August 27, 2012

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Handling Patient Complaints Opens Fall First Fridays Program; Sept. 7

The topic of handling patient complaints will be the subject of MMA's September 7, 2012 First Friday CME program, offered live at MMA offices in Manchester and through webcast.  The program runs from 9:00am to noon and includes discussion of complaints to the office, to the licensing boards, CMS,  professional liability complaints and media issues.  The program is presented by senior risk managers for Medical Mutual Insurance Company of Maine.

The presentation will address the importance of an office practice system for the management of patient complaints.  The following topics will be discussed:  patient complaint triggers and subsequent outcomes related to the manner in which the patient complaints are addressed, approaches and considerations for dealing with the patient who is outwardly distressed or angry, the use of preemptive methods to avoid potential escalation and risk management strategies designed to lead to a positive outcome.  The program will also offer tips for dealing with the particular problem of dealing with patients seeking opiate medication.

Faculty for the program includes Nancy Brandow, Senior Risk Manager with Medical Mutual Insurance Company of Maine (MMIC) and Stacey P. Doten, RN, CPHQ, also a Senior Risk Manager for MMIC.

The September program is the first of four First Friday programs scheduled for the Fall.  A fee of $65 is charged for each program and registration is available on the MMA website.

Oct. 5 First Friday Program on Physician Compensation, Recruitment and Retention Moved to Oct. 19.

Because of a change in attorney Michael Duddy's schedule, the October 5th program has been moved to Friday morning, October 19th.  The faculty will still consist of Mr. Duddy and Gordon Smith, Esq., Executive Vice President of MMA.  

Members or staff already registered for October 5th who cannot join us on the19th will be offered credit for another First Friday program or will receive a refund.

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Caring for Our Elders the Theme of MMA's 159th Annual Session; Sept. 7-9

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

The room block at the Harborside Hotel and Marina expired on August 10th.  However, rooms may still be available and 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 ( or call 622-3374 ext. 216.)

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 Geriatrics.  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 on the Association's website.

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EHR Meaningful Use Audits Underway

Audits are underway to assess whether electronic health record incentive payments made to physicians and other providers were made correctly.  At this time, the Centers for Medicare & Medicaid Services (CMS) is not sharing information on how many providers are being audited.

Physicians attesting to meeting the meaningful use of EHR's requirements for either Medicare or Medicaid incentive programs should retain all relevant supporting documentation (in either paper or electronic format used in completing the online attestation) for six years post-attestation.  The government has developed guidance materials, including a ten-step plan to help physicians navigate this process.  CMS also has an extensive list of frequently asked questions on the meaningful use requirements.  

More information on the audits can be found on CMS' Meaningful Use Attestation webpage.  

The contractor who is overseeing the Meaningful Use Audits is Figliozzi and Company. Meaningful use audit questions can be directed to Peter Figliozzi at (516) 745-6400 ext. 302 or by email at [return to top]

MaineCare Pain Management Policy Advisory Committee Met this Morning

The MaineCare Pain Management Policy Advisory Committee, chaired by MaineCare Medical Director Kevin Flanigan, M.D., met this morning to continue its work on the details of implementing the opiate limits which were part of the Supplemental Budget passed earlier this year.  Although the budget takes effect on August 30, the limits specified in the budget are not expected to be effective until January 1, 2013 in order to give the Advisory Committee time to make its recommendations and to have those recommendations drafted into emergency rules.

This morning's meeting focused on the proposal to use the data from the Prescription Monitoring Program to identify those prescribers who are prescribing opiate medication in a quantity that exceeds that written by peers in their specialty.  Those prescribers will be sent a communication from MaineCare noting the variance and asking for a response.  The letter is to be informational and educational in tone.  The letter would also include a list of educational opportunities and resources available in the pain management area.  The prescribers, likely to be about 100 in the first cut, will be expected to develop an action plan or letter of response within fourteen days, with a three month review of the plan to be performed by MaineCare.  If there is no change or explanation, MaineCare could consider de-credentialing the prescriber from MaineCare or reporting the individual to the appropriate licensing board.

The members of the Advisory Committee will provide input into the letter, recognizing that many prescribers may find the letter threatening or, at the very least, of concern. 

The Advisory Committee will meet again on September 25th, from 9:30 to 11:00am in Augusta.  Physicians participating on the Advisory Committee include Stephen Hull, M.D. of Portland and Noah Nesin, M.D. of Lincoln.  Gordon Smith, Esq., EVP of MMA also attends the meetings along with Noel Genova, PA-C, a consultant to MMA on pain management through a contract with the Maine Board of Licensure in Medicine.  Mark Cooper, M.D. Medical Director of the Board of Licensure in Medicine also attended this mornings meeting and is likely to continue to work with the Committee. [return to top]

ICD-10 Final Rule Locks in One Year Delay

On Friday, the Centers for Medicare & Medicaid Services (CMS) published a final rule on ICD-10.  The rule makes final the proposed one-year delay – from October 1, 2013, to October 1, 2014– in the compliance date for use of the ICD-10 diagnosis and procedure codes. 

Since the American Medical Association’s House of Delegates adopted policy in November 2011 to work to stop the implementation of the ICD-10 code set, the AMA has pressed hard for CMS to reconsider its plans to replace the current ICD-9 code set with ICD-10, which is far more complex and costly.

CMS does mention in the rule that they will continue to work with industry to provide outreach and education and continue to engage stakeholders on a wide variety of ICD-10 implementation issues, including reduction of burden on physicians and other health care segments.  A senior CMS official has underscored the administration’s commitment to work with the physician community to mitigate the burden on physicians.  AMA staff will actively engage the administration in the coming months towards that end.

