March 21, 2011

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State Senate Votes to Repeal Primary Enforcement of Seat Belt Law, House Votes Coming this Week

The Maine Senate voted last Tuesday, by one vote, to weaken Maine's seatbelt law, supporting a proposal to make failure to wear a seat belt a secondary offense, rather than a primary one.  MMA opposes this change, as does the Maine Public Health Association, the Maine Chapter of the American College of Surgeons, the Maine Osteopathic Association, the American Automobile Association (AAA), and many other medical and public health organizations.  The House is expected to vote on the bill this coming week. 

In a closely divided report, the Transportation Committee had voted against the bill, but the Senate Chair of the Committee, Senator Ronald Collins (R-York) was the sponsor of the bill and apparently made a convincing case to 18 of the 35 Senators that the law should revert back to way it was prior to 2007.  At that time, the legislature passed a bill allowing for primary enforcement, meaning that law enforcement officers could stop a driver for failure to have a seat belt fastened.  Under secondary enforcement, police could cite a driver for a seat belt violation only if the driver was stopped for another offense.

The vote was largely upon party lines, with most Republicans supporting the bill and most Democrats opposing it.  However, three Republicans, Senators Roger Katz of Augusta, Nichi Farnham of Bangor, and Richard Rosen of Bucksport, voted against the bill.  Senator Elizabeth Schneider, a Democrat from Orono, voted in favor of the law.

If the bill passes the House, it would then be placed upon the Appropriations table until the end of the session as it is estimated to cost the state $1.35 million in lost fines if the law is passed.

MMA members are urged to contact their representatives and express opposition to the bill. 

Maine's seat belt use was estimated at 83% in 2008, about the same as the national average.  At the hearing on the bill before the Transportation Committee, Drs. Kenneth Christian, Erik Steele, and Edward Walworth all testified in opposition to the bill.  Dr. Steele presented data showing that the medical costs associated with injuries from accidents where the victim was not wearing a seat belt were significantly higher than the costs for treating injuries from an accident where the injured drivers or passengers were wearing seat belts.

The bill is L.D. 64, An Act to Make a Violation of the Laws Governing Seat Belts a Secondary Offense:  You can find the bill, the roll call votes, and other information about the status of the bill on the legislature's web site.

You can find your legislators and their contact information on the web at:

If the legislator does not list a cell phone number on his or her web site and you wish to leave a message for him or her during the work week while legislators are in Augusta, you may use the following toll free numbers:

For Senators:  1-800-423-6900

For Representatives:  1-800-423-2900 

POLITICAL PULSE: Legislative Highlights of the Week


Last week, the Appropriations Committee continued its public hearings on the Governor's FY 2012-2013 biennial budget in areas other than DHHS.  The HHS Committee continued its work sessions on the health and social service portions of the budget.  The two committees will be similarly occupied this week.  The biennial budget now has been printed as L.D. 1043:  You also can find the Appropriations Committee materials on the biennial budget on the web at:


On Tuesday, March 15th, the Insurance & Financial Services Committee held a work session on L.D. 540, An Act to Implement the Insurance Payment Reform Recommendations of the Advisory Council on Health Systems Development.  The bill's prime sponsor is freshman Representative Anne P. Graham (D - North Yarmouth), a pediatric nurse practitioner who was a member of the Advisory Council before her election to the legislature. Despite no testimony in opposition to the bill, the Committee split along party lines with Democrats voting in favor or the bill and Republicans voting against.  Again, as suggested by the Committee's split on the tabling motion on the mental health parity bill (L.D. 364), it seems that the clear partisan divide about health care reform is reflected in the Maine legislature.

