October 31, 2011

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Attorney General Hosts Prescription Drug Abuse Summit

Last Tuesday, Maine Attorney General William Schneider held a summit on prescription drug abuse, attended by about 150 physicians, pharmacists, other health care providers, legislators, law enforcement officers, and interested parties.  Governor Paul LePage has pledged to create a task force to carry the recommendations of the group forward.   Over the weekend, MMA President, Dr. Nancy Cumming's, response to a recent editorial regarding the role of physicians in prescription drug abuse appeared in the Maine Sunday Telegram. 

The Attorney General's Summit opened with presentations framing the issue of prescription drug abuse in Maine, including by the Attorney General; the Governor; Dr. Margaret Greenwald, the State's Chief Medical Officer; Judge John Woodcock of the United States District Court of Maine; and Robert Carlson, the President of Penobscot Community Health Care. 

The remainder of the morning and afternoon were spent in work groups tackling the topics of prevention, treatment, education and enforcement.  A number of members of the LD 1501 work group were present to share how that group is addressing similar issues.  At the end of the day, the Attorney General announced the Governor's plan to create a task force to move these efforts forward. The four areas of focus for the task force will be:

     (1) the safe storage of prescription medications and the safe disposal of  unused medications; 

     (2) expanding the availability of diversion alerts, already in use in some Maine counties, which inform emergency rooms and primary care practices of who has been arrested in the county for prescription or illegal drug-related crimes; 

     (3) educating the community about the dangers of prescription drug abuse and increased education efforts aimed at prescribers, potentially required as a condition of licensure in the state; and 

     (4) encouraging more participation in the Prescription Monitoring Program, including examining the requirement for a notarized application and the the length of the contract with vendor. 

The Attorney General will be releasing a report with the proceedings of the day and suggestions for the task force can still be submitted to the Attorney General's office.  More information about the summit can be found at: http://www.maine.gov/ag/initiatives/drugsummit2011/

Dr. Cumming's piece responding to a recommendation in a recent editorial in the Portland Press Herald calling for the criminal prosecution of physicians who don't check the Prescription Monitoring Program database prior to prescribing controlled substances for chronic pain appeared in Sunday's Telegram.  A link to the article can be found here:  http://www.pressherald.com/opinion/doctors-cant-fight-drug-abuse-alone_2011-10-30.html

Medicare eRx Payment Adjustment - November 1, 2011 Deadline Tomorrow

The Centers for Medicare & Medicaid Services (CMS) released the final regulation on the 2012 Medicare Electronic Prescribing Incentive (and penalty) Program on August 31, 2011. If you have not successfully e-prescribed and reported G8553 at least 10 times for applicable Medicare office visits between January 1, 2011 and June 30, 2011, you should apply immediately for an exemption or face a penalty.

The penalty for not successfully participating in the e-prescribing program or for not filing for an exemption by November 1, 2011 is a 1% payment reduction for all Medicare claims based on the 2012 fee schedule amounts. The penalty increases to 1.5% in 2013 and 2% in 2014.

The final regulation identifies the exemption categories to avoid the 2012 e-prescribing penalty. You can select one or more of the following exemptions that apply to your particular hardship situation:

  • Your practice is located in a rural area without high speed internet access.

  • Your practice is located in an area without sufficient available pharmacies for e-prescribing

  • You are registered to participate in the Medicare or Medicaid electronic health record (EHR) Incentive Program and you adopted Certified EHR Technology by October 1, 2011 and prior to the time you request an exemption.

  • You are unable to electronically prescribe due to local, State or Federal law or regulation (CMS clarified that physicians who mainly prescribe narcotics but due to certain limitations cannot submit these prescriptions electronically can apply for this exemption category).

  • Limited prescribing (You do not prescribe on a regular basis).

  • There were too few opportunities to report the e-prescribing measure due to limitations of the measure's denominator (You do e-prescribe but your e-prescriptions are not related to qualifying services/visits).

