June 11, 2012

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Register Today for 21st Annual Practice Education Seminar, July 25 in Augusta

MMA will hold its 21st Annual Practice Education Seminar on Wednesday, July 25, 2012 at the Augusta Civic Center.  This popular educational program is intended to inform physicians, practice managers and support staff of the major new laws, regulations and market trends impacting on medical practice in Maine.  Three national speakers highlight the faculty for the program.

Registration is available on the MMA website at www.mainemed.com or by calling Lisa Martin at MMA at 622-3374 ext. 221 or via e-mail to lmartin@mainemed.com.

The keynote presenter is Susan Turney, M.D., President of the Medical Group Management Association (MGMA) in Englewood, Colorado.  Prior to accepting the MGMA position, Dr. Turney served as Executive Vice President of the Wisconsin Medical Society.  Dr. Turney will share with attendees the trends she sees across the country as practices wait to see what aspects of the Affordable Care Act remain as a result of the Supreme Court decision and the Presidential election.

Maine's former Insurance Superintendent Brian Atchinson, Esq. is the luncheon speaker.  Mr. Atchinson is now serving as President of the Physician Insurers Association of America and will update attendees on medical liability trends across the country.  He was instrumental in the enactment of Maine's prelitigation screening panel in the 1980s when he served as legal counsel to Susan Collins when she was Commissioner of Professional and Financial Regulation in the McKernan administration.

The afternoon keynote presentation will be given by Suzan Oran, a national speaker on the subject of engaging staff in the delivery of excellent patient care.

Nine breakout sessions are also scheduled on the following topics:

  • Employer Expectations of Maine Physicians

  • Maine's New CO-OP Health Plan

  • MaineCare Update

  • Update on State HIT and Health Information Exchange

  • Responding to Complaints to State Licensing Boards

  • Tools for Medical Professionals in Assessing Senior Drivers

  • Update on Actions of the 125th Legislature

  • Prescription Drug Abuse and the Prescription Monitoring Program

  • What's New in Academic Detailing

The program runs from 8:30am to 4:30pm and we hope to see you there!

AMA Annual Meeting Convenes on Saturday in Chicago

The American Medical Association will convene its Annual Meeting of the House of Delegates this coming Saturday beginning at 2:00pm.  The meeting will be held at the Hyatt Regency Hotel in Chicago.  Attending from Maine will be AMA delegates Richard Evans, M.D., and Maroulla Gleaton, M.D., MMA President Nancy M. Cummings, EVP Gordon Smith and Associate Counsel Jessa Barnard.  Specialty delegates attending from Maine include John McGill, M.D. of Bangor and Daniel Spratt, M.D. of Portland.

Colorado Psychiatrist Jeremy Lazarus, M.D. will be installed as President of the AMA on Tuesday evening, June 19th, following current President Peter Carmel, M.D.

You can find materials for the meeting, including reference committee reports and resolutions by clicking here (AMA password required). [return to top]

Report on MMA Board Meeting Last Week

The MMA Board of Directors met for its regularly scheduled meeting last Wednesday (June 6th) at the MMA offices in the Frank O. Stred Building in Manchester.  Board members heard a presentation from Dr. Kathleen Hickey on development of a mindfulness based stress reduction program and voted to ask the Maine Medical Education Trust to provide a $1000 contribution toward the course expenses.  Dr. Hickey practices pediatrics in Farmington.

Following Dr. Hickey's presentation, Dr. Neil Korsen presented an update on his work representing MMA on the Maine Health Data Organization.  Dr. Korsen discussed the current changes going on in the state in the interest of having the claims data information available on a more timely basis.

Upcoming events include the Annual Benefit Golf Tournament on Monday, July 30th, the 21st Annual Practice Education Seminar on Wednesday, July 25th and the 159th Annual Session at the Harborside Hotel and Marina in Bar Harbor on September 7-9, 2012.

Executive Committee nominations for the officer positions were presented to the Nominating Committee on June 5th.  Guy Raymond, M.D. was nominated to serve as President-elect and Drs. Gleaton and Pattavina were nominated to retain the AMA delegate and alternate delegate slots to the AMA.  Dr. Richard Evans is the other current AMA delegate and has a two year term ending in September 2013.  Dr. Raymond is a family physician practicing in the emergency room at Northern Maine Medical Center in Fort Kent.  He is a former chair of the Medical Professionals Health Committee and currently is the President of the Medical Staff at NMMC.  It was also noted that Lisa Ryan, D.O. is interested in serving as chair of the Board during the 2012-2013 year.

