January 10, 2011

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Paul Richard LePage Becomes Governor of Maine; Pledges to Listen and Work Constructively

Shortly after noontime last Wednesday, Paul R. LePage of Waterville took the oath of office to become the first Republican Governor in Maine in 16 years.  In his inaugural address, heard live by more than 5000 people at the Augusta Civic Center, Governor LePage emphasized the need to create jobs by improving the state's business climate and stressed the importance of education.  He also discussed putting limits on welfare benefits and said that state government had become "bloated."

Governor LePage did not mention health care during his address.  On the process side, he promised to hold town meetings in each of Maine's counties and to hold regular constituent hours.  He will also continue the "red tape" audits that his transition team has been holding around the state.  MMA participated in the first such event in Augusta several weeks ago.  At that time, immediate Past President David McDermott, M.D., M.P.H. encouraged the Governor to not only make Maine the best place in the country to start a business, but also to work with MMA and the medical community to make Maine the best place on earth to practice medicine.

On Thursday, Governor LePage announced three more commissioners, bringing to seven the number of commissioners announced so far.  Of particular interest to physicians, the Governor also announced on Thursday that former Maine Hospital Association lobbyist Mary Mayhew will serve as the Senior Health Policy Advisor in the LePage administration.  In that capacity, Mary will be responsible for health policy as well as insurance and banking, agriculture, forestry, and conservation.  MMA staff has worked closely with Mary over the past decade and wishes her well in her new position.

Governor LePage has not yet announced his nominee for Commissioner of the Department of Health & Human Services.

 You can find the Governor's inaugural address and other documents on the Governor's web site:  http://www.maine.gov/governor/lepage/news/.


Pathways to Excellence ("PTE") Updates Public Reporting Website

The Maine Health Management Coalition (MHMC) would like to alert all Maine primary care practices that the Pathways to Excellence (PTE) primary care portion of their public reporting website (www.getbetterme.org) was updated on Monday evening, January 3, 2011.   At that point, all non-current green ribbons were removed.  Since some practices may have been submitting data right up to the December 31st deadline, it will take a few days to make certain all information is captured accurately for the proper recognition.

Here is a quick summary of the status of the PTE PCP recognition program:

  •  As MHMC/PTE has moved more to national recognition over the last few years, they have allowed practices to keep their Maine based (green) recognition an extra 1-2 years to allow for expansion of national recognition programs, and to give Maine practices extra time to participate in the national programs.
  • As of January 3rd, all “grandfathered” recognition will expire.  PTE practice recognition moving forward will be given either for 2-3 years, depending on the program.
  • MHMC allowed local submission of clinical data for diabetes and CVD outcomes until December 31, 2010.  Moving forward, adult practices will need to use one of the national recognition programs (e.g. NCQA or BTE) for PTE recognition; local submission of clinical data will only be available for pediatric practices, which do not have an appropriate national recognition available yet, and for a few situations where adult practices are not able to participate in national recognition programs - e.g. too few patients, residency programs for CVD.
  • With this status update, MHMC expects to see about a (25%) decrease in the number of practices recognized for their performance.

To help with the transition:

  • MHMC launched a Maine-based office system survey program in the fall using the Bridges to Excellence instrument and process.  This made it more feasible for some Maine PCP practices to participate.  Practices interested in using this Maine-based office systems survey should visit http://www.mehmc.org/nat-l-recognition-program-info/view-category.html to review the steps to earn an office system survey through PTE and contact Stephanie Pratt at stephaniegpratt@gmail.com with any further questions.
  • MHMC will continue to recognize practices that have expiring green ribbons for their office systems or clinical outcomes 1 (1/31/11) month IF they have initiated the process of submitting their data to a national recognition program by December 31, 2010.  MHMC expects most of those practices will successfully obtain national recognition, and felt it would be less confusing to patients if the current recognition is continued until the national recognition process is complete.

MHMC expects to launch a new, more consumer-friendly format for the MHMC public reporting website, www.getbettermaine.org, in April, 2011.  At that point, MHMC will be transitioning from ribbons to the use of word icons (i.e. “good”, “better”, “best”) to recognize practice performance.  Additional updates will be released about these plans before April.

