November 28, 2011

 
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Democrats Call for Extending SGR Fix by Dec. 16, 2011

The Democratic Party leadership in the U.S. House of Representatives called last week for an extension of the sustainable growth rate Medicare payment formula in order to delay  the scheduled 27.4% cut in payments that will take place in January unless Congress acts.  A reduction of payments of this magnitude would represent a loss of over $100 million to Maine providers, including both hospitals and physicians, with an average loss of $21,000 per physician.

In a letter to House Speaker John Boehner, Minority Leader Nancy Pelosi, Democratic Whip Steny Hoyer and Assistant Minority Leader James Clyburn called on Republicans to ensure three pieces of legislation get passed prior to December 16th.  One of the three items was the delay in the SGR cut.

Pelosi's office called the extension of the SGR fix essential to ensure that seniors can maintain access to their physicians, but added that the length of any extension was unspecified at this time.

Last December, President Obama signed legislation passed at the last minute that froze payment for 12 months.  In 2010, Congress passed six separate short-term SGR patches.

MMA has communicated to Maine's Congressional delegation the significance of this issue in Maine which has the second largest percentage of residents in the nation who are over age 65.  Fully 20% of Mainer's are on Medicare, a rate significantly higher than the national average.  In addition, over 42,000 Tricare patients in Maine are also impacted by the proposed cut as Tricare reimburses physicians based on the Medicare fee schedule.

Primary Care Physicians Needed for Focus Group, Dec. 6, 5:00pm

The Maine Medical Association is making space available for NORC at the University of Chicago to hold a discussion group about physician experience with health information exchanges (HealthInfoNet in Maine).  The group discussion will be held on Tuesday evening, December 6th at 5:00pm in Manchester and will last about 90 minutes.  Each physician participating will receive a $75 honorarium for participating and dinner will be available.

The discussion group will be run by NORC, an independent research organization.  NORC is leading an evaluation of the State Health Information Exchange (HIE) Cooperative Agreement Program, which is funded by the federal Office of the National Coordinator for Health IT (ONC).  The goals of the State HIE Cooperative Agreement Program are to facilitate and expand secure exchange of health information within and across states according to nationally recognized standards and ensure that providers and hospitals meet meaningful use requirements.

As part of the evaluation, NORC is conducting a series of case studies in five states.  Maine was selected based on the progress that has been made in implementing the program.  Through the case studies, ONC is particularly interested in gathering lessons from states that can be shared with and benefit other states.  NORC plans to speak with various stakeholders involved in the state's program in addition to holding discussion groups with physicians.

Any primary care physician who would like to participate should contact Kate Quirk at quirk-catharine@norc.org or by calling her at 301-634-9384.  NORC hopes to include two to three physicians each from small, medium and large primary care practices.

 For additional information about NORC, please visit www.norc.org.

 

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MaineCare Physician Advisory Committee Discussing PMP, Suboxone, Dec. 8

The Physician Advisory Committee (PAC) is a core group of six MaineCare physicians facilitated by the MaineCare Medical Director.  Presently this group meets on a quarterly basis.  MaineCare would like to open its Physician Advisory Committee meeting to wider participation.  Any provider interested in MaineCare initiatives may attend the meeting in person or by phone. 

The next meeting will be held on Thursday, December 8, 2011 from 3-5 p.m. at the Augusta MaineCare Office located at 442 Civic Center Drive.  The topics for this meeting will be the Prescription Monitoring Program and upcoming changes to MaineCare coverage of Suboxone.

The conference call line is 1-800-394-6604, with passcode 959468#.  If planning to attend in person, please reply to Charyl Malik at 207-287-3320 or charyl.malik@maine.gov .   [return to top]

DHHS Seeks Comments on Value Based Purchasing Strategy

The Maine Department of Health & Human Services last week released a request for comments regarding certain aspects of the Department’s Value Based Purchasing (VBP) Strategy, focusing on:

  1. The planned Accountable Communities Initiative, under which MaineCare will enter into alternative, risk-based contracts with qualified provider organizations that will align financial incentives for those providers to work together with the community to improve value and decrease avoidable costs.

  2. The Department’s plans to take advantage of Section 2703 of the Affordable Care Act, establishing Health Homes to serve MaineCare and Medicare-Medicaid dual enrollees with chronic care needs. 

The RFI and more information on the Department’s Value Based Purchasing Strategy, can be found here: http://www.maine.gov/dhhs/oms/mgd_care/mgd_care_index.html.

