April 11, 2011

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More Than 500 Attend Quality Counts 2011, "Creating Accountable Communities of Care"

This past Wednesday, April 6th, more than 500 individuals participated in the 8th Annual Quality Counts conference at the Augusta Civic Center.  This year's theme was Creating Accountable Communities of Care:  Realizing the Promise of Better Health Care for Maine and featured keynote presentations by Susan Dentzer, Editor-in-Chief of Health Affairs and Jeffrey Brenner, M.D., Executive Director of the Camden (NJ) Coalition of Health Care Providers.  DHHS Commissioner Mary Mayhew also presented an update from the LePage administration.

The conference this year was co-sponsored by the Maine Public Health Association and the Maine Primary Care Association with additional support from the Maine Medical Association, the Maine Hospital Association, and the Maine Osteopathic Association.  In previous years, these organizations held similar conferences and this year all agreed to join together to host this event.  Martin's Point Health Care was the Platinum Sponsor of the event.

Quality Counts is a statewide health care collaborative committed to improving health and health care for the people of Maine.  Formed in 2003 and incorporated in 2006, Quality Counts provides leadership, advocacy, and support for improving care.  QC works through a broad group of stakeholders to coordinate disparate efforts to support local, patient-centered care and the resources that support them.  QC's goals are to improve health, promote consistent delivery of high-quality care, improve access to care, and contain health care costs.  Its mission is transforming health and health care in Maine by leading, collaborating, and aligning improvement efforts.  MMA EVP Gordon Smith currently serves as the Board Chair for QC.  Lisa Letourneau, M.D., M.P.H. is the Executive Director.

Following the plenary sessions, attendees participated in nearly twenty breakout sessions addressing topics ranging from Accountable Care Organizations to Medication Management.  Consumer engagement was also a consistent theme.  The day concluded with a panel discussion moderated by Susan Dentzer entitled, The Care & Feeding of Community Health Improvement Efforts:  The Role of Funders and Media in Supporting Improvement Efforts.  Panelists included Meg Haskell of the Bangor Daily News, Lisa Miller, MPH of the Bingham Fund, and Wendy Wolf, M.D., M.P.H. of the Maine Health Access Foundation.

Next year's conference will be held at the Augusta Civic Center on Wednesday, April 4, 2012.



Maine's Illicit Prescription Drug Diversion Problem Receives Media Attention

Two major news stories this week, one local and one national, highlighted some of the issues associated with prescription drug abuse and diversion in the state.  In yesterday's (April 10th) edition of The New York Times, a front page article entitled, "Newly Born, and Withdrawing From Painkillers," describes the medical and ethical difficulties in pregnant women and their infants when the mother has abused drugs.  The article notes that in 2010, the Maine Medical Center and Eastern Maine Medical Center treated a total of 276 newborns for opiate withdrawal, known as neonatal abstinence syndrome, up from about 70 in 2005.  Hospitals in other states have seen increases in the syndrome as well but the problem is particularly acute in rural areas.

In the April 6th issue of the Bangor Daily News, a front page article entitled, "Illicit, prescription drug sales plague Maine counties," BDN Reporter Diana Bowley writes that the poor economy and high unemployment rate in Piscataquis and Washington counties have pushed the rural areas to the top of the state list for street sales of both prescription and illegal drugs.  Two Milo residents died recently from accidental overdoses and two other Piscataquis County residents narrowly escaped death in recent weeks. 

In the article MMA Immediate Past President David McDermott, M.D., M.P.H. is quoted as saying that each year between six and ten people die from such circumstances in the emergency room he directs at Mayo Regional Hospital in Dover-Foxcroft.  The county sheriffs and other law enforcement officers are also quoted extensively in the article.  MMA recently participated in a four hour CME program for area prescribers on this topic held at Mayo. The hospital also recently formed a task force to work on the problem and invited law enforcement to participate.  The sessions, said McDermott, have been eye-openers and have led to popular "Diversion Alerts" sent to the prescribers regularly by law enforcement.  This approach was first used in the Waterville area.

The Maine legislature is expected to consider bills on this topic later in the current session. 


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POLITICAL PULSE: Legislative Highlights of the Week


The HHS Committee completed its work sessions on the health and social service portions of the budget and made its report back to the Appropriations Committee on Friday, April 8th.  The biennial budget is L.D. 1043:  http://www.mainelegislature.org/LawMakerWeb/summary.asp?ID=280040546.  You also can find the Appropriations Committee materials on the biennial budget on the web at:  http://www.maine.gov/legis/ofpr/appropriations_committee/materials/index.htm.  You will find the HHS Committee report here.  The Appropriations Committee begins its work sessions on the biennial budget this week.


