July 4, 2011

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AMA and MMA Advocate for Medicare SGR Reform in Federal Debt Limit Negotiations

The AMA and 112 state and medical specialty societies, including MMA, sent a letter last week to the President, Vice-President and Congressional leaders urging reform of Medicare's sustainable growth rate (SGR) formula as part of any deficit reduction plan. Medicare payments to physicians are set to decrease by nearly 30% on January 1, 2012 if action is not taken prior to that time.

A copy of the letter is available on the MMA website at www.mainemed.com.  In the letter, we informed policy makers that the cost of physician payment reform has grown over the years as Congress enacted frequent short-term fixes.  As recently as 2005, the ten-year cost of permanent reform would have been $48 billion, but today it is estimated to be nearly $300 billion.  If action is not taken this year, the cost will continue to escalate to $500 billion in only a few short years.

The AMA and other physician organizations have called for a three-pronged approach to reforming the physician payment system that includes:  repealing the failed SGR formula; implementing a five-year period of stable Medicare physician payments; and developing new health care payment and delivery models that could form the basis for a new Medicare physician payment system.

On Friday, July 1st, CMS, as expected, released the proposed 2012 Medicare physician fee schedule - including the 30% reduction in payments due to the SGR formula.  With the reduction, CMS anticipates that the conversion factor will be 23.96 in 2012, as compared to 33.97 this year.  The final rule due later this year may make significant changes to that amount, depending upon what happens in any SGR legislation considered this year.

Also in the proposed rule, CMS has proposed that the AMA Specialty Relative-value Update Committee (RUC) do an extensive review of the Evaluation and Management codes, citing a belief that the work and intensity of those services when provided by primary care physicians has increased.  Further, CMS is calling on the RUC to include several other high-volume services that have not been reviewed since 2006.

Finally, the rule includes proposed quality and cost measures that would be used in establishing a new value-based modifier that would reward physicians for providing higher quality and more efficient care.

CMS has fact sheets available on the 2012 proposed rule.


Save the Date: Rededication of Frank O. Stred Building, Wednesday, August 24, 2011

In conjunction with the next scheduled MMA Senior Section meeting, the Association will re-dedicate the Frank O. Stred building in Manchester in an event scheduled from 11:00 am to 2:00 pm on Wednesday, August 24, 2011.  Priscilla Stred and Kristin Stred will be attending the event which which feature the unveiling of a memorial to Frank and remarks by Robert McAfee, M.D., and Frederick Holler, M.D.  Watch your mail for a formal invitation.


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MeCDC Hosts Universal Immunization Program Regional Trainings

Maine Immunization Program Regional Trainings 

Vaccines for Children: Public Law 595 - Implications for Maine Immunization Providers

These workshops will provide an overview of the new Universal Childhood Immunization Program and provide information to help Maine immunization providers prepare for implementation in January 2012. The training will focus on vaccine management, ordering and accountability; provider requirements; Maine Immunization Registry; and information on vaccines that will be available through the Universal Childhood Immunization Program. There will also be information on the ACIP schedule, vaccine administration, vaccine usage and vaccine myths.

July 28, 2011- Presque Isle

August 4, 2011 - Bangor

August 11, 2011 - Portland

August 12, 2011 - Augusta

8:30 am - 3:30 pm; Registration begins at 8 am 

Sponsor: Maine Department of Health and Human Services, Center for Disease Control and Prevention, Division of Infectious Disease, Immunization Program

Space is limited.  For more information or to register, see http://www.maine.gov/dhhs/boh/ddc/immunization/

For an overview of the Universal Childhood Immunization Program, see the presentation available at:  http://www.maine.gov/dhhs/boh/ddc/immunization/providers

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Silent Auction Items Needed for Annual Session

Last year, MMA held its first annual silent auction to benefit the Maine Medical Education Trust and the John C. Dalco Fund, with proceeds totaling approximately $4,500.  There were 24 items donated by MMA members and corporate affiliates.  Donated items included event tickets, weekend and week-long stays at member’s vacation homes, golf packages, gift baskets, books, restaurant and spa certificates, and special items made by members and friends such as paintings, sculptures and carvings! 

The proceeds from this year’s auction will be directed to the MMET Scholarship Fund created by Dr. Jo Linder during her term as MMA President.  This fund will be used to provide scholarships for medical students who are Maine residents.  We encourage you to participate by donating an item to the auction to benefit this worthy cause, and by attending the event which is being held on Saturday, September 10th, during the MMA Annual Session in Bar Harbor.  

Look for the donation form to be mailed soon with annual session materials and for it to be posted soon on the MMA web site, www.mainemed.com.



