January 31, 2011

 
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Specialist Physician Groups Form Maine’s Largest Independent Practice Association

Four specialty medical practices in southern Maine announced last Thursday the formation of an Independent Practice Association (IPA).  Chest Medicine Associates, Portland Gastroenterology Associates, OA Centers for Orthopaedics, and Spectrum Medical Group are the founding members of the newly formed Maine Specialty IPA.  The largest of its kind in Maine, the IPA represents more than 250 physicians and other medical providers caring for patients in southern Maine and across the entire state.

Popular in other parts of the country, an IPA consists of a network of physicians who agree to participate in an association to contract with health insurance companies and other payer organizations.  Members of the Maine Specialty IPA will maintain their independent physician ownership structures and will seek to achieve cost efficiencies by sharing administrative services.

In forming Maine Specialty IPA, the physician association is countering a trend towards hospital-based employment and away from independent practice.  Members of the newly formed IPA believe that by combining their resources, they can be effective in providing physician-led solutions to the challenges facing Maine and the nation as it relates to the delivery and financing of health care services.  “Collectively, we believe that by aligning and integrating, our groups will be able to improve clinical care coordination and delivery of specialty medical services for the benefit of our patients,” said Dr. Robert McArdle, President of Chest Medicine Associates (CMA). “Simultaneously, we expect to improve efficiency and address the overall costs of health care services in a positive manner.”

 Eventually, the IPA intends to extend association membership to other area practices. 

For more information, contact David Landry, CEO, Spectrum Medical Group at (207) 482-7800, ext. 128; landrd@spectrummg.com

 


Andrew MacLean, J.D. Named MMA COO; Lani Graham, M.D., M.P.H. to Direct MPHP

In a staff change effective February 1, 2011, MMA Deputy EVP Andrew MacLean will become Chief Operating Officer (COO) having responsibility for Human Resources at MMA.  Mr. MacLean will also be the primary MMA staff liaison to the Medical Professionals Health Program.  Mr. MacLean has been with MMA for twelve years and will continue his existing roles as general counsel and the MMA's primary lobbyist at the State House.

"MMA is very fortunate to have a person with Andy's background and experience to take on this role.  Beginning his third term as Mayor of the City of Gardiner and as incoming Board Chair of the New England Division of the American Cancer Society, he continues to excel at whatever he takes on," said Gordon Smith, MMA EVP.  "This staff change is intended to give our growing staff strong and consistent leadership.  With Andy responsible for HR and day-to-day operations, I will be able to spend more time on member recruitment and retention, particularly within the area of group practices, both independent and employed.  I will also continue our active program of educational presentations and manage our grants and special programs," Smith added.

In other MMA staff changes, Lani Graham, M.D., M.P.H., a former Director of the Bureau of Health (now the Maine CDC), has been named the Director of the Medical Professionals Health Program, following a proud tradition of physician leaders of the program beginning with John Dalco, M.D. and more recently David Simmons, M.D.  Dr. Graham has been serving as Medical Director of the program but recently was asked to take on a greater degree of responsibility.  All MPHP staff will report to Dr. Graham.  As noted above, Andrew MacLean will be the primary MMA liaison to the program, effective February 1, 2011.

The Medical Professional Health Program, with more than 25 years of experience in working with the state's medical boards and impaired health professionals, now serves five licensing boards and health professionals in the fields of medicine (MD's, DOs, and PAs), dentistry, nursing, and pharmacy.  Legislation is currently pending in the 125th Legislature that would add podiatry and veterinary medicine to the program.  MPHP staff for the last year has been located in the John C. Dalco House adjacent to MMA's office park in Manchester.  The program has a staff of approximately six dedicated individuals who work hard every day on behalf of health professionals who struggle with diseases of addiction.

At its annual meeting in January, the Advisory Committee to the program elected Robert Chagrasulis, M.D. of Bridgton and Calais as Chair of the Committee and Jack Ellis, D.D.S. of Farmington as Vice-Chair.  Out-going Chair Guy Raymond, M.D. of Fort Kent was recognized for exemplary service as chair over the past two years.  He will continue to serve on the Committee. [return to top]

Karl Storz-Endoskope Presents Cadaver Workshop for Laparoscopic Surgeons Feb. 12 at Bates College

Karl Storz-Endoskope will offer a hands-on cadaver workshop for laparoscopic surgeons on Saturday, February 12, 2011 at Bates College in Lewiston.  The workshop is designed to provide and enhance the laparoscopic surgeon's knowledge of reduced port/single port access surgery.  Course attendees will participate in didactic and hands-on sessions to facilitate this working knowledge.  At the conclusion of the course, the participant will have a broad understanding of the following approaches as they relate to:

  • Adoption of reduced port techniques (including single port access surgery);

  • Techniques of accessing the abdomen for reduced port surgery;

  • Reduced port/single port access cholecystectomy; and

  • An understanding of the safety and applications of reduced port surgery.

