April 23, 2012

 
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Political Pulse: Legislature on Break - to Return on May 15th

The Legislature has recessed until May 15ht following enactment of the second FY 2012 - 2013 supplemental budget (L.D. 1903) more than a week ago.  In a controversial decision, the Republican leadership decided not to call the Legislature back into session last week to act on the Governor's line item veto impacting two areas of supplemental budget.   The Joint Standing Committee on Appropriations & Financial Affairs begins meetings again today and will meet each day this week to continue work on non-budget bills, including bond issues.  The Committee is scheduled to revisit the DHHS MaineCare eligibility system/claims management system incompatibility problem.  NOTE:  THERE WILL BE NO LEGISLATIVE COMMITTEE CONFERENCE CALL THIS WEEK.  Please check the Weekly Update next week for news on whether there will be a call on Tuesday evening.

Prior to taking a break last week, the Legislature accomplished the following:

SECOND SUPPLEMENTAL BUDGET 

The Legislature voted overwhelmingly to support the Appropriations Committee's solution for the second FY 2012 - 2013 supplemental budget (L.D. 1903), dealing largely with non-Department of Health & Human Services issues for 2012 and 2013.  In the end, the compromise budget package did include staff layoffs at Dorthea Dix Psychiatric Center, changes in financing for Riverview Psychiatric Center, and some minor reductions in the General Assistance program.   No cuts to the Fund for Healthy Maine were made. 

Many big decisions, including over significant proposed cuts in MaineCare coverage and the Fund for a Healthy Maine are expected when the Appropriations Committee takes up work on the 2013 DHHS budget in May.  The Committee is waiting for updated information regarding the financial impact of DHHS providing MaineCare services to more than 20,000 ineligible individuals as well as an updated revenue forecast. 

HEALTH INSURANCE EXCHANGE 

Following passionate statements both for and against, the Legislature did not proceed with establishing a state-based health insurance exchange, as authorized under the Affordable Care Act.   A majority in the Senate and House rejected LD 1498, the Democrat-supported bill to create an exchange.  LD 1497, an exchange bill initially supported by Republicans, was ultimately amended to do nothing more than regulate "navigators" - individuals who will help consumers and small businesses understand and access the plans sold through an exchange, if one is established.  If the state has not made further progress on establishing an exchange by January 1, 2013, the federal government will then step in to create an exchange in Maine. 

SAFE DRIVING 

An after-deadline bill, L.D. 1912, An Act to Encourage Responsible Teen Driving, received a hearing and work session in the Transportation Committee the week prior to recess and proceeded to the House and Senate floor.   Among other things, the bill increases the fines for young drivers who violate the terms of their provisional licenses, increases how long they can lose their license, and increases the fine for anyone cited for texting while driving from $100 to a minimum of $250. The bill grew out of an initiative by Secretary of State Charlie Summers to reduce teen driving deaths.  



Receive Two Hours of Category One CME for Completing Pain Management Home Study Course

The Home Study Course on the Management of Pain has recently been updated and is available on the MMA website.  Many thanks to primary author Noel Genova, PA-C and a physician advisory committee that reviewed and edited several drafts of this important material.  It can be taken, at no cost, for two hours of CME if the pre-test and post-test questions are taken and the evaluation form completed.  Thank you also to the Maine Board of Licensure in Medicine which has funded this work and the consultations that Noel has performed out in the practices.

The link to the course follows:  http://www.mainemed.com/painMgt/cme.php. [return to top]

Join Your Colleagues April 30th as the Hanley Center Honors Dr. McAfee and Launches PELI Course

Register today for a special evening honoring leadership that's transforming health and health care in Maine.  A highlight of the evening will be the presentation of the Daniel Hanley Leadership Award to Dr. Robert McAfee for his lifetime of extraordinary leadership in Maine and throughout the nation.

In honor of Dr. McAfee, the Center will name the physician leaders selected for the Physician Executive Leadership Institute Advanced Course as McAfee Fellows.

Hanley Leadership Award Dinner

Monday, April 30, 2012 from 5:30 PM to 9:00 PM

Reception: 5:30 - 6:15

Dinner & Program: 6:15 - 9:00

Portland Marriott at Sable Oaks, South Portland, Maine

Our keynote speaker will be the distinguished physician executive and author, Dr. Tom Lee, CEO of Partners Community Healthcare and Network President for Partners Healthcare System in Boston. 

