August 6, 2012

 
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Report on MMA Board of Directors Meeting, August 3

MMA's Board of Directors met on Friday, August 3, at the home of President Nancy Cummings, M.D. in Rockwood.  In addition to approving a draft budget for 2013 and a Nominations Committee Report for presentation at the upcoming annual session September 7-9 in Bar Harbor, the Board approved a pilot project allowing for membership of small rural health centers and discussed potential changes to the state's Rural Medical Access Fund.  

The proposed budget will be voted on by the membership at the business meeting held on Saturday morning, September 8th.  As prepared by the Budget and Investment Committee, the proposed budget does not contain any increase in member dues and after considering all revenue and expenses, the budget is in the black by $734.  Exclusive of grant and investment income, the revenue is projected to be approximately $1.3 million with expenses of $1.4 million.  Grant income and using 4% of the value of reserve funds make up the bulk of the difference.  The Budget and Investment Committee is chaired by Kevin Flanigan, M.D.  The treasurer is Michael Parker, M.D.

The report of the Nominating Committee focused on nominations for 10 new Board members to be elected at the Annual Meeting.  Six members have been nominated for Board positions so far, including Drs. Mark McAllister, Kristin Mitchell, Laura Jett, Greg D'Augustine, Steve Feder and Janis Petzel.  Guy Raymond, M.D., a family physician practicing emergency medicine in Fort Kent has been nominated as President-elect. Maroulla Gleaton, M.D. and Charles Pattavina, M.D. have been nominated for AMA delegate and alternate, respectively. The Committee will continue its work through the month of August focusing on additional Board members and beginning work on open MMA committee positions.

The Board approved a two-year pilot project allowing small federally qualified health centers (FQHCs) to become associate members of the association and receive a menu of benefits appropriate to their status.  Six to eight centers will be invited to participate and the project will be evaluated after two years.  FQHCs with five or fewer employed physicians will be eligible to participate in the project.

The state's Rural Medical Access fund is being evaluated by the Bureau of Insurance in an effort to determine whether the Fund continues to meet its original purpose of increasing access to obstetrics in rural areas by subsidizing professional liability premiums.  The fund was created nearly twenty years ago through the efforts of MMA and other organizations supporting tort reform.  In the past year, the fund assisted 38 physicians, 7 of whom were in independent practice.  The Board concluded that more information was necessary before providing staff a recommendation regarding the future of the Fund. Staff will put the requested information together prior to the next Board meeting on September 7th.

The Board also learned of a potential grant opportunity involving payment reform.  The Maine Health Access Foundation has announced a third round of two-year grants to complement several existing grants designed to implement payment reform in Maine.  Jessa Barnard, MMA Associate General Counsel, presented the objectives of the grant and staff was authorized to prepare an application as the deadline is August 10th.  MMA currently participates in two other MeHAF grants involving outreach on the Affordable Care Act and administrative advocacy regarding health insurance reform, respectively.

Registration Deadline for Hotel Rooms at MMA Annual Session Extended to August 10th

Registration materials for the Association's 159th Annual Meeting were recently mailed to all members.  The meeting will be held in Bar Harbor again this year, at the Bar Harbor Hotel and Marina, September 7-9th.  The Friday afternoon educational program will be held at the Jackson Laboratory.  

Room reservations must be made at the Harborside Hotel and Marina by August 10th (previously August 6th). Reservations received after August 10th will be based on availability.  The MMA does maintain a list of alternative accommodations in the Bar Harbor area and members and guests are asked to contact Diane McMahon at MMA for the list (dmcmahon@mainemed.com or call 622-3374 ext. 212).

The theme of this year's CME program is Caring for Our Elders and the keynote speaker is well-known author and geriatrician Dennis McCullough, M.D.  Dr. McCullough is the author of the best-selling book entitled, My Mother, Your Mother, Embracing Slow Medicine (2008). He is also the co-author of The Little Black Book of Pediatrics.  Dr. McCullough is associated with Dartmouth Medical School and resides in Norwich, Vermont.