The course is a single day, hands-on workshop.  For the didactic course, the facility has state of the art audio-visual equipment.  For the hands-on training, there will be 4 cadaver stations each with its own video tower.  There will be two to three participants at each of the four stations.

There is no cost for the course and coffee and lunch will be provided.  The course director is Jamie Loggins, M.D., FACS, Chief of Surgery at Central Maine Medical Center.  The guest instructor is Paul G. Curcillo II, M.D., FACS, Vice Chairman, Dept. of Surgery at Drexel University College of Medicine in Philadelphia.

To register for the course, contact any of the following:

Steve Fulton -  Cell:  207-210-8187

Tony Pollak - Cell:  603-566-2569

Tracy Nieuweboer - 508-248-1287 [return to top]

"First Fridays" Program on Health Care Reform at MMA this Friday

The next MMA First Fridays program scheduled for this Friday, February 4th from 9:00 a.m. to noon at the MMA office in Manchester is entitled, The Future of Health Care Reform:  Are We Moving Forward or Back?

The program objectives are:

  • To inform attendees of provisions of the federal Affordable Care Act (ACA) that benefit their practices and patients;

  • To inform attendees of provisions of the ACA which physicians may find onerous or burdensome;

  • To discuss the state's response to the federal law;

  • To inform attendees of the impact of the ACA on health insurance; and

  • To consider the impact on medical practice if the law repealed in part or in its entirety.

The faculty for the program include MMA attorneys Andrew MacLean and Jessa Barnard along with the following experts:

  • Joel Allumbaugh.  Mr. Allumbaugh is Chief Executive Officer of National Worksite Benefit Group, Inc. (NWBG), a full service employee benefits insurance agency specializing in consumer driven health plan strategies.  Prior to that, Mr. Allumbaugh was an independent insurance agent for six years.  He has served on the board for the Maine Association of Health Underwriters, including terms as President from 2002-2003 and from 2007 to the present.  He holds a certification in consumer driven health care, and instructs insurance agents throughout New England.  Mr. Allumbaugh is the host of "Inside Maine Healthcare," a cable access television program airing on the Time Warner Cable Network.

  • Benjamin P. Townsend, Esq.  Mr. Townsend is an attorney with Kozak & Gayer, P.A.  He maintains a general health care law practice with an emphasis on advising hospitals and their affiliates with regard to strategic and transactional planning, regulatory compliance, and clinical practice issues.  He has also advised physicians and other health care professionals with regard to staff privileges, professional licensure, Medicare and Medicaid reimbursement, and other issues.

You will find more information about the program, including registration information, on the web at:  http://www.mainemed.com/calendar/details.php?IDMeet=1098.  You also may contact Maureen Elwell at melwell@mainemed.com or 622-3374, ext. 219.  The program is available by Webex.

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MaineCare Seeking Volunteers to Help Develop Methodology for Determining Eligibility for HITECH Funds

MaineCare officials in Augusta are seeking assistance from ten or so practices to help develop an argument to CMS allowing Maine to use a simple charge-based accounting of the practice's eligible professionals' Medicaid share of total clinical activity.  The practices could be independent, hospital-based, or FQHC's.

CMS has declared that the accepted method of counting clinical activity is based on the number of encounters, where an encounter is defined as the set of services provided to a patient on a single day.  MaineCare officials have been concerned that this method could be subject to gaming but also that counting encounters from a practice billing or claims system could be difficult.  They have proposed to CMS a simple method based upon the ratio of Medicaid charges to all charges as an alternative.  CMS has rejected such a methodology, but has stated that they might accept the methodology if MaineCare can prove to them that the two methods are comparable, or perhaps that the charge-based method is a better indication of medicaid participation than the encounter-based method.

In order for MaineCare to make its case to CMS, officials are asking for some practices to develop the data both ways, as follows:

  1. Pick a 90-day period.

  2. For that period of time, count MaineCare encounters by rendering or servicing provider for all payers, and separately count encounters where Medicaid (any state, not just Maine) is the primary or secondary payer.

  3. For the same time period, sum charges by rendering provider for all payers, and separately sum charges where Medicaid is the primary or secondary payer.

An encounter can be considered whether or not the provider actually sees the patient.  Thus, an x-ray interpreted or EKG read could be considered an encounter.  A multi-day claim, for example for an inpatient hospitalization, would be considered an encounter for each day the provider actually saw the patient.  An encounter where there is a global payment, for example for a surgical procedure or obstetric care, would be considered as containing the number of separate days the provider provided care for the patient.