Practices with questions or needing further information should contact Ted Rooney RN, MPH, Pathways to Excellence Project Leader, at trooney@healthandwork.com, or tel 207-729-4929. [return to top]

Transition to New PMP Service Provider Delayed to January 24th

The Maine Office of Substance Abuse (OSA) has announced that the Prescription Monitoring Program (PMP) web site will be changing hosts in early January.  The tentative date for the "cutover" between the current service provider, Goold Health Systems (GHS), and the new service provider, Health Information Designs (HID), has been delayed from the anticipated date of January 10, 2011 and now will be Jan. 24. The database is likely to be unavailable much of that day, and the downtime may be as much as 24 hours. 

The web address, http://www.maine.gov/pmp, will remain the same.  However, if you have added the current log in page to your "Favorites" menu, or if you have saved a shortcut on your computer desktop, you should change the URL under the "Properties" so that it points to http://www.maine.gov/pmp, rather than any URL containing "mainepmp.org."  The http://www.maine.gov/pmp URL is both the current and future web address for the online OSA/PMP database.  Please note that the the change of host will require a password reset when you log into website for the first time after the transition. 

Other technical issues may arise after the transition to the new web site.  Attempting to log on to the new site before you actually need it for clinical use is highly recommended.  In preparation for the transition, OSA recommends that you make any queries that you can anticipate needing prior to January 24, 2011 (especially Prescriber History reports).  You should also inform OSA of any recent change in your contact information so that they can provide you with the most up-to-date information related to the transition. 

The new service will be called RxSentry®. More details related to the transition to the new service provider, HID, will be forthcoming in the days and weeks ahead and will be posted on OSA's web site, http://www.maine.gov/dhhs/osa/data/pmp/news.htm.  If you have any questions regarding the upcoming changes to the PMP web site, please contact Daniel Eccher at the Office of Substance Abuse at 207-287-3363 or daniel.eccher@maine.gov [return to top]

Medicare Enhanced Benefits for Preventive Services, Effective January 1st

One of the more concrete benefits of the federal health reform law (Affordable Care Act or ACA) is the enhanced Medicare coverage of preventive benefits.  Under the existing law, Medicare has covered a number of preventive health screenings such as mammograms and colonoscopies but with varying levels of cost-sharing (including, as applicable, deductibles, coinsurance or co-payments).  Typically, this meant that the Medicare beneficiary would pay 20% of the cost of the service, after he or she had met the $155 Part B deductible.  But beginning on January 1, 2011, your Medicare patients will no longer have to pay any out-of-pocket costs for most preventive health services, including annual wellness visits that are being added to the program.

In addition to the wellness visits (these are different from the one-time "welcome to Medicare physical"  that is available only to beneficiaries in the first year of their enrollment in Part B), CMS has announced the following list of preventive services subject to this provision:

  •  Breast cancer screening.  Yearly mammograms will be offered to women age 40 and older with Medicare;

  • Colorectal cancer screening.  This includes a flexible sigmoidoscopy or colonoscopy for all beneficiaries age 50 or older;

  • Cervical cancer screening.  Pap smear and pelvic exams are available every two years or annually for those at high risk;

  • Cardiovascular screenings.  Free blood test to check cholesterol, lipid and triglyceride levels offered every five years to all Medicare recipients;

  • Diabetes.  Twice-a-year screening for those at risk;

  • Medical Nutrition therapy.  Available to help people manage diabetes or kidney disease;

  • Prostate cancer screening.  An annual digital rectal exam and PSA test for all male beneficiaries age 50 or older; 

  • Bone mass measurements.  This osteoporosis test is available every two years to those at risk, or more often if medically necessary;

  • Abdominal aortic aneurysm screening.  Available to men ages 65 to 75 who have ever smoked;

  • HIV screening.  Available to those Medicare beneficiaries who are at increased risk or who ask for the test;

  • Vaccinations.  An annual flu shot, a vaccination against pneumococcal pneumonia and the hepatitis B vaccine;

For more information, look on-line at medicare.gov.

Beneficiaries covered through a Medicare Advantage plan may not have all these benefits or may have them all and more, depending upon the plan.  Most Medicare Advantage plans do presently offer Medicare-covered preventive services without cost-sharing.

