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Actually its more a Live than M4L issue. Its simply that Live, as the main environment, usually handles the MIDI in/out itself. However; this doesn't mean that you can't sent MIDI out of M4L at all; you can use Live's routing schemes for example and then get M4L to send its share of MIDI data along the way.
This is how I'm currently building a patch which allows me to control a rewired Reason using my APC40 in Live.