On Wednesday, March 16th, the Committee held a lengthy public hearing on L.D. 783, An Act to Amend the Laws Governing Captive Insurance Companies.  The bill is intended to facilitate the development of a health care plan conceived by a group of employers called the Maine Wellness Association and Martins Point Health Care.  Representatives of both organizations and the employer members of the Maine Wellness Association turned out in force for the public hearing.  The LePage Administration also supported the bill as an "innovative" approach to the provision of health care services.  Members of the Maine Association of Health Plans opposed the bill.  The concern of opponents before the Committee and of the Democratic members of the Committee is that a health care plan governed by the amended captive statute would not be subject to any other aspect of the insurance code - the solvency provisions, the portability and community rating provisions, and the patient-provider protection provisions, for example.  The MMA took no position on it.  The Maine Hospital Association and the Maine State Chamber of Commerce did not comment on the bill either. [return to top]

ALERT: Adolescent Health at Risk in Bills Being Heard Before Judiciary Committee Tomorrow!

For many years, the law in Maine has supported the decision of physicians and other health professionals to allow some minors to self-consent to treatment for conditions such as substance abuse, emotional  and mental health issues, venereal disease, and for family planning services recognizing that an absolute obligation to seek parental consent in all such circumstances might be an obstacle to treatment and may not always be in the best interest of the child.  Importantly, the law provides that the physician retains discretion to notify the parents if he or she believes that failure to do so would "seriously jeopardize the health of the minor or would seriously limit the practitioner's or provider's ability to provide treatment." 22 M.R.S.A. section 1505(2).

Two legislative proposals being heard by the Judiciary Committee tomorrow would change the law and require parental consent in many of these circumstances unless the minor is living separate and apart from his or her parents, is married, is serving in the armed forces, or is legally emancipated.

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, would permit treatment under the same circumstances as exist now, but would prohibit any prescriptions from being dispensed without the express consent of the minor's parent or legal guardian.  L.D. 746, An Act Regarding the Consent of Minors for Mental Health and Substance Abuse Aid, would require parental consent except for the four exceptions noted above or unless the minor is determined by a licensed professional trained in the treatment of mental health or substance abuse problems to be at risk of harm or maltreatment, including loss of access to treatment, if a legal guardian were to be notified and the mental health or substance abuse professional refers the legal guardian to the department for investigation of possible abuse or neglect as is required in 22 M.R.S.A. section 4011-A.

MMA will offer testimony tomorrow opposing both bills and will note the long history with the existing law and the responsibility of the physicians who have been living by it.  MMA will be joined in that testimony by the Maine Chapter of the American Academy of Pediatrics, the Maine Association of Psychiatric Physicians, and several other medical and social service organizations. 

If you agree that the health of many Maine adolescents could be put at risk by these bills, please contact your legislators and members of the Judiciary Committee.  You can find the members of the Judiciary Committee and their contact information on the web at:  You can find your own Senator and Representative on the web at:   [return to top]

MMA Family Welcomes Skyler Bennett Barnard, born on St. Patrick's Day

Congratulations to MMA Director of Public Health Policy Jessa Barnard, Esq. and her husband Justin Barnard, Esq. on the birth of their first child, Skyler Bennett Barnard, born on March 17th at the Maine Medical Center in Portland.  Skyler weighed in at a healthy nine pounds, thirteen ounces.  Mother, father, and baby are all healthy and doing fine. 

Jessa will be out of the office for approximately three months and her responsibilities have been assigned to various MMA staff and to Mariah Gleaton who has stepped in again to assist with the Public Health Committee.  Mariah, who will be attending law school in the Fall, assisted the Committee last year during the period between Kellie Miller's departure from MMA and Jessa's arrival.



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Let MMA Train Your New Staff on HIPAA, Friday, May 6th

MMA will present its annual HIPAA staff training on Friday, May 6th at the MMA office or via WebEx.  The program will be from 9:00 a.m. to noon and the cost per person is just $65 which includes substantial materials for all attendees and breakfast for those persons attending the live presentation in the office in Manchester.

This program would be most valuable for staff you may have hired in the past year but have not provided with any HIPAA training. 