MMA and nine other organizations in the state have one-year funding from the Maine Health Access Foundation (MeHAF) to educate patients about the enhanced coverage opportunities available through the ACA.  If you would like to have some of the materials developed as part of this grant for use in your office, please contact Gordon Smith or Jessa Barnard at MMA (gsmith@mainemed.com or jbarnard@mainemed.com).


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Save the Date: MMA Webinar on Health Care Reform Opportunities, Jan 28th

MMA Webinar

What Health Care Reform Means for You and Your Patients

Friday, January 28, 2011

12 pm – 1 pm

  • Learn how the Affordable Care Act (ACA) impacts Maine patients and physicians
  • Learn about efforts to educate patients regarding coverage opportunities
  • Know where to refer you patients for more information
  • Receive handouts to provide your patients

For more information or to register for the webinar, please contact Jessa Barnard at 207-622-3374, ext. 211 or jbarnard@mainemed.com

This program is associated with a grant MMA has received from the Maine Health Access Foundation.  The purpose of the grant is to inform patients of coverage opportunities in the Affordable Care Act.  For more information about the grant and how it can help you inform your patients,  contact either Jessa Barnard or Gordon Smith (gsmith@mainemed.com). [return to top]

Education for Physician Assistants at Sunday River from February 2-5

The Downeast Association of Physician Assistants (DEAPA) will hold its 21st Annual Winter CME Conference February 2-5, 2011 at the Grand Summit Hotel & Conference Center at Sunday River.  This cutting edge conference covers a multitude of topics for Mid-level Practitioners of varied clinical backgrounds.  On-line registration is available at http://www.deapa.com/conference.

The program begins at 11:30 a.m. on Wednesday, February 2nd with the first presentation beginning at 1:00 p.m. following a fifteen minute welcome and presentation of conference objectives by Cheryl DeGrandpre, PA-C, Chair of the DEAPA CME Committee.

Speakers include Stephen Sears, M.D., acting Director of the State CDC, Timothy Hayes, M.D.,  Scott Dufresne, M.D., Stephanie Calkins, M.D.,  Andrew Perron, M.D., Dervilla McCann, M.D., FACC, and Gordon Smith, Esq.  PAs speaking include Erika Pierce, PA-C, Rupinder Gill, PA-C, Tricia Marriott, PA-C, Noel Genova, PA-C, Kirsten Thomsen, PA-C, Laura Corbett, PA-C, John Bastin, PA-C, Alan White, PA-C, and David Kuhns, PA-C, CCPA, MPH.

Topics at the conference include Vitamin D update, treating shoulder pain, Maine's medical marijuana law, the influence of genetics on coronary artery disease, preventing and identifying domestic violence, and lyme disease.

This conference for more than 20 years has been the premier educational opportunity for PAs throughout New England.  MMA members are encouraged to bring this conference to the attention of their mid-level practitioners.  Any questions about the conference call be addressed to Warene Eldridge at MMA via e-mail to weldridge@mainemed.com or by calling 207-622-3374, ext. 227. [return to top]

Surviving Cardiac Arrest Symposium, February 11th

Surviving Cardiac Arrest: the latest on cardiac arrest treatment, regionalization and therapeutic hypothermia 

Please Join us for this Exciting One-Day Symposium -- Learn What You Can do to Assist with Cardiac Arrest Survival

February 11th , 2010, 7 am - 5 pm 

MaineHealth Conference Center

110 Free Street

Portland, ME


For more information or to register: http://guest.cvent.com/d/tdqtrf

Sponsored by:  The Maine Heart Center at Maine Medical Center, MaineHealth Emergency Medical Services, Maine Medical Center, & Maine Health

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Free Pediatric Vaccination Community Seminar, February 1st

An upcoming community education class, Vaccines: What is Best for Your Child?  will take place February 1st from 6-8 p.m. at Maine Medical Center's Dana Center.   This class will be free for all participants. 

The class was previously offered in September and was well received by participants:

  • 95% of participants agreed or strongly agreed that the information learned in the class will be useful when making decisions about childhood vaccinations
  •  91% of participants agreed or strongly agreed that they can make an informed decision about childhood vaccines as a result of the class
  • 70% of participants agreed or strongly agreed that they feel more comfortable talking with their child’s doctor about vaccines.

The program was created and supported by the MaineHealth Learning Resource Centers and MaineHealth's Child Health Program.  Presenters include Dr. Syd Sewall from Kennebec Pediatrics and Kathleen Mahoney from the Maine CDC's Immunization Program.  Please join the Maine Immunization Coalition in promoting this program to your patients. 