If your practice manager or billing assistant is willing to work with MaineCare on this analysis, please contact Rod Prior, M.D., Medical Director for MaineCare at 287-1827 or via e-mail to Roderick.E.Prior@maine.gov. [return to top]

Moms, Businesses, and Doctors Demand Action on Toxic Chemicals

Parents, business owners, doctors, and environmental health advocates converged on the State House on Thursday January 27, 2011 to express their outrage at Governor LePage's proposed repeal of laws that protect children, families, and businesses from toxic chemicals in every day products.

In 2008, Maine passed a law with overwhelming bi-partisan support to protect children from toxic chemicals. This year, the Maine Board of Environmental Protection (BEP) acted under the law to identify BPA as the first priority chemical to be banned from certain consumer products in a rule that is supposed to go into effect next January.  But, as part of his regulatory reforms, Governor Paul Lepage has identified the BPA rule as one that he wants repealed.    

“After a few short weeks in office Governor LePage wants to reverse the course of history - ignoring science in favor of political pandering to out-of-state chemical industries,” said Mike Belliveau, Executive Director of the Environmental Health Strategy Center, a Maine-based public health organization.  “Not only does the Governor want to throw out the baby with the bath water, he wants to poison the baby first!”

Megan Rice, a mother of two from the town of China, participated in last week’s environmental round-table with the Governor and expressed frustration with the Administration’s recommendations that were released this week.  She remarked, “I’m worried and I’m angry.  Who doesn’t want to protect kids from toxic chemicals?  And since not a single business testified against the Kid-Safe Products Act or the designation of BPA as a priority chemical, who is the Governor trying to protect with these repeals?  It seems he’s prioritizing the chemical industry’s wish list over a healthy future for our children.”

Dr. Syd Sewall spoke against the repeal on behalf of the Maine Chapter of the American Academy of Pediatrics and Physicians for Social Responsibility.   The Maine Medical Association Public Health Committee has taken a stand in favor of the law and BPA rules.   To get involved, please contact Jessa Barnard at jbarnard@mainemed.com or 622-3374, ext. 211. 


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MMA Public Health Committee CME: Social Determinants of Health Outcomes, Feb 9th

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, ext. 211 or jbarnard@mainemed.org.   [return to top]

Topics in Gastroenterology Update 2011 - April 9, 2011 Harraseeket Inn

Harraseekett Inn  April  9th, 2011

“Topics in Gastroenterology- Update for 2011”

Please contact Gail Begin for registration materials at gbegin@mainemed.com or 207-622-3374, ext. 210

Course co-directors:  Jay Bosco MD,  Gilbert Wilcox MD

Agenda

7:30-8:00 Registration

8:00-8:15 Opening remarks Dr. Bosco

Session I- Esophagus- Moderator Dr. Erkinnen

8:15-8:45 Esophageal reflux- diagnosis, and management –Dr. John Erkinnen

8:45-9:15 Esophageal testing what’s new? –Dr. Chris Kleeman

9:15-9:45 Esophageal reflux complications and treatments – Dr. Bosco

9:45-10:00 Questions and Answers, panel discussion

10:00-10:15 Break, visit exhibits.

Session II-Pancreatic Cancer symposium-  Moderator Dr. Stefan

10:15-10:45 Coordinated statewide strategies for management in Maine,–Dr Rutstein

10:45-11:15- Chemotherapy in the era of neo-adjuvant treatment.- Dr. Hertler

11:15-11:45- Radiation therapy – what and when. Dr. McGinn

11:45-12:00 Questions and Answers, panel discussion

12:00-12:45 Lunch (provided)

State of the Art Lecture- “MGS distinguished Lectureship  Award”

12:45-1:30- Natural orifice transluminal endoscopic surgery ((NOTESTM).- Dr. Rothstein

AGA interactive learning symposium- Moderator Dr. Wilcox

1:30-3:30 – Agenda to be determined, per Dr. Wilcox/AGA.

3:30- Adjourn Drs. Bosco and Wilcox


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Maine Tobacco Free Hospital Network Seeks Nominations

 The Maine Tobacco-Free Hospital Network wants to recognize hospitals that have adopted strong tobacco-free policies through the annual Gold Star Standards of Excellence Program.  Applications for the 2011 awards are being accepted through February 23rd.  Hospitals that have shown their commitment to maintaining a healthy environment and protecting their employees, patients, and visitors from secondhand smoke by implementing tobacco-free policies on their campus will be recognized at a ceremony at the Maine Hospital Association on March 23rd at 10am.  The application form for the Gold Star Standards Program and more information can be accessed through www.MaineTobaccoFreeHospitalNetwork.org.