Any individual or entity may respond to the RFI, including individual health care practices. The deadline for final submission of comments is 5:00 p.m. December 14, 2011.  [return to top]

CMS Administrator Donald Berwick, M.D. to Resign Dec. 2, 2011

The Associated Press reported last week that CMS Administrator Dr. Donald Berwick will resign on December 2nd and will be replaced by Deputy Administrator Marilyn Tavenner.  Dr. Berwick was holding the position on a temporary basis as he had not undergone Senate confirmation hearings.  Over forty Republican Senators had signed a letter months ago indicating that they would not vote to confirm Dr. Berwick, as they objected to a number of positions he has taken over the years that he had directed the Institute for Healthcare Improvement.

Dr. Berwick, a pediatrician, is expected to return to academic teaching positions in Boston. [return to top]

CMS Announces Version 5010 Enforcement Grace Period

While the compliance deadline for physicians to use the Health Insurance Portability And Accountability Act Version 5010 electronic transactions remains January 1, 2012,  the Centers for Medicare & Medicaid Services (CMS) has announced that it will not enforce compliance until March 31st.  However, physicians who are not compliant by January 1, 2012 will face claims processing interruptions and will need to demonstrate their efforts to comply if CMS receives a complaint about their practice's electronic transactions.

Please visit the CMS website at http://www.cms.gov/ICD10/11a_Version_5010.asp for more information and resources about Version 5010.  The American Medical Association (AMA) has developed a toolkit for physicians. Additionally, free archived webinars are available at http://www.getready5010.org/. [return to top]

Joint Commission: Physician Ordering via Text is Unacceptable

The Joint Commission recently updated its standards to indicate that text messages are an inappropriate means of placing physician orders.

"It is not acceptable for physicians or licensed independent practitioners to text orders for patients to the hospital or other care setting.  This method provides no ability to verify the identity of the person sending the text and there is no way to keep the original message as validation of what is entered into the medical record,"  the Nov. 10, 2011 Standards Update read. [return to top]

Soaring BPA Levels Found in People Who Eat Canned Foods

A new study by Harvard researchers may provide another reason to skip canned pumpkin and cranberry sauce this holiday season, the New York Times reported last Tuesday.  People who ate one serving of canned food daily over the course of five days, the study found, had significantly elevated levels — more than a tenfold increase — of bisphenol-A, or BPA, a substance that lines most food and drink cans.

BPA has been linked in some studies to a higher risk of cancer, heart disease, diabetes and obesity, and health officials in the United States have come under increasing pressure to regulate it. 

The new study, which was published last Tuesday in The Journal of the American Medical Association, is the first to measure the amounts that are ingested when people eat food that comes directly out of a can, in this case soup. The spike in BPA levels that the researchers recorded is one of the highest seen in any study.

In general, most studies have found that urinary BPA levels in typical adults average somewhere around 2 micrograms per liter.  After eating canned soup for five days, though,  levels rose above 20 micrograms per liter, a 1,221 percent increase.

Many companies began phasing out BPA in baby bottles and other plastic food containers in recent years to ease public anxieties, and Maine's Kid Save Products Act will soon require this in Maine, but it is still widely used in the linings of metal cans. 

The study can be found here (subscription required): http://jama.ama-assn.org/content/306/20/2218.2.extract

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Save the Date: MMA Legislative Committee Meeting, Dec. 6

Save the Date: MMA Legislative Committee Meeting 

Tuesday, December 6, 2011

6:30-8:30 p.m. 

MMA Headquarters, Association Drive, Manchester

All MMA members, specialty society leadership and legislative liaisons, and interested parties are welcome to join.  The Committee will discuss priorities for the second session of the legislature, MMA advocacy work related to the Affordable Care Act and Maine's health insurance reform law (Chapter 90) and organizational issues.  Dinner will be served. 

RSVP to Maureen Elwell, melwell@mainemed.com or (207) 622-3374x 219.

 

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First Friday Program, Dec. 2: Supervising Mid-level Providers and Delegation

MMA concludes its 2011 educational programs this Friday morning, December 2nd when health lawyers, risk managers, regulators and physician assistants will discuss the requirements of supervising mid-level providers and the standards and risks associated with delegating medical tasks to medical assistants. Standards of practice will be addressed from the point of view of risk management, state regulations and payor requirements.  This three hour program will be available live and via webex.  The cost is $65 per person and the program will run from 9:00am to noon.

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