December 6, 2010

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Quality Counts and Hanley Center Create Positive Energy at November 30th Events

More than 400 people attended the afternoon or evening events last Tuesday, November 30th in Portland organized by Quality Counts and the Daniel Hanley Center for Health Leadership.  The afternoon "convening" event focused on the Affordable Care Act and its opportunities for improving health care in Maine.  The evening event, featuring author and NPR and PBS correspondent T.R. Reid, recognized and honored nine individuals or organizations that have provided extraordinary leadership and service in medical and humanitarian relief.

The afternoon event was opened by Gordon Smith, Esq., MMA EVP and Chairman of the Board of Directors of Quality Counts.  Mr. Smith noted the remarkable size of the crowd and cited the optimism of health professionals in Maine regarding opportunities to improve care through the Affordable Care Act, despite the discussion in Washington and Augusta concerning possible repeal of the law.  He noted the recent federal report ranking Maine 4th overall in the quality of care provided to Medicare patients, up from 12th the previous year.  That movement from 12th to 4th was the greatest change of any state in the ranking provided by the Agency for Healthcare Research & Quality (AHRQ).

Other afternoon presenters included Anne F. Weiss, MPP, Senior Program Officer, Quality/Equality Health Care Team, Robert Wood Johnson Foundation; Ted Rooney RN, MPH, Maine Aligning Forces for Quality Project Director; Elizabeth Mitchell, CEO, Maine Health Management Coalition; and Robert Berenson, M.D., Senior Fellow, Urban Institute.

Two panels composed of distinguished individuals provided highlights of Maine AF4Q improvement efforts and provided a reaction to Dr. Berenson's remarks.

T.R. Reid was one of the members of the reactor panel and commented that, "Doctors are there, they have that commitment.  They work in a rotten system, but they are committed."

In the evening program, Reid discussed his experience in traveling the world looking for an efficient and quality based health care system.  His 2009 book, entitled, "The Healing of America:  A Global Quest For Better, Fairer, Cheaper Health Care," was a best seller for policy wonks and casual readers alike.

MMA Congratulates the following individuals and institutions honored Tuesday night by the Hanley Center for their extraordinary leadership and service in medical and humanitarian relief around the world. 

  • Constance Adler, M.D., of Farmington, for her work in the operations and development of the Maria Luisa Ortiz Cooperative Clinic in Mulukuka, Nicaragua.  Dr. Adler was presented the MMA's Mary Cushman Humanitarian Award in 2009.

  • Cheidza Jokonya, M.D., of the Maine-Dartmouth Family Practice Residency, Augusta, for her exceptional work in Haiti.

  • Elizabeth McLellan, MSN, MPH, for her role as the Founder and President of Partners for World Health in Portland.

  • Jennifer Morton, DNP, MPH, of the University of New England, for her work in conjunction with the Ghana Health Partnership.

  • Hector Tarraza, M.D., of the Maine Medical Center, for his volunteer work through Global Health Ministry in Latin America and the Caribbean.

  • Konbit Sante Cap Haitien Health Partnership.  This well-known organization was honored for its continuing role in saving lives and improving health care in northern Haiti.

  • Maine Eye Center and EyeCare Medical Group for Project Guatemala.  These two otherwise competing medical practices in Portland have teamed up for the last several years to send a 24 person team to Guatemala to provide surgery and other eye care to more than 1000 patients each trip.  Drs. Frank Read and Robert Daly received the award on behalf of the two practices.

  • Safe Passage.  This organization, based in Falmouth, was founded by the late Hanley Denning, a native of Maine and Bowdoin College graduate who worked tirelessly to support the children and community living in the Guatemala City garbage dump.  Hanley was killed in a tragic automobile accident in Guatemala in 2007, but her legacy lives on. 

  • St. Mary's Regional Medical Center was recognized for its 22 years work on behalf of "Helping Haiti."  Each year the hospital sends a team to Haiti with support being provided all year long by hundreds of individual employees and volunteers at the hospital.

