April 18, 2011

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Maine Health Management Coalition Launches New Website

At a state house news conference Tuesday, the Maine Health Management Coalition announced the creation of a new website intended to compare both physicians and hospitals based upon nationally and locally accepted standards of care.  GetBetterMaine.Org hopes to drive improvements in quality and to engage patients in the effort.  The effort is voluntary and no physician or hospital is required to submit data to the Coalition for the site.  

The Maine Health Management Coalition (MHMC) is a purchaser-led partnership among multiple stakeholders working collaboratively to maximize improvement in the value of health care services delivered to MHMC members, employees, and dependents.  The Coalition is made up of large employers, hospitals, large medical practices, and insurers and has been publishing health care data since 2004.  The new website replaces a site formerly used by the Coalition Foundation to publicize quality ratings.

GetBetterMaine.Org is a project of the Coalition's Foundation, the Maine Quality Forum, and Maine Quality Counts, with additional funding provided by the Maine Health Access Foundation and the Robert Wood Johnson Foundation.  

The website lists providers in two groups:  hospitals and physician practices.  A user enters his or her zip code and indicates how far he or she is willing to travel from home.  The site then lists the number of hospitals or physician practices within the designated area.  Hospitals are then rated for Effectiveness, Safety, and Patient Satisfaction for certain medical conditions like heart attack care, health failure care, pneumonia etc.  For physician practices, the practice is rated on different medical conditions like heart disease care or diabetic care in the same categories as hospitals.

The web site will be regularly updated as additional medical conditions are added.  The Foundation also plans to begin to introduce cost information later this year.

 For more information, see www.GetBetterMaine.org.







May 18th Annual Practice Education Seminar to Feature Your Most Pressing Issues

MMA's 20th Annual Practice Education Seminar, being held again this year at the Augusta Civic Center, will feature presentations on a number of topics that members say are difficult for them to get their hands around.  The program will be held on Wednesday, May 18, 2011 from 8:30 a.m. to 4:30 p.m.

Among the topics are the following: 

  • Measuring Quality in a physician practice;
  • What's New at Medicare;
  • Achieving Meaningful Use in a Meaningful Way;
  • Preparing for Accountable Care Organizations;
  • Addressing Issues with Elderly Drivers;
  • Social Media in Your Practice:  Friend or Foe; and
  • Preventing Prescription Drug Abuse

 Speakers include Insurance Superintendent Mila Koffman, J.D., John Freedman, M.D. of Freedman HealthCare, and Thomas Arnold, Deputy Secretary of State.

Registration materials will be mailed this week but you may also register now on the MMA website at www.mainemed.com.




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Monthly Member Website Question: What Do You Think?

The first day of each month MMA places a new question on the home page of the MMA website, http://www.mainemed.com, to get member opinions on issues.  This month's question is:  The federal government recently published proposed rules for the operation of Accountable Care Organizations (ACO's).  Do you expect to be participating in such an organization?

Please take a moment to go to http://www.mainemed.com and place your vote.  The questions are for members only, so you will need to enter your username and password and then it is as easy as toggling on a button indicating your choice and pressing submit.  If you haven’t registered as a member, you can do so easily by completing this form https://www.mainemed.com/register.php and pressing submit.  Your opinion matters - please take time to register your opinion today!
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Annual Coding Update Now Rescheduled for April 29th at MMA

The April 1st First Friday educational program entitled, No April's Fool, Annual Coding Update, rescheduled once because of weather and another time because of illness, is finally planned for Friday, April 29th from 9:00 a.m. to noon at the MMA office in Manchester.  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 www.mainemed.com.  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 discussion.

Questions about the program and any First Friday program may be addressed to Gail Begin at MMA at 622-3374 or via e-mail to gbegin@mainemed.com.

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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 19th 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. 1446, An Act to Establish the Maine Farm and Fish to School Program (support; Public Health Committee; pediatricians)

L.D. 1453, An Act to Legalize and Tax Marijuana (monitor; Public Health Committee)

L.D. 1457, An Act to Strengthen the Consent Laws for Abortions Performed on Minors and Incapacitated Persons (oppose; Public Health Committee; ob-gyns)

L.D. 1463, An Act Regarding Offenses Against an Unborn Child (oppose; Public Health Committee; ob-gyns)

L.D. 1467, An Act to Improve Timely Access to Health Care Data (monitor)

L.D. 1472, An Act to Create the State Advanced Practice Registered Nursing Board (monitor)

L.D. 1489, An Act Regarding Regulation of Emergency Medical Services (monitor)


Consent bills for discussion only if requested by a call participant:

L.D. 1439, An Act Regarding Permits to Carry Concealed Firearms (monitor; Public Health Committee)

L.D. 1443, An Act to Improve the Permitting Process for Wind Energy Developments and to Protect MaIne's Quality of Place (monitor; Public Health Committee)

