October 4, 2010

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Medicare Cuts Scheduled for December 1, 2010 and January 1, 2011; Congressional Action Needed

The American Medical Association and many national specialty societies asked Congress last week to enact, during its anticipated lame-duck session following the election, legislation that will again postpone the cuts and provide a positive update through 2011.  MMA signed on to the letter and asked Maine's Congressional delegation to support this approach.  The letter may be viewed on the MMA website at http://www.mainemed.com.

The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (P.L. 111-192) stabilized Medicare physician payments only until November 30, 2010.  After that, Medicare payments for physician services will be slashed by more than 23%.  To make matters worse, an additional cut of 6.5% will follow on January 1, 2011.  Physician practices in Maine simply cannot absorb cuts of this magnitude in a program as important as Medicare, particularly in a state with the greatest percentage of seniors in the nation.  Congress must act to break the cycle of forestalling a crisis in patient access to physician care for only a few months at a time, and take action during the upcoming lame-duck session to act on legislation to provide stability and predictability for the program at least through 2011.

Throughout 2010, Congress enacted short-term, stop-gap measures for durations as short as one month.  On three occasions, Congress failed to act in time and Medicare payments were cut by more than 20%.  The Centers for Medicare and Medicaid Services (CMS) reacted by ordering carriers to hold payments until legislation was passed.  Importantly, these steps did not protect physician payments from all the consequences of the repeated Congressional delays.  On the contrary, payment uncertainties and delays were highly disruptive.  Some practices were forced to seek loans to meet payroll expenses, lay off staff, or cancel capital improvements, and investments in electronic health records and other technology.  Furthermore, when payments resumed, many physicians experienced long delays in receiving retroactive adjustments.  This is not the way to manage a program that seniors rely on.

The next payment reduction is scheduled to occur during the period when physicians may change their status from a Medicare participating physician who accepts Medicare's allowance as payment in full to a non-participating physician who may bill patients more than the Medicare allowance.  We can anticipate that many physicians will be examining whether it makes any sense to continue their current relationship with Medicare given the severe disruptions of the past year.

The American Medical Association and many of the national specialty societies wrote to Congress this past week, asking for  a statutory payment update that lasts at least through the end of 2011.  Such action will provide time for Congress and the physician community to develop a long term solution to ensure that seniors can count on finding physicians to care for them, and that physicians will not view Medicare as a threat to the viability of their practice.  Congress was ask asked in the letter, which MMA  joined in, to take action during the first week of its lame-duck session, before the massive cuts take effect yet again.

Please ask Maine's four members of Congress to support at least this temporary solution to the SGR crisis.  You can communicate with Maine's Congressional delegation through the AMA's grassroots action center:  http://capwiz.com/ama/home/.



Next First Friday CME Program November 5th Featuring Medical Records

The next First Friday CME program will be offered at the MMA offices in the Frank O. Stred Building in Manchester (and remotely through Webex) on Friday, November 5, 2010 from 9:00 a.m. to noon.  There is a cost of $65.00 which covers all materials (and breakfast for those attending at the office).  The topic is Medical Records:  Everything you Always Wanted to Know and the faculty will consist of the MMA legal staff members Jessa Barnard, J.D. and Gordon Smith, Esq.  Additional attorneys will cover the topic of the transition from paper to electronic records. 

Specific topics will include how to prepare records, their retention, access to them, and their storage or destruction.

Registration materials will be included with the SeptemberOctober issue of Maine Medicine which should be arriving in members' offices late this week or early the following week.  You may also register on the MMA website at http://www.mainemed.com.

The First Friday sessions for 2011 are currently being planned.  If you have a suggested topic, please contact Gordon Smith at gsmith@mainemed.com or Gail Begin at gbegin@mainemed.com. [return to top]

Bates College Presents CME on African Refugee Health from October 15-17th

Bates College presents a program on African refugee health October 15-17, 2010 on the Bates College Campus.  The program is jointly sponsored by Bates, the Central Maine Medical Family, St. Mary's Health System, and the National Center for Emerging and the Zoonotic Infectious Diseases, Centers for Disease Control & Prevention.  The conference will present best practices in immigrant health care in the medical, nursing, public health, behavioral/mental health, and administrative fields from nationally and internationally recognized experts in these fields.  

You can find registration information for the conference on the web at:  http://www.bates.edu/x221346.xml.

The event begins on Friday evening, October 15th at 6:30 p.m. and concludes on Sunday, October 17th at 12:30 p.m.    There is a registration fee of $200 for physicians and category one CME has been approved.  For more information, contact Brenda Pelletier at bpelleti@bates.edu. [return to top]

Maine's Immunization Rate at 72.3 Percent for Children (2009)

A recent federal report shows Maine had the fourth-highest immunization rate in New England for children younger than three years of age in 2009.  Connecticut and Massachusetts tied for the highest rates in the region and sixth-highest in the country.  The federal Centers for Disease Control and Prevention said 72.3% of young children in Maine were immunized in 2009 against polio, measles, mumps, and other preventable illnesses. 

