can handle a few more golfers, but is in more need of sponsors for the event.  The cost to sponsor a hole in the tournament is $500.  If your firm or group practice is interested in sponsorship, please contact either Buell Miller, M.D. at MMA at 622-3374, ext. 228 or Gail Begin at 622-3374, ext. 210.  Items are also being accepted for the raffle which takes place following the tournament.

The tournament chairman is Brian Jumper, M.D.  [return to top]

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