Dr. Lee wrote "
Turning Doctors Into Leaders," a powerful Harvard Business Review article that builds the case for greater physician leadership in the transformation of the nation's healthcare system.

Registration Deadline:  April 23, 2012. 

The cost of the dinner is $75.00 per person.  To register, go to the following link:  http://honoringdoctormcafee.eventbrite.com.


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Join Practice Managers at Regional Conference in Rockport, May 15-17, 2012

For details, click on Upcoming Events and Conferences article, below. [return to top]

New Prescription Drug Abuse Task Force Meets Today

The 17-member Prescription Drug Abuse Task Force appointed earlier this year by Governor LePage and Attorney General Schneider will meet at 3:00 p.m. today (Monday) at the office of the Attorney General.  It will be the second meeting of the Task Force and the members will hear reports from the four working groups organized around the following four issues:

1.  Education of the public and providers;

2.  Proper disposal of unused medication;

3.  Enhancements to the Prescription Monitoring Program; and

4.  Establishment of a statewide system of alerts sent from law enforcement to prescribers.

The meeting has been scheduled for two hours and is open to the public.  Task Force members are from law enforcement, education, medicine, and state government.  MMA is represented by EVP Gordon Smith.  Any physicians with ideas that they wish to share with the Task Force are encouraged to contact Gordon at 622-3374, ext 212 or via e-mail to gsmith@mainemed.com.  

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Maine Health Policy Study Group and Maine AllCare Presents May 11 Program on Universal Coverage

The Maine Health Policy Study Group and Maine AllCare present, Beyond Patient Care:  Defining the Doctor's Role in Health Care Policy, on Friday morning, May 11, 2012 from 8:30 a.m. to 10:30 a.m. at the Maine Medical Association in Manchester.  Please join us for a dialogue with physicians about efforts to bring accessible, high quality, affordable health care to all of the people of Maine.

Guest Speaker:  Margaret Flowers, M.D., Congressional Fellow, Physicians for a National Health Program

Reaction Panel will include:

 Jeffrey Barkin, M.D., Associate Medical Director, Goold Health Systems, Co-Chair Maine Health Policy Study Group;

Linda Sanborn, M.D., State Representative, House District 130, part of Gorham; and

Philip Caper, M.D., Vice-Chairman of Maine AllCare Board and Member of Health Policy Study Group.

There is no charge to attend but space is limited and advance registration is requested.  To register, please e-mail Julie Pease, M.D. at jpease@maineallcare.org

Coffee and on-site registration opens at 8:00 a.m. and the program will begin at 8:30 a.m.

 

 


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Portland Gastroenterology Center Seeking Nurse Practitioner

Are you looking to maximize your professional career? Portland Gastroenterology Center is one of the leading providers of G.I. health care in Maine and Northern New England and we are looking for a dedicated Nurse Practitioner to join our team!

Our Nurse Practitioners are an integral part of our practice; performing patient follow up and consultative clinical evaluation, conducting physical exams, preparing treatment plans, and providing patients with health and disease prevention information.

Candidates should have advanced knowledge and skills in conducting physical examinations and treating patients in an expanded practice model with minimal direction. An advanced knowledge of nursing theory and practice, and additional specialized training acquired through completion of a concentrated study and clinical internship leading to a Master’s Degree. Applicants should have or be eligible to obtain a current license and registration to practice as a certified Advanced Practice Nurse in the State of Maine.

We offer a competitive salary and benefits packet.

If you have always wanted to live in a vibrant city that offers affordable housing, excellent schools, and an energetic arts community, then Portland, Maine is for you!

Resumes should be sent to: TABERA@mmc.org

4/30/12




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Harvard Pilgrim Health Care Foundation Awards $4 Million to Combat Childhood Obesity and Improve Health Equity

The Harvard Pilgrim Health Care Foundation (HPHCF) announced that it will award $4 million in grants and services to regional organizations to combat childhood obesity and health disparities. 

ChildObesity180 at Tufts University's Friedman School of Nutrition Science and Policy in Boston and MaineHealth of Portland, Maine will each receive $1.5 million over three years to bolster their efforts to stem the epidemic of childhood obesity by expanding promising campaigns that promote healthier environments and lifestyles for young people. 

MaineHealth will use the additional resources provided by HPHCF to expand its successful childhood obesity prevention initiative, "Let's Go! Healthcare," to more than 190 primary care physicians and 14 hospitals in Maine, Grafton and Hillsborough Counties in New Hampshire and Worcester County in Massachusetts.  This multi-level program -designed to help prevent, assess and treat childhood obesity - will provide health care professionals with the resources, training, tools, techniques and support they need to influence the children and families in their care.