Among the other New England states, Connecticut, and Massachusetts had an immunization rate of 76%; New Hampshire 73.3%; Rhode Island 69.7%; and Vermont, 59.9%.

It is hoped that the legislation passed earlier this year aimed at making immunizations affordable again in the state will assist in improving the percentage of Maine children receiving the recommended doses of vaccine.  The Governor is expected to name the members of the Maine Vaccine Board shortly.  The Board will oversee the implementation of the new law. [return to top]

International Expert to Lecture on Health Care Reform, October 18th

Dr. William Hsiao, Professor of Economics at the Harvard School of Public Health, architect of Taiwan’s universal health care system, and consultant to the Vermont Legislature’s health care reform initiative, will speak at Bates College on Monday, October 18th at 7:30 p.m. in the Muskie Archives, 70 Campus Avenue, Lewiston.  His topic is “Taiwan’s Health Reforms: Lessons for the U.S. and Maine.” 

Dr. Hsiao is the co-author of Getting Health Reform Right and regularly advises U.S. government agencies, foreign governments and non-governmental organizations, such as the World Bank, UNICEF, and the World Health Organization.  Dr. Hsiao is in Maine to testify before the Maine Legislature’s Joint Select Committee on Healthcare Reform Opportunities & Implementation as the Committee works through the new national health care reform law.

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SAVE THE DATE: Be Part of the Revolution in Payment Practices

Mark your calendars for “Pathways to success:  What physicians need to know about the coming revolution in payment practices,” a seminar scheduled for 10 a.m. to 3 p.m. Eastern time, November 13th, in Concord, N.H. (location TBD).  The seminar will explain how physicians can lead new payment and delivery models, such as accountable care organizations (ACOs) and episode-of-care bundled payments, being tested in Medicare and adopted in the private sector.  Keynote speaker, Harold Miller, executive director of the Center for Healthcare Quality and Payment Reform, and other national and local experts, will explore how physicians can find success with new payment practices.

Watch your inbox for future MMA Weekly Updates with the location and more details on the seminar.

This seminar is an American Medical Association program presented in conjunction with the Maine Medical Association, the New Hampshire Medical Society, and the Vermont Medical Society.

Visit www.ama-assn.org/go/paymentpathways to view other payment resources from the American Medical Association. [return to top]

Know Your Options: Medicare Participation Guide

From mid-November through December 31, physicians will have their annual opportunity to review and perhaps change their participation status with the Medicare program.  Given the severe Medicare payment disruptions caused this year as Congress established, and then missed, multiple deadlines to stop payment cuts caused by the sustainable growth rate (SGR) formula, the AMA is encouraging physicians to prepare for this opportunity and review their options carefully.  To help them choose the direction that is right for their practices, the AMA has developed the “Know your options:  Medicare participation guide.”  This kit contains a detailed explanation of the three available options:  participation (PAR), non-participation (non-PAR), and private contracting.  It also includes a helpful revenue calculator and various sample materials to help physicians share information with current, new, and prospective patients.

The Medicare options kit is accessible to all physicians on-line at http://www.ama-assn.org/go/medicareoptions.

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Maine Receives $1 Million to Plan for Health Insurance Exchanges

On September 30th, the U.S. Department of Health and Human Services (HHS) awarded nearly $49 million to help 48 states and the District of Columbia plan for the establishment of health insurance exchanges.  Maine was awarded $1 million, the maximum amount available. 

A key part of the Affordable Care Act, starting in 2014, state health insurance exchanges will make purchasing health insurance easier by providing eligible consumers and businesses with “one-stop-shopping” where they can compare and purchase health insurance coverage. 

The grants of up to $1 million each will give states the resources they need to conduct the research and planning needed to build a better health insurance marketplace and determine how their exchanges will be operated and governed, including:

  • Assessing current information technology (IT) systems and infrastructure and determining new requirements.

  • Developing partnerships with community organizations to gain public input into the exchange planning process.

  • Planning for consumer call centers to answer questions from their residents.

  • Determining the statutory rules needed to build the exchanges.

  • Hiring key staff and determining ongoing staffing needs.

  • Planning the coordination of eligibility and enrollment systems across Medicaid, the Children’s Health Insurance Program (CHIP), and the exchanges.

  • Developing performance metrics, milestones and ongoing evaluation.

