March 3, 2006

 
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MMA & MOA Host Successful Physicians' Day at the Legislature
Physicians from all over the state and from a number of specialties take time to build relationships with health care policymakers in Augusta. These relationships will help to ensure that physicians' views on major health policy decisions affecting the practice of medicine receive appropriate consideration.
 

On Thursday, March 2, 2006, the MMA and the Maine Osteopathic Association sponsored a second Physicians' Day at the Legislature for the 122nd Maine Legislature.  During the first session, Physicians' Day focused on the medical liability reform effort and L.D. 1378.  This year, the organizations' chose to highlight physician efforts to improve the quality of health care in Maine.  Beginning with a welcome by Governor John Baldacci and the two physicians in the Maine legislature, Rep. Tom Shields, M.D. (R-Auburn) and Rep. Lisa Marrache, M.D. (D-Waterville), the day then gave participants an opportunity to mingle with legislators informally over coffee in the State House Hall of Flags, to observe proceedings in the House and the Senate chambers, and to follow committee action in the afternoon. 

Fortunately, it was a busy day at the State House with several public hearings or work sessions of interest to physicians in the afternoon - on certificate-of-need, Dirigo health care reform issues, advance directives, and the supplemental budget.  Representatives of both organizations also met privately with members of the legislative leadership to discuss current issues of concern to physicians, such as the MaineCare claims management system issues (MECMS), medical liability reform, and the Medicare Part D benefit.  Several specialty organizations exhibited in the Hall of Flags as well.  As usual, the University of New England College of Osteopathic Medicine was well represented with Deans Boyd Buser, D.O. and Bruce Bates, D.O. and a number of medical students attending the event.

Thanks to all of you who took time out of your busy practices to attend the event. 

The MMA and MOA likely will host the next Physicians' Day at the Legislature during the First Regular Session of the 123rd Maine Legislature in February or March of 2007.

REMINDER: Legislative Committee Meets Tuesday, March 7, 2006!
The MMA's Committee on Legislation, chaired by Katherine Pope, M.D., will hold its last meeting of the session this Tuesday, March 7, 2006 beginning at 6 p.m. at the MMA office in Manchester.  Any interested member is welcome to attend.  For more information, please contact Charyl Smith, Legislative Assistant, at csmith@mainemed.com. [return to top]

Appropriations Committee to Continue Supplemental Budget Work This Week
This week, the Appropriations & Financial Affairs Committee will continue with work sessions on L.D. 1968, the Governor's supplemental budget proposal for the SFY 2006-2007 biennium.  Two items in the budget are of particular interest to physicians - $4 M in the second year of the biennium to reimburse health care providers participating in MaineCare for interest costs incurred because of the MECMS transition problems and $250,000 in each year of the biennium for supplemental funding for the Maine tobacco helpline.  Both items received the endorsement of a majority of the Health & Human Services Committee.  The tobacco money is probably at greater risk than the MECMS money, but you can help ensure inclusion of both items in the final budget recommendation from the Appropriations Committee by telling members how important each is.

You can find contact information for members of the Appropriations Committee on the web at:  http://janus.state.me.us/house/jt_com/afa.htm.

You can find information about the Maine tobacco helpline and other tobacco control resources on the web at the Partnership for a Tobacco-Free Maine site:  http://www.tobaccofreemaine.org/[return to top]

MMA EVP Addresses HHS Committee on Release of Physician Data from the MHDO
On Tuesday, February 28, 2006, MMA EVP Gordon Smith testifed before the HHS Committee on L.D. 1976, a bill seeking legislative approval of amendments to Maine Health Data Organization (MHDO) Rule Chapter 120, Release of Data to the Public

You can read the rule on the web at:  http://www.maine.gov/sos/cec/rules/90/90/590/590c120.doc.

Mr. Smith characterized his testimony as being in "limited support" of final adoption of the rule.  The following is a substantive excerpt from the testimony.