On Wednesday, April 6th, the Insurance & Financial Services Committee held public hearings on L.D. 496, An Act to Amend the Laws Governing Accessibility of Services Covered by Health Insurance Providers.  The MMA joined the MHA in opposing this bill, given the MMA's long standing support for the patient protection provisions of the Health Plan Improvement Act and Rule Chapter 850.  This subject has been a matter of significant debate in the legislature for the better part of the last ten years and the MMA acknowledges differences of opinion within the membership.  Rather than patient protections, some see the geographic access standards as an obstacle to developing "centers of excellence."  We are interested in physician feedback on this issue.  Please contact Gordon Smith (gsmith@mainemed.com) or Andrew MacLean (amaclean@mainemed.com), if you have thoughts on this or if you would like to discuss it further. 


On Tuesday, March 22nd, the Judiciary Committee heard two bills that would change current law giving the treating health care practitioner the discretion to treat a minor patient confidentially without parental consent if he or she believes it is in the best interest of the child:  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 and L.D. 746, An Act Regarding the Consent of Minors for Mental Health and Substance Abuse Aid.  The bills have not yet been scheduled for work session.

The MMA expects these bills to be closely divided coming from the Judiciary Committee and will be vigorously debated on the floor.  We encourage you to contact your own two legislators to urge them to oppose the bills now.  You can find your legislators through the following tool on the legislature's web site:  http://www.maine.gov/legis/house/townlist.htm.  Also, if you are a constituent of a Judiciary Committee member or have a relationship with a member, we ask you to contact him or her.  You can find the members of the Judiciary Committee and their contact information on the web at:  http://www.maine.gov/legis/house/jt_com/jud.htm.

Here's the link to L.D. 31:  http://www.mainelegislature.org/LawMakerWeb/summary.asp?ID=280038923.

Here's the link to L.D. 746:  http://www.mainelegislature.org/LawMakerWeb/summary.asp?ID=280039990.

Remember, you can leave a message for a legislator during the week at the State House as follows:

Senators:  1-800-423-6900

Representatives:  1-800-423-2900


Last week was the first week that the HHS Committee returned to substantive bills since it began its hearings and work sessions on the biennial budget more than 6 weeks ago.  On Tuesday, the Committee heard two bills challenging the medical, scientific, and public health benefits of immunizations:  L.D. 694, An Act to Encourage Transparency in Disclosing the Ingredients in Vaccinations for Children to Parents and Guardians and L.D. 941, An Act to Prohibit Mandatory Immunizations.  The MMA and the Maine Chapter of the American Academy of Pediatrics spoke in opposition to both bills.  Unlike past legislative sessions, these bills may come out of the Committee as divided reports, so they may be debated on the floor.  Grassroots contact with Committee members would be helpful.  You can find the members of the HHS Committee and their contact information on the web at:  http://www.maine.gov/legis/house/jt_com/hum.htm.

Here's the link to L.D. 694:  http://www.mainelegislature.org/LawMakerWeb/summary.asp?ID=280039982.

Here's the link to L.D. 941:  http://www.mainelegislature.org/LawMakerWeb/summary.asp?ID=280040354.

You also can use the toll free numbers above.

On Wednesday, April 6th, the Committee held a hearing on a series of certificate-of-need (CON) bills.  One (L.D. 360) would eliminate CON review in Maine,  another (L.D. 582 would raise the thresholds for CON review, and a third (L.D. 581) would eliminate Capital Investment Fund (CIF), the annual limit on spending for projects requiring CON review.  The MMA and Dan McCormack, CEO of InterMed, testified in favor of all three bills.  The MHA spoke in favor of L.D.s 581 and 582.  While repeal of the Maine Certificate-of-Need Act of 2002 seems unlikely, it seems quite likely that the Committee will increase the thresholds for CON review.

On Thursday afternoon, April 7th, the Committee held a hearing on L.D. 531, An Act to Specify Qualifications for the Director of the Office of Adult Mental Health Services within the Office of Adult Mental Health Services within the Department of Health & Human Services, a bill submitted by the Maine Association of Psychiatric Physicians (MAPP) in response to the Department's elimination of 3 psychiatrist positions during a supplemental budget in 2010.  MAPP President Julie K. Pease, M.D. and Division of Adult Mental Health Director Ron Welch both spoke in favor of the bill.  A consumer advocate spoke against.