On Saturday evening, MMA President Nancy M. Cummings, M.D. will  present the Presidential gavel and medallion to in-coming President Dieter Kreckel, M.D.  Dr. Kreckel is a family physician practicing in Rumford. He is a former President of the Maine Academy of Family Physicians.

Interested members may also register now on the Association's website.

 
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Effective Date of MaineCare Opiate Limits to be Delayed

Kevin Flanigan, MD, Medical Director of MaineCare Services, today convened the second meeting of an advisory committee to provide input on how the State should implement changes to MaineCare opioid coverage and other pain management issues contained in the supplemental budget that passed the legislature in May. 

MaineCare has not yet released the details of their plan to implement these changes, but Dr. Flanigan did share at the meeting today that the limits for patients and prior authorization requirements will not be put into effect until the advisory group settles on criteria for a prior authorization process and the changes go through the rulemaking process.  A realstic date for any limits or prior authorizations being in place for patients is January 2013.  The State is planning to begin generating reports comparing clinicians' opioid prescribing to peers sooner, ideally by the August 30th effective date of the budget.  

The group meeting this morning morning included MMA EVP Gordon Smith, Dr. Steven Hull, Dr. Noah Nesin and Noel Genova, PA-C.   They next meet on August 27th at 9:30 am at the DHHS Building on Union Street in Augusta.  Any MMA member wishing to participate or comment should contact Mr. Smith at 207-622-3374 x 212 or gsmith@mainemed.com

As a reminder, a summary of the provisions in the budget can be found on the MMA website, here, and include limits on prescriptions of opioid medication for acute pain, requirements for patients to participate in alternative interventions before receiving prescriptions for chronic pain, prior authorizations before patients with certain diagnoses can receive opioid medications, and generating reports for prescribers showing how their prescribing patterns compare to their peers.  [return to top]

Maine DHHS Files Formal Request for Feds to Permit Reductions in MaineCare Eligibility

On last Wednesday, August 1, DHHS Commissioner Mary Mayhew and Governor Paul LePage filed a formal request with the federal government to allow the state to eliminate MaineCare benefits for approximately 26,500 Mainers, including 1,825 seniors participating in the Medicare Savings Program.  Also eliminated would be coverage for 19 and 20 year olds and non-disabled and non-pregnant adults earning over 133% of the federal poverty level.

The cuts are scheduled to take place on October 1, 2012 and the state has asked for an expedited review of the request.  If the request is not approved, the state budget would face a hole of about $20 million.  Both Governor LePage and Attorney General Schneider has stated the state will consider filing a lawsuit against the federal government if the request is not granted. 

The Governor has stated with some frequency his opinion that the MaineCare program has grown beyond the state's ability to pay.  There are approximately 361,000 Mainers enrolled in MaineCare.  If the national average were achieved in the state, the number would be approximately 260,000.

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Bruce L. Churchill, M.D., 1954-2012

Association staff was saddened early this week to learn of the death on July 30th of Bruce Churchill, M.D. who had fought a valiant and very public battle against ALS since being diagnosed with the disease in 2007.  Dr. Churchill was a very popular obstetrician-gynecologist who practiced with Coastal Women's Health Care in Scarborough.  He was an active member of MMA and was active at Medical Mutual Insurance Company of Maine, as well.  Our condolences go out to his wife of 37 years, Cindy and their three daughters, Cristina, Tessa and Leah.

Dr. Churchill was a native of Michigan and a graduate of Michigan State University (BS) and the University of Michigan Medical School.  He completed his Ob-Gyn residency at the Maine Medical Center and chose to stay in Maine to begin his practice.  Fortunately for Maine and his patients, he never left.  Over 30 years in practice, he delivered over 6000 babies.  He was also dedicated to his family and church and was an assistant coach for the Greely High School girl's volleyball team.

As he showed us how to live, he also showed us how to die, managing the devastating disease of ALS with grace and dignity.  He will be greatly missed by his family, friends, professional colleagues, his many patients and many others who had the privilege of knowing him.

