January 17, 2011

 
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Governor Unveils Supplemental Budget Addressing Hospital Debt and MaineCare Expansion

Governor Paul LePage last week unveiled a $150 million supplemental budget, including nearly $70 million as the state share of hospital settlement payments.  At the current federal match rate, the state appropriation will leverage an additional $179 million in federal matching funds allowing the state to cover most of the outstanding MaineCare liability to hospitals through most of 2009. 

The remainder of the existing debt to Maine hospitals is expected to be addressed in the biennial budget due to be released in February.  That budget will address the two-year period beginning July 1, 2011. 

The budget also includes slightly over $70 million to get MaineCare through the next few months until the end of the fiscal year.  The shortfall resulted from increased enrollment and a decrease in the federal match rate.  Without this appropriation, MaineCare would run out of  funds before the end of February.  MMA will support the Supplemental package and advocate for its passage as an emergency measure, so that physicians seeing MaineCare patients can continue to be paid on a timely basis.

Money to pay for the additional spending comes from a combination of increasing tax receipts, spending cuts and curtailments.

Hearings on the supplemental budget will begin the week of January 24 before the Joint Standing Committee on Appropriations and Financial Affairs.  The budget adjustments must pass by a two-thirds vote prior to April 1 if the more favorable federal match rate is to apply.

 

Legislative Committee Conference Call Moves to Tuesday this Week; New Bills for Review

The MMA's Legislative Committee will hold its next weekly conference call this Tuesday, January 18th 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 last week's call and will be discussed on Tuesday.  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. 45, An Act to Allow Marriage and Family Therapists to Serve as Mental Health Professionals in Public Schools (monitor; psychiatrists, pediatricians)

L.D. 46, An Act to Allow Marriage and Family Therapists to Serve as Mental Health Professionals in the Civil Service System (monitor; psychiatrists, pediatricians)

L.D. 51, An Act Regarding Access to Sexually Explicit Material (monitor; pediatricians)

L.D. 57, Resolve, to Update the Study Regarding the Feasibility of Establishing a Single-payor Health Care System (monitor)

L.D. 58, An Act to Prohibit Enforcement of the Federal Patient Protection and Affordable Care Act (monitor)

L.D. 60, An Act to Extend Coverage Under the State's Mini-COBRA Law (support)

L.D. 64, An Act to Make a Violation of the Laws Governing Seat Belts a Secondary Offense (oppose; Public Health Committee)

L.D. 65, Resolve, to Require Dementia Care Training in Long-term Care Facilities, Adult Day Care Programs, Certain Residential Care Facilities and Supported Living Arrangements (monitor)

L.D. 70, An Act to Include Independent Practice Dental Hygienists in MaineCare (monitor; Public Health Committee)

L.D. 75, Resolve, Directing the Department of Health & Human Services to Amend Its Rules Governing Electronic Benefits Transfer Cards (monitor; pediatricians)

 

 

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To Repeal ACA or Not to Repeal ACA: Still a Big Question

The coming week continues to feature quite a bit of action regarding Republican efforts in Congress to repeal the ACA, the efforts of Governor LePage and Attorney General Schneider to have the state join one of the federal lawsuits seeking to declare portions of the law unconstitutional (chiefly focusing of the individual mandate requiring individuals to purchase insurance), and related activities aimed at influencing those decisions. 

Here in Maine, the Maine Can Do Better Coalition, which supports the ACA, has organized a rally of pro-reform forces outside the State House at 11:30am on Wednesday (Jan. 19). Those attending the rally will try to influence the decision as to whether Maine should join the federal lawsuit.

On this past Thursday, MMA President Jo Linder, M.D. and MMA attorneys met with Attorney General William Schneider to discuss MMA's support for the requirement that there be coverage for all citizens and our belief that requiring persons who could afford coverage to buy it was about the only way to get there.  The recent survey of MMA members showed strong support for the individual mandate among MMA membership (greater than 75%).  The meeting was very cordial and the Attorney General was quick to point out that he supports the need to significantly reform the health care delivery and financing system.  At the same time, he believes that it is important for Maine to join the lawsuit to argue the constitutional point.  MMA attorneys pointed out that the law does not actually mandate the purchase of insurance, rather it imposes a financial penalty if an individual does not make make such a purchase.  Ultimately, the United States Supreme Court is expected to determine the issue.