MMA Congratulates all of the honorees and indeed, all those Maine health professionals providing humanitarian medical missions around the globe.  You represent medicine well.


President Signs 31-Day Delay in Medicare SCR Cut; Now a 12-Month Delay is Needed

On November 30th, President Obama signed the Physician Payment and Therapy Relief Act of 2010 (H.R. 5712) delaying a scheduled 23% Medicare payment cut for physicians and instead enacting a 2.2% increase.  During the rest of the lame duck session, the Congress will try to pass a payment fix.  The $1 billion cost of the 1-month delay in the cut is covered by cutting reimbursement for physical therapy services.

Prior to the bill signing, the White House released a statement saying, "President Obama is pleased Congress has passed legislation that will prevent payment cuts to doctors from taking effect next month.  The President urges Congress to now pass a one-year extension to ensure seniors maintain access to the doctor they know and trust over the coming year."

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.

Even with this favorable action last week,  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 and other newspapers in recent days 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 today (December 6th) on this subject. MMA and the AARP joined in an Op-Ed article published in the Bangor Daily News this past Friday.  Maine public radio on last Thursday night also featured a report on the issue.


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

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. presented an overview of the Guide.  Other topics during the three hour program included informed consent, the FTC Red Flag rule relating to identity theft (taking effect on January 1, 2011) and the Maine Health Security Act

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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 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]

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]

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. 


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Senate Passes Bill to Narrow Application of FTC "Red Flags" Rule

On November 30th, the Senate passed the Red Flag Program Clarification Act of 2010 (S. 3987) narrowing the scope of the Federal Trade Commission's (FTC's) "red flags" rule on identify theft.  The bill would amend the definition of "creditor" to exempt one "that advances funds on behalf of a person for expenses incidental to a service provided by the creditor to that person."  The House may consider companion legislation (H.R. 6420) during the lame duck session.  The compliance deadline remains December 31st.  On May 21st, the AMA and other health care organizations filed an action in the U.S. District Court for the District of Columbia seeking to prevent the FTC from applying the rule to health care providers.  [return to top]

125th Maine Legislature Convenes

The 186 members of the 125th Maine Legislature convened their First Regular Session on Wednesday, December 1st.  The opening day is mostly ceremonial with the legislators' swearing in and related activities.  Majority Republicans were able to elect their candidates for three Constitutional officers - former state senator, aide to Senator Olympia Snowe, and First District Congressional candidate Charlie Summers as Secretary of State; former gubernatorial candidate Bruce Poliquin as Treasurer; and former state representative and Assistant U.S. Attorney Bill Schneider as Attorney General.  The new legislature also adopted its joint rules, including the extension of the "cloture" deadline for submission of bills from December 17th to January 7th.  The legislature has planned to be in session on Friday, December 17th and then they will adjourn for the holidays, returning to the State House on Wednesday, January 6th.

You can find information about the 125th Maine Senate on the web here:

You can find information about the 125th Maine House on the web here:

The MMA Legislative Committee held its organizational meeting on Monday, November 29th.  It will finalize the MMA's legislative agenda and assist specialty societies in their agendas between now and the January 7th cloture deadline.  The Committee's weekly conference calls will begin the week of January 11th.  Look for more details on the MMA's legislative advocacy work in the Weekly Update.

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Governor-Elect LePage Adds Health Care Experts to Transition Team

Governor-elect Paul LePage recently announced an expansion of his transition team to include 5 new people with substantial health care experience:


  • Jane Sheehan, President & CEO of the Foundation for Blood Research in Scarborough and former DHHS Commissioner;

  • Lee Thibodeau, M.D., a neurosurgeon with Maine Medical Partners Neurosurgery & Spine and a partner in Cold River Vodka;

  • Lisa Marrache, M.D., a family practitioner from Waterville and former state legislator;

  • Daniel Landry, M.D., a pediatric anesthesiologist and President & Chairman of the Board of Spectrum Medical Group; and 

  • Dawn Stiles, President of Spurwink Services.

You can find more information about these and other members of the LePage Transition Team on the web at:

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