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Maine Law Court Upholds Restrictive Covenant

Physicians and residents frequently ask questions about "restrictive covenants" or "non-compete" agreements in physician employment agreements during the MMA's presentations on employment law.  For years, MMA attorneys have pointed to Brignull v. Albert, 666 A.2nd 82 (Me. 1995) as the leading Maine case in the health care context supporting enforcement of these contract provisions if the terms are reasonable in duration, geographic scope, and the business interest to be protected.  The Maine Supreme Judicial Court recently considered a dispute involving three physicians who left employment with Sisters of Charity Health Care System, Inc. to be employed by Central Maine Healthcare System, Sisters of Charity Health System, Inc. v. Douglas Farrago et al. 2011 ME 62 (May 26, 2011).  In this case, the physicians challenged not the duration or geographic scope, but the legitimacy of the business interest protected.  They also challenged the $100,000 per physician liquidated damages provision.  The Law Court confirmed the Superior Court's conclusion that protecting the former practice's existing patient base and "good will" were legitimate business interests.  The Law Court also found the liquidated damages provision to be enforceable based on the precedents in Maine law.  

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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.

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Register for Maine Public Health Association Annual Meeting

Registration is open for the Maine Public Health Association's Annual Meeting!  

You are invited to attend Maine's premier professional public health event, MPHA's 27th Annual Meeting titled Facing Public Health Challenges of Today for a Healthier Tomorrow. The event will take place on Tuesday, October 18th at MaineHealth's beautiful new facility in Portland. We will be partnering with organizations across the State to bring the highest quality of education, innovation and inspiration to those that work in, and around, the field of public health.

This year's event will bring together approximately 300 public health professionals throughout the State and will feature 12 breakout sessions focusing on innovative prevention strategies to model policies and collaborations.  Our keynote speaker will be the dynamic Dr. Georges Benjamin, Executive Director of the American Public Health Association who will address the audience on the theme of the conference including collaborative national evidence-based policies and strategies and the power of public health in this economy. Don't miss the presentation of our two annual service awards which highlight programmatic and policy leaders in our field and opportunities for statewide networking and strategic policy planning.

For a detailed agenda, breakout session listings and to register- click here.  

We look forward to seeing you on October 18th!

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Save the Date: Chemicals, Obesity, and Diabetes


How Science Leads Us to Action


Colby College, Waterville, Maine

Registration Fee: $50 • Lunch included • Time: 8:30am-5:00pm

Presented by the Environmental Health Strategy Center (EHSC), in partnership with the Goldfarb Center at Colby College

Critical, ongoing public health efforts to reduce obesity are addressing multiple societal factors through policy, environmental and social justice system changes to address contributing factors which include inadequate nutrition and physical inactivity. Recent scientific research shows that chemical exposures may also be a risk factor.  Our conference will explore two questions about chemical “obesogens:”

  • What is the current state of the science that links chemical exposures to obesity, diabetes and other diseases?
  • What public health policy actions are appropriate based on the current evidence?

Keynote Speaker: Bruce Blumberg, PhD: University of California-Irvine, Department of Developmental and Cell Biology. National expert on the role of chemical exposures as a contributing factor for obesity and diabetes.

For more information, see the flyer at http://www.preventharm.org/Images/443/Conf%20STD%20Email.pdf or contact Michelle Surdoval, Project Manager, 207-650-8704, msurdoval@preventharm.org



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Supreme Court Orders Review of Maine's Prescription Data Law

Last Tuesday, the U.S. Supreme Court issued an order requiring that the First Circuit Court of Appeals reconsider its decision upholding Maine's prescription data law.  

In August 2010, the First Circuit held that Maine's law that allows physicians and other prescribers to opt out of having their prescribing data sold to health information firms and drugmakers for marketing purposes is constitutional.  IMS Health filed an appeal of that decision to the U.S. Supreme Court.  

Granting IMS Health's appeal last Tuesday, the Court voided the First Circuit's 2010 decision and ordered the court reconsider its decision in light of the Supreme Court's decision two weeks ago in Sorrell v. IMS Health.  In that case, the Supreme Court struck down Vermont's law that barred the sale of doctors' prescription data to drug companies, ruling the law interfered with the pharmaceutical industry's First Amendment right to market its products.

Read the recent Supreme Court decision in the Vermont case (Sorrell v. IMS Health) at http://www.supremecourt.gov/opinions/10pdf/10-779.pdf

The  First Circuit Court of Appeals decision on the Maine law (IMS Health v. Mills) is available at: www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=08-1248P.01A


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AMA Reaffirms Support for Individual Responsibility for Health Insurance to Cover the Uninsured

The American Medical Association at its Annual Meeting this past week in Chicago voted to continue its policy supporting individual responsibility for health insurance with assistance for those who cannot afford it.  Support for the so-called "individual mandate" had been challenged by a group of state and national medical societies.  The New England Delegation to the AMA had supported the mandate as one means to achieve universal coverage.

"The AMA has strong policy in support of covering the uninsured, and we have renewed our commitment to achieving this through individual responsibility for health insurance with assistance for those who need it, said AMA President Cecil Wilson, M.D. "The AMA's policy supporting individual responsibility has bipartisan roots, helps Americans get the care they need when they need it and ends cost shifting from those who are uninsured to those who are insured.  Important insurance market reforms, such as an end to coverage denials based on pre-existing conditions, are only possible by having broad participation in the health insurance market."

