November 1, 2010

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MMA Urges You to Vote Tomorrow

Tomorrow, November 2nd, is Election Day in Maine and across the country.  It is the one day when Americans and Mainers can come together to exercise the most fundamental right held by citizens in a democracy - the right to vote.  You may also vote early or by absentee vote today, and avoid possible lines tomorrow.  "As busy as we all are, it is important to step back for the few moments it takes to join your fellow citizens in voting.  As President of MMA, I won't presume to tell you how to vote.  Patients and physicians will both win if all physicians and their family and staff members vote for whomever they believe are the best candidates.  MMA has endorsed Question 2, the bond issue providing funds to improve access to dental care, so I do ask you to keep that in mind.  But however you choose to vote, please do so today or tomorrow,"  said Jo Linder, M.D., President, Maine Medical Association.


In additional to the hotly contested Governor's race, all 151 seats in the State House of Representatives and all 35 seats in the State Senate are up for grabs.  Several state legislative candidates have been supported by the Maine Physician Action Fund (MPAF), a political action committee affiliated with the Maine Medical Association.  Decisions on whom to support are based upon a published criteria with the final decisions being made by physicians serving on the Board of Trustees of the MPAF.  A list of the MPAF supported candidates this year is available by communicating with Maureen Elwell at MMA (622-3374 or via e-mail to

Pursuant to its bylaws, the MPAF does not endorse candidates in the Governor's race and is not a federal PAC so it does not make contributions to candidates for federal office, such as the U.S. Congress.

As the majority of candidates for the state races are running under public financing system known as the Maine Clean Elections Act (MCEA), the number of candidates supported by the MPAF is smaller with each election.  For those candidates who can accept PAC contributions, there is a $350 limit.  Unfortunately, these limits and laws have led to a situation where much of the funding of advertisements is provided by PACs and groups outside the state.  In the last week of the campaign, a conservative oriented group related to Karl Rove contributed $400,000 to the Maine Republican Party for its use in a handful of state senate races.  Democratic interests nationally, including Donald Sussman, also provided hundreds of thousands of dollars to advocate for or against certain candidates.

We will have to wait until Tuesday evening to see how Maine voters react to this unprecedented infusion of cash by out-of-state interests.


MaineCare Announces Changes to Consultation Codes

The MMA has received several inquiries from physician practices about MaineCare's recent policy change on consultation codes.  The Office of MaineCare Services posted the following note on the provider listserve last week.

As of September 1, 2010, for office or outpatient consultations, MaineCare will not recognize codes 99241-99245.  Instead, providers can bill these services as new (99201-99205) or established office/outpatient (99211-99215) visits.

For inpatient consultations, MaineCare will not recognize codes 99251-99255.  Providers can bill these services as initial inpatient patient visits (99221-99223).  For reporting consults during inpatient initial hospital visits, these codes will require a modifier, AI.  

Emergency Department consultations, formerly coded as outpatient consultations (99241-99245), will now be billed as Emergency Department visits (99281-99285).

For claims and billing questions, please contact MaineCare Provider Services at 1-866-690-5585.

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November 18th Dinner Meeting Features Maine MSO's Ambulatory EHR for a Connected Maine Healthcare Community

You don't have to be a large healthcare system or employ a staff of information technology professionals to have full featured affordable EHR.  Dan Mingle, M.D., extends this invitation to any practice for dinner, discussion, and a product demonstration at the Marriott Residence Inn on the Portland waterfront at 6:00 p.m. on Thursday evening, November 18th.

Maine MSO has teamed with Allscripts to put enterprise-class EHR and Practice Management software into the hands of private practices and small to medium sized healthcare organizations.  The EHR is locally operated and locally supported.  Maine MSO will provide connectivity, content, and data meaningful to Maine.  Do not miss this opportunity to see how Maine MSO's One-Patient One-Chart EHR strategy will provide you with unparalleled patient safety and practice performance.

The dinner and product demonstration are free of cost.  Space is limited so call today to reserve your seat for November 18th or for an alternate date and location.  Contact Ashley Picard at Maine MSO via e-mail to or call 207-370-6445, extension 223.




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Schedule Free In-Office Hypertension Education

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 

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

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Medical Student Residence in Farmington Named for David Dixon, M.D.

Longtime MMA member David Dixon, M.D. of Farmington had a surprise waiting for him recently when he attended the open house of the new student residence center established by Franklin Memorial Hospital.  The facility, located on Wilton Road in Farmington, is for third-year medical students located at the hospital as part of the rural training program through the Tufts/Maine Medical Center Medical School partnership.  During the ceremony, it was announced that the building will be called the Dixon House in honor of Dr. Dixon, in recognition of his efforts in the hospital becoming a training site for the program.  Dr. Dixon also serves as the Vice President for Medical Affairs for the hospital, following a successful career as a general surgeon in Farmington.

