October 18, 2010

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Amendments to PMP Rules Set for Public Hearing on November 1st

Several important changes to the rules governing the Controlled Substances Prescription Monitoring Program will be the subject of a public hearing in Augusta on Monday morning, November 1st, beginning at 9:00 a.m.  One of the most significant changes is a proposal to allow the Office of Substance Abuse (OSA), which operates the Program, to review the information in the database on at least a quarterly basis to determine whether there has been questionable activitiy by patients or prescribers.  OSA also is given the authority to refer those cases involving prescribers that merit further investigation to the appropriate licensing board.  The Office would notify the prescriber prior to, or concurrently with, referral to the licensing board.

Section 9 of the proposed amendments to the existing rule, subsection 3, states as follows:

3.  Prescriber Review

     A.  The Office, upon consultation with the Monitor, shall review prescription monitoring information in such a way as to determine if there are any cases that merit investigation of a prescriber by a licensing board.  This review shall be conducted in such a manner as to identify any prescriber who has conducted all of the following:

  • prescribed controlled substances to more than 1000 patients during the six months prior to the review;

  • prescribed to at least one of those patients more than twelve daily doses per day for more than one week during those same six months.

  • prescribed controlled substances in more than one therapeutic category to at least one of those patients: and

  • prescribed to at least one patient who has been to more than one pharmacy in different public health districts within one month.  

     Self-prescribing of controlled substances will also trigger review by the Office.

     B.    As a result of the prescriber review identified in Section 9 (2)(A), the Office may take any or all of the following courses of action on a case by case basis:

  • take no action,

  • contact the prescriber involved for educational intervention,

  • contact any of the patients involved,

  • refer the prescriber involved to the Medical Professional Health Program (MPHP), or its successor program, and/or

  • refer the prescriber to the licensing board as described in Subsection 9(3). 

If the Office determines that referral to the MPHP is merited, but the prescriber in question refuses to enroll in the program within a reasonable timeframe, as determined by the Office, the Office shall refer the case to the appropriate licensing board.

MMA has a number of concerns about the proposed amendments and will discuss an appropriate response at the MMA Executive Committee meeting on October 20th. 

You can find more information about the Prescription Monitoring Program on the web at:  http://www.maine.gov/dhhs/osa/data/pmp/index.htm.


Report on 2010 International Symposium on Safe Medicine

The 2010 International Symposium on Safe Medicine (previously known as the International Symposium on Pharmaceuticals in the Home and Environment) was held in Portland, Maine from October 10-12.  More than 100 individuals from across the country (and some international guests) attended the conference which was designed for medical, health, pharmaceutical, and human service practitioners, educators, policymakers, law enforcement personnel, environmentalists, substance abuse professionals, and others concerned with the human and environmental impact of prescription drugs on individuals and their external environment.

The conference presented sessions on the full range of issues surrounding:

1.  the environmental and social impact of unused prescription drugs stored in homes and flushed or otherwise discarded into the environment;

2.  innovative return and disposal policy and program responses and related environmental issues;

3.  the multitude of issues surrounding the use, misuse, and abuse of prescription drugs with a special focus on benzodiazepines; and

4.  pertinent health, safety, and improved medication prescribing practices and policies.

On Monday morning, the conference opened with welcoming remarks by John Schloss, Ph.D. and Stevan Gressit, M.D., followed by a presentation by Anne H. Jordan, Commissioner of the Maine Department of Public Safety.  Commissioner Jordan highlighted the sobering statistics in Maine concerning prescription drug abuse.  She noted that, once again, in 2009, deaths from accidental overdoses exceeded highway deaths in the state (and in 16 other states).  Prescription drugs were involved in 92% of these deaths.  492 drivers were found impaired by prescription drugs, as opposed to fewer than 50 drivers adversely impacted by cocaine and other illegal drugs.  Even more tragically, 474 babies were born in Maine last year with signs of withdrawal.  There was also a 19% increase in robberies, most of them involving pharmacies. 

Following the Commissioner's presentation, MMA Executive Vice President Gordon H. Smith, Esq., welcomed attendees and shared with them the various efforts taking place in the state to address the problems, noting particularly the pro-active support of the Board of Licensure in Medicine and the Office of Substance Abuse.  Dean Marc Hahn, D.O. of the University of New England College of Osteopathic Medicine followed Mr. Smith's presentation focusing on the current science underlying the problems of addiction and abuse.

In addition to presentations on prescription drug abuse, several presentations during the two-day conference focused on efforts to dispose of medicine safely, including the recent "take-back"  efforts organized by public health advocates and law enforcement personnel.

Concurrent with the conference, the International Institute on Pharmaceutical Safety convened the charter meeting of the International Association of Drug Waste Prevention, Disposal, and Medicine Safety Organizations. 

