November 29, 2010

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2010 Physician's Guide to Maine Law Now on MMA Website

MMA is pleased to announce that the latest edition of the popular Physician's Guide to Maine Law has now been published on-line and is available in the member's only section of the MMA website at  Members and practice staff of members can access the document by following the simple steps described below.  The Guide is intended to be a convenient source of state laws and regulations for physicians, with helpful references to the AMA Code of Medical Ethics and other relevant documents.  A limited number of copies will be printed in loose-leaf binders and are available for $75 by calling the MMA office at 622-3374.

Published until 2002 in a printed form, it has been our goal for several years to get an updated copy of the Guide on-line so that appropriate links could be provided and the document could be updated frequently.  It has been updated through the Second Regular Session of the 123rd Legislature and in the next six months will be updated through the actions of the 124th Legislature.  Several of the more significant health items approved by the 124th legislature have already been added to the Guide, such as the laws on the medical use of marijuana.

If you or your staff have not accessed the member's only section of the website, simply go to the site at and click on the member's only section.  You will then be asked for a user name which will be your e-mail address.  Our staff then will receive notification that you wish access and you will be sent an e-mail authorizing your use of the section.  You will continue to use your e-mail address as your user name but will be able to choose your own password.

At the December 3rd First Friday CME program entitled, "Current Topics in the Medical-Legal World," MMA attorney Jessa Barnard, Esq. will present an overview of the Guide.  Other topics during the three hour program include informed consent, the FTC Red Flag rule relating to identity theft (taking effect on January 1, 2011) and the Maine Health Security Act.  For registration information, see more detailed information on the program in another article in this Update.


National Survey Cites Healthcare in Maine as Fourth Best in the Nation

Maine ranked fourth overall for 2009 in national quality measures, according to the federal Agency for Healthcare Research & Quality (AHRQ).  New Hampshire ranked first, followed by Wisconsin, Minnesota, Maine, and Rhode Island.  Maine moved up from 12th last year - the biggest one-year improvement of any state. The state-level information used to create the state snapshots is based upon data collected for the National Healthcare Quality Report.

The annual rankings (found at ) are based on a list of measures, such as the rate of eye and foot exams for diabetes patients and the mortality rates for cancer patients.  Maine scored very high on care of diabetes and respiratory patients, but was below average on nursing home care and maternal and child health measures.

There was widely reported speculation in the Maine media last week regarding why Maine was outperforming other states.  Many commentators stated their opinion that a major cause for the improvement was the result of patients, employers, the state, and insurers learning to shop around for high-quality care.  Others noted the importance of transparency and the ability of patients now to see how hospitals and physicians perform on several different websites ( for example.  But other experts noted that we are in the infancy of measuring health care quality and that is too early to speculate on the cause.

But one thing is for certain, the collaborative nature of the work being done by Quality Counts, the Maine Quality Forum (Dirigo Health Agency), the Maine Health Management Coalition, and Aligning Forces for Quality is raising the bar and providing additional tools for physicians, hospitals, and other providers to improve quality and patient safety.  While the motivation to do their very best was always there, frequently the information and tools necessary to do so were not.

Congratulations to all the dedicated health professionals providing care in Maine for this recognition.  No reason not to shoot for the top spot next year and the nearly 400 attendees at the Quality Counts/AF4Q "Convening Event" Tuesday in Portland will be charged with that challenge.


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Senate Takes First Step on Temporary SGR Fix; House Needs to Act Before Wednesday

On November 18th, Senate Majority Leader Harry Reid (D-NV), Minority Leader Mitch McConnell (R-KY), Finance Committee Chair Max Baucus (D-MT), and Finance Committee Ranking Member Charles Grassley (R-IA) reached an agreement on a unanimous consent request for a 31-day reprieve from the 23% Medicare physician payment cut scheduled to take effect on December 1st.  This move is a necessary first step to avoid a disruption in December payments while Congressional leaders continue to seek funding offsets for legislation that will stabilize Medicare physician payments through 2011.

Earlier this fall the AMA, along with 66 national physician organizations and all the state medical societies, asked Congress to prevent the Medicare payment cuts being produced by the SGR for at least 13 months, and indications are that this proposal enjoys bipartisan support in Congress.  Further, bipartisan discussions are underway to identify acceptable funding offsets for a full 12-month reprieve that would be passed in December, while the short-term extension is in effect.

For even this brief 31 day reprieve to happen, the House of Representatives needs to act on the Senate bill when they return to Washington today.  Assuming this happens (and it is expected), it will still require a diligent effort by physicians to advocate for a 12 month delay which will need to be enacted in December before lawmakers recess for the holidays.  MMA was pleased to see a full-page advertisement placed by the AARP in the Maine Sunday Telegram yesterday encouraging seniors to call the Congress advocating for the SGR problem to be fixed.  MMA President Jo Linder, M.D. will be joining in an AARP (Maine Chapter) tele-town hall call next week on this subject.