The  Network has also developed a new resource to assist health care organizations in implementing a tobacco-free policy for their campuses.  Materials have been created to support hospitals as they communicate and enforce tobacco-free policies.  Hard copies of the new Hospital Support Kit were mailed to Maine hospitals last week and the materials can also be accessed at www.MaineTobaccoFreeHospitalNetwork.org/resources.  

 

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Maine Gastroenterology Society Winter Meeting March 4-6, 2011, Rangeley Inn

Please contact Gail Begin to register at gbegin@mainemed.com or 207-622-3374 ext. 210

SCHEDULE FOR MAINE GASTROENTEROLOGY SOCIETY WINTER MEETING 2011

Friday, March 4:

6:00-7:30pm             Welcome Reception

Saturday, March 5:

7:30-8:00am             Continental breakfast

8:00-8:45am             Advances in Endoscopic Therapy for Barrett's Esophagus

8:45-9:00am             Coffee break

9:00-10:00                 Case Presentations

Adjourn for day's activities

5:00-5:45pm             Serologies in IBD--Any benefit?

6:00-6:45pm             Dinner reception

Sunday, March 6

7:30-8:00am              Continental breakfast

8:00-8:45am              New Therapies for Hepatitis C

8:45-9:30am              Health care reform: What it means for us  Gordon Smith, J.D., Maine Medical Association

9:30-9:45am              Coffee break

9:45-10:15am            Medical Malpractice  John Doyle, Medical Mutual Insurance Company of Maine

10:30-11:00am          Maine GI Society Business Meeting


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More Information on CMS Electronic Prescribing Incentive Program

A recent Maine Medicine Weekly Update article on the new CMS Electronic Prescribing Incentive Program that begins with a financial incentive, but requires a penalty for eligible physicians who do not eprescribe during 2012 through 2014, has prompted several follow-up questions from members.  The AMA has more information, including a helpful FAQ document, on the web at:  http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/health-information-technology/hit-resources-activities/cms-electronic-prescribing.shtml.  The penalty in 2012 is based on 2011 data.  

A practitioner must meet a certain threshold of prescribing activity to be either eligible for the incentive or subject to the penalty.  These would not apply to:

  • An eligible physician for whom office visits and other services listed in the CMS ePrescribing measure specifications represent less than 10% of their Medicare allowed charges in the first six months of 2011; or

  • An eligible physician who has less than 100 claims for patient services containing visit and service codes that fall within the ePrescribing measure specifications for dates of service between January 1, 2011 through June 30, 2011.

CMS also is providing two hardship exemptions:

  • Eligible professionals, including physicians, who practice in a rural area without sufficient high-speed internet access are exempt from penalties.

  • Eligible professionals, including physicians, who practice in an area without sufficient available pharmacies for electronic prescribing are exempt from penalties. 

If you have further questions about the program, please contact MMA attorneys Gordon Smith (gsmith@mainemed.com; 622-3374, ext. 212), Andrew MacLean (amaclean@mainemed.com; 622-3374, ext. 214), or Jessa Barnard (jbarnard@mainemed.com; 622-3374, ext. 211).

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Legislative Committee Conference Call This Tuesday; New Bills for Review

The MMA's Legislative Committee will hold its next weekly conference call this Tuesday, February 1st 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. 143, An Act Relating to Disability License Plates and Placards for People with Permanent Disabilities (monitor)

L.D. 146, An Act to Prohibit the Use of Mercury Amalgams in Dental Procedures for Children, Pregnant Women and Nursing Mothers (monitor; pediatricians, OB/GYNs, Public Health Committee)

L.D. 149, An Act to Authorize Municipalities to Impose Service Charges on Tax-exempt Property Owned by Certain Nonprofit Organizations (monitor)

L.D. 150, An Act to Require Drug Testing for Medicaid Recipients with Prescriptions for Scheduled Drugs (monitor)

L.D. 157, An Act to Encourage Access to Health Care in Maine (monitor)

L.D. 164, An Act to Extend the Dental Care Access Credit for Dentists Who Practice in Underserved Areas of the State (monitor)

L.D. 168, An Act to Require a Medical Examiner to Determine whether an Autopsy is Needed in the Case of the Death of a Prisoner in a Correctional Facility (monitor)

L.D. 177, An Act to Require Licensed Veterinarians to Honor Prescriptions from Other Licensed Veterinarians (monitor)

L.D. 189, An Act to Achieve Cost Savings by Eliminating Deputy Commissioner Positions throughout State Government (monitor)

L.D. 193, An Act to Require an Applicant for State Assistance to Show Proof of Legal Residence in the United States and Proof of Residency for at Least the Previous 90 Days in this State (monitor)

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