July 11, 2011

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Governor LePage Signs Bills on "Most Favored Nation" Clauses, CON, Among Others

Following the 4th of July holiday weekend, Governor LePage signed a number of bills enacted during the final hours of the First Regular Session of the 125th Maine Legislature, including several of interest to the MMA membership - a bill prohibiting so-called "most favored nation" clauses in health insurer provider agreements replacing one vetoed by the Governor, as well as bills amending the certificate-of-need law, prohibiting the sale or possession of "bath salts," and preventing the use of methadone by commercial vehicle operators.

On July 6th, Governor LePage signed L.D. 1583, An Act to Provide Oversight in Certain Negotiations (P.L. 2011, Chapter 451).  L.D. 1583 was a Governor's bill submitted at the request of the Chairs of the Joint Standing Committee on Insurance & Financial Services following the Governor's veto of L.D. 1222, An Act to Promote Fairness in Negotiations between Health Insurance Carriers and Health Care Service Providers, a bill submitted by Representative Sharon Treat (D-Hallowell) on behalf of the MMA.  L.D. 1222 prohibited the use of "most favored nation" clauses while L.D. 1583 prohibits their inclusion in provider agreements unless approved by the Superintendent of Insurance upon request of a party to provider agreement negotiations.  Both bills received the unanimous support of the Insurance & Financial Services Committee.  The MMA asked Representative Treat to submit the original bill at the request of a Bangor area practice that had been unsuccessful in negotiating the removal of such a clause from a provider agreement following several years of trying.  The Federal Trade Commission and U.S. Department of Justice find these clauses to be anti-competitive, particularly in regions where there is a dominant health insurance carrier and the agencies are investigating several carriers' use of such clauses in health insurance markets around the country.  In addition to the MMA, the state association of physical therapists, the Maine Hospital Association, and several other provider groups participated in the development of this legislation.

You can find more information about L.D. 1583 on the web at:  http://www.mainelegislature.org/LawMakerWeb/summary.asp?ID=280042088.

Also on July 6th, the Governor signed L.D. 360, An Act to Amend the Maine Certificate of Need Act of 2002 (P.L. 2011, Chapter 424).  Following months of work by the Joint Standing Committee on Health & Human Services on more than half a dozen bills on the topic and debate in the legislature in the waning hours of the session, the Governor has signed a bill making the most substantial changes in the state's CON statute in its history, including increases in the various thresholds triggering CON review.  

You can find more information about L.D. 360 on the web at:  http://www.mainelegislature.org/LawMakerWeb/summary.asp?ID=280039484.  The MMA, MHA, and other provider organization's planning departments will need to spend some time thinking through the implications for future health care investment in Maine following enactment of this sweeping bill.  

Finally on July 6th, the Governor signed L.D. 1562, An Act to Prohibit the Sale or Possession of So-called Bath Salts Containing Dangerous Synthetic Drugs (P.L. 2011, Chapter 447).  You can find more information about this bill on the web at:  http://www.mainelegislature.org/LawMakerWeb/summary.asp?ID=280041671.

Governor LePage also has signed L.D. 966, An Act Regarding the Use of Methadone by Operators of Commercial Motor Vehicles (P.L. 2011, Chapter 455), a bill sponsored by Representative Anne Graham (D-North Yarmouth), a pediatric nurse practitioner.  You can find more information about this bill on the web at:  http://www.mainelegislature.org/LawMakerWeb/summary.asp?ID=280040381.

Most bills become effective 90 days following adjournment of the legislature - September 28, 2011.  Bills including an emergency preamble take effect immediately upon the Governor's signature.  A few bills have specified effective dates within their text.  

The MMA's summary of all health care legislation tracked by the MMA Legislative Committee will be available later this summer.  If you have any questions about any legislation from the First Regular Session of the 125th Maine Legislature, please contact Andrew MacLean, Deputy EVP (amaclean@mainemed.com; 622-3374, ext. 214), Gordon Smith, EVP (gsmith@mainemed.com; 622-3374, ext. 212), or Jessa Barnard, Director of Public Health Policy (jbarnard@mainemed.com; 622-3374, ext. 211).