Capitol Hill offices were inundated with telephone calls from physicians and patients on November 17th when state, county, and national specialty societies participated in a "White Coat Wednesday" grassroots effort on the pending Medicare physician payment cuts.  The New York Times reported that:  "Doctors flooded Congress on Wednesday with telephone calls urging lawmakers to prevent the cut.  Many physicians have posted placards in their offices saying, 'Your doctor may have to stop seeing Medicare patients if Congress does not act.'"  The success of this grassroots effort demonstrates medicine's strength when all work together to deliver a strong, common message.

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White House & CMS Host Meeting with Physicians on Delivery Reforms

On November 15th, the White House and CMS hosted a meeting with physicians to discuss the development of innovative delivery reforms such as bundled payments, medical homes, and accountable care organizations (ACOs).  AMA President Cecil Wilson, M.D. and AMA Board Chair Ardis Hoven, M.D. participated in the meeting on behalf of the AMA.

The meeting was timely, since CMS is currently drafting a regulatory proposal on the shared savings/ACO program authorized by the ACA that is expected to be released at the end of this year or early in 2011.  CMS is also preparing its priorities for the newly launched CMMI, which will identify and support a variety of new innovative delivery reforms.

The Administration heard from individuals representing a broad range of specialties and practice types, including several large group practices that participate in the CMS Physician Group Practice demonstration program, leaders of existing Independent Practice Associations (IPAs) delivering integrated care, physicians involved in the Medicare Acute Care Episode demonstration program, and representatives of specialty and state medical associations.  These groups discussed their unique experiences in delivery reform and the significant barriers they have faced.  Participants further emphasized that the Administration cannot and should not adopt a "one-size-fits-all" approach as it drafts regulations to implement the shared savings and ACO provisions of the ACA and establish the CMMI.  The AMA and others also stressed that the majority of physicians are in practices of four or fewer, so the Administration must provide flexibility as well as resources to assist with transition.

At the recent interim meeting of the AMA House of Delegates, the AMA adopted certain principles for ACOs.  You can read the AMA's press statement on this action at:

For more information on AMA advocacy on ACOs and other delivery reforms included in the ACA, go to

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"Current Topics in the Medical-Legal World" is Final 2010 First Fridays Topic on December 3rd

On December 3, 2010, MMA presents the final First Friday presentation of 2010 with a program entitled, "Current Topics in the Medical-Legal World."  The program runs from 9:00 a.m. to noon and features presentations from five health lawyers on the following topics:

  • The 2010 Physicians Guide to Maine Law;

  • Maine Laws on Informed Consent;

  • The Federal Trade Commission "Red Flag" Rules, effective January 1, 2011;

  • The 2007 Medicare law requiring reporting of waiving of co-payments; and

  • The Maine Health Security Act.

Attorneys Stephen Johnson and Benjamin Townsend of the Augusta health law firm of Kozak & Gayer and MMA lawyers Andrew MacLean, Jessa Barnard, and Gordon Smith will all participate.  The program promises to be a fitting conclusion to a very successful series of programs in 2010.  The program can be attended live in Manchester or via WebEx.  There is a $65 fee and anyone interested can register on the MMA website at  Those individuals interested in attending through WebEx may register by e-mailing

Watch for an insert in the November-December Maine Medicine that will list all the First Friday programs for 2011.  The series begins on Friday, February 4, 2011 with a program on the future of health system reform.  Nine programs have been scheduled, not including the 20th Annual Practice Education Seminar being held on Wednesday, May 18, 2011 at the Augusta Civic Center. [return to top]

Free In-Office Hypertension Education Available Through MMA's Academic Detailing Program

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

Academic Detailing Visits at No Cost

NEW Hypertension Module Available Now!  

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  Three academic detailers have been trained in the new hypertension model and they are ready to go!  Put them to use in your practice. [return to top]

CMS Launches Center for Medicare & Medicaid Innovation

The Centers for Medicare & Medicaid Services (CMS) formally established the Center for Medicare & Medicaid Innovation (CMMI) that was created by the Affordable Care Act (ACA).  Cecil Wilson, M.D., President of the AMA, participated in a stakeholder meeting on the day of the launch.  During the meeting, Dr. Wilson stressed that the CMMI holds promise as a testing ground for emerging models of patient care.  In this and other meetings, the AMA continues to urge the Administration to ensure that the Center will provide physicians from all types of practices with the resources to move ahead with improvements in health care delivery systems.  For more information on the CMMI and the initial demonstration projects, visit: [return to top]

REMINDER: MMA Legislative Committee Meets Tonight!

