January 2, 2012

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Best Wishes for the New Year; Thank You for Your Continuing Support

On behalf of MMA President Nancy Cummings, M.D. and the voluntary leadership and staff of the Maine Medical Association, we extend to all  MMA members, their families, and their staffs best wishes for a healthy and successful new year.  We appreciate the support you provide to your professional association all through the year and extend our heartfelt thanks to each of you.  With your help and support, we envision a successful year for the Association.

Association staff will begin a busy year today as work sessions continue at the State House on the Governor's Supplemental Budget.  On Wednesday,  the Second Regular Session of the 125th Legislature convenes and will eventually consider nearly 300 legislative proposals either submitted and approved for consideration, held over  from the last session, or presented by the LePage Administration.

The weekly conference calls of MMA's Legislative Committee will begin on Tuesday night, January 10th at 8:00 p.m.  Any MMA member is welcome to participate on these calls.

 Happy New Year!

Congress Finally Passes Two-Month Delay in Medicare SGR Payment Cut

At the 11th hour, House Republicans in Congress agreed to support the two-month package delaying implementation of the Medicare payment (SGR) cut and extending the unemployment tax cut which had been passed by the Senate the previous week.  President Obama signed the legislation into law just prior to leaving Washington for the holidays.  Without the legislation, Maine physicians would have seen a reduction of 28.4% and 31.4% depending upon in which of the two Medicare payment zones the physician practices. 

President Obama signed the Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3765) on December 23, 2011.  A House-Senate conference committee now will try to negotiate the extension of the payroll tax cut, including the physician payment provision, through 2012.  This law also includes a 2-month extension of Medicare payment provisions for a number of other health care providers, including hospitals, nursing homes, and ambulance service providers.

When Congress returns to Washington in January, it will be important for all of medicine to communicate the need for a long-term fix to the SGR problem.  It is expected that Congress will work on either a one-year or two-year delay.  Each physician in Maine should communicate with Maine's Congressional delegation as soon as possible and emphasize what this cut now scheduled for March 1, 2012 would mean to them and their patients.  Find contact information and a sample letter at the AMA Advocacy website.

You can find more information about the Medicare physician payment issue on the AMA's web site

The AMA also has some helpful guidance on Medicare participation options for physicians here.  

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Maine Legislature Reconvenes January 4th; MMA Invites Physicians to Serve as "Doctor of the Day"

The 186 members of the 125th Maine Legislature will reconvene for their Second Regular Session on Wednesday, January 4, 2012 for a "short" session that is expected to end in mid-April.  The Department of Health and Human Services budget shortfall will be a substantial piece of business upon their return to the State House.  The legislature also will address bills carried over from the First Regular Session and some "emergency" bills admitted by vote of the Legislative Council, the 10 members comprising the legislative leadership.  

The MMA needs physicians to serve as "Doctor of the Day" for this session.  In particular, we are looking for physicians able to serve on January 17, 24, & 31, as well as February 2.  The session begins at 10:00 a.m. on each of these days and you would likely be finished by noon.  FMI, contact Maureen Elwell, Legislative Assistant, at 622-3374, ext. 219 or melwell@mainemed.com, or see the MMA web site at:  http://www.mainemed.com/legislation/drday.php.

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MMA Public Health Committee Announces 2012 Meeting Dates

The Maine Medical Association Public Health Committee held its last regular meeting of the year last Wednesday, December 14th.  The Committee discussed a response to the Governor's proposed supplemental budget, the upcoming legislative session and how to support MMA President Dr. Nancy Cumming's physician wellness initiative. Other topics of discussion included: 

  • how best to support the work of the Maine CDC 
  • reform of the federal Toxic Substances Control Act 
  • emerging public health concerns such as exposure to particulate matter from wood smoke 

The Committee also set its meeting schedule for 2012: 

February 8th

April 11th

June 13th

August 8th

October 10th

December 12th

All meetings take place from 4-6 pm at the MMA Headquarters in Manchester.  There is always an option to join by phone. 

Any physician interested in joining for all or some of the Committee activities should contact Jessa Barnard at jbarnard@mainemed.com or 622-3374 x211. 

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MeCDC Reports Influenza Has Arrived in Maine

Influenza has officially arrived in Maine.  The first laboratory confirmed case of seasonal influenza was reported to Maine CDC on December 23, 2011.  An adult from Lincoln County tested positive for influenza B at Maine’s Health and Environmental Testing Laboratory (HETL).  The patient was not hospitalized, and had not recently traveled.