For a poster or postcards to distribute in your practice, please contact Jessa Barnard at 207-622-3374, ext. 211 or jbarnard@mainemed.com.   [return to top]

Institute for Clinical and Economic Review Seeks Nominations

The Institute for Clinical and Economic Review (ICER) is seeking nominations of clinicians and patient or public representatives to serve on the New England Comparative Effectiveness Public Advisory Council (CEPAC).  

CEPAC is a new regional body whose goal will be to provide objective, independent guidance on the application of medical evidence to clinical practice and payer policy decisions across New England.  

Supported by a federal grant from the Agency for Healthcare Research & Quality (AHRQ), and with backing from a consortium of New England state health policy leaders, CEPAC will hold public meetings to consider evidence reviews of medical tests and treatments and provide judgments regarding how the evidence can best be used across New England to improve the quality and value of health care services. 

All CEPAC nominations should be submitted to ICER on or before January 31, 2011 and the final selection will be completed shortly thereafter.  An online application form is available on ICER’s website at www.icer-review.org.  Nomination by sponsoring organizations and self nominations are both welcome.  All nominations should be accompanied by a CV and a letter of interest from the nominee.  Questions regarding activities of the CEPAC and eligibility of nominees can be addressed to Aurelie Cordier at acordier@icer-review.org, 617-643-4568.

About ICER

The Institute for Clinical and Economic Review (ICER), based at the Massachusetts General Hospital’s Institute for Technology Assessment (ITA) and an affiliate of Harvard Medical School, provides independent evaluation of the clinical effectiveness and comparative value of new and emerging technologies.  Structured as a fully transparent organization, ICER seeks to achieve its ultimate mission of informing public policy and spurring innovation in the use of evidence to improve the value of health care for all.  For more information, please visit www.icer-review.org


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MeCDC Weighs in on “Smart Meters”

On October 25th, 2010 a complaint was filed with the Maine Public Utilities Commission (PUC) focusing on concerns related to health, safety (malfunctioning, shorting out, and igniting), and security (vulnerability to hacking) of smart meters, also known as advanced metering infrastructure.  Smart meters are generally electrical meters that record electricity consumption and communicate that information back to the utility using remote means.

In November, Maine CDC completed a review of the data regarding potential health effects of smart meters and did not find any consistent or convincing evidence to support a concern for health effects related to the use of radio frequency in the range of frequencies and power used by smart meters. They also do not indicate an association of EMF exposure and symptoms that have been described as electromagnetic sensitivity.

The MeCDC response and additional background materials can be found at the links below.

  • FCC Letter - August 2010 PDF*
  • Maine CDC Executive Summary of Review of Health Issues Related to Smart Meters (Word* | PDF*)
  • Government or Government-Affiliated Resources Reviewed on the Health Effects of Non-Ionizing Radiation (November 2010) (Word* | PDF*)
  • FAQ on Maine CDC’s Nov. 8 Report  (Word* | PDF*)

You can also link to the documents from http://www.maine.gov/dhhs/boh/smart_meters.shtml or from the MeCDC homepage, www.mainepublichealth.gov.   [return to top]

Latest Flu Vaccination Rates

The MeCDC recently shared data from the November 2010 Rapid Flu Survey, conducted November 1 through November 14, 2010 and sponsored by the Centers for Disease Control and Prevention (CDC).   Cumberland County, Maine was one of 20 participating local areas.

Heath Care Workers (HCW)

As of November 7, 2010, only 49% of HCWs both in Cumberland County and nationally were estimated to have already received a flu vaccine this season.  Among Cumberland County HCW who reported that they had not yet been vaccinated this year, an estimated 20% indicated that they would definitely get a flu vaccine this year and 14% indicated that they would probably get a flu vaccine this year. 

Overall flu vaccine coverage

In Cumberland County, 34% of children and 39% of adults were estimated to have already been vaccinated by November 7, 2010.   

Don’t forget to remind your staff:

1.      Even if you're healthy, you can get sick and spread the flu. Get vaccinated to help protect yourself from influenza and to keep from spreading it to your family, co-workers, and patients. Studies conducted in health care settings show when a lot of health care workers get vaccinated, vulnerable patients are protected.