A visitation will be held at Coastal Women's Healthcare in Scarborough on Friday, August 24th from 3:00 to 5:00 pm.  A memorial service will be held at 1:00 pm on Saturday, August 25 at the Hannaford Lecture Hall on the USM Portland Campus.  Memorial donations can be made to the ALS Association of Northern New England, Walk to Defeat ALS, or the Coach Bruce Churchill Volleyball Scholarship, c/o Greely High School, Cumberland, Maine 04021.

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Work Group on Breast Density Holds Second Meeting

Work group members for the LD 1886 Resolve, Directing Review of Strategies to Improve Communications between Patients and Physicians, held their second meeting last Thursday.   The goal of the work group is to recommend strategies to improve the dialogue between patients and physicians regarding breast density and breast imaging options.  Dense breast tissue can make it more difficult to identify cancer on a mammogram and may also increase the risk of breast cancer. 

While the group did not reach any formal decisions, the discussion on Thursday centered around recommending that all radiologists and radiology practices include information about a women's breast density on the "lay letter" that is sent to every woman following a mammogram.   The group also suggested that practices should consider using sample language provided by the American College of Radiology, available to be downloaded and viewed here.   A large portion of the meeting was spent discussing whether the language or letter should be mandated by statute or voluntary.  

Members also discussed the fact that primary care/referring providers will need resources for discussing breast density and imaging options with patients after a patient receives such a letter.  Suggestions included adding resources directly to imaging reports sent from radiologists to referring clinicians, creating CME presentations, and adding resources to the MeCDC website.  

Members should provide any feedback on these suggestions to Jessa Barnard at the Maine Medical Association, jbarnard@mainemed.com or 207-622-3374 x211.   A number of physicians participated in the meeting, including Drs. John Benson, Cameron Saber, Amy Harrow and Gregory Hardy.   The group will next circulate comments via email and meet to discuss recommendations on October 11th at 7 am at the MMA Headquarters in Manchester.

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New Geriatric Society Seeks Participation

A Maine chapter of the American Geriatrics Society (AGS) is forming and needs your help. An organizational meeting will be held on Monday, September 10, 2012 at 5:00 pm at the MaineHealth building on 110 Free Street in Portland. Teleconferencing will be available to interested individuals unable to attend the meeting in person.

The group encourages all practicing geriatric care providers to join and hope to have all disciplines represented. They also welcome trainees and other clinicians interested in learning more about geriatric medicine. Membership in the AGS is not required for participation.

The hope is that a Maine chapter will provide clinicians a “local” opportunity to form collegial relationships with other geriatric providers and the organizational framework to collaborate on geriatric quality and educational initiatives to improve care for our patients.

If you are interested in learning more about the meeting or wish to attend, either in person or via teleconferencing, please contact: Christy Tibbetts,TIBBEC2@mainehealth.org, 661-7120.

The group is also planning an evening business meeting for the Chapter, to address issues such as Bylaws and Officers, on Tuesday April 9, 2013 just prior to the Maine Medical Center Geriatric conference on Wednesday, April 10.


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Affordable Care Act Extends Free Preventive Benefits to Women's Services

Forty-seven million women are getting greater control over their health care and access to eight new prevention-related health care services without paying more out of their own pocket beginning August 1, 2012, Health and Human Services (HHS) Secretary Kathleen Sebelius announced last week.

Previously some insurance companies did not cover these preventive services for women at all under their health plans, while some women had to pay deductibles or copays for the care they needed to stay healthy. The new rules in the health care law requiring coverage of these services at no cost to the patient take effect at the next renewal date – on or after Aug. 1, 2012—for most health insurance plans.

According to a new HHS report also released today, approximately 47 million women are in health plans that must cover these new preventive services at no charge.  

