October 25, 2010

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MMA Executive Committee Endorses Bond Issue #2 Regarding Dental Access

MMA's Executive Committee voted unanimously last Wednesday to support the $5 million bond issue on the election ballot that will provide financial support for dental care provided in clinics across the state.  Committee members noted the significant use of emergency rooms for dental pain and the shortage of dentists, particularly in rural areas.  The bond proceeds also will provide some momentum for establishment of a dental school in the state.  The bond issue is Question 2 on the statewide ballot.  MMA encourages members to take time to vote.  In order to avoid lines on election day, absentee ballots are available at your polling place or town office.

The bond issue also is supported by the Maine Dental Association, the Maine Primary Care Association, the Maine Hospital Association, and the Maine Osteopathic Association.  

Maine has substantially fewer practicing dentists than the national average, the majority of Maine dentists are approaching retirement age, and we have a real scarcity of dental care in the most rural areas of the state.  Passage of the bond issue will allow more dental students to practice in clinics all over the state, serving an additional 60,000 patients each year.  

While the proceeds of the bond will not, in and of itself, guarantee that a dental school will be built, a portion of the proceeds will be available for eligible academic institutions to begin work on a school.  It is estimated that building a dental school will generate $37 million in economic activity during the building phase alone.  Such a school when operational would employ numerous health professionals and support staff generating an estimated $35 million a year in economic impact.


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. in Room 209 of the Cross State Office Building (the HHS Committee room).  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 the MMA Executive Committee discussed those concerns at length during its meeting last week. 

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

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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]

Maine Health Management Coalition's Annual Symposium, Held Last Wednesday

The Maine Health Management Coalition presented its Annual Symposium last Wednesday, October 20th at the Portland Club with more than 100 employers, providers, patients, and payers represented.  The title of the Symposium was Unlocking the Potential of Health Care Reform Through Alignment & Engagement

Erik Steele, D.O., FAAFP led off the day with a talk entitled, Health Care Costs...A Provider Perspective.  Dr. Steele provided his perspective as both a primary care physician and a hospital CEO, the latter role he occupied as interim CEO at Blue Hill Memorial Hospital until recently.  His excellent Powerpoint detailing some of the daily challenges of a primary care physician is available by calling MMA (622-3374) or via the Coalition's website at www.mehmc.org.  It is worth reviewing.

Dr. Steele's presentation was followed by a talk by Victoria J. Robinson, Manager of Risk, Compensation & Benefits for the City of Las Vegas.  Ms. Robinson discussed the City's six year experience with a consumer driven health program that was the first in the nation.  Today, 80% of the City's employees participate in the CDH program and the City's health care costs have remained virtually flat since that time.

Following lunch, April Greene, Director of Payment Reform for BCBS of Massachusetts, spoke of the plan's effort to improve health care quality and affordability through payment reform.  The Plan has established an alternate quality contract, offered to physicians in order to accelerate the use of quality, outcomes-based metrics as a basis for payment.  The contract creates a payment model that provides incentives for the integration of care delivery and patient outcomes.  Twenty-six percent of PCPs contracting with the plan are now using the alternative quality contract, including more than 1500 primary care physicians and more than 3,000 specialists.

Concluding the afternoon session was National Basketball Hall of Famer Dominique Wilkins who offered his perspective in a talk called, Leading the Way:  On the Court, in the Community and in Life.  Wilkins is entering his third season as Vice-President of Basketball for the NBA's Atlanta Hawks. [return to top]

Report on Advisory Council on Health Systems Development, October 22nd

The Advisory Council on Health Systems Development (ACHSD) met on Friday morning October 22nd.  The Council received updates from Trish Riley on the exchange planning grant, the payment reform work group, the work of the Joint Select Committee on Health Reform Opportunities and Implementation and a timetable to complete the work. 

Council members also received a presentation on the impact of the Accountable Care Act on Maine's Medicaid & CHIP programs by Beth Waldman, Senior Consultant, Bailit Health Purchasing, LLC & Robert Seifert, Principal Associate, Center for Health Law and Economics, Commonwealth Medicine, University of Massachusetts Medical School. 

Slides from the presentations can be accessed at www.maine.gov/healthreform under the Advisory Council on Health Systems Development as an attachment on the ACHSD Meeting Agenda. [return to top]

MMA Public Health Committee Seeks Input on Priorities

The MMA Public Health Committee met at the MMA offices on October 13th, 2010.   Top on their agenda was developing policy priorities for 2010-2011.   Currently, their top four policy priorities are:  addressing environmental toxins, improving immunization financing, strengthening the public health infrastructure, and addressing the health implications of climate change.  The Committee also supports anti-tobacco and healthy weight initiatives. 