The funds will be administered in Maine by the Governor's Office of Health Policy and Finance.   For more information, visit: http://www.maine.gov/governor/baldacci/cabinet/health_policy.html [return to top]

Regional Extension Center Hosts Regional Forums on EMR Opportunities

The Maine Regional Extension Center, in partnership with Quality Counts, will host a series of free regional forums to educate primary health care providers about electronic medical record systems and new federal and state incentive programs.  The forums will be held in four locations across the state and will specifically target primary care providers and practice staff of small independent practices interested in adopting electronic medical record systems.

For more information on the forums, visit www.hinfonet.org or e-mail rec@hinfonet.org. [return to top]

Athenahealth Offers Webinar on Replacing Your EHR for Better Results on October 13th

Replacing Your EHR for Better Results: Top Tips for Making the Switch

Thursday, October 13, 2010, 12:15 PM EDT

Despite 30 years of availability, electronic health records (EHRs) have failed to live up to expectations. Widespread adoption has been undermined by long and costly implementations, unwieldy formats and high costs. Rather than improve efficiency and productivity in a practice, some EHRs have generated so much frustration that physicians are looking for the exits.

In an effort to overcome these problems and encourage adoption, the federal government is offering physicians up to $44,000 in Medicare incentives for demonstrating “meaningful use” of an EHR. For doctors stuck with an underperforming EHR, this presents financial motivation and a window of opportunity to make the switch to a system that meets practice needs and can guarantee incentives.

Learn how a web-based system can reach beyond just serving as an electronic version of a paper chart and produce tangible results in your practice, providing more money and more control of your workflow. Find out how replacing your current EHR with athenaClinicalsSM can deliver:

•             Quick and easy implementation

•             Smooth data migration

•             Improved workflow

•             Measurable cost savings and ROI

•             Guaranteed HITECH Act incentives

With the guidance provided in this webinar and the accompanying whitepaper, you’ll learn how the right EHR solution can make your practice more competitive by minimizing the huge costs of implementation and maintenance, uncovering and banking new incentive revenue, and removing the burden of clinical paperwork starting on day one. And you’ll leave with key tips and considerations to make switching your EHR system as smooth and seamless as possible.

Join us on Wednesday, October 13th at 12:15 PM ET for a live Webinar, and bring your questions - we’ve set aside plenty of time for Q&A. Register today!


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View Recent Gubernatorial Forum at www.mainemed.com

As part of the Association's recently concluded Annual Session in Bar Harbor, the five gubernatorial candidates all appeared for a 90-minute Public Health Forum.  The candidates each answered six questions prepared by the MMA's Committee on Public Health and made closing statements.  More than 200 people attended the event held at the Bar Harbor Club.  The event was videotaped and is available for viewing on the Association's website at www.mainemed.com.  Click on "Annual Session."

MMA encourages all members to vote on or before November 2nd (absentee ballots are already available in most communities) and further encourages members to be active in their support of candidates of their choice.  If you are interested in a list of legislative candidates that the Maine Physician Action Fund has contributed to, please contact Andrew MacLean, Deputy EVP, at amaclean@mainemed.com.  The Association does not take a position in gubernatorial campaigns.  And, the Fund is not a federal PAC so does not contribute to candidates for Congress, although the PAC trustees do make recommendations to AMPAC, the political action fund of the American Medical Association.



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NHMS Annual Scientific Conference Scheduled for October 15-17

The New Hampshire Medical Society invites Maine physicians to participate in its Annual Scientific Conference scheduled for October 15th to 17th at the Colony Hotel in Kennebunkport.  The topics include:

  • Better Choices:  Better Health Management of Chronic Disease

  • After Bariatric Surgery

  • HIPAA Breaches - Avoiding Pitfalls

  • Sign on the Line:  Pain Management Contracts

  • Management of Concussions

  • Physician Workforce 2010

You will find registration information on the NHMS web site at:  http://www.nhms.org/calendar/2010/10-15-2010.pdf.

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Community-Acquired Pneumonia: latest AMA Therapeutic Insights Online Topic

The latest AMA Therapeutic Insights newsletter has been released and is now available online.  This quarter's (very timely) topic is Community-Acquired Pneumonia and Maine physicians can now access their Personal Prescribing Profiles for this and the other diseases featured in recent newsletters:  Hypertension, HIV, and Alzheimer's Disease.


AMA Therapeutic Insights

  • is free and online

  • highlights one disease condition per issue

  • features individual, state, national prescribing data and evidence-based treatment guidelines

  • is written by top disease experts in collaboration with the AMA

  • offers AMA PRA Category 1 Credit

Look for AMA Therapeutic Insights on the web at:  http://www.ama-assn.org/ama/pub/education-careers/continuing-medical-education/cme-credit-offerings/therapeutic-insights.shtml.

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