2.      Health care workers should get a seasonal flu vaccine every year because flu viruses change yearly and a flu vaccine from a previous season may not protect against current flu viruses.

3.      Health care workers should routinely offer seasonal influenza vaccination to everyone age 6 months and older as soon as it is available in their community, and throughout the flu season, which can last as late as May.

For more information, visit: http://www.preventinfluenza.org/profs_workers.asp or http://www.maine.gov/dhhs/boh/maineflu/h1n1/health-care-providers.shtml[return to top]

Dirigo Health Agency Names Ellen Schneiter Interim Director of Maine Quality Forum

Ellen Schneiter, former commissioner of the Department of Administrative & Financial Services and State Budget Officer in the Baldacci administration was named this past week as Interim Director of the Maine Quality Forum replacing Josh Cutler, M.D. who resigned last Fall.

Ellen is well known to many in health care circles as she served as the Associate Director of the Maine Medical Assessment Foundation before the MMAF ceased operations in l999.  She also served as the deputy director of the Governor's Office of Health Policy & Finance in the early years of Governor Baldacci's first term.  She had previously held positions at Health Dialog and the National Academy for State Health Policy. [return to top]

Family Physician Looking for Supervisory Relationship; Will Consider Re-location

MMA has been approached by a family physician who practiced successfully in Maine but voluntarily took a leave of absence in 1990.  That leave eventually resulted in a nearly twenty year hiatus from practice. Following successful completion of the SPEX exam,  he has now been issued a conditional license to resume practice by the Board of Licensure in Medicine, but the license is conditioned on his practicing under close supervision of a board-certified primary care physician for an unknown period of time.  Except for the period of non-practice, the physician has a clean record.  His practice prior to 1990 was in general surgery.

If you or someone you know would be interested and willing to interview the physician and consider him for practice, please contact Gordon Smith, MMA EVP at gsmith@mainemed.com or call Gordon at 622-3374, ext. 212. [return to top]

Legislative Committee Conference Calls Begin Thursday; First Bills of Session for Review

The MMA's Legislative Committee will begin its weekly conference calls during the legislative session this Thursday, January 13th at 8:00 p.m.  Legislative Committee members and specialty society legislative liaisons are strongly encouraged to participate.  Any physician, practice manager, or other staff member who is interested in the MMA's legislative advocacy also is welcome to participate.  It is not necessary to RSVP for the calls.

Please use the following conference call number and passcode.  These will remain the same for every weekly call during the session:

Conference call number:  1-877-669-3239

Passcode:  23045263

The purpose of the weekly conference calls is to review and finalize the MMA's position on bills printed that week, to hear the views of specialty societies on the new bills or their concerns about any health policy issues, and to discuss the highlights of legislative action that week.  The calls rarely last longer than an hour and usually we can accomplish our business in much less time.

If you have any questions about the conference calls, please contact Andrew MacLean, Deputy EVP at amaclean@mainemed.com or 622-3374, ext. 214.

The following bills of interest to the physician community have been printed since the 125th Legislature convened on January 5th and will be discussed on Thursday.  For each bill, MMA Deputy EVP Andrew MacLean has proposed a staff recommendation for the MMA's position (support, oppose, monitor) and any specialty society or MMA committee that may be particularly interested in the bill.  Clicking on the "L.D. XX" will take you to the summary page on the legislature's web site showing you the procedural status of the bill.  To find the bill text for review, click on the "Bill Text and Other Docs" tab on the left side of the page.

L.D. 1, An Act To Ensure Regulatory Fairness and Reform (monitor)

L.D. 23, An Act to Authorize the Inclusion of Information Regarding Blood Type on Driver's Licenses (monitor or support; Public Health Committee)

L.D. 28, Resolve, To Improve Access to Employment Opportunities for Persons with Intellectual Disabilities and Autistic Disorders (monitor; pediatricians)

L.D. 29, An Act to Limit Salaries of Hospital Administrators (monitor)

L.D. 31, An Act To Protect the Safety of Maine Children by Requiring the Express Consent of a Legal Guardian To Dispense Prescription Medication to a Minor (oppose; pediatricians; Public Health Committee)

L.D. 35, An Act Relating to Concealed Firearms Locked in Vehicles (monitor; pediatricians, Public Health Committee)


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