The Annual HIPAA staff training is one of MMA's most popular programs so don't delay in registering.  Registration is available now on the Association's website at

For questions, contact Gail Begin or Maureen Elwell at MMA at 622-3374 or via e-mail to or , respectively. [return to top]

April 1st First Friday Program Featuring Coding Update Moved to Afternoon

The April 1st First Friday educational program, entitled, No April's Fool, Annual Coding Update, has been moved from the morning to the afternoon from 1:00 p.m. to 4:00 p.m.  Featuring Laurie Desjardins, CPC and Jana Purrell, CPC from the Learning Center (formerly the Coding Center of MMA) at Baker, Newman & Noyes, this annual update will feature several current coding topics.  A flier including the topics and agenda will be distributed this week and placed on the MMA website at  The cost of the seminar is $65 and interested individuals may attend either via WebEx or by joining the faculty at the MMA offices in Manchester.  MMA Executive Vice President Gordon H. Smith, Esq. will be moderating the afternoon discussion.

Questions about the program and any First Friday program may be addressed to Gail Begin or Maureen Elwell at MMA at 622-3374 or via e-mail to or, respectively.



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UNE Physician Assistant Program Seeking Physicians Interested in Becoming Clinical Preceptors

The University of New England (UNE) Physician Assistant Program is looking for physicians and physician assistants who are interested in joining their team of dedicated faculty as clinical preceptors.  Beginning June 1, 2011, the PA Program will be offering clinical preceptors an honorarium along with a University adjunct faculty appointment.  Internists are particularly needed.

The UNE PA Program is the only PA program in Maine.  It's mission is to provide primary care to Maine's underserved and geriatric populations and its graduates currently account for 34% of the PA's currently practicing in Maine.

If you would like to learn more about this opportunity, please contact the Clinical Coordinator, Karen Marlin, PA, at 207-221-4408 or via e-mail to

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MIHMS Practice Focus Groups REGISTER TODAY!

MaineCare and Molina Medicaid Solutions would like to hear practice feedback on MIHMS (Maine Integrated Health Management Solution).

Focus groups are planned to take place across the state throughout the months of March and April.  Each focus group session will be followed by afternoon demonstrations. 

The morning session will include:

  • Overview of known issues and progress report on resolving these
  • Small-group discussions (by provider type) on how MIHMS is working, and what can be improved

Please note that the purpose of the morning will be to gather high level feedback for process improvement from providers as it relates to MIHMS.  Questions and answers related to specific claims and payments issues will not be addressed in these sessions.  We anticipate providing the opportunity for this type of discussion at future events.  

At the afternoon session, providers can see a demonstration of the MIHMS Online Portal. Demonstration areas will include:  Member Eligibility, Authorizations, Claims, and Remittance Advice Statements.

You can view the dates, locations and register online for all  sessions at:

Note: Special hospital-only and dentists-only sessions are planned but not yet scheduled.


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President Signs Another Continuing Resolution on Federal Spending
On March 18th, President Obama signed another continuing resolution (H.J. Res. 48) to keep the government running and to avoid a shutdown until April 8th.  The bill passed by a vote of 87-13 in the Senate on March 17th.  The bill received support from 48 Democrats, 38 Republicans, and 1 Independent. [return to top]

CBO Estimates 0.4% Reduction in National Health Spending From Federal Medical Malpractice Bill
On March 10th, the Congressional Budget Office (CBO) released its analysis of the Help Efficient, Accessible, Low-cost Timely Healthcare Act of 2011, the tort reform bill that passed the House Judiciary Committee on February 16th.  The bill includes a $250,000 cap on non-economic damages, a 3 year statute of limitations measured from discovery, and restrictions on punitive damages.  CBO estimates the bill would reduce the nation's health care spending by about 0.4% by reducing medical liability insurance premiums and by reducing the costs of defensive medicine.  CBO suggests that the bill could also reduce the federal deficit by $40 billion during the years from 2011-2021 through reductions in spending in Medicaid, Medicare, and the FEHBP, as well as an increase in revenue of $6 billion during this period. [return to top]

Legislative Committee Conference Call This Tuesday; New Bills for Review

The MMA's Legislative Committee will hold its next weekly conference call this Tuesday, March 22nd 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 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.

