June 6, 2011

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Governor's Veto of Most Favored Nation Clause Prohibition Sustained After Introduction of Similar Bill

On Thursday, June 2nd, Governor LePage's veto of the MMA-sponsored bill, L.D. 1222, was sustained on a party-line vote, but only after the Governor agreed to present his own bill also prohibiting the use of such clauses in health plan contracting.  The Governor's bill will be introduced but will be carried over into the Second Regular Session of the 125th Legislature.

The Governor's bill does have an exception for cases where the Superintendent of Insurance authorizes the use of the clause at the request of one of the parties.  The Superintendent would develop some criteria for when such a waiver of the general prohibition could be granted.

Several Republican legislators were supporting the original bill, L.D. 1222, which had been unanimously supported by the Joint Standing Committee on Insurance & Financial Services.  These legislators were instrumental in getting the LePage Administration on board regarding the anti-competitive nature of these clauses in a state where the health insurance marketplace is heavily consolidated.

As the veto of L.D. 1222 was the Governor's first veto since taking office in January, it received much attention in the media, resulting in a lot of publicity for the topic of MFN clauses.

The Governor's bill is expected to be referred to the Insurance & Financial Services Committee where it will receive a public hearing early in 2012.

The House vote on the veto override was 70-74 and you can view the roll call vote on the web at:  http://www.mainelegislature.org/LawMakerWeb/rollcall.asp?ID=280040797&chamber=House&serialnumber=104.

AMA Names James L. Madara, M.D. as New Executive Vice President & Chief Executive Officer

On June 2, 2011, the AMA announced the appointment of James L. Madara, M.D. as its new EVP/CEO effective July 1st.  Dr. Madara, 60, is an accomplished academic medical center physician, medical scientist, and administrator who served as Timmie Professor and Chair of Pathology and Laboratory Medicine at the Emory University School of Medicine before assuming the Thompson Distinguished Service Professorship and deanship at the University of Chicago Pritzker School of Medicine, where he was the longest serving Pritzker dean in the last 35 years.  Subsequently, he added the responsibility of CEO of the University of Chicago Medical Center, bringing together the university's biomedical research, teaching, and clinical activities.  As CEO, he engineered significant new affiliations with community hospitals, teaching hospital systems, community Federally Qualified Health Centers on Chicago's South Side, as well as with national research organizations including the Janelia Campus of the Howard Hughes Medical Institute in Bethesda and the Ludwig Foundation of New York.  

Dr. Madara earned his medical degree from Hahnemann Medical College in Philadelphia.  He completed his internship and residency at New England Deaconess Hospital in Boston.  He subsequently completed a fellowship in anatomy and cell biology at Peter Bent Brigham Hospital in Boston (now Brigham & Women's Hospital).  Following his fellowship, Dr. Madara joined the faculty of Harvard Medical School where he rose to a full tenured professor and served as director of the Harvard Digestive Diseases Center.

You can see the full AMA press release on this appointment on the web at:  http://www.ama-assn.org/ama/pub/news/news/ama-names-new-evp-ceo.page#.

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Three Openings on Board of Licensure in Medicine

There are currently three openings on the nine-member Board of Licensure in Medicine, occasioned by the completion of the terms of Sheridan Oldham, M.D., the resignation of George "Joe" Dreyer, M.D., and the resignation of the newest public member of the Board, Meredith Baxter.  Qualifications for appointment to the Board include five years of continuous medical practice in the state immediately prior to appointment.  Terms are for six years.  The Board meets for a full day the second Tuesday of each month and at least one day of preparation for the meeting is generally required.  Compensation is nominal.

The appointments are considered personal appointments of the Governor, meaning that no confirmation hearings or legislative review is required.  Physicians interested in serving on the Board should send a current CV and a letter expressing interest to:

                                                                           Michael Hersey  (Att:  Scott Van Ormand)

                                                                           Director of Boards and Commissions

                                                                           1 State House Station

                                                                            Augusta, Maine 04333

While the Board is particularly interested in surgeons and psychiatrists, given the current mix of specialties represented, any physician meeting the above noted statutory requirements may apply.

