September 12, 2011

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MMA Concludes 158th Annual Session; Nancy M. Cummings, M.D. Installed as President

The Association's 158th Annual Session concluded yesterday in Bar Harbor.  U.S. Senator Olympia Snowe attended the opening reception on Friday evening and the recently named CEO of Jackson Lab, Ed Liu, M.D. opened up the Saturday morning general membership meeting with an enthralling summary of what the future will be at the Lab.  More than 200 people attended some portion of the meeting which occurred under sunny skies.  Make your plans now to attend next year's Annual Meeting, September 7-9, 2012 at the Harborside Hotel & Marina in Bar Harbor.

Nancy M. Cummings, M.D. was installed Saturday night as the 159th President and the fourth woman President of the Association.  Dr. Cummings is a practicing orthopaedic surgeon at Franklin Memorial Hospital in Farmington.   She follows Jo Linder, M.D. who completed a very successful year as President.  Dr. Linder will remain on the Executive Committee, which will now become the Board of Directors as a result of amendments to the Constitution and Bylaws approved at the General Membership meeting on Saturday morning.  Dieter Kreckel, M.D. of Rumford was elected President-elect of the Association.  Dr. Kreckel practices family medicine at Rumford Community Hospital and is a former President of the Maine Academy of Family Physicians.

At the annual dinner of the Executive Committee on Friday evening, Peter Bates, M.D., Vice President for Medical Affairs at Maine Medical Center and Academic Dean of the Tufts-MMC School of Medicine, received the President's Award for Distinguished Service.  In presenting the award, President Jo Linder noted Dr. Bates' passion for medical education and his pivotal role in the establishment of the partnership with Tufts University School of Medicine.

The Mary Cushman, M.D. Humanitarian Award (International) was presented on Saturday evening to Frank W. Read, M.D. and Project Guatemala.  For more than fifteen years, Project Guatemala has brought medical and surgical eye care to the indigenous people of the Quiche province of Northern Guatemala.  Dr. Read and his colleagues at the Maine Eye Center in Portland have been involved with the Project since 1997 and were joined by eye care professionals at Eye Care Medical Group in 2003 to make the Project a joint venture.

Five Resolutions were passed at the General Membership meeting, including one addressing the serious problem in the state of prescription drug abuse and diversion.  Copies of the Resolutions are on the MMA website at

Watch for more details of the meeting and photos in the next issue of Maine Medicine  and on the MMA website at







Silent Action Raises $4,055 to Support MMET Scholarship Fund

The 2nd Annual MMA Silent Auction was held this past weekend at the Association's Annual Session in Bar Harbor.  As a result of the generosity of MMA members and Corporate Affiliates, we had 32 items to auction, including a one-week stay at member’s properties on the Bahamas, Orrs Island, and Upper Narrow Pond;  a handmade glass platter;  a marble and onyx chess set from Mexico;  beautifully framed photographs and etchings;  ceramics;  Red Sox tickets; and much more!  The auction brought in a total of $4,055 in proceeds.

All proceeds, aside from one that was directed specifically to the Dalco Fund, will benefit the Maine Medical Education Trust ‘Scholarship Fund.’  This newly created Scholarship Fund was started by Jo Linder, MD at the onset of her presidency with a very generous $10,000 donation.  Dr. Linder has pledged to match all donations collected prior to or at the Annual Session up to $15,000.

A sincere thank you to those who donated items to this very worthwhile initiative and to the Session attendees who bid on the items and helped us increase the balance of the scholarship fund which will be used to help offset some of the tuition money needed by Maine students attending medical school. 

This year’s auction donors were:

Apothocary by Design

Atlee, William

Augusta Civic Center

Burke, John

Chagrasulis, Robert

Chamberlain, Dr. R. & Mrs.

Cummings, Nancy

Cunningham-Spindler, Alice

Elavon Financial Services

Gleaton, Maroulla

Graham, Lani

HAVANA Restaurant

HM Payson

Holler, Fred & Nancy

Jumper, Brian & Yvonne

Klugar, Paul

Kreckel, Dieter

Lash, Stephanie

McDermott, David & Ellen

McHugh, Charles

Miller, Buell

Ocean Properties

Pope, Katherine

Smith, Gordon

Solish, Sam

Strassberg, William

Sunday River Resort

Surprise Advertising [return to top]

4th Circuit Rules on ACA

In a long-awaited decision, the U.S. Court of Appeals for the Fourth Circuit declared September 8th that the tax anti-injunction act stripped it of jurisdiction to hear a challenge to the constitutionality of a key provision of the Affordable Care Act (ACA), the federal health reform law (Liberty University Inc. v. Geithner, 4th Cir., No. 10-2347, 9/8/11).