The Republican leadership in the U.S. House of Representatives has announced plans to have a House vote later this week to repeal the ACA but this is widely seen as an attempt to make political points rather than a serious attempt to change the law, given the Senate still has a Democratic majority and that the President would undoubtedly veto such a bill in any case.  National polls now show that the country is about evenly divided between supporters and critics of the law.



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Tony Marple, Director of MaineCare, Resigns

Tony Marple, who has served as Director of MaineCare for the past few years, abruptly left the program last week.  No further information on his departure was available at press time.

The Association has worked closely with Tony during his time as Director.  One of his most significant efforts was preparing the program for a transition to managed care in 2012.  Those efforts are expected to continue as Maine is one of only a handful of states that has not embraced a managed care solution to growing medicaid expenses.  The MaineCare Program also successfully transitioned to the new claims management system this Fall, leaving behind the failed MeCMS system that had been brought on line in 2005, well before Tony got to the program.

 We wish Tony well in whatever his future may hold.

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Introducing "Get with the Guidelines - Outpatient" - Jan 26 Webinar

Introducing: Get With the Guidelines - Outpaitient

Webinar

Wednesday, January 26, 2011

9 am - 10 am

Guest Speaker: Vincent Bufalino, MD, FAHA

Get With The Guidelines® -Outpatient puts evidence-based guidelines for preventing and treating chronic diseases to work in outpatient settings.

The program brings together the disease prevention and management efforts of the American Cancer Society, American Diabetes Association, and American Heart Association/American Stroke Association to offer a broad approach to primary and secondary prevention. Practices’ existing electronic health records (EHRs) or health technology systems extract relevant patient data without disturbing clinical workflow. Participants receive quarterly reports charting guidelines adherence, providing benchmarking information and supporting continuing quality improvement.  Get With The Guidelines-Outpatient currently captures the core clinical quality measures required to achieve Meaningful Use in the program’s ideal data set. Many EHR vendors support Get With The Guidelines-Outpatient

For Webinar Registration and Information, email: profedfda@heart.org and reference GWTG-Outpaient

For additional information on the Get with The Guidelines Program, visit: http://outpatient.heart.org/GWTG/ [return to top]

MMA Public Health Committee CME: Social Determinants of Health Outcomes

The MMA Public Health Committee Presents:

Social Determinants of Health Outcomes

Wednesday, February 9, 2011

4 pm - 5 pm

MMA Large Conference Room, 30 Association Drive, Manchester

Speaker: Dr. Ed Pontius

1 AMA PRE Category 1 Credit

This CME seminar will discuss the social determinants of physical and mental health outcomes, the causes of our increasing health challenges and how we can best advocate for the health of Maine communities.  Topics include:

  • Current research relating mental health outcomes to social factors internationally and in the United States;
  • The physical and mental illnesses that demonstrate significant gradients in prevalence with socioeconomic status, and how prevalence of those illnesses relates both to poverty and to income inequality;   
  • Trends in health outcomes and the future need for health services in nations reducing income inequality and in nations with increasing income inequality.

For more information, or to register, contact Jessa Barnard at 207-622-3374 x 211 or jbarnard@mainemed.org.   [return to top]

Maine Court Appointed Special Advocates Seeks Volunteers

Speak Up for a Child

Maine's Court Appointed Special Advocates (CASA) is the only volunteer organization that empowers everyday citizens as appointed members of the court to act as guardian ad litem for abused and neglected Maine children involved in protective custody cases. CASA volunteers are appointed by the judge and act as his or her neutral and impartial eyes and ears.  CASA volunteers typically handle just one case at a time – and commit to staying on that one case until the child is placed in a safe, permanent home.  Training is free and CASA offers supervision and ongoing support.   

For more information contact Reid Hayton-Hull at 287-5830 or Reid.Hayton-Hull@maine.gov, or Lisa Waitt at 287-5403 or casamaine@maine.gov.  You may also visit the CASA website for more information or to download the application directly at  www.courts.state.me.us/maine_courts/specialized/family/casa.   [return to top]

Governor Issues Order on Executive Branch Rulemaking; Legislature Schedules Hearings on Regulations

The new Republican Governor and legislative majority are pursuing one of their primary goals in the opening weeks of the 125th Legislature's First Regular Session.  On January 10, 2011, Governor LePage issued Executive Order 09 FY 11/12, An Order to Improve Review of the Rulemaking Process:  http://www.maine.gov/tools/whatsnew/index.php?topic=Gov_Executive_Orders&id=182022&v=article2011.  With the exception of emergency rules and those required by federal law or a Maine statute other than the Administrative Procedures Act, the Order requires specific approval by the Governor's Office before the agency may proceed with the rulemaking process.  This requirement shall remain in place for the next 6 months.