L.D. 1475, An Act to Authorize the Training of Expanded Function Dental Assistants within Tribal Territories (monitor)

L.D. 1479, An Act to Minimize Conflicts Between Property Owners and Grid-scale Wind Energy Developments (monitor; Public Health Committee)

L.D. 1485, An Act to Promote Transparency in the Medicaid Reimbursement Process (monitor)

L.D. 1490, An Act to Amend the Laws Regarding Custody of the Remains of Deceased Persons (monitor)

L.D. 1487, An Act to Assist Maine Pharmacies (monitor)

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POLITICAL PULSE: Legislative Highlights of the Week


On Tuesday, April 12th, the Insurance & Financial Services Committee held a public hearing on six bills (L.D.s 226, 455, 473, 645, 1162, & 1200) that would explore the possibility of, or authorize, selling health insurance across state lines.  Despite a lot of discussion of this idea during the fall political campaigns, only the Maine Chapter of the National Federation of Independent Business (NFIB) and CIGNA Healthcare testified in favor of any of these bills.  Most other stakeholders, including health insurers, the Maine State Chamber of Commerce, and the Maine Medical Association testified in opposition to the bills.  The MMA testified on behalf of Health Care for Maine (HC4ME), a new coalition to which MMA belongs.  You can see the HC4ME testimony on the MMA web site at:  http://www.mainemed.com/legislation/testimony/ld226_hc4me.pdf.

On Wednesday, April 13th, the Commissioner held a public hearing on L.D. 1222, An Act to Promote Fairness in Negotiations Between Health Insurance Carriers and Health Care Service Providers, a bill submitted by the MMA to address so-called "most favored nation" clauses in health insurance provider agreements.  Bob McElwain, the administrator of Northeast Neurosurgery in Bangor spoke in favor of the bill, as did the MMA and representatives of the physical therapy association.  No one spoke in opposition to the bill.  The Maine Hospital Association spoke "neither for nor against" because the group's policy committee had not yet reviewed the bill.  But, the MHA comments were generally favorable.  

On Friday, April 15th, the Committee held a work session on all bills heard to date that might be characterized as "mandates" and recommended "ought not to pass" on all of them.  The committee will return to the issue of mandated benefits and the ACA's "essential benefits" package when it takes up the bill or bills on the exchange.  Unfortunately, this group of bills included two supported by the MMA:  L.D. 364, Resolve, Directing Update Review and Evaluation of Maine's Mental Health Parity Law and L.D. 712, An Act to Expand Access to Clinical Trials.


During a work session on Tuesday, April 12th, the HHS Committee issued 10-3 "ought not to pass" reports on two bills that likely would impair Maine's childhood vaccination rates:  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's testimony on both bills is posted on the MMA web site at:  http://www.mainemed.com/legislation/testimony/index.php.  The three dissenting votes were the three freshman Republican women on the committee:  Rep. Beth O'Connor (R-Berwick), Rep. Heather Sirocki (R-Scarborough), and Rep. Deborah Sanderson (R-Chelsea).  While we have faced bills like this before, never have they made it out of committee.  The MMA urges you to contact your own Senator and Representative to request their support for the majority "ought not to pass" report on these bills.  Information on finding your legislators may be found in the article on minors' rights bills below.

Also this week, the committee held a couple of work sessions on several bills on the State's certificate-of-need (CON) law.  On Thursday, April 14th, the committee split 7-6 "ought to pass" on L.D. 360, a bill to repeal the CON law.  The basis for the minority report on this bill will be L.D. 582, a bill submitted on behalf of the Maine Hospital Association that would raise various monetary thresholds that trigger CON review.

Also on Thursday, the committee issued a 9-3 "ought to pass" report on L.D. 531, An Act to Specify Qualifications for the Director of the Office of Adult Mental Health Services within the Department of Health & Human Services, a bill submitted on behalf of the Maine Association of Psychiatric Physicians (MAPP).  Rep. Deborah Sanderson (R-Chelsea) was not present for the vote on the bill.  It's not clear why the three dissenting members voted against the bill.  They were Rep. Heather Sirocki (R-Scarborough), Rep. Richard Malaby (R-Hancock), and Rep. Beth O'Connor (R-Berwick).


The Labor, Commerce, Research, & Economic Development Committee held a public hearing on a series of workers' compensation bills, including three of interest to organized medicine, last week.  Among the bills heard on a long afternoon of Wednesday, April 13th were L.D. 1056, An Act to Increase the Availability of Independent Medical Examiners under the Workers' Compensation Act of 1992, L.D. 1065, An Act to Amend the Laws Governing the Determination of Permanent Impairment under the Maine Workers' Compensation Act of 1992, and L.D. 1244, An Act to Clarify Usual and Customary Charges under the Workers' Compensation Laws.  The MMA joined a majority (the Executive Director and management members) of the Workers' Compensation Board and business groups in supporting L.D. 1056.  The MMA joined labor groups in opposing L.D. 1065 and L.D. 1244.  L.D. 1065 would have codified the AMA's Guides to Evaluation of Permanent Impairment, 4th edition, rather than the 6th edition.  It also would have prohibited a determination of permanent impairment on the basis of mental health issues.  L.D. 1244 proposes to define "usual and customary charge" in an effort to have the legislature side with the business community in a long-running dispute over facility fee charges. 