The eight new prevention-related services are:

  • Well-woman visits.
  • Gestational diabetes screening that helps protect pregnant women from one of the most serious pregnancy-related diseases.
  • Domestic and interpersonal violence screening and counseling.
  • FDA-approved contraceptive methods, and contraceptive education and counseling.
  • Breastfeeding support, supplies, and counseling.
  • HPV DNA testing, for women 30 or older.
  • Sexually transmitted infections counseling for sexually-active women.
  • HIV screening and counseling for sexually-active women. 
For more information on the newly-covered services, click here
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AMA Summary of 2013 CMS Physician Fee Schedule Now Available

The American Medical Association has prepared a summary of the CMS physician fee schedule proposed rule for 2013.  The summary addresses key provisions of the proposed rule including the 27% Sustainable Growth Rate cut, changes to the Physician Quality Reporting System, the Value-Based Payment Modifier, Physician Compare, the e-Rx Prescribing Incentive Program and many others.  The summary is posted here on the Maine Medical Association website. 

In related news, freezing physicians' Medicare reimbursement at current levels for 2013, rather than allow the 27 percent cut to be implemented, would cost $18.5 billion over 10 years and leave doctors again facing a pay cut of up to 26 percent in 2014, the Congressional Budget Office said in a July 30 analysis.  CBO said the freeze would cost $11.1 billion in 2013.

Many stakeholders expect Congress to put forth legislation canceling the 27 percent cut, perhaps in a package of other legislative initiatives that also could include an extension of expiring Medicare payment provisions for other providers.

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Follow MMA on Twitter

For even more late-breaking updates on health policy, health news and MMA events and activities, follow the Maine Medical Association on Twitter.  Search for us at @MaineMedAssn.   For information about how to join and use Twitter, click here

 
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Upcoming Events & Conferences

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

Registration information available by clicking here

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Maine Immunization Program Regional Trainings 

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

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3rd Annual Maine Telehealth Conference 

August 14, 2012

Colby College, Waterville

The conference will feature talks on new and emerging clinical telemedicicne programs, Legal and Regulatory issues related to Tele-healthcare programs, IT and Management, Telehealth options for primary care, Updates on Reimbursement for Telehealth Services. 

For more information, or to register, click here

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Rewiring the Brain

August 20, 2012

Samoset Resort, Rockport 

This seminar will examine the use of brain-based interventions to enhance outcomes with a variety of client populations.  Keynote presenter John Arden, PhD. 

More information will be posted here as the date approaches. 

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2012 New England Clinical Symposium & Workforce Summit 

August 23, 2012 

Holiday Inn By the Bay, Portland

Maine Primary Care Association and the Maine Office of Rural Health and Primary Care will host their first Summit  featuring two prominent keynote addresses, an 'Ask the Expert' Roundtable/World Café, a clinical track on caring for aging New England and a workforce development track. Target audience includes the clinicians and administrators of New England's critical access hospitals, community health centers, rural clinics and tribal health centers.

For more information or to register, click here

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3rd Annual Patient Safety Academy

September 7, 2012

USM Portland Campus, Abromson Center 

Join colleagues and other health care professionals this September in an engaging and thought-provoking day of presentations, workshops, and skill-building activities designed to advance patient safety throughout the state and region.

For more information or to register, click here

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17th Annual Northern New England Conference on Child Maltreatment 

September 13 & 14, 2012

University of New England Campus Center, Biddeford, ME 

The goal of this conference is to provide multi-disciplinary training to increase professional skills and knowledge of professionals who are involved in child abuse prevention, recognition, evaluation, reporting, investigation, treatment and all forms of child maltreatment. 

For more information, email spec@spurwink.org or call 207-321-6080 x 3311. 

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First Annual Let's Go 5210 Childhood Obesity Conference 

September 27 & 28, 2012

Maine Health Conference Center, 110 Free Street, Portland 

For anyone who works 1:1 with patients and families.  Learn how to build capacity in your practice, in your community and for your patients. 

For more information, click here.

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11th Annual Downeast Ophthalmology Symposium

September 28-30, 2012

Harborside Hotel & Marina, Bar Harbor, Maine

The Maine Society of Eye Physicians and Surgeons will host the 11th Annual Downeast Ophthalmology Symposium in beautiful Bar Harbor, Maine once again this year.  Offering 15.25 AMA PRA Category 1 Credits to ophthalmologists across the country.  