The Board will hold their summer meeting at the Rockwood home of President Nancy M. Cummings, on Friday, August 3 at 3:00pm.  The meeting was been moved to a Friday to accommodate any members who may wish to extend their stay into the weekend in the Moosehead region.

The Board meeting was chaired by Board chairman Kenneth Christain, M.D.

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Physicians, Hospitals Likely to See Major Impact if Court Overturns Health Law

With the Supreme Court's decision on the health reform law expected by the end of June, health policy advisers are beginning to outline a series of “what ifs” for hospitals and major provider groups, describing how they could be affected, depending on how the court rules.

On the one hand, under the most far-reaching of the court's potential rulings—an invalidation of the entire Patient Protection and Affordable Care Act—provider groups could see the reversal of scheduled cuts in Medicare reimbursement rates, at least for the short term, health policy experts told Bloomberg BNA in recent interviews.

On the other hand, the huge expansion in coverage initiated by the law would disappear, eliminating a vast market of millions of individuals and families eligible to obtain health insurance through federally subsidized state health insurance exchanges.

The law also includes a major expansion of Medicaid eligibility—subject to a separate constitutional challenge—that also would be canceled if the court invalidates the entire law or strikes the expansion as part of the separate legal challenge.

Even with a Supreme Court invalidation of the law, however, the strong trend spurring providers to cut costs through payment and delivery reforms is likely to continue, although without the federal push provided by PPACA, the experts said.

Many of the new initiatives in the law could be continued by the Centers for Medicare & Medicaid Services under its waiver and demonstration authority, the experts noted, adding the caveat that Congress would have to provide funding.

“Whether or not the court overturns the law, the fundamentals of the health care economy aren't going to be overturned,” Mark McClellan, a former administrator of the Centers for Medicare & Medicaid Services in the George W. Bush administration, told BNA. “The pressures of rising costs that are encouraging all payers to find ways to lower their costs are not going away.”

While opinions varied on how the court was likely to rule, the experts were most comfortable offering their views on the consequences for provider groups if the court overturned the entire law.

“It's much cleaner to analyze repeal of the whole thing,” Len Nichols, director of George Mason University's Center for Health Policy and Ethics, said. “The truth is if they take out the individual mandate plus or minus some other insurance reform provisions, the devil will really be in the details.”

A repeal of the entire law could occur if the court finds that the individual mandate—the requirement that all individuals obtain insurance—is so intertwined with the rest of the law that it cannot be stricken separately. The court heard arguments on the severability issue in March as part of the challenge to the law brought by 26 states

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Maine Vaccine Board Provider Loss Mitigation Fund Claims Due June 30

If you are a Maine Provider who administered vaccines to minors between January 1, 2012 and April 30, 2012, and reimbursement was denied by an insurer, then you may be eligible for reimbursement by the Maine Vaccine Board under its Provider Transitional Loss Mitigation Program.

The Maine Vaccine Board (MVB) recognizes that as the new universal vaccine program for children began on January 1, 2012 providers may have unused vaccine which they previously purchased for use in children under the age of 19.  The MVB is concerned about transitional costs borne by providers as this new program is implemented.  Many insurers will continue to reimburse providers for use of purchased vaccine, but some may not.  To lessen the potential financial burden on providers, the MVB has established a process to reimburse providers at least a portion of the cost of purchased vaccine if reimbursement is denied by an insurance carrier. This applies only to vaccines administered to children from January 1, 2012 and through April 30, 2012.

For more information or to submit claims to the Loss Mitigation Program, please visit the MVB website at http://www.mevaccine.org/mevaccine.nsf/pages/provider-ptlmp.html.  Claims must be post marked no later than June 30, 2012.  [return to top]

Maine HIE to Pilot Nationís First Statewide Medical Image Archive

HealthInfoNet, working with some of Maine’s largest health care organizations, will pilot the nation’s first statewide medical image archive.

An estimated 1.8 million medical images (x-rays, mammograms, CT scans, MRIs and other images) are generated in Maine each year, totaling more than 45 terabytes of data. Currently those images are stored in a number of different electronic archives and mostly shared between non-affiliated providers by copying the images to CDs. By consolidating these images into a single archive, HealthInfoNet estimates that Maine’s providers stand to save $6 million over seven years through reduced storage and transport costs.