Conference partners included the University of Maine Center on Aging, the Maine Benzodiazepine Study Group, the University of New England, Husson University, and the International Institute for Pharmaceutical Safety. [return to top]

MMA Executive Committee Meets Wednesday, October 20th

The 28-member Maine Medical Association Executive Committee meets this week on Wednesday, October 20th.  Priority items for the meeting include the Medicare SGR cuts effective December 1st and January 1, 2011, the proposed amendments to rules governing the Prescription Monitoring Program, and MMA's role in quality improvement activities in the state.  Committee members also will share observations about the Annual Session held last month in Bar Harbor.  The meeting will be held in the Frank O. Stred Building in Manchester from 2:00 p.m. to 5:00 p.m.  All MMA committee meetings are open to any MMA member, regardless of whether they are on the committee.

The Committee is chaired this year by Kenneth Christian, M.D., an emergency medicine physician practicing in Ellsworth. [return to top]

ME, NH, & VT Medical Societies Join AMA for Payment Reform Seminar in Concord on November 13th

AMA Pathways to Success:  What physicians need to know about the coming revolution in payment practices

10:00 a.m. – 3:00 p.m., November 13 • Marriott Grappone Conference Center, Concord, N.H.

Attend this dynamic seminar on physician payment and delivery models being tested within Medicare and adopted in the private sector.  Hear from experts who have had success with the new payment models, in accountable care organizations, the medical home and more.  The American Medical Association designates this educational activity for a maximum of 4.0 AMA PRA Category 1 Credits™.

Topics to include: 

  • “Pathways for physician success under healthcare payment and delivery reforms,” Harold Miller, executive director of the Center for Healthcare Quality and Payment Reform, will explore new approaches to physician payment and delivery of care.
  • “Physician leadership in the coming revolution,” AMA Immediate Past President J. James Rohack, MD, will describe the Washington landscape with regard to new federal pilot programs and discuss how physicians can lead in this new payment revolution.
  • “Vermont’s Blueprint for Health and the patient-centered medical home,” Jennifer Gilwee, MD, will discuss Vermont’s Blueprint for Health and its model for a patient-centered medical home and the opportunities and challenges facing primary care physicians.
  • “Moving orthopaedics toward a functioning market in Portland,” Orthopaedic surgeon James D. Kuhn, MD, will discuss a program to make the market for surgical services function more effective by offering warranties and other innovations at the Mercy Joint Replacement Center in Maine.
  • “The New Hampshire Citizens Health Initiative ACO pilot program,” Co-chair of the New Hampshire Citizens Health Initiative, Philip Boulter, MD, will delve into the initiative’s new multipayer ACO pilot project. 

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


$125 for AMA members and their office staff;

$155 for State or specialty society members and their office staff;

$195 for Non-members

[return to top]

Dr. Erik Steele Receives Lung Association Huddilston Award

Dr. Erik Steele, DO, FAAFP, received the 2010 Roselle Huddilston award at the October 15th Annual Meeting of the American Lung Association in Maine. 

Dr. Steele  has served the entire state through his role as Co-Chairman of the Governor’s Council on Physical Fitness, Sports, Health & Wellness.  He has also filled a number of key administrative positions within Eastern Maine Healthcare Systems, most notably serving for nearly two years as the CEO of the Blue Hill Hospital (and the only physician hospital CEO in Maine).  Dr. Steele is committed to prevention and is a contributing writing to the Bangor Daily News, where he brings clarity to the intertwined issues of health and health care.  Dr. Steele's efforts reach beyond organizational boundaries and promote prevention across Maine. Dr. Steele was also presented with the MMA President's Award for Distinguished Service in September.  

The Roselle Huddilston Award was created in 1957 in honor of Roselle Huddilston of Orono, a past president of the American Lung Association in Maine and an exceptional volunteer dedicated to improving the health of Maine's Citizens.  The award is given annually.  



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Office of Inspector General Releases 2011 Work Plan, Effective October 1st

In September, the Office of the Inspector General (OIG) of the U.S. Department of Health & Human Services published its 2011 Work Plan, which became effective on October 1, 2010.  The Work Plan describes the areas in which the OIG will focus specific audit, investigation, enforcement, and compliance activities in the coming year.  The OIG indicated that it will review the extent of potentially inappropriate payments for evaluation and management (E&M) services.  The OIG stated that Medicare contractors have noted an increased frequency of medical records with identical documentation across services.  Visit the OIG website at http://oig.hhs.gov/publications/workplan/2011 to access its Work Plan.

MMA attorneys currently are reviewing the 150-page Plan to see what particular aspects may be of interest to MMA members and their staffs.  We will report our results in the Weekly Update.  Updates will also be available on the MMA website at www.mainemed.com.