The MMA Legislative Committee Chair, Lisa Ryan, D.O., a Bridgton pediatrician, would like to invite all Committee members, specialty society officers or legislative liaisons, and any interested physician to the organizational meeting of the Legislative Committee for the 125th Maine Legislature tonight - Monday, November 29th from 6:30 to approximately 8:30 p.m.  Dinner will be available at 6 p.m.  The agenda for the meeting will include a review of the remarkable 2010 election results, decisions about Committee work for the session, discussion of legislation anticipated from other interest groups, and consideration of the MMA's & specialty society legislative agendas for the next 2 years.  All are welcome, but please RSVP your attendance to Maureen Elwell, Legislative Assistant, at 622-3374, ext. 219, or so we can plan for food.  

The 125th Maine Legislature will be seated in early December.  Legislators must have bill requests submitted by December 17th.  The new legislature will return to work in Augusta on Wednesday, January 5th & is expected to conclude its First Regular Session in mid-June 2011.

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CMS to Host December PQRS Open Door Forum

On December 15th, CMS will host a special Open Door Forum on the 2011 PQRS and eRx Incentive programs from 1:00 p.m. to 3:00 p.m. ET.  CMS will provide an overview of changes to the Group Practice Reporting Option (GPRO) for the 2011 program year, and will discuss the eRx 2012 payment adjustment.  Group practices interested in participating in the 2011 GPRO for PQRS and/or the GPRO for eRx Incentive Program must submit a self-nomination letter to CMS no later than January 31, 2011.  Following CMS presentations, telephone lines will be opened to allow participants to ask questions of CMS staff.  The number for the Open Door Forum is 1-800-837-1935 and the Conference ID is 24749053.  Additional information regarding the Open Door Forum can be found at: [return to top]

CMS Resumes Production of 2009 PQRS & eRx Feedback Reports
After beginning the release of the 2009 Physician Quality Reporting System (PQRS, formerly the PQRI) Feedback Reports, CMS temporarily halted production of these files to investigate some conflicting information in the reports.  Starting the week of November 22nd, CMS will resume posting 2009 PQRS and eRx Incentive Program feedback reports on the PQRS portal.  Individual NPI reports may also be obtained by contacting your Carrier or Medicare Administrative Contractor.  For questions regarding the 2009 PQRS and eRx feedback reports, please contact the QualityNet Help Desk at 1-866-288-8912 (Monday - Friday from 7:00 a.m. to 7:00 p.m. CST) or by email at [return to top]

Medical Marijuana Patients Need State ID Card by January 1st; 50 Physicians have Completed Medical Certificates

The State Department of Health & Human Services reported this week that 50 different physicians have completed medical certificates for patients under the new medical marijuana law.  Twenty-nine of these physicians were family physicians with the remaining physicians representing a mix of other specialties. Several hundred patients are expected to have ID cards issued by the state by January 1, 2011, although the first state-licensed dispensaries are not likely to be open before March. 

The MMA and the Maine Osteopathic Association are soliciting names of physicians interested in serving on the state mandated advisory board.  To be eligible to serve on the board, which is likely to meet only once or twice a year, a physician must be board certified and have a current Maine license and a DEA license.  One position each is available in family medicine, pediatrics, psychiatry, addictionology, pain management, neurology, palliative care, gastroenterology, medical oncology, infectious disease, gynecology, and internal medicine.

The MMA has resources on its website at for physicians desiring more information on the law and the risks and benefits of physicians and patients participating.

The MMA also has a one-hour course on the law, certified for CME, delivered by one of our three health lawyers.  If your medical staff, group practice, or specialty society would like a presentation, contact Gail Begin at the MMA at  There is normally a $200 charge to cover travel and copying costs.  The Powerpoint presentation is located on the MMA website.

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Physicians Invited to Meet with Aetna Officials on December 13th to Discuss Medicaid Managed Care

The Maine Medical Association and Aetna will host a dinner meeting at the offices of MMA in Manchester on Monday evening, December 13th, beginning at 6:00 p.m.  Aetna officials would like input from Maine physicians regarding MaineCare's plans to move patients into a managed care contract in 2011.  Aetna is providing managed care under contracts in other states, along with United, Wellpoint, and other insurers.

Attending the meeting will be Judith Chamberlain, M.D., Virginia Cate, Senior Network Market Lead, and Lynda Grajeda, Network Operations Market Head.

Physicians wishing to attend may RSVP to Diane McMahon at [return to top]

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