Influenza A (2009 H1N1), influenza A (H3), and influenza B are all circulating nationally.  Maine had previously detected two swine-origin novel strains of influenza A in October, but this is the first lab confirmed case of seasonal influenza in the state.  

Recommendations for this influenza season include:

  • Clinicians should consider influenza in the differential diagnosis of febrile respiratory illnesses in patients of any age, encourage their high risk patients to be immunized against influenza if they have not already done so, and review updated recommendations of the use of antiviral medications for influenza prophylaxis and treatment.
  •  Infection preventionists, clinicians, school nurses and other reporting entities must report all suspected outbreaks of influenza to Maine CDC by phone at 1-800-821-5821 or by e- mail at disease.reporting@maine.gov.

For up-to-date information/recommendations on influenza for health professionals, go to http://www.cdc.gov/flu/professionals.  

For surveillance information in Maine, go to www.maineflu.gov

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Downeast Association of Physician Assistants Winter CME Meeting is Open for Registration

22nd Annual Downeast Association of Physician Assistants

Winter CME Conference

February 1-4, 2012

Grand Summit Resort Hotel & Conference Center

Sunday River, Newry Maine

This conference offers a wide range of topics for all PAs!

                 Register before the Early Bird Special expires 12/31/11

Visit www.deapa.com/conference

Visit www.sundayriver.com for all hotel, skiing/winter activities and directions!

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Vigil to Remember Victims of Gun Violence, January 8th

On Sunday, January 8, 2012, at noon at City Hall in Portland the MMA will be cosponsoring a vigil to remember victims of gun violence.

We all deserve to be safe and free from gun violence.  Yet every day, mothers, fathers, and children are killed and injured by guns.  January 8th will mark one year since the shooting in Tucson, Arizona that injured US Representative Gabrielle Giffords and where 19 people were shot, six of whom died.  

On Sunday, January 8th, concerned citizens across the country will take part in the Too Many Victims National Candlelight Vigil.  To see a list of participating communities visit http://www.bradycampaign.org/toomanyvictims/  .

Please us in Portland at noon on the steps of City Hall.  For more information contact:  info@mcahv.org or call 780-0501

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Critical Access Hospital in Central Maine Area Seeks Physician VPMA

A twenty-five bed, federally designated critical access hospital is seeking a physician interested in serving as its Vice President for Medical Affairs.  A limited clinical practice could also be part of the package.  Any physician interested in this opportunity may contact Gordon Smith, Esq., EVP of MMA who will pass the name on to the institution.  They may call Mr. Smith at 622-3374, ext. 212 or communicate via e-mail to gsmith@mainemed.com. [return to top]

Work Group Recommends Mandatory Flu Vaccine for Health Care Workers

Health care facilities should require their workers to receive influenza vaccinations to ensure patient safety, a Department of Health and Human Services work group recommended in a draft report announced December 15th in the Federal Register (76 Fed. Reg. 78,659).
Compiled by a work group of the National Vaccine Advisory Committee (NVAC), the report said that if a facility or employer cannot achieve a vaccination coverage rate of 90 percent of its workforce, “the most effective mechanism to rapidly reach and maintain the … goal” is to make it mandatory.
Public comments on the draft report are due January 16th and a webinar will be held on January 9th. 

At its annual membership meeting in September 2011, the Maine Medical Association adopted a policy urging universal vaccination of all health care workers.   The resolution states that if health care workers cannot achieve a 90 percent vaccination rate, the Association will considering supporting legislation that requires flu vaccination.  
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NQF Updates Reportable, Preventable Medical Error List

On December 20th, the National Quality Forum released a report entitled, Serious Reportable Events in Healthcare - a 2011 Update that identifies 29 preventable medical errors that may be used as health care provider performance measurements.  Twenty-five are updated from the 2006 list and four are new.  The new serious reportable events are: 

  • death or serious injury of a newborn during labor or delivery in a low-risk pregnancy;

  • patient death or injury resulting from failure to follow up or communicate lab results;

  • patient death or injury resulting from loss of a biological specimen; and

  • death or injury caused by the introduction of a metallic object into an MRI area.

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CMS Names 32 Health Systems as Pioneer ACOs

On December 19th, CMS named 32 initial participants in the ACA's Pioneer ACO initiative.  The Pioneer ACO program is different from the ACO program under the Medicare Shared Savings Program (MSSP) designed for health systems already experienced in providing coordinated, patient-centered care.  They must take on greater risk than those ACOs operating under the MSSP, but they may also benefit from a greater share of savings. 