“When a patient has an x-ray or MRI at a facility outside our system, it can take days for their doctor at Maine Medical Center, for example, to get a copy of that image” says Barry Blumenfeld, MD, Chief Information Officer at MaineHealth, which supports the project and participated in its design. “This new service will save time for our providers and their patients. With instant access to a patient’s images, medical staff can treat them much faster and the patient won’t have to take the time to pick up and deliver CDs.”

There are several additional benefits of having images stored in one place. First, easier access to past image studies should lead to less repeat tests, meaning less cost and less radiation exposure for patients. Also, HealthInfoNet will be able to link each image with a single patient identifier through its HIE Master Person Index, making it easier for providers to search for all a patient’s prior images when needed to track changes over time. 

MaineGeneral Medical Center, Eastern Maine Medical Center and Cary Medical Center will be the first three location around the state to test the new archive. 

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Number of Pertussis Cases Continues to Rise

Maine, like many other states, has been experiencing an increasing number of pertussis cases over the past year.  According to the MeCDC, there have been a total of 111 pertussis cases reported statewide through June 6, 2012, compared to 50 reported cases in 2011 during the same period. Clusters of pertussis have occurred in schools, child care centers, camps, sport teams and workplaces.

The MeCDC has released recommendations to guide clinical management of suspect cases and persons reporting exposure to pertussis.  Click here for more information.

A recent article in the Bangor Daily News highlighted the need to increase childhood immunization rates: For [some] babies, the unrelenting cough can prove life-threatening, according to Dr. Lawrence Losey, a pediatrician at Parkview Adventist Medical Center in Brunswick. 

"They are coughing so hard and so long that they run out of oxygen and it can cause brain damage and seizures," he said.

For the full article, click here

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Prepare for Version 5010 - Enforcement Deadline Approaching

Version 5010 refers to the standards that HIPAA-covered entities (health plans, health care clearinghouses, and certain health care providers) must use when electronically conducting certain health care administrative transactions, such as claims, remittance, eligibility, and claims status requests and responses.

All covered entities should have been fully compliant with Version 5010 by January 1, 2012; however, an enforcement delay is in effect until June 30, 2012.

Regional CMS staff are hosting an informative webinar for healthcare providers, clearinghouses and vendors on Version 5010 on June 20th from 10:00 am - 11:00 am.  Topics include:  Current Conversion Statistics, Final Preparations for 5010/D.0 Cutover, Operational Concerns and Future of EDI Communications.  CMS will be distributing call registration information as the date approaches. 

MaineCare also reminds practices that If your organization submits electronically in batches to MaineCare, you must complete certification testing by June 30, 2012. To certify, log in to the MIHMS Health PAS Online Portal. If you are unable to submit HIPAA Version 5010 transactions after June 30, 2012, you will be required to submit via Direct Data Entry (DDE) or through paper claims. On July 1, 2012, any HIPAA Version 4010 transactions submitted electronically in batches to MaineCare will be rejected.  Testing resources are available. Visit the HIPAA Version 5010 webpage for background information, testing instructions, and Frequently Asked Questions about testing HIPAA Version 5010 transactions with MaineCare. [return to top]

Dr. Vincent Felitti to Discuss Adverse Childhood Experiences

The Bingham Program and the American Academy of Pediatrics, Maine Chapter are pleased to announce the opportunity to participate in one of two seminars with Dr. Vincent Felitti to learn more about Adverse Childhood Experiences (ACEs) and how Maine is using this information at a variety of local pilot sites throughout the state.

  • Wednesday, June 20th:  6-8:00 p.m. at Maine Medical Association in Manchester.  This session is primarily for clinicians who have heard Dr. Felitti before or are familiar with this work.   Dr. Felitti will update participants on his work on ACEs since his last visit to Maine, clinical teams in Maine who are implementing ACEs will discuss their experiences (including successes and obstacles), and Dr. Felitti will lead an engaged discussion with the implementation teams and all attendees on strategies for implementation in Maine.   This session provides a chance to discuss implementation ideas, challenges and barriers with Dr. Felitti particularly from the medical setting perspective and for clinicians throughout Maine to learn from each other.

  • Thursday, June 21st: 9:30 a.m. - 12:00 p.m. at MaineGeneral's Thayer Unit/Dean Auditorium in Waterville.  This session is primarily for individuals who have not heard Dr. Felitti speak about ACEs, or those who wish to hear him again.  Following his presentation, representatives from some Maine sites who are implementing ACEs prevention services at the local level will provide an overview of their projects.  This session provides an overview of ACEs and a chance to discuss beginning implementation ideas, challenges and barriers with Dr. Felitti.