Until 2005, the MMA opposed the release of such data, believing that claims data is inherently unreliable for purposes other than paying an individual claim.  However, in 2005, we took the position, based upon the movement of the health care system toward more transparency and accountability, that such data could be released, but subject to very stringent conditions.  These conditions include: 

  1. The physician must receive the data before it is released in order to ensure its accuracy.
  2. The physician must have a reasonable amount of time to examine the data and to respond to the organization if there are comments to be made.
  3. That data not be released until the unique provider numbers required by HIPAA are distributed.
  4. That an advisory committee of physician specialists be created to review any public reports on the data to ensure that such reports are accurate, useful to the public, and not likely to mislead people.
  5. That prior to general release, a pilot project be conducted that would test the quality of the data and its value to the public.  We recommend that for a one-year period, the data be available only to the Maine Quality Forum prior to becoming available to competitors and commercial companies.  As the Forum is a state agency, its use of the data would be subject to public scrutiny and accountability expected of public entities.
  6. Finally, we requested that data for the period prior to January 2003 not be released, as that was the date the all-payor claims database began. 

The MHDO accepted some, but not all of these suggestions and the MMA has asked the legislative committee to adopt the remainder of them.  L.D. 1976 will have a work session in the HHS Committee this week. [return to top]

MMA President Testifies in Favor of Bill to Gather Data About Large Employers' Health Care Coverage
On Wednesday, March 1, 2006, MMA President Jacob Gerritsen, M.D. spoke to the HHS Committee in favor of L.D. 1927, An Act to Prevent State Taxpayers from Subsidizing Large Employers, sponsored by Senate President Beth Edmonds (D-Cumberland).  L.D. 1927 follows "employer mandate" legislation passed in Maryland and being considered in more than 20 other states this year.  Unlike this so-called "fair share" legislation in other states, the Maine bill seeks to gather information about the types of work and employers represented in the MaineCare population. 

Dr. Gerritsen mentioned that the MMA's 2003 White Paper on Health Care Reform in Maine includes the recommendation for an "individual mandate."  Moreover, he said that the MMA's Ad Hoc Committee on Health System Reform is reviewing the White Paper and comparing the individual and employer mandates as part of that process.  Dr. Gerritsen made it clear that the MMA is supporting the data gathering bill and has not yet taken a position on the employer mandate question.  L.D. 1927 also will have a work session in the HHS Committee this week. [return to top]

MMA & Maine ASUs Oppose Consumer Advocates' Bill to Expand Reach of CON
At a public hearing on Thursday, March 2, 2006, representatives of the MHA, the MMA, and the Maine Ambulatory Surgery Center Coalition all spoke in opposition to L.D. 1814, An Act to Strengthen and Improve Review Procedures in the Certificate of Need Program, sponsored by Rep. Lisa Miller (D-Somerville).

The bill is a concept draft meaning that no statutory language has yet been offered and it represents the position advocated by Consumers for Affordable Health Care (CAHC) during the Dirigo hospital study commission last year.  The bill proposes the following changes to the CON program:

  • Lower the dollar amounts for the thresholds for review;
  • Add requirements for reporting regarding projects that do not require review;
  • Add methods for determining community need, including the use of population surveys, replacing the method of relying on utilization rates;
  • Clarify the roles for other state agencies and offices, in particular the Department of Professional & Financial Regulation, Bureau of Insurance and the Maine Center for Disease Control and Prevention; and
  • Impose upon the certificate of need process the adjudicatory hearings procedures applicable under the Maine Administrative Procedure Act, including the use of an impartial hearing officer who would make a recommendation to the Commissioner of Health & Human Services.