  [return to top]

November 5th First Friday Program Features Medical Record Issues

MMA's next First Friday educational program will be presented on Friday morning, November 5th from 9:00 a.m. to noon in the offices of the Association in the Frank O. Stred Building in Manchester.  Interested persons may attend by joining us in Manchester or by participating via Webex from their personal computers.  The topic is Medical Records, Everything You Always Wanted to Know and the faculty represents a collaboration between MMA legal staff (Andrew MacLean, Jessa Barnard and Gordon Smith) and the health law firm of Kozak & Gayer (Ben Townsend and Steve Johnson).  In addition to dealing with the areas of preparation, retention, disclosure and destruction, the program will also cover the transition to electronic records.

The cost is $65 per person and registration is available on the MMA website at www.mainemed.com.  Fliers more fully describing the program will also be included in the just mailed September-October issue of Maine Medicine.

The last First Friday program of 2010 will be held on Friday morning, December 3rd and will feature Medical-Legal topics such as consent to care and compliance. [return to top]

UNE College of Osteopathic Medicine White Coat Ceremony, October 7th

The University of New England College of Osteopathic Medicine presented traditional white coats to students in the first year class last week in a ceremony at the Holiday Inn by the Bay in Portland.  More than 1100 people attended the ceremony.  Dean Marc Hahn, D.O  served as the Master of Ceremonies and introduced several presenters, including President-elect of MMA Nancy Cummings, M.D. and MOA President Joel Kase, D.O., M.P.H.  Both Dr. Cummings and Dr. Kase made brief remarks on behalf of the two associations.  Other speakers included Danielle Ripich, President of UNE, and the current President of the American Osteopathic Association.

Dr. Cummings invited students to become student members of the Maine Medical Association and noted that MMA supports the activities of the AMA student chapter at UNECOM by paying for the AMA dues for the students during their four years of medical school.  Representatives of the chapter regularly attend the AMA Student Section meetings held concurrently with the AMA meetings twice a year.  MMA charges no dues to medical students or residents.  Osteopathic students are also eligible to apply for loans from the Maine Medical Education Foundation. [return to top]

Hanley Center Seeks Nominations for Health Leadership Awards to be Presented November 30th

You're Invited To Nominate 
a Maine-based Organization or Health Care Professional For...

The 2010 Hanley Center Honors
for Leadership in
Medical & Humanitarian Relief

Recognition Dinner on November 30, 2010

Keynote Speaker
T. R. Reid

Popular NPR commentator and author of

The Healing of America
A Global Quest for Better, Cheaper, 
and Fairer Health Care

Mark Your Calendars for this Special Event! 

Tuesday, November 30, 2010

Holiday Inn by the Bay, Portland
Learn more about Dan Hanley and his achievements by visiting The Dan Hanley Center For Health Leadership
Or Call Jim Harnar

Nomination Form

To request the form in MS Word:


The Hanley Center-Honoring Leadership, Collaboration, Courage, Kindness & Hard Work 

Dear Colleague,

This year, the Daniel Hanley Center for Health Leadership will recognize four Maine-based organizations and one individual who have provided outstanding voluntary medical relief and humanitarian service outside our state. Those honored will embody the values that made Dr. Dan Hanley one of Maine's most effective-and respected-healthcare leaders. 

I hope you'll take a few minutes to submit a nomination.  This is an excellent opportunity for you to recognize an organization for its achievements in helping others in the US or abroad. You also are encouraged to nominate a colleague for his or her outstanding personal commitment to medical relief or humanitarian efforts.

Follow the links to download the Nomination Form or request to have the forms sent to you via email.

Don't delay. Nomination deadline is Friday, October 29.

I'm looking forward to receiving your nomination(s)!


James Harnar
Executive Director
Daniel Hanley Center for Health Leadership

Save The Date:
Tuesday, November 30, 2010
Hanley Center Honors for Leadership in Medical & Humanitarian Relief
Holiday Inn by the Bay, Portland

Keynote Speaker 
T.R. Reid
The Healing of America
A Global Quest for Better, Cheaper, and Fairer Health Care
This recognition dinner is part of an exciting afternoon and evening event co-hosted by the Hanley Center andQuality Counts with support from the Maine World Affairs Council.
More information about the event will follow.