Eastern Maine Healthcare Systems in Bangor will be the only Pioneer ACO operating in Maine. Approximately 8,000 Medicare patients associated with EMHS, the Aroostook Medical Center in Presque Isle and Inland Hospital in Waterville will initially be included in the program.

Other New England regional awardees include Beth Israel Deaconess Physician Organization in Massachusetts and Dartmouth-Hitchcock ACO in New Hampshire and Vermont.

You can find the CMS announcement on the web at:  http://www.hhs.gov/news/press/2011pres/12/20111219a.html.

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Legislative Committee Conference Calls Begin Next Week; New Bills for Review & Consideration

The MMA's Legislative Committee will begin its weekly conference calls during the legislative session NEXT Tuesday, January 10th 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.

The following are bills of interest to the physician community identified by the MMA staff.  By clicking on the highlighted "LD XXXX," you will go to the summary page for the bill on the legislature's web site.  You can find the text of the bill by following the tabs on the left side of the summary page.  These bills will be on the agenda for the weekly Legislative Committee conference call next week, or you may provide feedback directly to Andrew MacLean, Deputy EVP, by phone at 622-3374, ext. 214 or by email at amaclean@mainemed.com.  You will note that the MMA staff has suggested a position for each bill along with a MMA committee or specialty society that may have a particular interest in the bill.

L.D. 1603, An Act To Amend the Law Relating to Concealed Firearms Locked in Vehicles (oppose; Public Health Committee)

L.D. 1608, An Act To Clarify the Laws Governing Pharmacy Interns (monitor)

L.D. 1621, An Act To Remove a Barrier to Response by Emergency Medical Personnel (support; emergency physicians; Public Health Committee)

L.D. 1624, An Act To Lessen the Regulatory Burden on Medical Laboratories by Removing Outdated Requirements from the Maine Medical Laboratory Act (oppose; pathologists)

L.D. 1627, An Act Regarding the Filing of Birth, Death and Marriage Data (monitor)

L.D. 1628, An Act To Limit Payment for Care and Treatment of Residents of State Institutions (monitor; psychiatrists)

L.D. 1629, An Act To Allow for a Contingency Fee Agreement with a MaineCare Recovery Audit Contractor (oppose)

L.D. 1646, An Act To Facilitate the Use of Alternative Methods for Biomedical Waste Treatment and Disposal (support; Public Health Committee)

L.D. 1666, An Act To Guarantee Basic Preventive Dental Health Services for Children in Maine (monitor or support; pediatricians, Public Health Committee)

L.D. 1670, An Act To Extend the Scope of the Maine Guaranteed Access Reinsurance Association (monitor)

L.D. 1678, An Act To Amend the Laws Governing Stalking and Domestic Violence (monitor; Public Health Committee)

L.D. 1679, An Act To Conform Maine's Prescription Drug Privacy Laws with the United States Constitution (monitor)

L.D. 1688, An Act To Clarify the Status of Patients Held under Involuntary Commitment Applications (support; psychiatrists)

L.D. 1691, An Act Related to Specialty Tiers in Prescription Medication Pricing (support)

L.D. 1692, An Act To Clarify Case Management Supervision Authority and Ensure Access to Case Management Services (monitor; psychiatrists)

L.D. 1694, Resolve, Directing the Department of Health and Human Services To Review Rules Governing Reimbursement to MaineCare Recipients for Transportation to Freestanding Methadone Clinics (monitor; psychiatrists)

L.D. 1695, An Act To Provide Additional In-store Space for Maine's Businesses by Removing License and Permit Posting Requirements (monitor; Public Health Committee)

L.D. 1698, An Act To Establish Veterans Treatment Courts (monitor; psychiatrists)

L.D. 1700, An Act To Provide an Alternative Method of Calculating Minimum Staffing Levels in Nursing Homes (monitor)

L.D. 1702, An Act To Correct Inconsistencies and Ambiguities in the Maine Guaranteed Access Reinsurance Association Act (monitor)

L.D. 1705, Resolve, To Create the Task Force on the Prevention of Sexual Abuse of Children (monitor; pediatricians)

L.D. 1711, An Act To Mandate the Use of Standardized Risk Assessment in the Management of Domestic Violence Crimes (monitor; Public Health Committee)

L.D. 1714, An Act To Restrict Further the Amount of Methamphetamine Precursors That May Be Bought or Sold (monitor; Public Health Committee)

L.D. 1715, An Act To Allow for Timely Access to and Enhanced Administration of All Vaccines (oppose; pediatricians; Public Health Committee)

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