The Foundation's Culture InSight program - which provides consulting, training and educational programs to healthcare organizations and professionals to improve care provided to populations and communities affected by health disparities - will contribute $1 million in technical assistance and consultation services over three years to five organizations throughout Massachusetts, New Hampshire, and Maine.  The Hanley Center of Portland, Maine will receive Culture InSight's support to work with local organizations to plan and deliver effective health care services and programs.

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MaineCare PAG/TAG Update

MaineCare held a regularly scheduled Provider Advisory Group/Technical Advisory Group on April 12th.  Among the issues discussed were the following: 

  • HIPAA 5010 Compliance:  MaineCare has extended the deadline for HIPAA Version 5010 compliance to align with the Centers for Medicare & Medicaid Services (CMS) announcement that it will not initiate enforcement of HIPAA Version 5010 until June 30, 2012.  If your organization submits electronically in batches to MaineCare, you must complete certification testing by June 30, 2012. 

  • "Ineligible Segment" Issue:  Director of MaineCare Services, Stefanie Nadeau, gave an update on the more than 20,000 individuals whose eligibility for MaineCare was not terminated in the MIHMS claims processing system despite them no longer being eligible for services.  Ms. Nadeau confirmed that as long as practices had made a good faith effort to verity patient eligibility before providing services, the practice will be paid for their services even if the patient was not actually eligible for MaineCare.  If a patient's eligibility was terminated prior to the practice submitting a claim, so the practice's claims is denied, the practice should contact their provider representative to resolve the issue.  

  • Volume of Pended Claims:  While the number of claims in pending status is low, practices present suggested that this is not representative of the number of claims that have been paid at $0 for various reasons or denied claims.  In a related issue, a number of practices and facilities commented that the number of issues with processing claims over the past month has been worse than usual, including receiving thousands of pages of remittance advice documents that have to be reconciled line by line with patient accounts.  MaineCare and Molina stated that they are aware of the issue and will work with practices to come to a resolution.  They are also going to schedule a stand alone hospital PAG meeting to discuss facility concerns in more detail. 

The next PAG/TAG meeting is scheduled for May 10, 2012 at 9 a.m. and practice representatives can attend in person at 41 Anthony Avenue in Augusta or join by phone.   

 
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Upcoming Events & Conferences

6th Annual Psychiatry Update

Challenging Patients: From Problems to Solutions

Friday, April 27, 2012

8 am - 5 pm

    Marriott at Sable Oaks

 So. Portland, ME

             Presented by Maine Association of Psychiatric Physicians & MAPP Consultation Project

             The educational sessions will provide an update of clinical issues pertaining to the treatment of mental illness at the interface of psychiatry and medical health, and are designed to be of interest to psychiatrists and to primary care practitioners. Physicians, nurse practitioners, physician assistants, nurses and therapists will benefit from attending.

              For more information, please contact Warene Eldridge at warene54@yahoo.com 

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11th Annual Obesity Workshop 

Price Matters: Sugar Sweetened Beverages, Taxes & Obesity - The Evidence 

May 3, 2012

8:00 am - 3:00 pm 

Maple Hill Farm, Hallowell

The annual obesity workshop is an event not-to-miss for all people interested in public health and the health of our children.  Three nationally known speakers will present the latest research and information about sugar sweetened beverages, how they impact obesity rates and how purchase price influences our choices.

For more information or to register, click here

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The Maine Society of Eye Physicians and Surgeons Spring Meeting

May 4, 2012 

12:00pm - 4:45pm

Harraseeket Inn, Freeport

The Spring Meeting will include lunch, educational presentations and a business meeting.  The educational talks include Trexler M. Topping, MD presenting on Lessons Learned from Malpractice Claims and Bradford Shingleton, MD presenting on Pseudoexfoliation:  IOP, Cataract Surgery and Postoperative IOL Issues.

For more information or to register, contact Shirley Goggin at sgoggin@mainemed.com or 207-445-2260.

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Back to School: Pediatric and Adolescent Hot Topics and School Based Health

May 5-6, 2012

Harborside Hotel, Bar Harbor 

Approved for 10.5 Hours of Category 1 CME 

For more information or to register, go to www.maineaap.org 

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Maine Association Medical Staff Services Biennial Education Conference: The Many Spokes of the Wheel

 May 9-11, 2012

 Residence Inn Hotel and Conference Center

Portland, ME

The conference welcomes physicians and other health professionals with an interest in medical staff activities, including credentialing and quality improvement.  Category I CME is offered for physicians.