For more information, including award criteria and nomination forms please visit www.hanleyleadership.org or  contact Jim Harnarjamesharnar@hanleyleadership.org or 207-523-1501

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Annual Infectious Disease Conference, November 9th

The Maine Center for Disease Control and Prevention, Division of Infectious Disease Presents: 

Infectious Disease Annual Conference

Tuesday, November 9th, 2010

8:00 am - 3:30 pm 

Augusta Civic Center, Augusta, ME 


Cases of Interest * Epidemiology Presentations * Clinical Updates

Register now at: http://www.mcdregistration.org/signup.asp?ID=228

Since 1983, the Division of Infectious Disease, Maine Center for Disease Control and Prevention has organized an annual infectious disease conference targeting public health issues of emerging concern. Health care practitioners, laboratorians, and public health partners are invited to receive current information on surveillance, clinical management and diagnosis, and disease control interventions. 

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Legislature's Health Reform Committee Meets Again on Exchanges Tomorrow; Will Hear from Harvard's Professor Hsaio

The Legislature's Joint Select Committee on Health Care Reform Opportunities & Implementation is scheduled to meet in the State Office Building tomorrow from 10:00 a.m. to 3:30 p.m.  The draft agenda follows:

Joint Select Committee on Health Care Reform

Opportunities and Implementation

Tuesday October 19, 2010

10:00 am to 3:30 pm
Room 208, Cross State Office Building

Augusta, Maine

Draft Agenda

1. Welcome and introduction from chairs and members                         (10:00 am - 10:15 am)   

2. Update from the Steering Committee                                                       (10:15 am – 10:30 am)

      Trish Riley, Governor’s Office of Health Policy and Finance

3. State Options for Waiver Under Affordable Care Act:                            (10:30 am - 11:30 am)

          Alternatives to an Exchange                                             

          Dr. William Hsaio, Harvard School of Public Health  

4. Overview of the CLASS Act                                                                          (11:30 am - 12:00 pm)   

        Committee staff

LUNCH BREAK                                                                                                 (12:00 pm - 1:00 pm)   

5. State Models for Exchange Governance and Oversight                      (1:00 pm - 1:30 pm)

        Committee staff

6. Discussion and Development of Principles for Health Reform          (1:30 pm - 2:30 pm)

        Committee members

7. Public Comment                                                                                          (2:30 pm – 3:00 pm)

8. Planning for Next Meeting/ Wrap Up                                                         (3:00 pm - 3:30 pm) 

You can listen to the Committee via web audio stream at the following site:  http://www.maine.gov/legis/audio/.

You can find the Joint Select Committee membership and a link to its working documents on the web at:  http://www.maine.gov/legis/house/jt_com/hlt.htm.

[return to top]

MeMGMA Presents Employment Law Update at MMA on November 10th

The Medical Group Management Association, Maine Affiliate presents an Employment Law Update from 8:30 a.m. to 12:00 p.m. on Wednesday, November 10th at the MMA offices in Manchester.  The featured speaker is Lawrence C. Winger, Esq.  Mr. Winger has more than 24 years of experience in Labor & Employment Law and he is on retainer to MeMGMA to answer employment law questions for members.  He has handled labor and employment law litigation matters such as, NLRB unfair labor practice trials, union picketing injunction litigation, age, sex, and handicap discrimination trials, sexual harassment jury trials, wage and hour cases, non-compete cases, wrongful discharge allegations, unemployment compensation, and arbitrations.

During this session, Mr. Winger will address the following current topics in labor and employment law:

  • Family medical leave;
  • Discrimination laws;
  • Lactation breaks;
  • FLSA overtime exemptions;
  • the Maine Medical Marijuana law; and
  • the applicability of various statutes to domestic partners.

The cost for the program (whether live or by Webex) is $25 for members and staff, $50 for non-members.  For more information, please contact Karen Wheeler at 873-6173 or by email at kwheeler@mmimvw.com. [return to top]

MaineGeneral Health Presents Fall Coding Conference on November 17th

MaineGeneral Health has planned its Fall 2010 Coding Conference entitled, Navigating the Coding Maze for 7:30 a.m. to 4 p.m. on Wednesday, November 17th at the Waterville Elks Lodge, 76 Industrial Road, Waterville.  The cost is $75 and 6.5 AAPC CEUs are available for attendance.  The conference speakers include:

  • Laurie Desjardins, CPC, PCS, Senior Manager, Health Care Consulting Division, Baker, Newman & Noyes
  • Wendy Pelletier, RHIT, CCS, CPC, Clinical Coding Manager, MaineGeneral Medical Center's Health Information Services Division
  • Marci Alexander, Esq., Chief Compliance Officer & Counsel, MaineGeneral Health
  • Jeffrey J. Wrigley, Detective, Maine Office of the Attorney General.

The registration deadline is November 12th and no late or same day registrations are permitted.  For more information, please contact Lisa Beeckel, CPC, Physician Liaison, MaineGeneral Health at 626-1094 or by email at lisa.beeckel@mainegeneral.org. [return to top]

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