 

Meanwhile, the legislature's Joint Select Committee on Regulatory Fairness & Reform, http://www.maine.gov/legis/house/jt_com/rfr.htm, has scheduled a series of 9 public hearings around the state between January 24th and February 14th to hear Mainers' views on the state's regulatory climate.  The hearing dates and locations are:

 

  • January 24, 2011, Northern Maine Community College, Presque Isle, 1-4 p.m.

  • January 26, 2011, Hutchinson Center, Belfast, 3-6 p.m.

  • January 31, 2011, University of Maine at Machias, Machias, 1-4 p.m.

  • February 2, 2011, Eastern Maine Community College, Bangor, 3-6 p.m.

  • February 3, 2011, Central Maine Community College, Auburn, 3-6 p.m.

  • February 7, 2011, Town Hall, Sanford, 3-6 p.m.

  • February 9, 2011, Southern Maine Community College, South Portland, 3-6 p.m.

  • February 14, 2011, Cross State Office Building, Augusta, 1 p.m.

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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]

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]

Free Webinars: What Health Care Reform Means for the Health Care Community (Jan 25) and Practices (Jan 28)

What Health Care Reform Means for Maine Practices and Patients

Friday, January 28, 2011

12 pm – 1 pm

CLICK HERE TO REGISTER FOR THE 1/28 PROGRAM 

This webinar program is geared towards those who work with patients or in a health care practice.  

  • Learn how the Affordable Care Act (ACA) impacts Maine patients and physicians
  • Learn about efforts to educate patients regarding coverage opportunities
  • Learn where to refer your patients for more information, and where to get educational materials for your patients
NEW WEBINAR ADDED!

What Health Care Reform Means for the Health Care Community in Maine 
Quality Counts Brown Bag Forum 

Tuesday, January 25th     

 12 pm - 1 pm   

 CLICK HERE TO REGISTER FOR THE 1/25 PROGRAM

            This webinar program will be geared towards all interested parties.  

  • Learn how the Affordable Care Act (ACA) impacts Maine patients and the health care community at large

  • Learn about efforts to educate ME residents about coverage opportunities

  • Learn where to get more information

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

These programs are offered as a collaborative effort of the Maine Medical Association, the Maine Primary Care Association and CarePartners, with support from the Maine Health Access Foundation in an effort to inform patients of coverage opportunities under the federal 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]

U.S. Supreme Court to Review Appellate Court Order Striking Down Vermont Data Mining Law

On January 7th, the U.S. Supreme Court granted Vermont Attorney General William Sorrell's request for review of the Second Circuit Court of Appeals' finding that Vermont's law prohibiting the sale or use of prescriber-identifiable data for the marketing of prescription drugs unduly restricts commercial speech.  This decision is contrary to two issued by the First Circuit Court of Appeals upon review of similar laws in Maine and New Hampshire in which that court held that the laws regulated commercial conduct, but not speech.  The U.S. Supreme Court likely agreed to review the Vermont case because of this conflict in the decisions of the circuit courts of appeal and because a number of state legislatures are likely to consider similar legislation.  The Court should decide this case along with 5 other health care cases during the current term.


The case is Sorrell v. IMS Health, Inc., U.S., No. 10-779.

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CMS Enhances Physician Directory Tool

In late December, the Centers for Medicare & Medicaid Services (CMS) announced that it enhanced its physician directory tool with new information.  Called Physician Compare, the new aspect of the web site is intended to help beneficiaries find physicians and other health care professionals in their communities.  The new site is required by the ACA.

 

The information on the site includes:

 

  • contact and address information for the practice office;

  • medical specialty;

  • institution awarding professional degree and residency or other clinical training;

  • any foreign language spoken by the practitioner;

  • the practitioner's gender; and

  • whether the practitioner has reported data through the Physician Quality Reporting System (PQRS).

The web site is at http://www.medicare.gov/find-a-doctor.

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