You must use the CMS on-line web-based tool to apply for the exemption(s). Application for exemptions can only be made online at: https://www.qualitynet.org/portal/server.pt/community/communications_support_system/234 

You will be asked for your TIN, NPI, business name (as enrolled in PECOS), and contact information. If your exemption claim is that you have enrolled in the Medicare and Medicaid EHR Incentive Program, you should also be prepared to give your registration ID and the ONC Certification number of your product.  You will also need to submit a 250 words or less justification for your hardship. If submitting more than one exemption request, have your statement reflect all of your exemption requests. Each hardship exemption must be submitted separately.

CMS has posted more information on the 2011 specifications at http://www.cms.gov/ERXIncentive.

See also the FAQs.

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Final 2011 First Friday Programs (Nov. 4, Dec. 2) Focus on Minors and Supervising Mid-level Providers

MMA concludes its 2011 educational programs with two popular topics.  On Friday morning, November 4th, health lawyers and practicing pediatricians will present a three-hour CME program on medical legal issues in a pediatric practice.  The program will be of particular interest to pediatric practices and family physicians.  The program will run from 9:00am to noon and will be available live in Manchester or via webex.  The cost is $65 per person. 

On Friday morning, December 2nd, health lawyers, regulators and practicing physicians and physician assistants will discuss the requirements of supervising mid-level providers.  Standards of practice will be addressed from the point of view of risk management, state regulations and payor considerations.  This three hour program will also be available live and via webex.  The cost is $65 per person and the program will run from 9:00am to noon.

Watch your e-mail later this month for a flyer with a full agenda and faculty for each program.

Any questions about these two programs should be addressed to Gail Begin at MMA.  Gail can be reached at 622-3374 ext. 210 or via e-mail to gbegin@mainemed.com.  
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Legislative Council Considers Bill Requests

Maine's Legislative Council, comprised of the ten elected members of legislative leadership, met today to consider legislative requests or “LRs” submitted for consideration during the second session of the Maine Legislature.  The only new legislation considered during the second session is supposed to be of a fiscal or “emergency” nature and the Legislative Council must approve submission of these LRs according to this standard.  Sponsors have an opportunity to appeal an initial denial and the list of bills approved for consideration during the second session should be complete by late November or early December.  Some of the proposals approved by Legislative Council today include: 

  • LR 2426, An Act to Conform Maine’s Prescription Privacy Laws with the United States Constitution (Senator McCormick)
  • LR 2514, An Act to Facilitate the Use of Alternative Biomedical Waste Treatment Devices (Senator Saviello) 
  • LR 2580, An Act to Allow for the Timely Access to and Enhanced Administration of Injectable Medications, Biologicals, Immunizations and Vaccines (Representative Strang Burgess) 
  • LR 2614, An Act Relating to False Claims under the Medicaid Program (Representative Gifford)
  • LR 2652, Resolve, Directing the Workers’ Compensation Board to Revise the Medical Fee Schedule to Use an Appropriate Conversion Factor in the Payment of Anesthesia Services (Representative Prescott)

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Medicare Covers Screening & Counseling for Alcohol Misuse and Screening for Depression

The Centers for Medicare & Medicaid Services (CMS) announced October 14th two new national coverage determinations that cover alcohol misuse screening and behavioral counseling for Medicare beneficiaries as well as screening for depression. These new coverage policies add to the existing portfolio of covered preventive services, most of which are now available to people with Medicare at no additional cost.

Annual alcohol misuse screening by primary care providers, such as a beneficiary’s family practice physician, internal medicine physician, or nurse practitioner, in settings such as physicians’ offices are covered under CMS’ new policies.  The benefit also includes four behavioral counseling sessions per year furnished by the primary care provider, if beneficiaries screen positive for alcohol misuse. 

Annual screening for depression for Medicare beneficiaries is now covered in primary care settings that have staff resources to follow up with appropriate treatment and referrals.  The purpose of  this screening is to assure accurate diagnosis, effective treatment and follow-up.

The coverage decision on alcohol misuse screening is online here and the decision on depression screening is available here.