In a second separate opinion, the 4th Circuit ruled that the state of Virginia did not have standing to challenge the ACA (Virginia ex rel. Cuccinelli v. Sebelius, 4th Cir., No. 11-1057, 9/8/11).

By declaring that it did not have jurisdiction in either case, the Fourth Circuit sidestepped the key issue of whether Congress exceeded its authority by enacting that requirement that individuals purchase health insurance. Opponents of the individual mandate argued that it goes beyond the limits set on congressional power and, if approved, would mean that Congress could require citizens to purchase virtually anything.

In a third case, a federal district court in Mississippi on August 29th overturned an earlier ruling that private plaintiffs did not have standing to challenge the constitutionality of a key provision of the federal health reform law (Bryant v. Holder, S.D. Miss., No. 2:10-cv-76, 8/29/11).

Although two federal appeals courts already have decided on the merits of the constitutionality of the ACA's individual mandate, and a petition for review has been filed in the U.S. Supreme Court, the U.S. District Court for the Southern District of Mississippi's decision raises several issues not considered in those cases, including the standing of a state employee and whether the provision affects the plaintiffs' right to medical privacy.

For more information on the status of lawsuits challenging the ACA, see:

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CMS Releases Final Rule Amending Medicare, Medicaid Incentive Program

 The Centers for Medicare & Medicaid Services on August 31st released a final rule amending the Medicare electronic prescribing incentive program to encourage more doctors and other health care professionals to successfully adopt and use e-prescribing technology.

Specifically, the changes will better recognize those circumstances when physicians and other clinicians are not able to meet the e-prescribing program's requirements and when the requirements clearly pose a significant hardship for providers, Patrick Conway, chief medical officer and director of the CMS Office of Clinical Standards & Quality, said in a release.

The final rule, which was published in the September 6th Federal Register (76 Fed. Reg. 54953), will become effective on October 6th.

The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) established the Medicare e-prescribing incentive program, which allowed eligible providers, starting in 2009, to earn incentives based on electronic prescribing activities. Medicare providers, however, face penalties beginning in 2012 if they do not meet electronic prescribing thresholds. Currently, the e-prescribing program requires physicians to electronically send at least 10 prescriptions in the first six months of 2011 to avoid penalties in 2012, and send 25 prescriptions electronically in 2012 to avoid penalties in 2013.

CMS published a proposed rule outlining the changes to the e-prescribing incentive program in the June 1 Federal Register (76 Fed. Reg. 31547).

The final eRx rule also modifies the 2011 electronic prescribing measure to align with the Medicare and Medicaid electronic health record incentive programs, CMS said.

Under the final rule, a certified EHR technology system used by physicians and other clinicians to meet “meaningful use” incentive program requirements also will qualify for use in the Medicare e-prescribing incentive program. The meaningful use program requires that certified EHRs have electronic prescribing capabilities.

Additionally, CMS included four significant hardship exemptions, in addition to those already included in the e-prescribing incentive program, that will allow professionals to be exempt from the 2012 payment adjustment. The exemptions would apply to:

  • eligible professionals who register to participate in the Medicare or Medicaid EHR incentive programs and adopt certified EHR technology;

  • eligible professionals who are unable to electronically prescribe due to local, state, or federal laws or regulations;

  • eligible professionals who have limited prescribing activity; and

  • eligible professionals who do not prescribe often enough to patients to meet the e-prescribing measure requirements.

Currently, eligible professionals or group practices with limited high speed internet access and eligible professional or group practice practices in areas with limited available pharmacies for electronic prescribing are exempt from the e-precribing incentive program penalties.

Under the existing e-prescribing program, eligible providers who were not successful electronic prescribers based on claims submitted between January 1 and June 30th of this year would have been subject to a payment adjustment for their Medicare Part B covered services in 2012. However, the final rule extends the deadline for requesting significant hardship exemptions to Nov. 1, CMS said.  Physicians can apply for exemption via a web-based tool for individual eligible professionals and via a mailed letter for group practices that are participating in the 2011 eRx group practice reporting option, CMS said.

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MMA Seeks Academic Detailer


Job Description:

The Maine Medical Association, on behalf of the Maine Independent Clinical Information Service (MICIS), is seeking a clinical health professional to serve in the role of a contract “academic detailer.”  Academic detailing entails offering independent, scientific evidence on prescription drugs at the request of prescribers working in primary care.

The part-time contract academic detailer will conduct face-to-face educational outreach visits to discuss the current evidence on best clinical prescribing practices.  The candidate will be available to do one-on-one consultations with prescribers and group teaching sessions in practices, hospitals and at conferences, per request, across the state.

