June 7, 2010

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Congress Returns to Washington Today; Senate Has a Week to Address Medicare SGR Payment Issue

MMA Executive Committee members expressed increasing frustration with the lack of action by Congress on the Medicare physician payment issue during their meeting last Wednesday.  Maine would be disproportionately affected by Medicare payment cuts.  MMA members should urge Senators Snowe and Collins to push colleagues for bipartisan resolution to this problem before it becomes a crisis!

Just before the Memorial Day holiday weekend, 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 produced by the sustainable growth rate (SGR) formula for 19 months.  In lieu of the 21% cut originally scheduled for 2010, the House-passed 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 taking effect that year.

The SGR provisions were voted on separately from the rest of the legislation, passing on a bipartisan vote of 245 to 171.

The Senate adjourned for the holiday weekend prior to the House action, so the Senate will first have an opportunity to take up the legislation when it returns today, Monday, June 7th.  This represents the third time in 2010 that Congress has missed a deadline, causing a Medicare payment cut to take effect.  As was previously the case, CMS has instructed its carriers to hold Medicare claims for services provided on or after June 1st for 10 business days, until June 14th, which should provide sufficient time for Congress to stop implementation of the cut retroactively.

Last week, the AMA launched a major SGR ad campaign aimed at the U.S. Senate.  You can find materials related to the ad campaign and the advocacy campaign on the SGR issue, including the likely impact on Maine, on the AMA web site at:  http://www.ama-assn.org/ama/pub/advocacy/current-topics-advocacy/practice-management/medicare-physician-payment-reform-regulatory-relief/fix-medicare-now.shtml.

Physicians are encouraged to contact Congress to explain how its mismanagement of the Medicare program is wreaking havoc on their practices.  They should use the AMA grassroots hotline at 1-800-833-6354, or send an email via:  http://www.capwiz.com/ama/issues/alert/?alertid=15086046&type=CO.


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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Draft State Health Plan Released; Public Hearings Scheduled on Wednesday

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 most recent meeting.  Public hearings are June 9th in the morning in Portland and in the afternoon in Augusta. The hearing in Augusta begins at 2:00 p.m. in room 209 of the Cross Office Building attached to the State House.  Representatives of MMA will attend the hearing. [return to top]

Aroostook County Medical Society to Meet on Wednesday Evening in Presque Isle

The Aroostook County Medical Society will meet this coming Wednesday evening at 6:00 p.m. at the Cafe Expresso on Main Steet in Presque Isle.  Gordon Smith, Esq., EVP of the MMA will attend and discuss current issues of interest to physicians in the County.  In addition, the members attending will discuss the future of the Society.  If no leadership comes forward to serve the society in the coming months, dissolution of the society will be considered.

Members interested in attending should contact Carole St. Pierre-Engels, M.D. at cengels@maine.rr.com. [return to top]

MMA Public Health Committee Meets Wednesday, June 9th, at MMA

MMA's Committee on Public Health will hold its regular meeting on this coming Wednesday, June 9th, at the offices of the Association in the Frank O. Stred Building in Manchester.  The meeting will begin at 4:00 p.m. and will conclude by 6:00 p.m.  Norma Dreyfus, M.D. and Lani Graham, M.D., M.P.H. serve as co-chairs of the committee.

To review an agenda of the committee or to RSVP, please contact committee staff Kellie Miller at kmiller@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; and
  • 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]

AMA & Specialties Comment on E-Prescribing for Controlled Substances

The AMA together with 32 specialty societies submitted a letter to the Drug Enforcement Agency (DEA) in response to an Interim Final Rule (IFR) on e-prescribing for controlled substances published on March 31st.  The IFR specifies the rules that physicians and other health care providers will need to follow in order to electronically prescribe controlled substances.  E-prescribing for controlled substances remains optional for physicians.  For those physicians who would like to prescribe controlled substances electronically, the DEA requires physicians to use two of the following three methods to authenticate their prescriptions: 

  1. Password;
  2. Biometric (i.e., thumbprint); and
  3. Hard token (i.e., USB drive).

While the DEA made a number of positive changes in the final rule, physician organizations remain concerned that physicians will find some of the requirements too burdensome and will be forced to implement two distinct workflows for e-prescribing (one for controlled and another for non-controlled substances).  The letter also encourages CMS to retain flexibility in the new electronic health record (EHR) incentive program to allow physicians to select the method for prescribing controlled substances that best meets their needs and retains the best accesss to care for their patients. 

The comment letter and a fact sheet are available at:  http://www.ama-assn.org/ama1/pub/upload/mm/399/dea-comments-letter-may2010.pdf. [return to top]

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]

Shortage of General Surgeons in Rural Maine Discussed at ACS Meeting in Kennebunkport

The Maine Chapter of the American College of Surgeons met in Kennebunkport this past weekend.  On Friday, June 4th, attendees were presented with information on the problem of the pressures on general surgery in rural areas.   Healthcare consultant Jonathan Sprague opened the day-long program with an overview of the problem.  Ralph Gabarro, President of Mayo Regional Hospital in Dover-Foxcroft, presented the perspective of a rural hospital and Gordon Smith of MMA presented an environmental scan of the current circumstances in the state putting pressure on general surgery.

General surgeons from other states offered some solutions to the problem and all of the speakers participated in an hour-long panel at the conclusion of the plenary session.

Rodney Lahren, M.D., FACS of Fort Kent serves as President of the Chapter and M. Parker Roberts, M.D. of Portland serves as Secretary-Treasurer and organized the meeting which attracted surgeons from across the state.  Clinical talks were presented on Saturday and Sunday morning.

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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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Vote on Primary Election Day, Tuesday, June 8th

MMA members and their families are encouraged to take the time to vote in Maine's primary election tomorrow.  There are active primaries in each political party for the office of Governor, several contested legislative races, and referendum questions and bond issues to be voted upon.

Regardless of whom you vote for, it is important to vote and express your private opinion as to who should lead Maine in the future.  In most communities, independent voters can enroll in a party on election day and vote in that party's primary.

Legislators and the Governor can exert enormous influence on medicine in Maine.  Tuesday is the time for you to express your opinion on who you would like to see make these decisions.

Following the primary election, MMA's political action committee, the Maine Physicians Action Fund will become active and the trustees will meet and consider endorsements and contributions in the general election.  MMA members are encouraged to provide input into these important decisions.  They may do so by communicating with Andy MacLean or Gordon Smith at MMA (amaclean@mainemed.com and gsmith@mainemed.com respectively.

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RUC Recommendations to CMS for 2011 Medicare Physician Payment Schedule

On May 27, 2010, the AMA/Specialty Society RVS Update Committee (RUC) submitted recommendations to CMS for the 2011 Medicare Physician Payment Schedule.  These relative value recommendations relate to 204 new and revised CPT codes, most originating from the current process to identify misvalued services within the Resource-Based Relative Value Scale (RBRVS).  The RUC submitted recommendations for an additional 88 services that did not first require CPT clarification or nomenclature changes.  CMS will publish information regarding the review of these 292 recommendations on November 1, 2010, for implementation on January 1, 2011. [return to top]

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