In July, the Board will elect new officers for a term year period.  Dr. Oldham has chaired the Board for the last four years and has served two six-year terms. She has been a strong and effective leader at the Board during her tenure.  Likewise, Dr. Dreyer has served admirably during his term on the Board.



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New MedPAC Members Appointed

Two new members have been appointed to the Medicare Payment Advisory Commission (MedPAC).  They are William J. Hall, M.D., a geriatrician and Professor of Medicine at the University of Rochester School of Medicine and Willis D. Gradison, Jr., M.B.A., a Scholar in Residence in the Health Sector Management Program at Duke University's Fuqua School of Business.  Their terms will expire in 2014.  The AMA supported Dr. Hall's nomination.  He will become the fifth physician on the Commission, serving with Robert Berenson, M.D., Karen Borman, M.D., Ron Castellanos, M.D., and Tom Dean, M.D. [return to top]

New Proposed Privacy Rule Released

The U.S. Department of Health & Human Services (DHHS) has released a proposed rule that would revise the Health Insurance Portability & Accountability Act (HIPAA) privacy rule.  The rule responds in part to requirements mandated under the Health Information Technology for Economic and Clinical Health (HITECH) Act, which expands how HIPAA covered entities, including physicians, account for patient health data that is shared, including the ability to detail who has accessed a patient's electronic health records.  It appears that the proposed rule goes beyond what is required by law and would pose significant burdens on physicians if finalized.  For example, physicians would only have 30 days to respond to disclosure requests.  The AMA and MMA are reviewing the rule carefully during the comment period.  There will be a 60-day comment period from publication in the Federal Register. [return to top]

MMA Featured in New York Times Article on the Changing Priorities of Physicians

In a front page article in the New York Times yesterday, May 30th entitled, As Physicians' Jobs Change, So Do Their Politics, the Maine Medical Association is featured.  While the story is accurate, there are a lot of nuances that do not fit neatly into an article this size.  There are actually several reasons why MMA did not pursue further tort reform this year, in addition to the reasons noted in the article.  Not the least among these is the generally favorable experience with respect to claims over the past seven years.  We encourage you to read the article (the link follows) and share your reaction and thoughts to MMA EVP Gordon Smith at gsmith@mainemed.com.



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Register Now for MMA's 158th Annual Session in Bar Harbor, September 9-11

Registration materials for MMA's 158th Annual Session are now available and were included as an insert in the recent issue of Maine Medicine which arrived in members' offices the week before last.  You may also register on the MMA website at www.mainemed.com.  The meeting will be held September 9-11 in Bar Harbor with the Friday educational program being held again this year at the Jackson Laboratory and the Saturday and Sunday morning events being held at the Bar Harbor Club adjacent to the Harborside Hotel.

The theme of this year's educational program is INNOVATION and 8 hours of CME category 1 credits are being offered.  The educational program begins at 1:00 p.m. Friday, September 9th with a keynote presentation by Carol Bult, PhD.  Dr. Bult is a Principal Investigator in the Mouse Genome Informatics database consortium at the Jackson Laboratory.   Tours of the Lab will again be available at 3:00 p.m. following the two lectures.  The Friday evening reception will be held at the Laboratory as has been the case the last two years.

Saturday's events will be held back at the Bar Harbor Club with the Annual Meeting in the morning, featuring the presentation of 50 year pins at 10:30 a.m.  At noontime, J. Randy Darby, M.D. of Spectrum Medical Group will keynote the afternoon educational session with a presentation entitled, Innovations in Medical Education and Team Building.  Dr. Darby's presentation will be followed by a panel on clinical technology innovation and a presentation on nanotechnology. 