Hours required will vary from month to month, based on demand, and may range anywhere from 5 to 35 hours a month. Flexibility is required.


Candidates must be available to attend a two-day training session on the principles and techniques of academic detailing, including small-group sessions with current academic detailers and videotaped detailing sessions with practicing physicians.

Location: Boston                  Date: November 7 and 8

Additional trainings on specific clinical topics to be detailed will take place in Maine or Boston periodically, dates to be determined.


Clinical background: MD, PA-C, RN, CNP, or PharmD or similar.

Two or more years of clinical experience.

Therapeutic competency.

Strong interpersonal skills including service-orientation.

Excellent presentation and public speaking skills.

Ability to travel throughout state as well as to occasional overnight trainings in Boston.

Ability to attend monthly work group meeting in Manchester (mornings) and quarterly advisory committee meetings in Augusta (evenings).


The contractor will be paid on an hourly basis commensurate with the candidate’s background and skills.


Please send cover letter and resume by September 30th to Jennifer Reck, MA, MICIS Program Manager, at [return to top]

Filing Deadlines For Small Firms to Claim Health Care Credit

The Internal Revenue Service and the Department of Health and Human Services reminded small business owners of upcoming filing dates to take advantage of the Small Business Health Care Tax Credit available under the Affordable Care Act to help pay for health insurance. 

In a news release (IR-2011-90), IRS highlighted two important deadlines for businesses claiming the credit. The credit was included in the health care reform law to help small businesses and tax exempt organizations with fewer than 25 employees with average incomes of less than $50,000 and that pay at least half of the premiums for employee health insurance coverage under a qualifying arrangement.

Corporations that file on a calendar year basis and requested an extension should calculate the small employer health care credit on Form 8941 and claim it as part of the general business credit on Form 3800 as part of their corporate income tax return by September 15th. 

Sole proprietors who file Form 1040 and partners and S-corporation shareholders reporting their income on Form 1040 should file by October 17th. These taxpayers also would use Form 8941 to calculate the credit and then claim it as a general business credit on Form 3800, which is reflected on line 53 of Form 1040. Similarly, tax exempt organizations that file by calendar year and requested an extension can claim the credit on Form 990-T and can use Form 8941 by November 15th.

“As the filing deadlines approach, we want to make sure that small business owners don't leave any money on the table,” said IRS Commissioner Doug Shulman in the release. “Small businesses that offer health insurance should learn about this credit and claim it if they are eligible.”

More information is available on the IRS website [return to top]

Maine Health Hospital Medicine Day 2011, September 28th

Maine Health Hospital Medicine 2011 Conference

September 28, 2011, 7:30 am - 12:30 pm 

Where We Are / Where We Are Going

Hospital Medicine has become a robust field.  Hospitalists are now in a unique position to collaborate with multiple disciplines and across the spectrum of health care. Join us to discuss
principles and practical skills to improve the value of care for our patients. 

Featured topics include:

  • How and Why to Use Ultrasound at the Bedside

  • Optimizing Care for Patients with Congestive Heart Failure

  • Palliative Care – Incorporating the Paradigm

  • Tackling Readmissions – Teamwork Across Transitions

  • Falls in the Elderly – Diagnosis and Prevention

  • VTE – A Panel Discussion of Challenging Cases

Keynote Address: The Value of Hospital Medicine 

Joseph Ming Wah Li, M.D., SFHM, FACP
President, Society of Hospital Medicine
Associate Professor of Medicine, Harvard Medical School
Director, Hospital Medicine Program
Associate Chief, Division of General Medicine & Primary Care
Beth Israel Deaconess Medical Center

*Keynote Address offered as part of   the Department of Medicine Grand Rounds

September 28, 2011 / 7:30 a.m. - 12:30 p.m.


MMC Dana Educational Center

22 Bramhall Street, Portland, ME 04101


$40.00 per person

For More information, contact Julie at

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Register Now for Maine Medical Directors Association Annual Conference, Oct 14th

AMDA Maine Chapter Annual Conference

October 14, 2011

Location: DiMillo’s Floating Restaurant

25 Long Warf

Portland, ME

Topics include:  Medical Billing & coding in Nursing Homes, Practical Approach to Geriatric Polypharmacy, Palliative Care in Nursing Home Setting and Use of Medicinal Marijuana in Nursing Homes

To register online visit or call Tammy at 207-878-6564.

Register before Friday, Sept. 30 and pay only $50.00 for 2 people. Includes parking, lunch & snacks.

Register after Friday, Sept. 30 and you pay $75.00 for 2 people. Includes parking, lunch & snacks.

        Registration fee: Members “free” 

       Non members: Physicians $100.00

       Non members:  Nurses, Administrators & others $50.00


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NNEPC Bath Salts Webinar Available

The Northern New England Poison Center (NNEPC) is offering recorded webinar presentations regarding the new synthetic drugs known as “bath salts.”