Physician Insurers Association of America Names Brian K. Atchinson President and CEO

The Physician Insurers Association of America (PIAA), the national insurance industry trade association representing medical professional liability insurance companies, announced on July 8th that Brian K. Atchinson will assume the office of President and Chief Executive Officer on August 1st.  Atchinson succeeds Lawrence E. Smarr, who is leaving the Association after 19 years of service.

Atchinson has a strong connection to Maine, having served as Superintendent of Insurance for the State from 1992 to 1997.  Following his term as Superintendent, he served as managing counsel and vice president of UNUM.   Prior to 1991, Atchinson served as counsel to the Department of Professional & Financial Regulation where he was instrumental in working with MMA on the several tort reforms that were enacted in the the  late 1980's.  The Commissioner of the Department at that time was Susan Collins, now the junior U.S. Senator for the State.  While serving as Superintendent, he was an officer and President of the National Association of Insurance Commissioners (NAIC) from l994 to l997.

Most recently,  from 2001 to 2010, Atchinson served as President and Chief Executive Officer of the Insurance Marketplace Standards Association in Bethesda, Maryland.

Medical Mutual Insurance Company of Maine is an active member of the PIAA and Board Chairman William Medd, M.D.serves on the Board of the Association.  Gordon Smith, MMA EVP serves as Vice-Chairman of the Medical Society section of the PIAA.

"Serving as President of the PIAA will bring Brian back to many of the issues he worked with us on here in Maine and we could not be more excited about the appointment.," said Gordon Smith of MMA.  " We wish him all the best as he assumes this position which is so important to our efforts in Maine and in this country to have a fair and equitable medical liability system."

Commenting on his appointment, Atchinson said, "The PIAA is a vital contributor to the ongoing success of the MPL insurance industry.  I'm excited about the opportunity to work with the member companies of the PIAA and the Association's professional staff, in advancing the excellent reputation this organization has built over many years.  In my role as president of the PIAA, I look forward to confronting the challenges that the MPL industry inevitably faces in today's rapidly changing healthcare environment."









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Obama Administration Announces Proposed Rules on Insurance Exchanges

Today, the U.S. Department of Health & Human Services (DHHS) has issued a press release announcing the issuance of two proposed rules on insurance exchanges under the ACA.  The first rule would address the establishment of health insurance exchanges and the second addresses standards for reinsurance, risk corridors, and risk adjustment.  Both rules are scheduled to be published in the Federal Register on July 15th with comments due 75 days after publication.  

You can see the HHS press release on the web at:  http://www.hhs.gov/news/press/2011pres/07/20110711a.html.

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Maine Leads New England in Obesity According to New Report

Maine is now the 27th fattest state in the nation, up from 29th in 2010 and 35th in 2009 according to a report released Thursday, July 7th by the Trust for America's Health with funding from the Robert Wood Johnson Foundation.  The annual study draws on publicly reported data from the past three years.

Adult obesity rates rose in 16 states compared with one year ago.  No state decreased its rate.  The five states with the highest rates of adult obesity are Mississippi, Alabama, West Virginia, Tennessee, and Louisiana.  The five lowest are Colorado, Connecticut, Massachusetts, Hawaii, and Utah.  Maine is the most obese of any of the New England states, although the New England states are generally less obese that other states around the country, particularly in the south.

Recommendations in the report focus on the importance of public policy and the engagement of the food and beverage industries.   Specifically, the report calls for prioritized funding for public health, anti-hunger and physical activity initiatives, particularly in the schools and other public settings.  The authors of the report also note the importance of developing industry guidelines for labeling and marketing foods and beverages.

MMA and other public health interests were instrumental in achieving legislative approval in Maine of a tax on sugared beverages three years ago, but that initiative was overturned by the voters following a "People's Veto" referendum financed by the beverage industry and other business interests.