Saturday evening will feature the annual President's Reception and Annual Awards Banquet at which time President Jo Linder, M.D. will pass the President's gavel to President-elect Nancy Cummings, M.D. 

Sunday morning will begin bright and early at 6:30 a.m. with the 31st running of the Edmund Hardy Road Race, again sponsored by Medical Mutual Insurance Company of Maine.  Following brunch at 8:00 a.m., a panel focusing on Innovations in Physician Wellness, moderated by Dr. Cummings, will inform attendees on how to incorporate mindfulness, wellness and balance into busy lives.

DONATIONS NEEDED!  We will once again be conducting a silent auction to benefit one or more programs falling under the Maine Medical Education Trust (MMET).  If you have something you'd be willing to donate as a silent auction item, please contact Dee DeHaas at ddehaas@mainemed.com.

We look forward to seeing you in Bar Harbor! [return to top]

BNN Learning Center & MMA Offer Upcoming Coding Certification Course at USM

The Learning Center at Baker Newman Noyes in conjunction with the Maine Medical Association is offering a AAPC Approved Coding Certification course.

´  Thursdays, June 9, 2011 to September 22, 2011

´  4:00pm – 8:00pm

´  University of Southern Maine in Portland (#1 Payson Smith Room)

Click Here for the link to the Learning Center’s website for additional details and a Registration form.

Should you have any questions, please don’t hesitate to contact either the Learning Center or Hayat Freeman-Lutes, CPC, CEMC at 207-791-7126 begin_of_the_skype_highlighting            207-791-7126      end_of_the_skype_highlighting. [return to top]

SAVE THE DATE: Pierce Atwood Labor & Employment Seminars, Co-sponsored by MMA, June 10th & 17th

Save the Date! Pierce Atwood Program in your area June 10 & 17:

Labor & Employment Issues for the Maine Healthcare Industry

 Brewer & Portland, Maine

Date: June 10 and 17, 2011
Time: 8:30 AM - 3:00 PM

The Pierce Atwood Employment Group, with our co-sponsor Maine Medical Association, is pleased to invite you to a program on Labor & Employment Issues in the Healthcare Industry.  We will be offering this program twice.

  • June 10, also sponsored and hosted by Eastern Maine Healthcare Systems, at the EMHS Brewer office 
  • June 17, also sponsored by Martin's Point HealthCare, at The Woodlands Club in Falmouth

Our tentative agenda includes the following topics:

  • Managing the impaired worker
  • Wage-hour challenges for healthcare employers
  • The latest on union activities around the state including, Maine State Nurses Association/California Nurses Association, Teamsters and others
  • Significant developments in Augusta and Washington
  • Immigration issues in the healthcare industry
  • HIPAA, privacy and technology, including duties of employers and employees
  • Special guest Short Fuse Theater: "Coping with the high performing, high risk healthcare employee". (Portland only) 
  • Rapid-fire round - questions and answers on topics across the labor & employment spectrum

Our agenda is tentative because we want your help in shaping it.  When you register, please use the box on the registration screen to suggest questions or topics you'd like to see us address.  We'll synthesize your responses and incorporate as many as we can into our presentation.

Also, when registering, please indicate which program you wish to attend.

This program will be of interest to senior management, human resources management and staff, in-house counsel, risk managers and upper level supervisors.  Please forward to any interested persons in your organization.

The program will run from 8:30 am to approximately 3:00 pm.  There is no charge to register, and lunch will be served.  Our sincere thanks to our co-sponsors for helping to make these events possible.

Please check your email box for a reminder in the next couple of weeks.

If you have any questions, please contact Amber Elliott at aelliott@pierceatwood.com or 207-791-1143.

Copyright � 2011. Pierce Atwood LLP. All rights reserved.

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Legislative Committee Conference Call This Tuesday

The MMA's Legislative Committee will hold its next weekly conference call this Tuesday, June 7th 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.