The webinar is a slide and audio presentation recroded by Dr. Karen Simone, NNEPC Director, and Dr. Tamas Peredy, NNEPC Medical Director.  The presentation is available for viewing at any time.  It can be accessed through our website,, or directly at  

The presentation is given in two parts.  The first is a general overview of bath salts appropriate for all audiences.  The second is aimed at health care professionals and gives information related to treating bath salts patients.

NNEPC is currently able to offer continuing education credits for Maine and New Hampshire EMS personnel for the bath salts recorded webinar.  They expect to be able to offer other types of continuing education credits in the near future.

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Upcoming HIV, Infectious Disease Conferences

HIV, STD, and Viral Hepatitis Integrated Conference – October 17, 2011 at the Augusta Civic Center

The Maine HIV, STD, and Viral Hepatitis Program is pleased to host an integrated prevention, care, and treatment conference this fall. The 2011 conference theme of “Integration and Change” will highlight local and national best practices, innovations, and examples of effective integration of HIV, STD, and Viral Hepatitis programs and services. We invite all health care, sexual health, mental health providers as well as consumers to attend this exciting learning opportunity.

Infectious Disease Annual Conference – November 15, 2011 at the Augusta Civic Center

Since 1983, the Maine Center for Disease Control and Prevention, Division of Infectious Disease, Department of Health and Human Services has organized an annual infectious disease conference targeting public health issues of emerging concern to medical practitioners throughout the State.

This year’s meeting will continue this tradition, and is dedicated to a review of emerging issues in the field of infectious diseases, particularly as they impact the Maine medical community. Issues presented will include challenges in controlling infectious diseases, information on responding to new disease threats, and clinical updates and approaches.

How To Register:

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MMA and OSA Offer Free CME on Preventing Prescription Drug Abuse in Lewiston and Manchester

Through funding provided by the State Office of Substance Abuse, the Maine Medical Association is presenting two CME programs in  Lewiston and Manchester on September 14th and October 7th, respectively, focusing on the very serious problem of prescription drug addiction and diversion.

The September 14th program will be held at St. Mary's General Hospital,  from 4:00 to 8:00 p.m. with dinner provided.  On the 14th, the clinical presentation will be made by Mark Publicker, M.D., Director of the Recovery Center at Mercy Hospital.  The October 7th program will be held as part of MMA's popular First Fridays educational series from 9:00 a.m. to noon and will also be offered as a webinar.presentation.  The clinical presentation in Manchester will given by Tamas Peredy, M.D. Dr. Peredy is an attending emergency physician at the Maine Medical Center and is the Medical Director of the Northern New England Poison Control Center. There is no cost for these programs.

The format for each program is identical, although the faculty varies.  Each program will begin with a review of the problem by a local DEA agent, followed by presentations by program staff for the prescription monitoring program, legal staff for MMA, and a clinical talk by a physician experienced in addiction and diversion.

You may reserve a seat now by registering with Gail Begin at MMA through e-mail to or call the MMA office at 622-3374 and press 0 for the attendant.  Registration is also available on the MMA website at [return to top]

"What Value is Your Peer Review Program," CME Program Offered Free at Noon on Oct. 6

The Peer Review Advisory Committee of MMA is presenting a webinar on peer review on Thursday, October 6, 2011 as part of its mission to advance and improve peer review in the state, and more specifically to improve and enhance the Association's external peer review program.  The objectives of the one hour program are to:

  • Delineate the factors accounting for the impact of clinical peer review on quality and safety 
  • Understand the role of healthcare and physician leaders in catalyzing clinical peer review improvement

Facilitating the program is Marc T. Edwards, M.D., MBA, who brings more than 20 years of broad-based healthcare management and consulting experience to management research on important but frequently neglected topics such as the clinical peer review process.  Dr. Edwards has conducted two national studies and published five scientific manuscripts on this subject.   He was able to characterize and elaborate an evidence-based approach for conducting clinical peer review within a quality improvement framework - the QI MODEL.  Dr. Edwards is currently organizing an "Ideal Clinical Peer Review Practices Collaborative" and a "Normative Peer Review Database Project" to further advance this work.

Dr. Edwards is a graduate of the University of Washington and received his medical degree from the University of Colorado.  He completed training in family medicine at Thomas Jefferson University Hospital and later completed an Executive MBA program at he University of Connecticut.  He maintains board certification in Family Medicine, is a Fellow of the American Academy of Family Physicians and a member of the American College of Physician Executives.

Anyone interested in registering for the program, which is offered without charge, should contact Peggy Pinkham at

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