The AMA reviewed alternatives and concluded that any approach to covering the uninsured that is in line with AMA policy cannot be fully successful in covering the uninsured without individual responsibility for health insurance.

The policy was affirmed by a vote in the AMA House of Delegates last Monday (June 20).  The House also reaffirmed support for AMA policy supporting health insurance tax credits and health insurance market regulation, health savings accounts and direct subsidies for the coverage of high risk patients.

Former AMA President Robert McAfee, M.D., of Portland,  testified in favor of the existing policy on the floor of the House.  Alternate Delegate Maroulla Gleaton, M.D. of Palermo had testified on behalf of the Maine delegation to the AMA in favor of the same position in the reference committee receiving testimony on the various resolutions and Council report on the subject. 
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Treatment of Tobacco Dependence is Latest AMA Therapeutic Insights Topic

The American Medical Association (AMA) announces the release of Treatment of Tobacco Dependence, the latest AMA Therapeutic Insights newsletter.  

Take a quick look - read an overview of the tobacco dependence issue.

Maine physicians can access their personal prescribing profile showing their individual prescribing patterns alongside state, national and specialty prescribing patterns. Just select the Maine newsletter and click Personal Prescribing Profile

AMA Therapeutic Insights

  • is free and online
  • highlights one disease condition per issue
  • features individual, state, national prescribing data* and evidence-based treatment guidelines
  • is written by top disease experts in collaboration with the AMA
  • offers AMA PRA Category 1 Credit

While most treatment-oriented CME programs focus solely on disease management, AMA Therapeutic Insights takes it one step further. This program delivers the actual prescribing patterns for the disease.

Visit AMA Therapeutic Insights to read this issue, as well as previous newsletters on COPD, Hypertension, Migraine, Alzheimer’s Disease and more.

*The prescribing data in AMA Therapeutic Insights are provided by IMS Health. The AMA does not collect or have access to physician prescribing data in any form. 

The AMA is accredited by the ACCME to provide continuing medical education for physicians.

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2011 AMA National Health Insurer Report Card Finds Increasing Inaccuracy in Claims Payment

The AMA unveiled its fourth annual National Health Insurer Report Card during an educational session at the AMA’s Annual Meeting on June 20th.  As the cornerstone of the AMA’s “Heal the Claims Process”™ campaign, the report card encourages a more efficient claims payment system by providing an annual check-up for the nation’s largest health insurers and benchmarking the systems they use to manage, process and pay claims.  This year’s findings show that commercial health insurers have an average claims-processing error rate of 19.3 percent, an increase of 2 percent compared to last year.  The increase in overall inaccuracy represents an extra 3.6 million in erroneous claims payments, and added an estimated $1.5 billion in unnecessary administrative costs to the health system.  A 20 percent error rate among health insurers represents an intolerable level of inefficiency that wastes an estimated $17 billion annually,” said AMA Board Member Barbara L. McAneny, M.D.  Visit www.ama-assn.org/go/reportcard to access the report card’s findings, including denial and accuracy rates and claims processing timeliness.  You can also watch an archived webinar that details the findings and learn more about the “Heal the Claims Process”™ campaign. 

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125th Maine Legislature Adjourns First Regular Session

The 186 members of the 125th Maine Legislature adjourned the First Regular Session sine die in the early evening of Thursday, June 30th.  The legislature adjourned following enactment of the FY 2012-2013 biennial budget (L.D. 1043) during the week of June 13th and returned on Tuesday, June 29th to complete the remaining items on its calendar, including several gubernatorial vetoes.  Several bills of interest to MMA members were among those resolved during the final two days of the session.  The Governor had vetoed a second bill submitted on behalf of organized medicine in Maine - L.D. 531, a bill submitted on behalf of the Maine Association of Psychiatric Physicians that would have required the State to have a psychiatrist in a significant policymaking position within the Division of Adult Mental Health.  Although the Governor vetoed the bill, his veto message stated that he agreed in principle with the psychiatrists' position and would work with the Commissioner of Human Services to achieve this goal.  After months of work in the HHS Committee, the legislature enacted L.D. 360, a bill that will raise most of the thresholds for review in the Maine Certificate of Need Act of 2002.  Finally, the legislature enacted L.D. 719, a bill that rolls back Maine's prescription drug marketing disclosure and clinical trial laws in favor of relying on federal standards enacted as part of the ACA.  The bill does retain funding for the State's academic detailing program, run by the MMA.

 The MMA staff will have a summary of all the health care legislation tracked by the MMA during the First Regular Session of the 125th Legislature later this summer.  The MMA staff also is available to provide any practice, medical staff, or specialty group with a legislative update as an inservice.

The 125th Maine Legislature will return for its Second Regular Session on the Wednesday following New Year's Day 2012.  The MMA Legislative Committee will have an organizational meeting this coming fall. 

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