An agenda and registration materials are available at www.meamss.org

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2012 New England Medical Group Management Association Regional Conference 

Practice Management - A Changing Landscape 

May 15-17, 2012

Samoset Resort

Rockland, ME 

In the face of the changing healthcare landscape, you need to understand the challenges and opportunities your practice is facing. The 2012 New England MGMA Regional Conference features a wide range of speakers who will provide you with the insight and tools you need to help your practice thrive.

For more information or registration, visit: http://newenglandmgma.com/

Members of the Maine Chapter MGMA now receive a $50 registration reimbursement. 

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22nd Annual Maine GERIATRICS Conference - Save the Date

June 7-8, 2012 

Harborside Hotel & Marina

Bar Harbor, ME

Registration Open.  CME Available. 

 For more information or to register visit http://www.une.edu/com/cme/

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Save the Date: 

Emergency Ultrasound Course

October 25-26, 2012

MaineGeneral Medical Center

Waterville, ME 

Primarily geared to emergency and intensivist physicians and mid-levels.  Expected 14 Category 1 CME Credits.  Course Director: John Joseph, MD, FACEP 

To reserve your spot: 626-1303 or sharon.judkins@mainegeneral.org



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Opportunity to Further Expand Maine PCMH Pilot - Application Process Re-Opened!

We are writing to notify the Maine primary care community of a potential opportunity to increase the planned expansion of the multi-payer Maine PCMH Pilot to include up to 50 qualified adult primary care practices.  It should be noted that several issues must be addressed before this opportunity can be finalized.

Maine’s participation in the CMS MAPCP demo currently brings in approximately $2.5M per year in new Medicare payments to the 22 adult Pilot practices ($1.7M) and the 8 Community Care Teams (CCTs) ($720K).  Bringing in the planned 20 new practices is expected to bring in approximately $2.5M of additional Medicare payments to practices and CCTs (i.e. nearly doubling that revenue).  Bringing in an additional 30 new practices could be expected to bring in an additional $3.4M in new Medicare payments to these new practices and CCTs.

In order to proceed, CMS requires that the other payers agree to participate, and that Pilot Conveners offer the same level of practice transformation support for all practices in the Pilot.  While we fully recognize the importance of this opportunity, resources do not currently exist to provide this practice transformation support for an additional 50 practices, and we do not have sufficient time to secure additional grant resources  in the  required timeframe.  Given that, we are proposing that new practices selected for the Pilot contribute a modest per member per month (pmpm) payment to support these required practice improvement activities.

While final approval of this additional expansion of the Pilot is contingent upon these additional steps and subject to CMS approval, we feel that it is highly possible that we will be allowed to proceed.  Given that, we are re-opening the online application process for the Maine PCMH Pilot and the MaineCare Health Homes initiative for a 2 week period, from Friday, April 20 through 5PM on Friday, May 4.  

For more information or questions about eligibility, please contact Dr. Lisa Letourneau at tel. 415.4043 or Lletourneau@mainequalitycounts.org or Nancy Grenier at tel. 240.8768, or ngrenier@mainequalitycounts.org

We appreciate your interest in and support for the Maine PCMH Pilot.

Maine PCMH Pilot Conveners,

Karlynee Harrington, DHA’s Maine Quality Forum

Lisa M. Letourneau MD, MPH, Maine Quality Counts

Elizabeth Mitchell, Maine Health Management Coalition

 


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Next DEA Medication Collection Day, April 28th

The U.S. Drug Enforcement Administration (DEA) has scheduled another National Prescription Drug Take-Back Day which will take place on Saturday, April 28, 2012, from 10:00 a.m. to 2:00 p.m.  This is a great opportunity for those who missed the previous events, or who have subsequently accumulated unwanted, unused prescription drugs, to safely dispose of those medications.

Americans who participated in the DEA’s third National Prescription Drug Take-Back Day on October 29, 2011, turned in more than 377,086 pounds (188.5 tons) of unwanted or expired medications for safe and proper disposal at the 5,327 take-back sites that were available in all 50 states and U.S. territories. 

For collection sites in Maine, please visit www.dea.gov.

Collection is for individual households only, not facility disposal.  

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