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Week-long T.R. Reid Speaking Tour on Finding Better, Cheaper & Fairer Healthcare

Bestselling author, journalist, and NPR correspondent T.R. Reid is coming to Maine to talk about what we can all do to find and receive better, cheaper and fairer healthcare!  We encourage you to read his book, The Healing of America, and to join in the discussion by attending one of his public appearances around the state.  For more information, visit:  http://www.getbettermaine.org/tr-reids-speaking-schedule-maine

Monday, November 7th
University of Maine, Augusta *
Jewett Hall
7:00 PM - 8:30 PM 

Tuesday, November 8th
Husson University Business Breakfast *
Bangor, ME
8:00 AM - 9:00 AM
Email greenj@husson.edu to sign up

Tuesday, November 8th
Portland Public Library *
Rines Auditorium
Portland, ME
5:30 PM - 6:30 PM

Wednesday, November 9th
Greater Portland Chamber Commerce
Eggs and Issues Business Breakfast
Portland, ME
7:30 AM - 8:30 AM

Thursday, November 10th
Androscoggin Chamber of Commerce Business Breakfast
Martindale Country Club Inc
Auburn, ME
7:15 AM - 8:55 AM
Click HERE to register

Thursday, November 10th
MHMC Annual Symposium
Abromson Center, USM
Portland, ME
8:00 AM - 3:00 PM

* Denotes free programs

TR Reid's week-long visit to Maine is being sponsored by the Maine Health Management Coalition Foundation, the Daniel Hanley Center for Health Leadership and the Maine Health Access Foundation, with support from Aligning Forces for QualityMaine Medical AssociationMaine Osteopathic AssociationAARPMaine Quality Counts and the Maine Development Foundation.

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UNE Offers Maine's First Accredited MPH Degree

The University of New England has announced that its Master of Public Health Program has received accreditation from the Council on Education for Public Health – making UNE’s program the first accredited in the state of Maine.  

“An MPH is considered one of the most marketable degrees, since health care providers are increasingly being required to use public health skills to care for their patients,” said Dora Anne Mills, M.D., M.P.H., UNE’s vice president for clinical affairs.  “As the largest educator of health care providers in Maine, we at UNE are excited to be offering this degree to many health professional students while they are on campus as well as working health professionals across Maine and the globe.”

The Graduate Programs in Public Health within the College of Graduate Studies at UNE currently offers an online certificate program and an online MPH degree program in both full and part-time formats. All students graduating from UNE’s new College of Dental Medicine will also receive an advanced certificate in public health. 

For more information on UNE’s Graduate Programs in Public Health, please contact: Denise Bisaillon, Ed.D., Director at 207-221-4464 or visit http://www.une.edu/publichealth/

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Reduced Payments Lead NH Provider Group To End Primary Care for Medicaid Patients

Citing reduced reimbursements and state budget cuts, a major health care network in central New Hampshire has notified its 3,500 Medicaid patients that it no longer will provide them with primary care beginning in mid-November.

LRGHealthcare said in an October 26th announcement that it would close its 12 primary care offices to new and existing patients with Medicaid as their primary coverage. The decision, approved by the LRGH board of trustees, “responds to unprecedented financial challenges faced by the organization and other hospitals and healthcare institutions across the state,” it said.

The Lakes Region General Hospital network was one of 10 providers that filed suit against the state in July, alleging that cuts in the 2012-2013 state budget violated the federal Medicaid Act. The hospitals warned that as a result of the cuts they would consider closing affiliated physician practices. [return to top]

Upcoming Events & Conferences

Fall is conference season!  Take advantage of the many upcoming learning opportunities, including: 

Spotlight on Coding and Compliance with National Speaker Margie Vaught!

MaineGeneral Medical Center 2011 Fall Coding & Compliance Conference

Friday, November 4, 2011 ~ 8 a.m. - 4 p.m.

Augusta Civic Center, North Wing, Augusta/Capital/PIne Tree Room

Starring Margie Scalley Vaught, CPC, CPC-H, CPC-I, CCS-P, MCS-P, ACS-EM, ACS-OR


$125 (includes breakfast, lunch, & breaks); registration deadline is October 24th.