Last Monday, April 11th, the Criminal Justice & Public Safety Committee held a lengthy hearing on a series of bills proponents likely would characterize as promoting gun rights, while public health and domestic violence advocates would describe as weakening Maine's gun laws.  These bills included L.D.s 1347, 658, 932, 1176, 35, 446, and 1168.  Maine Citizens Against Handgun Violence testified in opposition to all of these bills, while the Governor's Legal Counsel, Dan Billings, testified in favor of most.  L.D. 578, An Act to Allow Municipalities to Restrict the Possession of Firearms in Certain Circumstances, sponsored by Senator Roger Katz (R-Kennebec) did receive the support of the Maine Citizens Against Handgun Violence.


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 understands the Judiciary Committee may hold these bills to be worked with the abortion bills, yet to be heard.

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

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Maine Tobacco HelpLine Referral Form Simplified

The Partnership for a Tobacco-Free Maine's Maine Tobacco HelpLine recently simplified its referral form for providers who wish to refer patients interested in quitting tobacco.  The new form can be found at http://www.tobaccofreemaine.org/channels/providers/documents/MTHLFaxReferral.PDF
and can now be emailed or faxed to the HelpLine!
The Maine Tobacco HelpLine has a proven track record of providing high-quality telephonic tobacco counseling by trained specialists.  Long-term abstinence rates for tobacco users who have received HelpLine services have consistently been between 25-35%.  These rates are 20-30% higher than those quitting on their own.  Free nicotine replacement therapy is also available to eligible callers.
Providers who use the approach of recommending their patients call the HelpLine will see that about 3-4% of their patients will make that call.  On the other hand, providers who use the approach of proactively referring (either via fax or email) form will see that HelpLine staff are able to reach 50% of those referred. 

If your practice would like a free, in-office educational session to learn more about the Maine Tobacco HelpLine services, please contact Sarah Gagne at gagnes@mainehealth.org or 662-4795.
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Providers Can Meet Meaningful Use with Services from the MEREC

The MEREC is pleased to announce that EHR vendors athenahealth, Ingenix, and e-MDs, as well as EHR implementation support provider Concordant, are now supported in the MEREC program.  A multi-stakeholder advisory group underwent an extensive selection process to evaluate and compare candidates’ products, services, and pricing structures.  In addition to discounted EHR products and services, all enrolled providers receive eight hours of core quality coaching support services through our partner Quality Counts, connection to Maine’s statewide health information exchange, and access to low interest loans to these services services through the Maine Health Access Foundation and the Finance Authority of Maine.  To enroll in the MEREC program or learn more about eligibility and services, contact Gemma Cannon at 541-9250, ext 214 or gcannon@hinfonet.org and visit our website at http://www.hinfonet.org/REC.html. [return to top]

Attend the EHR Educational Events For Critical Access Hospitals and Primary Care Providers

MEREC, in partnership with Quality Counts, will be hosting the second in a series of free regional forums about electronic health records, meaningful use, and related federal and state incentive programs.  The forums are specifically targeted for primary care providers and staff of small independent practices as well as clinical and administrative staff in Maine’s rural and critical access hospitals.  The events will include a panel of health information technology experts, both local and national, a specific discussion on the integration of HIT in the patient centered medical home, and as group breakout sessions focused on using EHRs (inpatient and outpatient) to improve health care quality and outcomes, reduce costs and ultimately achieve federal meaningful use requirements.  Hope to see you at one of the following events:

•       Franklin Memorial Hospital:  Tues, May 10, 1:30 - 5:30 p.m.
•       Mt. Desert Island Hospital:  Wed, May 11, 2 - 6 p.m.
•       Mayo Hospital: Wed, May 25, 2 - 6 p.m.
•       Goodall Hospital:  Wed, Jun 1, 2 - 6 p.m.

Register online at http://www.hinfonet.org/rec_news.html or by calling Maria Stevenson at 207-541-9250, ext 201.

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"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]

ONC Deputy Mostashari Replaces Blumenthal as ONC Director

On April 8th, DHHS Secretary Sebelius named ONC Deputy Farzad Mostashari the new National Coordinator for Health Information Technology.  Dr. Mostashari replaces David Blumenthal who returns to Harvard.  Dr. Mostashari has been at the ONC since July 2009.  Prior the current appointment, he served in the New York City Department of Health & Mental Hygiene as assistant commissioner for the Primary Care Information Project. [return to top]

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