Maine Medicine Weekly Update - 05/08/2017  (Plain Text Version)

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In this issue:
•  U.S. House Passes American Health Care Act 217 to 213. Senate Vows to Start from Scratch
•  AMA Reacts to ACHA House Vote
•  AAP Reacts to AHCA Vote
•  Anthem asks U.S. Supreme Court to Overturn Rejection of Proposed Anthem-Cigna Merger
•  MMA, Lown Institute and Colleagues Present Challenges to Professionalism in a Time of Change, in Portsmouth, June 17
•  New England AMA Delegation Meets in Providence, R.I.
•  MIPS Web-interface and CAHPS for MIPS Registration Open Until June 30
•  Maine DHHS Now Accepting Applcations for Opioid Health Homes
•  Physician-focused Payment Models Recommended to Secretary Price
•  Online Learning Opportunities Offering CME Credits - from the Northern New England Practice Transformation Network
•  Weekly MMA Legislative Committee Conference Call Information
•  Legislative Highlights of the Week
•  Save the Date! Physicians' Day at the Legislature, May 31st
•  L.D. 46 Eliminating Physician Exemption from Jury Duty Poses Threat to Physician Practices
•  Learn How You Can Be Ready for the E-Prescribing Mandate: Free Webinars on May 10, May 24, and June 7
•  Maine Society of Eye Physicians and Surgeons Spring Educational Program & Business Meeting - May 12
•  Maine Chapter, American College of Surgeons Annual Meeting - May 19-21
•  How Can I Choose Wisely? A Community Conversation on Healthcare Changes and Rising Costs June 8
•  Family Medicine Physician - Pittsfield, ME
•  Physician Assistant - Newcastle
•  Physician Assistant or Nurse Practitioner Hospitalist - Full Time or Per Diem, Bridgton Hospital
•  Family Medicine Physician - Maine Medical Partners Primary Care - Standish, ME
•  Primary Care Physician - Eastern Maine Medical Center
•  Outpatient Only - Internal Medicine with Loan Repayment & Sign-on Bonus
•  Part-time Clinical & Part-time Research Position in Central Maine
•  Family Medicine Physician - Winthrop, ME
•  DO or MD Physician - Augusta, ME
•  Family Medicine Physician - Waterville, ME


Legislative Highlights of the Week

Read what happened this past week in the Maine Legislature: hearings, work sessions and more.

Health & Human Service

Most of the bills heard in the HHS Committee this past week were peripherally related to the practice of medicine, including bills concerning transportation and housing for persons with disabilities and a controversial bill that would allow creation of safe spaces for persons with substance use disorder to inject drugs. There were also hearings on a number of bills relating to MaineCare.  The MMA did express concern about the additional administrative burden to physician practices and potential additional cost to patients about a bill (L.D. 1300) proposing a prescription requirement for methamphetamine precursor drugs.


The Labor, Commerce, Research and Economic Development Committee held hearings and work sessions on several bills of interest to the medical community. LD 1200, dealing with maintenance of certification, was modified to cover only a prohibition for MOC requirements in licensing. In that form, it was voted unanimously "ought to pass." The same result occurred with LD 1359, approving Maine's participation in the Interstate Medical Licensing Compact. Because the Compact requires specialty certification at the time of compact licensing (but not maintenance of certification after that time), the reciprocity language was removed from LD 1200. Unanimous "ought to pass" was also the result for LD 911, which will prohibit drug manufacturers from offering gifts to physicians beyond a nominal value. It will not interfere with reasonable honoraria for speaking engagements. The MMA was successful in keeping the focus of the bill on the behavior of manufacturers, rather than on physicians who might be receiving such gifts. 


The Education & Cultural Affairs Committee took testimony on May 1st on a bill to allow the concealed carry of firearms on public college campuses (excluding dormitories and places of public entertainment). While there was little testimony in support of the proposal (the NRA submitted written testimony but did not appear), those testifying against included college professors and students, the Chief of Police for the University of Maine, a physician, and the Maine Gun Safety Coalition. The MMA testified in opposition to the bill, pointing out that brain science has shown that people in the age range of college students have brains which are not yet completely developed, and the last areas that mature are those dealing with judgment, executive function, and impulse control. A work session on the bill will take place this week.


The Department of Health and Human Services MaineCare section has proposed rule changes relating to opioid (including MAT) prescribing for MaineCare recipients. On May 8th a public hearing was held. While the MMA did not testify orally at the hearing, we, the Maine Hospital Association, and others will be submitting written testimony by the filing deadline, May 18th. Anyone who wishes to comment on the proposed rules should do so in writing by the deadline.


The Committee held a work session last Thursday on a bill (L.D. 1426) regarding the use of bioptic telescopic lenses for driving.  During the 126th Legislature, a group of physicians including Bob Dreher, M.D., Linda Schumacher-Feero, M.D., and Dan Onion, M.D., M.P.H. participated with BMV staff and other stakeholders in a working group to review the history of the use of BTLs in driving and to make certain recommendations.  Members of the Maine Society of Eye Physicians & Surgeons (MSEPS) felt that the recommendations remained sound & that this bill went beyond those recommendations.  L.D. 1426 was submitted on behalf of a woman whose family wishes to move to Maine and feared she could not get a Maine license and use her BTLs to drive.  Dr. Schumacher-Feero attended the work session to speak briefly about the history of BTLs in Maine, the recent working group, and the circumstances of this bill.  Based upon her statement and response to the Committee's questions, the Committee tabled the bill following a motion "ought not to pass" to give the proponent an opportunity to discuss her case with the BMV staff.  While the proponent didn't attend the work session, representations made about her level of vision suggested to many that she probably could meet the current Maine standards to get a driver's license.

Insurance & Financial Services

Also last Thursday afternoon, the IFS Committee held a long afternoon of public hearings on a series of bills of interest to many physicians. First, the Committee heard a bill (L.D. 1279) that seeks to protect patient and provider protections in Maine law that precede the ACA, if the ACA is ultimately repealed in Washington, D.C.  The MMA joined other consumer advocacy organizations in support of the bill. Next, the Committee heard a bill (L.D. 1385) to clarify the nature of a "direct primary care" relationship between a physician and a patient.  Several MMA members attended and spoke in favor of the legislation. Lastly, the Committee heard a bill (L.D. 1274) advocating a single payer approach to health care reform in Maine. The Committee spent several hours hearing passionate testimony from the public, including many physicians who have been engaged in advocacy in favor of single payer health care through Maine AllCare. The MMA delivered a letter in the "neither for nor against" category, including the new Statement on Reform of the U.S. Health Care System approved by the MMA board in January 2017. The MMA also provided member survey data showing that more than 60% of MMA members support a "Medicare for All" single payer approach to health care reform. The Committee will hold an initial work session on the bills tomorrow afternoon.