For more information:  Lisa Beeckel, CPC, Physician Liaison; lisa.beeckel@mainegeneral.org; 626-1094.

Drugs, HIPAA & Safety Concerns

Wednesday, November 9, 2011 ~ 12:30 p.m - 4:00 p.m. 

Maine Medical Center, Dana Health Education Center, Portland, Maine 

Hospital health care providers and hospital security staff may be faced with issues related to contraband substances brought to the hospital with the patient.  In this session participates will learn about common drugs and the legal responsibilities when caring for the addicted patient. 

$10 registration fee (non MMC staff). CME Credit & Contact Hours available. 

For more information or to register, contact:  Beth Turner at (207) 622-2734 or turneb@mmc.org 


2011 Infectious Disease Conference 

Tuesday, November 15, 2011 ~ 8:30 a.m. - 4:00 p.m. 

Augusta Civic Center, Augusta, Maine 

Since 1983, the Maine Center for Disease Control and Prevention, Division of Infectious Disease, Department of Health and Human Services has organized an annual infectious disease conference targeting public health issues of emerging concern to medical practitioners throughout the State.

For more information, or to register, click here


Maine Medical Group Management Association Half Day Educational Session 

Wednesday, November 30, 2011 ~ 8:00 a.m. - 12:00 p.m. 

Maine Medical Association, 30 Association Drive, Manchester, Maine or via Webex 

Collection Law presented by William Lund & Confidentiality in the Office presented by Medical Mutual 

$25 for MEMGMA members and $40 for all non-members

For for information, contact:

 Karen Wheeler at (207) 873-6173 or kwheeler@mmimvw.com

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MMA Members Eligible for 25% Discount on MMS Online CME Opportunities

Members of the Maine Medical Associate are eligible to receive a 25% discount on all online CME courses offered by the Massachusetts Medical Society.  To view current Massachusetts Medical Society CME Offerings, go to  www.massmed.org/cme

The following tutorial includes a step-by-step guide for MMA members who would like to participate in this program.  PDF MMA/MMS Online CME Tutorial Guide

Important Information

  • The MMA discount educational voucher code is MMACME11.
  • If you have any questions about the registration or log in process, please contact the MMS Continuing Education Department at (800) 322-2303, ext 7306 or continuingeducation@mms.org.
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Free ACA & Maine Health Insurance Reform Law Webinar, Nov 18

The MMA is pleased to announce a series of free webinars covering health care reform updates. 

The Affordable Care Act and Maine's New Health Insurance Law (Chapter 90) 

Hear from MMA staff attorneys about important updates impacting Maine patients and physician practices from the national Affordable Care Act and Chapter 90, Maine's new health insurance law. 

November 18th, 12-1 pm 

The Medicare Wellness Visit

What practices need to know about billing and coding for the new Medicare Wellness visit.  Make sure your office is taking advantage of the opportunity to bill for this new service. 

December 16th, 12-1 pm 

Speaker: Laurie A. Desjardins, CPC, PCS

Laurie joined Baker Newman Noyes in 2006. She is a Senior Manager in the Healthcare Management Consulting Division specializing in revenue management including physician coding, provider based implementation, chargemaster analysis, fee schedule analysis, chart review, and coding and billing education.

For more information or to register for any of the sessions, contact Jessa Barnard, MMA Associate General Counsel, at jbarnard@mainemed.com or  207-622-3374 x 211 

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New Online Domestic Violence CME Program Available

The University of New England College of Osteopathic Medicine is hosting an ongoing online Continuing Medical Education (CME) course, Domestic Violence Response Initiative - Screening For Abuse. This course for practicing clinicians, taught by Daniel Oppenheim, MD, Endocrinologist and Domestic Violence Community Educator, Karen Wentworth, will provide participants with an overview of the dynamics of domestic abuse, indicators of abuse that providers should be aware of, the health care providers role in screening for abuse, discussions on the medical RADAR tool used to effectively and efficiently screen for abuse, and resources available for providers as well as patients.  

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