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Clock is Ticking on Effort to Solve Debt Ceiling Crisis, Medicare at Risk

With less than three weeks to go to solve the debt ceiling crisis, Democrats and Republicans still remain far apart in their approaches to resolving the crisis.  Simply stated, the Republicans refuse to have any tax increases be part of the package and Democrats refuse to accept any deal that impacts adversely on Medicare and other entitlements (this is an over-simplification).  There also is no agreement on how much needs to be saved, with proposals ranging from $1 trillion to as much as $4 trillion.  But, there is no doubt that cuts of this magnitude will involve Medicare and Medicaid and will make it that much more difficult to fix the sustainable growth rate problem.  On the other hand, failure to come to some type of agreement to raise the debt ceiling would result in an unprecedented default of the U.S. government on its loans, leading to economic crisis.  As has been the pattern in Washington D.C. lately, it appears that the players are waiting to see who will blink first.  The clock is ticking.

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MMA Joins Clean Air Coalition

The Maine Medical Association is pleased to announce that our organization has joined the Maine Healthy Air Coalition!  Created by the American Lung Association, the Maine Healthy Air Coalition will be working to defend the Clean Air Act and protect Maine's children and adults from the harmful effects of breathing toxic air. 

In the State of the Air report released last month, we learned that more than half the people in Maine live in counties with unsafe air. This is unacceptable, according to Ed Miller of the American Lung Association, as he announced Maine's air quality grades

At the event launching the Coalition, MMA Public Health Committee co-chair Dr. Norma Dreyfus, explained, "Maine is particularly vulnerable to air pollution because of prevailing winds that convey pollution from the industrial Midwest. Not only does the clean air act need to be enforced immediately, but it needs to be strengthenend." Dr. Dreyfus says there's an economic price to pay for pollution in lost work time and higher health care costs.

If you want to help protect our air, there are a few steps you can take right now. 

First, the Coalition is building its list of health experts who can speak at press conferences and other media events.  They are also look for people who have struggled with the effects of unhealthy air, like parents of children with asthma or adults with lung or cardiovascular illness, to tell their stories. If you are interested in being added to the list of health experts, or if someone you know would be willing to share their personal experiences, please contact Amy Cookson, the Maine Healthy Air Coalition Coordinator, at acookson@lungne.org or at 207-624-0323.

Second, send an email to acookson@lungne.org to ask to be added to the Clean Air Alert list. If there is breaking news, or urgent action is needed, the Maine Healthy Air Coalition will make sure you are among the first to know, and have the opportunity to speak out in favor of strong laws, like the Clean Air Act, that protect our air.   Finally, if you are interested in joining the MMA Public Health Committee to become more involved with this or other public health issues, contact Jessa Barnard, MMA Director of Public Health Policy at jbarnard@mainemed.com or 207-622-3374 x 211. 

Click here to read the full MPBN story announcing the launch of the Coalition.  



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CMS Publishes Proposed Rule on Medicare Data Release

The Centers for Medicare & Medicaid Services (CMS) published its proposed rule on June 8th regarding the "Availability of Medicare Data for Performance Measurement."  The ACA authorizes the release of standardized extracts of claims data under Medicare parts A, B, and D to "qualified entities" for evaluating the performance of providers and suppliers.  These data may be provided to qualified entities beginning January 1, 2012.  While the ACA as being drafted, the AMA secured several safeguardsin these provisions, including requirements that enable physicians to reveiw, appeal, and correct errors in the reports prior to publication.

The proposed regulation defines a "qualified entity" as a public or private entity that is qualified to use claims data to evaluate the performance of service providers and suppliers on measures of quality, efficiency, effectiveness, and resource use.  To evaluate an organization's qualifications, CMS will examine three areas:  organizational and governance capabilities; ability to add claims data from other sources; and data privacy and security.  The regulation also requires entities applying for data access to describe their risk adjustment and physician attribution methods, as well as data specifications.  In addition, they must outline processes for physicians to review, appeal, and correct errors.

AMA staff participated in a September 20, 2010 CMS Listening Session that solicited input from relevant stakeholders on implementation of the Medicare data release program.  The AMA also submitted a formal statement to the agency:  http://www.ama-assn.org/resources/doc/washington/medicare-data-performance-measurement-statement-27sept2010.pdf.  The AMA will be coordinating comments on the proposed rule prior to the August 8th comment deadline.

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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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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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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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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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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]

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