Lastly, the Committee heard three HIV bills on Friday, April 8th:  L.D. 596, An Act to Allow Medical Records to Contain an Option Regarding HIV Status Disclosure, L.D. 724, Resolve, to Create an Evidence-Based Study and Comprehensive Plan for HIV and AIDS Services in Maine, and L.D. 702, An Act to Prevent HIV Transmission from a Pregnant Mother to a Child.  The MMA testified in opposition to L.D. 596 as unnecessary under current law and in favor of L.D. 702 as consistent with ACOG guidelines.

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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, April 12th 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.

Priority bills for discussion:

L.D. 1393, An Act to Require Estimates of Patient Costs in Any Plan of Care Prior to Treatment (oppose)

L.D. 1398, An Act to Amend the Laws Administered by the Department of Environmental Protection (monitor; Public Health Committee)

L.D. 1406, An Act Regarding the Scope of Services that May be Provided by Pharmacies Owned by Hospitals (support; MHA has requested support)

L.D. 1412, An Act to Promote the Proper Disposal of Used Medical Sharps (monitor; Public Health Committee)

L.D. 1426, An Act Concerning Notification to an Employer of Misrepresented Medical Information under the Maine Human Rights Act (monitor)

L.D. 1429, An Act to Amend the Laws Governing Prescription Monitoring Information (support)

L.D. 1435, An Act to Adopt the Interstate Prescription Monitoring Program Compact (support)

L.D. 1436, An Act to Reform Maine's Health Insurance Laws (oppose)

Consent bills for discussion only if requested by a participant:

L.D. 1391, An Act to Improve Access to Veterinary Medicine and Improve Veterinary Care (monitor)

L.D. 1397, An Act to Establish a Single-payor Health Care System to be Effective in 2017 (monitor)

L.D. 1420, An Act to Modify the Laws Regarding Status as an Independent Contractor (monitor)

L.D. 1433, An Act to Provide for the Recycling or Proper Disposal of Architectural Paint (monitor; Public Health Committee)

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AMA Releases CPT App; Issues "App Challenge" Contest

On March 29, 2011, the AMA announced its first physician "app," one that would allow physicians to quickly find a appropriate CPT codes.  You can read the AMA's press release on the app and the related "App Challenge" on the web at:  http://www.ama-assn.org/ama/pub/news/news/app-challenge-physician-app.page?.

You can find more information about the "App Challenge" on the web at:  http://amaidealab.org/.

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MMA Executive Committee Meets on Wednesday, April 13th

The 28-member MMA Executive Committee will holds its regularly scheduled meeting this coming Wednesday, April 13th, at the Frank O. Stred Building in Manchester.  Priority topics for the meetings include:

  • A consideration of whether a Maine-based organization should seek the Medicare Quality Improvement federal contract now held by the Northeast Healthcare Quality Improvement Foundation in Dover, N.H.

  • A presentation by staff from the Board of Licensure in Medicine regarding the recently announced requirement that physicians seeking licensure renewal take the open-book, jurisprudence exam, previously required only of new applicants.

  • Review of pending amendments to the MMA Constitution and Bylaws, several of which impact on the make-up of the Executive Committee and how E.C. members are recruited and selected.

Many legislative items are also on the agenda for discussion, including legislation affecting certificate-of-need laws, health insurance regulations, medical fees paid under workers' compensation, and several public health issues (immunizations and HIV testing among others).

The meeting will begin at 2:00 p.m. and any MMA member is welcome to attend.  The Committee is chaired by Kenneth Christian, M.D., who practices emergency medicine in Ellsworth. [return to top]

Faculty Announced for May 6th Annual HIPAA Udate: Let MMA Do Your Staff Training

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.  The HIPAA regulations require annual training for staff and recommends that new staff be trained as soon as practicable.

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 Faculty will consist of Kenneth Lehman, Esq., Stacey Mondschein, Esq., Andrew MacLean, Esq., and Gordon Smith, Esq., MMA EVP.

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 www.mainemed.com.

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

Maine House Votes to Ban Bisphenol-A (BPA), Senate Vote Expected this Week

The Maine House of Representatives on Thursday, April 7th overwhelmingly endorsed banning the chemical bisphenol-A from children's products.  The ban on BPA, which many studies have shown poses cancer risks to children and pregnant women, was the first chemical banned under the Maine's Kids Safe Product Act of 2008.  The vote to approve the ban was 145 to 3.  A Senate vote is expected this coming week.  The bill is expected to pass the Senate given its unanimous approval by the Legislature's Environment & Natural Resources Committee.