For more information and registration information, click here

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Making Strides Against Breast Cancer Fundraising Walk 

October 14, 2012

Monument Square, Portland 

The annual American Cancer Society Making Strides Against Breast Cancer® three-mile fundraising walk will unite the community to honor and celebrate breast cancer survivors, educate women about the importance of early detection, raise funds for the fight to end breast cancer, and commemorate two decades of making a difference in the fight to end breast cancer. 

For more information or to register, click here.

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Maine Public Health Association 2012 Annual Conference 

Community Connections: Building Creative Partnerships for the Health of All Mainers

October 17, 2012

Civic Center, Augusta 

Join us at Maine's premier Professional Public Health event, the 28th MPHA Annual Meeting. We will be partnering with many organizations across the State to bring the highest quality of education, innovation and inspiration to those that work in and around the field of public health.

For for information or to register, click here

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Maine CDC Infectious Disease Conference 

November 13, 12012

Augusta Civic Center, Augusta, Maine

Presenting a review of emerging issues in the field of infectious diseases, particularly as they impact the Maine medical community. 

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

Job Openings

Medical Director/Family Practice Physician

Katahdin Valley Health Center, established in 1974, is a high performing FQHC with a continuous track record of growth and stability.   KVHC seeks a Medical Director/Family Practice Physician to join our team and pursue our mission to provide community accessible, quality healthcare with compassion and dignity.   The Medical Director at KVHC will begin by providing patient primary care 3 days per week and performing administrative Medical Director Duties the other 2 days of the week.  This position will progressively move to a Full Time Medical Director Administrative role.  KVHC offers state of the art facilities and technology, electronic medical records, as well as a competitive salary and benefits package which include sign on bonus, generous amounts of paid time off, health insurance, life and disability insurance as well as Federal Torts Claims Act (FTCA) malpractice coverage. No nights, no weekends, either limited or no inpatient care and limited call coverage.  

KVHC has site locations in Houlton, Island Falls, Patten and Millinocket.  The Medical Director will work between the Houlton and Patten site, or the Millinocket and Patten Site.  Interested applicants should contact Michelle LeFay at mlefay@kvhc.org or visit our website at www.kvhc.org.  KVHC is an equal opportunity employer.

8/27/12

Family Practice Physicians - Millinocket & Houlton, Maine Locations

Katahdin Valley Health Center is recruiting dedicated Family Practice Physicians that are committed to providing quality health care services to the people in Central/Northern Maine.  Join our practice in one of the newly expanded facilities.  We are seeking physicians for our Millinocket and Houlton locations.  KVHC is a fully electronic medical record site and offers a competitive salary and benefits package which includes sign on bonus, generous amounts of paid time off, health insurance, life and disability insurance as well as Federal Torts Claims Act (FTCA) malpractice coverage.  No nights, no weekends, either limited or no inpatient care and limited call coverage.  Physicians who join KVHC are eligible to apply for NHSC Loan Repayment.

Physicians that join KVHC will be providing quality care in a dynamic, cutting edge environment, within a patient focused team of 11 Providers and 90 Staff Members.  As one of New England’s highest performing Federally Qualified Health Centers (FQHC), KVHC has a mission to provide community accessible, quality healthcare with compassion and dignity. 

To learn more about KVHC and Practitioner Opportunities, please contact Michelle LeFay at mlefay@kvhc.org or visit our website at www.kvhc.org.  KVHC is an equal opportunity employer.

8/27/12
 

Exceptional Internal Medicine Opportunity in Kennebunk, Maine 

SMMC PrimeCare Internal Medicine Kennebunk is seeking a BC/BE internal medicine physician for their busy outpatient office located in downtown Kennebunk on the beautiful southern coast of Maine.  This well-established, highly desirable practice has current providers leaving clinical practice and is a unique opportunity for a motivated and creative individual interested in ensuring the healthcare needs of patients is delivered with highest level of quality.  For more information, please contact Katie Wechter at (207)294-8404.

9/3/12
 



 
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