Priority bills for discussion:

L.D. 859, Resolve, to Convene a Task Force to Study Cost-effective Ways of Dealing with an Increased Population of Those Affected by Alzheimer's Disease (monitor; psychiatrists, geriatricians)

L.D. 867, An Act to Amend the Laws Governing Insurance as They Relate to Civil Penalties Imposed for Violations of Those Laws (oppose)

L.D. 887, An Act to Include Medicinal Marijuana Patients in the Controlled Substances Prescription Monitoring Program (MMA bill; support)

L.D. 889, An Act to Regulate Boxing and Prizefighting in Maine (monitor; Public Health Committee)

L.D. 897, An Act to Amend the Application Process for the Progressive Treatment Program (monitor; psychiatrists)

L.D. 914, An Act to Make Certain Synthetic Cannabinoids Illegal (monitor; Public Health Committee)

L.D. 918, An Act to Reduce the Cost of Mental Health Services in Maine (monitor; psychiatrists)

L.D. 920, An Act to Ensure the Availability of Preventive Health Care Services for Children (monitor; pediatricians)

L.D. 924, An Act to Educate Women on the Medical Risks Associated with Abortion (oppose; ob-gyns)

L.D. 933, Resolve, Requiring the Department of Health & Human Services to Conduct a Review of Medicaid "Any Willing Provider" Requirements (monitor)

L.D. 936, An Act to Conform Maine Menu Labeling Laws to Federal Standards (monitor; Public Health Committee)

L.D. 941, An Act to Prohibit Mandatory Immunizations (oppose; pediatricians)

L.D. 947, An Act to Encourage Professionals to Move to the State (oppose)

L.D. 950, An Act to Exempt Health Care Sharing Ministries from Insurance Requirements (monitor)

L.D. 966, An Act Regarding the Use of Methadone by Operators of Commercial Motor Vehicles (monitor; Public Health Committee)

L.D. 971, An Act to Improve the Health of Maine Students (support; pediatricians, Public Health Committee)

L.D. 980, An Act to Prohibit Cyberbullying in Public Schools (support; pediatricians)

L.D. 988, An Act Concerning Immunity for School Administrative Units in the Discharge of Their Responsibilities (monitor; pediatricians)

Consent bills for discussion only if requested by a participant:

L.D. 858, An Act to Amend the Law Related to Multiple-employer Welfare Arrangements (oppose)

L.D. 866, Resolve, to Establish a Consistent Workers' Compensation Classification for Pharmacies (monitor)

L.D. 869, An Act to Clarify the State's Authority under Public Health Laws for Municipal Inspections of Establishments (monitor; Public Health Committee)

L.D. 882, An Act to Limit Health Care Mandates (monitor)

L.D. 892, An Act to Establish an Insurance Fraud Division within the Department of Professional & Financial Regulation, Bureau of Insurance (monitor)

L.D. 934, An Act to Reform the Dirigo Health Program (monitor)

L.D. 899, An Act to Disclose Insurance Policy Options to Senior Citizens (monitor)

L.D. 930, An Act to Clarify Maine's Phaseout of the "Deca" Mixture of Polybrominated Diphenvl Ethers (monitor; Public Health Committee)

L.D. 932, An Act to Allow Concealed Weapons in the State House (monitor; Public Health Committee)

L.D. 937, An Act to Increase Access to Dental Care in Rural Areas (monitor)

L.D. 939, An Act to Enhance Mandated Reporting and Prosecution of Elder Abuse, Neglect and Exploitation (monitor)

L.D. 955, An Act to Establish the Dental Adjudicatory Panel (monitor)

L.D. 962, An Act to Amend the Medicaid Income Requirements to Promote Agricultural Labor (monitor)

L.D. 963, An Act to Ensure Humane Treatment for Special Management Prisoners (monitor; psychiatrists)

L.D. 967, An Act to Cut the Cost of Behavioral Health Care in Hospital Emergency Rooms and to Enhance Access to Peer Support and Community-based Services (monitor; psychiatrists)

L.D. 995, An Act to Require Dental Professionals to Provide Education to the Public on Oral Hygiene (monitor; Public Health Committee)



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