Dr. Dixon serves on the Board of the Maine Community Foundation and the Medical Education Advisory Committee of the Finance Authority of Maine.  He also assists with the work of MMA's Small Hospital Peer Review Collaborative and is an accomplished jazz pianist.

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MeCDC Seeks Ticks to Track Lyme Disease

Maine Medical Center Research Institute (MMCRI), in partnership with the Maine Center for Disease Control and Prevention (Maine CDC), is expanding its efforts in northern and western Maine to track the spread of the ticks that may carry Lyme disease.

“We encourage submission of ticks from northern and western Maine to better map the location of deer ticks and to learn more about the spread of Lyme disease.” said Dr. Stephen Sears, State Epidemiologist with Maine CDC. “We need to gather more information from Aroostook, Piscataquis, Penobscot, Somerset, Franklin and Oxford counties.”

MMCRI Vector-borne Disease Laboratory tracks the spread of deer ticks throughout the state. It has been doing so for two decades, creating maps of how the disease is spreading. “Residents, veterinarians, and physicians who find ticks should send them to MMCRI for identification,” said Dr. Peter Rand of the Vector-borne Disease Laboratory. “The information gained through this program can help identify new areas of the state that may be at increased risk of Lyme disease.”

Although the majority of Lyme disease cases occur in the summer, the adult deer ticks are prevalent in the fall, so the risk remains present. 

To submit ticks for identification: 1) Capture the tick in a small, water-tight and crush-proof bottle with rubbing alcohol, and 2) send the tick to the address below along with your name, address, phone number, date and town the tick was found.

Vector-borne Disease Laboratory
Maine Medical Center Research Institute
75 John Roberts Road, Suite 9B
South Portland, ME 04106

Instructions and a submission form can be downloaded from MMCRI’s website at .

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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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The Latest on Medical Records; Friday's CME Presentation at MMA

MMA's First Friday CME presentation this week features the topic of medical records and a faculty consisting of four attorneys specializing in health law.  MMA attorney Jessa Barnard will discuss what makes up the medical record, who has access to it, and who owns it.  Gordon Smith will follow with information on how long to keep the record and what obligations are imposed when it is time to dispose of it.  Attorneys Ben Townsend and Steve Johnson of  the health la firm of Kozak & Gayer will talk about the transition from paper records to electronic records, and also will deal with the relatively new issue of breach notification.

The program will be held this Friday, November 5th from 9:00 a.m. to noon at the offices of MMA in the Frank O. Stred Building in Manchester.  There is a $65 charge which covers all materials and breakfast for those attendees who attend the live presentation.  Participation by WebEx is also available.  For more information, go to the MMA website at or call Maureen or Gail or MMA at 622-3374 ( or

The December First Friday presentation is a various medical legal topics, such as consent to care, and will be held on Friday morning, December 3rd.  Faculty will include attorneys Barnard, Smith, MacLean, and Ben Townsend, as well as a presenter on the confusing topic of waiving Medicare payments.  [return to top]

Appropriations Committee Hears Update on Hospital Settlement Payments Status, Other DHHS Issues

The legislature's Joint Standing Committee on Appropriations & Financial Affairs held its regular meeting last Thursday, October 28th.  State revenues for the first quarter of FY 2011 exceeded projections by 4.7% (about $26.3 million ahead of projections) and the positive trend appears to have continued into October.  

During the afternoon session, DHHS Commissioner Brenda Harvey provided an update on a number of DHHS issues.  The Commissioner presented a document showing $350,067,952 as the total estimate for hospital settlement payments owed for hospital fiscal years ending 9/30/10 ($88 million General Fund).  She also reported the total MaineCare caseload to be 298,221 as of September 2010.  The last biennial budget, P.L. 2009, Chapter 213, directed the Department to produce a report on the impact of the recent increases in MaineCare physician reimbursement described as follows:

Sec. CC-10. Report on the impact of increased physician MaineCare reimbursement. By October 1, 2010, the Department of Health and Human Services shall present a report to the Joint Standing Committee on Health and Human Services and the Joint Standing Committee on Appropriations and Financial Affairs on the impact of increased MaineCare physician reimbursement rates on access to and use of preventive and primary care services by MaineCare members.

Commissioner Harvey requested that the Committee defer this report until January 2011.

The Appropriations Committee is scheduled to meet next on Monday, November 15th.

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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 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 or 622-3374, ext. 214.

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DHHS Launches Data Dashboard

The Maine Department of Health & Human Services (DHHS) has launched a Data Dashboard to the public.  The site is searchable and provides quick access to DHHS information that is commonly sought.  The data are sorted into four major sections - safety, health, financial management and services and supports, with tabs that lead users to each of the four areas. 

The dashboard is available at: The 2010 Public Health Indicators can be viewed here:


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