There are no new bills for review this week.  The MMA staff will provide an update on the most recent activities at the State House.  With the legislature's anticipated adjournment on June 15th, next Tuesday, June 14th likely will be the last conference call of this session.

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POLITICAL PULSE: Legislature Continues Work on Certificate of Need, Medical Marijuana and Prescription Drug Abuse


With only a week and a half to go in the scheduled session, the 125th Legislature continues to work on a number of bills of interest to physicians, as well as the two-year biennial budget which must receive a two-thirds vote.  The Appropriations Committee met over this past weekend to continue its work on the budget.

On other bills of interest, the HHS Committee this past week reversed its previously voted unanimous report on amendments to the state's controversial certificate-of-need law and following a four-hour work session, voted out two reports divided upon party lines.  Republicans support an amendment that would raise the threshold for new facilities to $10 million, with a limit on third year operating costs of $1 million.  Democrats have offered an alternative (now supported by the Maine Hospital Association) raising the capital cost threshold for a new service to $300,000.

A significant amendment to the existing medical marijuana law has received unanimous support of the HHS committee and is expected to pass.  Governor LePage has already expressed his support for the bill, which is more in line with the law passed by the voters in November of 2009.  While the provisions of the existing law regarding physicians are basically the same in the new proposal, many of the additions to the original law enacted last session will be repealed, including the requirement for a medical certificate holder to register with the state and obtain an I.D. card.  That provision will now be voluntary.

L.D. 1501, a bill that would have put significant restrictions on physicians and other prescribers treating chronic pain, is now likely to be defeated in favor of a Resolve that would direct the Maine Substance Abuse Services Council to study the provision in the bill and report back to the HHS Committee in December 2011.

Also last week, the legislature killed L.D. 694, An Act to Encourage Transparency in Disclosing the Ingredients in Vaccines for Children to Parents and Guardians, a bill that would have been a burden on medical practices and likely would have discouraged parents from vaccinating their children.  The roll call vote in the House was 118-25 in favor of the majority "ought not to pass" report from the HHS Committee.  You can see the legislative history of the bill on the web at:  http://www.mainelegislature.org/LawMakerWeb/summary.asp?ID=280039982.


The Appropriations Committee is expected this week to continue its work sessions on the FY 2012-2013 biennial budget (L.D. 1043).  The Committee hopes to report the bill out this week. 

You can find the Appropriations Committee materials, including the change package update of May 11th, on the web at:  http://www.maine.gov/legis/ofpr/appropriations_committee/materials/index.htm.


L.D. 746, An Act Regarding the Consent of Minors for Mental Health and Substance Abuse Aidhttp://www.mainelegislature.org/LawMakerWeb/summary.asp?ID=280039990, an 11-2 "ought not to pass" report from the Judiciary Committee is tabled pending debate in the House.  The bill's sponsor, Representative Kathleen Chase (R-Wells), plans to offer a floor amendment that does not improve it in our view.  Also, today's House calendar includes the second bill, 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.  This bill comes to the floor with the same 11-2 "ought not to pass" report from the Judiciary Committee. 

The MMA urges you to contact your own Senator and Representative to encourage them to support the majority "ought not to pass" report on these bills.  It is important that practitioners retain the discretion in current law to provide medical care to minors confidentially in situations where a requirement of parental consent is a barrier to treatment.  You can find your legislators and their contact information on the web at:  http://www.maine.gov/legis/house/townlist.htm.

You can also leave a message at the State House for your legislators by using the following toll free numbers:

Call your Senator:              1-800-423-6900 begin_of_the_skype_highlighting            1-800-423-6900      end_of_the_skype_highlighting      

Call your Representative:          1-800-423-2900 begin_of_the_skype_highlighting            1-800-423-2900      end_of_the_skype_highlighting

1-800-423-2900 begin_of_the_skype_highlighting            1-800-423-2900      end_of_the_skype_highlighting [return to top]

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