For more information or to register, please go to https://www.surveymonkey.com/s/FelittiRegistration

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Ninth Annual MMA Benefit Golf Tournament Postponed to July 30, 2012

Continuing inclement weather and a very wet golf course have forced the postponement of the MMA Annual Golf Tournament scheduled for last Monday to Monday, July 30th.  The tournament will still be at the Augusta Country Club which has graciously provided us another day later in the summer to hold the tournament.  So if you did not register to play because of a conflict in scheduling, please re-consider the tournament which this year will benefit the medical student scholarship fund within the Maine Medical Education Trust. 

Hole sponsorships are also available for $500.

Registration will remain available on the MMA website or by communicating with Lisa Martin at 622-3374 ext. 221 or via e-mail to lmartin@mainemed.com.


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Upcoming Events & Conferences

Medical Mutual Practice Manager Seminar: 

Caring for our Seniors - Complex medical & liability issues

June 13, 2012

DoubleTree by Hilton Hotel, South Portland, ME 

Agenda and registration information available here


Maine Quality Counts and the Maine Primary Care Association Present:

Partnering, Engaging and Transforming Healthcare

Tuesday, June 12 - Bangor
Wednesday, June 13 - Freeport

These events will provide guidance for creating and successful patient and family engagement activities within the Medical Home model of care. This event will build on statewide, collaborative efforts to partner with patients and families in sustained and effective ways.

For more information or to register, click here


MaineCare Physician Advisory Committee

Thursday, June 14, 2012, 3:00-5:00pm

Conference Room 103A, Cross State Office Building, Augusta, Maine or 1-800-394-6604, with passcode 959468#

MaineCare topics on the agenda for this meeting will be follow-up to March’s Opioid discussion and Health Homes. MaineCare providers are also invited to present issues in the community they would like MaineCare to address.

RSVP to Charyl Malik at 207-287-3320 or charyl.malik@maine.gov


Save the Date: 

CMS Region 1 National Medicare Training Program 2012

August 7-9, 2012

Sheraton Framingham Hotel and Conference Center, Framingham, MA

Information about key aspects of Medicare, Medicaid, Children's Health Insurance Program (CHIP), and pertinent legislation

More information to be distributed via CMS later in May


Maine Immunization Program Regional Trainings 

July 27, 2012 – Houlton Regional Hospital – Houlton

August 3, 2012 – Hilton Garden Inn – Bangor

August 9, 2012 – Fireside Inn – Portland

Augusta 10, 2012 – Maine Principals Association – Augusta

Open to all health professionals responsible for managing and supporting childhood vaccine programs including physicians, nurse practitioners, physician assistants, and practice managers.

For more information or to register, click here[return to top]

Job Opening - Family Practitioner

Family Practitioner Position in Jonesport

Busy rural practice located in Jonesport seeking a Family Practitioner to join our successful, well-established practice.  Coverage would include a four day work week, nursing home coverage, and shared call for the practice.  We are currently not looking at any hospital coverage.  We offer a competitive salary and benefits with the possibility of loan repayment through the National Health Service Corps.  This is an excellent opportunity to practice in a gorgeous ocean community.  For more information, please contact Laurie Charbonneau, Administrator at lauriec@ammc.us207-497-5614.


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MMA Member Benefit of the Month

The member benefit the Association wishes to highlight in June is the Office-Based Quality Improvement Program which protects from discovery the quality improvement or peer review discussions and documents in an office-based practice.  Without such protection, these records from any practice outside the setting of a hospital are vulnerable to disclosure.  For over ten years, the Association has made available to medical practices participation in a program, overseen by the Committee on Physician Quality, that is very economical and offers the protection noted above as well as review of a quality improvement plan.

The initial fee for a practice applying to join the program is only $200 and an additional $100 per physician with a maximum application fee of $3000.  Annual renewal is only $100.  In other words, a practice with three physicians would pay $500 to join.  It is a very modest investment to get help with QI AND protect QI and peer review documents from discovery in a malpractice case.

This program is now overseen by Dianna Poulin at MMA.  For application materials or more information, contact Dianna at 622-3374 ext 223 or via e-mail to dpoulin@mainemed.com. [return to top]

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