Governor Paul LePage still opposes the ban, stating that he is not convinced that BPA is dangerous.  However, at the hearing on the bill in late March, the administration dropped its opposition to the bill, testifying in the category of "neither for nor against" the bill.

MMA's Committee on Public Health submitted testimony in support of the ban.
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Space Available at Me ACEP CME Program on Drug Diversion Tuesday evening in Orono

The Maine Chapter of the American College of Emergency Physicians has received a grant from ACEP to present five CME sessions for emergency physicians on the subject of prescription drug diversion and specifically the value of the Prescription Monitoring Program.  The programs are presented without cost to attendees.  The next program is this coming Tuesday, April 12th evening at the Black Bear Inn in Orono.  The program runs from 5:00 p.m. to 8:00 p.m. and a light dinner is served.  MMA is assisting with the content for the programs.

While specifically designed for emergency physicians, any interested prescriber is welcome to attend.  Please contact Anna Bragdon, the Maine ACEP staff person if you would like to register for this free program and receive up to three hours of category one credit.  Anna can be reached at 207-441-5989 or via e-mail to maineacep@roadrunner.com

Additional programs are scheduled for Parkview Adventist Medical Center in Brunswick (April 27th), Southern Maine Medical Center (April 28th) and Central Maine Medical Center in Lewiston (April 21st). [return to top]

MMA's Annual Corporate Affiliate Breakfast Featuring Bill Green is this Thursday

This year's Corporate Affiliate Breakfast will be held this coming Thursday, April 14ht from 7:30 a.m. to 9:30 a.m.  The venue is again the Portland Country Club in Falmouth which has proven to be a popular location for the event in the past.  The featured speaker this year is well-known television personality Bill Green of Bill Green's Maine, seen on Saturday evenings at 7:00 p.m. on WCSH television.

All MMA Corporate Affiliates are invited to attend.  There is no cost as the annual breakfast is an opportunity to thank the affiliates for their support of MMA all year.  MMA members serving on various committees are also welcome to attend.

MMA currently has about ninety Corporate Affiliates.  The breakfast is expected to attract about one hundred invitees.

Please let Lisa Martin in the office know if you are attending and have not yet RSVP'd.  Her office number is 622-3374, ext. 221 and her e-mail is lmartin@mainemed.com. [return to top]

"Brigham Update in Medicine" Scheduled for May 23-26 in Boston

The Department of Medicine at Brigham and Women's Hospital in conjunction with the Department of Continuing Education at Harvard Medical School, is pleased to offer medical society membership a special reduced tuition rate to attend the upcoming "Brigham Update in Medicine" course being held in Boston at the Fairmont Copley Hotel (May 23-26, 2011).  The standard physician rate to attend this course is $1,900.  For our society membership, the sponsors would like to offer a special reduced rate of $995. (includes daily Breakfast, daily Lunch/Cases & 1 Dinner/Lecture by Dr. Martin Samuels).   A brief course description is below and you may register (and view entire program) online at: www.cme.hms.harvard.edu/courses/brigham.    


MAY 23-26, 2011 


Course Directors: Drs. Stuart Mushlin, Maria Yialamas & Joseph Loscalzo

For CME (41.5 AMA PRA Category 1) Credits - REGISTER AT: www.cme.hms.harvard.edu/courses/brigham

Harvard Medical School (Department of CME) and Brigham & Women's Hospital (Department of Medicine)

Special Reduced Rate for Society Members: $995 (Includes daily Breakfast, daily Lunch/Cases & 1 Dinner/Lecture by Dr. Martin Samuels)

For Practicing Physicians (PCPs & Subspecialists)

• An interactive Case Based Format

• Review of the Literature to guide evidence-based practice

•Clinical Pearls

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2011 Northern New England MGMA Conference Set for May 11-13 in Boston

The Northern New England MGMA Joint Conference has been scheduled for Wednesday, May 11th through Friday, May 13th at the Hilton - Boston - Logan Airport.  Keynote speakers include MGMA President & CEO William F. Jessee, M.D. speaking on ACOs; Laura Z. Stout, an advocate for individuals with disabilities; and professional facilitators from the Disney Institute.  You can find more information about the conference on the web at:  http://www.newenglandmgma.com/. [return to top]

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