The Governor's Office of Health Policy & Finance and Consumers for Affordable Health Care supported the bill.  Peter Kraut of the GOHPF stated that his office and the sponsor have agreed that the only substantive part of the bill would be a proposal to increase the filing fees to ensure more resources for the CON staff.  They recommend that the rest of the bill be a study of the issues mentioned above.  Again, this bill will have a work session in the HHS Committee this week. [return to top]

Judiciary Committee Considers Bills on "DNR" Orders, Advance Directives, & End-of-Life Care
On Thursday, March 2, 2006, the Judiciary Committee held public hearings on L.D. 1763, An Act to Ensure the Authority of "Do Not Resuscitate" Orders in Advance Healthcare Directives and L.D. 1842, An Act to Amend the Laws Governing Living Wills of Terminally Ill Persons

L.D. 1763, sponsored by Sen. Bruce Bryant (D-Oxford), grows out of a constituent issue raised during the first session of the 122nd Legislature that has been the subject of a working group including the MMA, MHA, Maine EMS, Legal Services for the Elderly, and others through the summer and fall of 2005.  Senator Bryant's constituent was upset because EMS personnel did not recognize an advance directive as a "DNR" order for a family member who wished to die at home.  While the working group has not yet made its final recommendations, it seems likely to recommend amending the Uniform Health Care Decisions Act and the model advance directive package to make it clear that a "DNR" order is a document separate and distinct from a "general" advance directive and to promote use of the standardized Maine EMS Comfort Care/DNR form.

L.D. 1842, sponsored by Rep. Carol Grose (D-Woolwich), is another concept draft.  While it is unclear what Rep. Grose hopes to accomplish with the legislation, she expressed concern about poor pain control for her father dying from cancer at the Togus VA hospital.

The MMA will work with other interested parties to pursue an acceptable resolution to both of these bills that will be up for work session in the Judiciary Committee this week.  [return to top]

Update on Bill Regarding Thimerosal in Vaccines
The MMA, the MOA, and the Maine Chapter of the AAP worked with Maine CDC Director Dora Mills, M.D., M.P.H. and other interested parties to oppose L.D. 1947, An Act to Protect Children from the Onset of Autism in the HHS Committee.  A strong majority of the HHS Committee voted "ought not to pass" on the bill, but it has not yet been reported out to the House where it first will be debated because the prime sponsor of the bill is Rep. Arthur Lerman (D-Augusta).  The MMA will alert you through the Political Pulse when the bill comes to the floor, but it's not too early for you to be communicating with your own legislators about the bill and urging them not to jeopardize the State's vaccine supply.

You can find information about thimerosal on the Maine CDC web site:  http://www.maine.gov/dhhs/boh/influenza_2005-2006_thimerosal.htm. [return to top]

Bills for Review and Discussion on 3/7/06

LD 2036,  An Act To Facilitate the Hiring of Healthcare Personnel During Emergency Circumstances (Sen. Strimling)

[return to top]

Conference Call and Meeting Information
 

The MMA Legislative Committee (and any interested member) will next meet in person at the MMA office on Tuesday, March 7, 2006 at 6 p.m.  For more information, please contact Charyl Smith, Legislative Assistant, at csmith@mainemed.com

The Committee's conference call for Wednesday, March 15th at 7 p.m. will use the following ACCESS PHONE NUMBER AND CODE:

Access phone number:  1-800-989-2842

Access code:  6223374 [return to top]

Upcoming Public Hearings
 Monday, March 6

Health and Human Services - Room 209, Cross State Office Building (287-1317)

9:00 am, LD 1994, An Act to Preserve Patient Records; LD 1995, Resolve, Directing the Department of Health and Human Services to Amend Its Rules to Ensure Efficiencies in the Billing and Delivery of Outpatient Clinical Services [return to top]

Legislative Links
 

  • Maine Legislature's main page
  • Joint Standing Committee list
  • Legislative action - audio links
  • AMA's Washington, D.C. website
  • [return to top]

    To Contact Your State Legislator in Augusta
      For Members of the House:

    The Honorable John/Jane Doe

    State House Station 2

    Augusta, Maine 04333-0002

    1-800-423-2900/207-287-1400 (to leave a message)

    For Senators:

    The Honorable John/Jane Doe

    State House Station 3

    Augusta, Maine 04333-0003

    1-800-423-6900/207-287-1540 (to leave a message)

    You may also see the Legislative link section of this publication to get the information from the Maine State website. [return to top]

    To Contact Governor Baldacci
    The Honorable John E. Baldacci

    State House Station 1, Augusta, Maine 04333-0001, 287-3531

    governor@maine.gov [return to top]

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