Committee co-chairs, Drs. Lani Graham and Norma Dreyfus, would like to hear from specialty societies and all MMA members with suggestions for new or additional public health topics that the Committee should address in the coming year.  

Please submit suggestions to Jessa Barnard at 207-622-3374, ext. 211 or jbarnard@mainemed.com.  

For more information about the Committee's areas of focus, see:  www.mainemed.com/public/. [return to top]

Hypertension Treatment Information Coming to your Office!

The Maine Medical Association and the Maine Independent Clinical Information Service Present: 

Academic Detailing Visits at No Cost

NEW Hypertension Module Arriving Early November!  

Schedule your visit today: 207-622-3374 or academicdetailing@mainemed.com 

The "Silent Killer" - Still at Large 

Most Americans over age 60 have hypertension.  Even among those whose blood pressure are normal at age 55, the lifetime risk of hypertension is 90%.  Despite the availability of dozens of effective treatments and decades of data, less than two-thirds of patients in the U.S. with hypertension are receiving treatment, and less than half are adequately controlled.

Effective hypertension control is one of the best ways a physician can make a real difference in patients' health by preventing myocardial infarction, stroke, renal damage, and premature death.  

Meet with our academic detailers to learn more about key steps that can improve current management, such as: 

  • Low-dose thiazides should play a central role as initial therapy for many patients, and as part of combination treatment for others;
  • Choose other medications based on compelling indications;
  • Combination therapy will often be needed;
  • When choosing agents, consider cost and compliance.

For more information, visit www.mainemed.com/academic/.

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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]

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

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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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Stop the Flu - It Starts with You!

Recognizing that influenza infection in health care workers can lead to outbreaks with serious consequences for patients, the Maine Medical Association's Public Health Committee and the Maine Center for Disease Control and Prevention are committed to increasing influenza immunization rates among Maine's medical staff.  

Influenza kills approximately 36,000 people and causes 226,000 hospitalizations each year in the United States.  The most vulnerable patient populations are those who are very old or young (65 years or older or <2 years of age) or who have certain medical conditions that increase the risk of complications.  Viral shedding begins a day or two before symptoms appear, so health care workers can acquire influenza and unwittingly transmit the virus to their patients, co-workers, and family before even knowing they are ill.

Influenza immunization rates in health care workers nationally are low (36% to 42%) despite evidence of the efficacy and safety of the vaccine in preventing illness in staff and patients and reducing employee absenteeism.  Annual influenza immunization is recommended for health care workers by the Centers for Disease Control and Prevention to minimize the risk of infection of workers and transmission of infection to vulnerable patients.

The MMA Public Health Committee and MeCDC therefore encourage all Maine physicians to receive the influenza vaccination this fall and to create policies regarding vaccination among your staff.  For more information, visit: http://www.preventinfluenza.org/profs_workers.asp

- Norma Dreyfus, MD, MMA Public Health Committee Co-Chair

- Lani Graham, MD, MPH, MMA Public Health Committee Co-Chair

- Stephen Sears, MD, MPH, State Epidemiologist, MeCDC 

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SAVE THE DATE: MMA Legislative Committee to Meet on Monday, November 29th

The MMA's Committee on Legislation, chaired by Bridgton Pediatrician Lisa Ryan, D.O., will hold its organizational meeting for the 125th Maine Legislature on Monday, November 29th from 6:00 p.m. to approximately 8:30 p.m. in the MMA headquarters at the Frank O. Stred Building in Manchester.  The agenda for the meeting will include a recap of the 2010 election results and the implications of those results for health policy in 2011, an update on legislative leadership races, committee chairmanships, and committee assignments, a preview of anticipated legislation, and a discussion of the MMA's legislative agenda for the 125th Maine Legislature.


Physician specialty societies are strongly encouraged to send a representative or two from your leadership to raise issues of particular interest to your specialty.  This is your opportunity to join in the development of the MMA's legislative agenda for the next two years.  Following the discussion at this meeting, the MMA staff will develop potential legislative requests and will refine the legislative agenda prior to the deadline for submitting legislation on Friday, December 17th at 4:00 p.m.

Supper will be available at 6:00 p.m.  If you would like to attend, please RSVP to Maureen Elwell, Legislative Assistant, at melwell@mainemed.com or 622-3374, ext. 219.  If you have further questions about the meeting or would like to discuss a possible legislative initiative, please contact Andrew MacLean, Deputy EVP, at amaclean@mainemed.com or 622-3374, ext. 214.

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