Click here for the ICD-10 final rule.

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HHS Releases Final Stage 2 Meaningful Use Standards Rules; Timeline Delayed One Year

The Centers for Medicare & Medicaid Services last week released the final rule for Stage 2 of the “meaningful use” program, delaying the start of the next phase of the Medicare and Medicaid electronic health record incentive programs until 2014.

The Stage 2 rule spells out the criteria health care providers, hospitals, and critical access hospitals must meet to be eligible for what the Department of Health and Human Services estimates to be more than $15 billion in expected incentive payments.

The Office of the National Coordinator for Health Information Technology on the same day released a companion rule defining the standards and certification criteria for EHR technology eligible professionals and hospitals must use to meet the meaningful use criteria.

The Stage 2 rule increases health information exchange requirements for providers and hospitals and promotes patient engagement by giving patients secure online access to their health information, HHS stated in a release.

In Stage 1 of the incentive program, CMS established that it would begin using Stage 2 criteria in 2013. The agency delayed the start of Stage 2 to provide the needed time for vendors to develop EHR technology. 

A fact sheet on CMS’s final rule is available here.

The final rules announced today may be viewed here. More information on the Stage 2 rule can be found at the CMS EHR Incentive Programs website.

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MaineCDC Requests Assistance in Identifying Arboviral Disease

Maine CDC is asking for physician's help in identifying potential cases of arboviral disease.  While rare, mosquito-borne arboviral diseases such as Eastern equine encephalitis (EEE) and West Nile virus (WNV) can have severe and even fatal outcomes for those who contract them.  There has been a recent increase in arboviral illness both regionally and nationally in the last month, including human cases of EEE and WNV in Massachusetts.  

Maine CDC is asking physicians to consider testing for arboviral disease in patients presenting with unexplained encephalitis, meningitis, or high fever (≥100.4°F or 38°C) during the late summer and early fall.  

If arboviral disease is suspected, appropriate specimens should be submitted for arboviral testing.  Testing can be performed at Maine’s Health and Environmental Testing Laboratory (HETL) and at private reference laboratories. Timing of sample collection is extremely important for the confirmation of arboviral disease.  For most arboviral infections, IgM antibodies are generally first detectable at 3 to 8 days after the onset of illness, but in some cases – especially in the case of WNV – serum collected within 8 days of illness onset may not have detectable IgM.

 If you have any questions, please contact the MeCDC Infectious Disease Epidemiology Program at 1-800-821-5821.  Information on arboviral disease is also available on the MeCDC website.

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New Laws Take Effect August 30

Many of the bills passed by the Maine Legislature this year go into effect this Thursday, August 30th.  A summary of all of the laws passed by the 125th Legislature that MMA followed can be found here on the MMA website.  

Laws going into effect next week that practices should be aware of include: 

  • L.D. 806, An Act to Increase Public Access to Information Regarding Health Care Facility & Practitioner Payments: Requires MHDO to post data semiannually and to ensure the data are current within 12 months
  • L.D. 1628, An Act to Limit Payment for Care & Treatment of Residents of State Institutions: Practices will be reimbursed at Medicare fee schedule rates when providing care for residents of state institutions 
  • L.D. 1715, An Act to Allow for Timely Access to & Enhanced Administration of All Vaccines: Permits qualified pharmacists to administer any federally-approved vaccine to an adult
  • L.D. 1813, An Act to Amend the Laws Governing Confidentiality of Health Care Information: Makes Maine’s confidentiality law consistent with federal law regarding reports to law enforcement of potential criminal conduct on the provider’s premises
  • L.D. 1837, An Act to Authorize the Establishment of Pilot Projects for Community Paramedicine: Permits the Maine EMS Board to approve up to 12 pilot projects of no more than 3 years in duration for “community paramedicine," allowing EMS providers to care for patients in the community 

Other laws going into effect include changes to insurance regulation (LD 1497, LD 1670 and LD 1702), policies on bullying in schools (LD 1237), study groups on the All Payer Claims Database (LD 1818) and breast density (LD 1886), and administrative changes to the Fund for a Healthy Maine (LD 1855 and LD 1884). 

For questions about any of these provisions, contact Andrew MacLean at or Jessa Barnard at  

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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 or visit our website at  KVHC is an equal opportunity employer.


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 or visit our website at  KVHC is an equal opportunity employer.


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.


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Upcoming Events & Conferences

 Midcoast Chapter of Maine AllCare Inaugural Meeting

Wednesday, August 29,  6:30 p.m.

Bath City Hall Auditorium, Bath  

The speaker for the evening will be Dr. Julie Pease from Brunswick, president of Maine All Care, who will guide attendees through a film called The Healthcare Movie. The mission of the Midcoast AllCare chapter, an all-volunteer, non-profit organization, is to promote quality, affordable, equitable and universal health care for Maine people through research, education and advocacy.  

Contact:  Karen Johnson, Chapter leader,  263-4815 or


Tobacco Free Hospital Network Gold Star Standards of Excellence Webinar

Thursday, August 30, 1-2:30 pm 

The Gold Star Standards of Excellence are a free opportunity for Maine hospitals to be recognized for their efforts to create tobacco-free environments and support tobacco-free lifestyles.  Make sure that your hospital is prepared to apply for the 2013 Gold Star Standards of Excellence by joining a free webinar that explains each of the standards, tips for meeting each at your hospital and provides an opportunity to ask questions about the program.

For more information or to register, click here


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


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 or call 207-321-6080 x 3311. 


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.


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


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.


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


The Lung Cancer Free Alliance Save Your Breath Walk

November 3, 2012

Buker School, 21 Armory Street, Augusta

For more information or to register, click here


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]

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