October 8, 2012

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MMA Board of Directors to Meet Wednesday, October 10th

This will be the first meeting of the MMA Board of Directors to reflect implementation of changes in the governance of the Association resulting from bylaws amendments that became effective at the 2011 annual meeting.  The MMA Nominating Committee developed a slate of outstanding candidates for board membership and many physicians seem enthusiastic about taking on a leadership role in the Association.

The MMA Board of Directors will meet this coming Wednesday at the MMA offices in the Frank O. Stred Building in Manchester.  The Board will welcome eight new members elected at the Annual Session, including Drs. Steve Feder, Thomas Marshall, Gregory D'Augustine, Laura Jett Anderson, Paul Cain, Janis Petzel, Mark McAllister, and Kristin Mitchell.  Benjamin Young, M.D., a second year resident in Internal Medicine at the Maine Medical Center, is expected to be elected to the resident position on the Board.  Dr. Young is a graduate of Dartmouth Medical School and is a native of New Hampshire.

Highlights of the meeting will include:

  • Election of three at-large members from the Board to the Executive Committee;

  • Consideration for adoption of the six Resolutions passed by the Membership at the Annual Session;

  • Discussion of the November 6th general election and the potential composition of the 126th Maine Legislature;

  • Consideration of a request to join the Maine Council on Aging

The Board is chaired by Lisa Ryan, D.O.  The Wednesday meeting was preceded by an Executive Committee conference call last night, October 8th, at 8:00 p.m.


Federal Court in Missouri Rejects Challenge to ACA's Contraceptive Mandate

On September 28th, the U.S. District Court for the Eastern District of Missouri dismissed a complaint by Plaintiffs Frank O'Brien and O'Brien Industrial Holdings, LLC that the ACA's preventive services mandate (the so-called contraceptive mandate) violates the Religious Freedom Restoration Act (RFRA) and the First Amendment's Free Exercise, Establishment, and Freedom of Speech clauses.  Judge Carol E. Jackson's decision said that these ACA regulations did not impose a substantial burden on the plaintiffs' exercise of their religious beliefs, that they were neutral laws of general application, and that they did not compel speech.  "RFRA is a shield, not a sword," said the Court.  "It protects individuals from substantial burdens on religious exercise . . . . ; it is not a means to force one's religious practices on others."  The Court found it a de minimis burden on religious practice that the law requires a company to pay towards an aspect of health insurance coverage that may not be consistent with the payer's religious values.  

Other federal courts have rejected challenges to the preventive services regulations on jurisdictional grounds, but this is the first court to dismiss a complaint on the merits.  The case is O'Brien v. HHS, E.D. Mo., No. 4:12-cv-476, 9/28/12.

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Meet Your MMA Offficers: Board Chair Lisa Ryan, D.O.

Lisa Ryan, D.O., FAAP, FACOP of Naples was elected to chair the Board of Directors of MMA at the meeting of the Board held during the Annual Session on September 7th.  Lisa practices pediatrics at Bridgton Hospital and is Board certified by the American Board of Pediatrics.  

A native of New Jersey, Lisa received a B.S. degree cum laude in psychobiology from Albright College and a D.O. degree from the New York College of Osteopathic Medicine.  After completing a transitional year at St. Michael's Medical Center in Newark, N.J., she completed a pediatric residency at the Medical Center of Vermont in Burlington.  She has been at Bridgton Pediatrics for twelve years where she is responsible for well child, acute care, and inpatient care in a community practice setting.  She formerly practiced at Pediatric Associates in Lewiston and with Londonderry Pediatrics.

Lisa is a Clinical Instructor in Pediatrics at Tufts University School of Medicine and was formerly a clinical instructor for the University of Vermont College of Medicine.

Lisa has been a very active participant in organized medicine beginning in her residency where she was a Residency Program Director and a District I Coordinator.  She was active in both the New Hampshire and Maine pediatric societies, and served as President of the Maine Chapter of the American Academy of Pediatrics from 2002-2005.  At MMA, Lisa served until this past September as chair of the busy Legislative Committee, completing a three year term.  She has served on the MMA Executive Committee (now reorganized as the Board of Directors) since 2009.  She is also Chairperson of the Section on Osteopathic Pediatricians at the American Academy of Pediatrics.

Lisa is active in her community, serving on the School Administrative District #61 District Wellness Committee and participating from 2010 to 2012 in the Communities Putting Prevention to Work Grant Leadership Team.

In her spare time, and surely there is not much, she enjoys skiing, hiking, gardening, and cooking.  She also enjoys time with her two children, Cole who is 15 and Lauren who is 12.  She resides in Naples with her children and her partner, Rich Hines.

MMA appreciates Lisa's leadership and she welcomes contact with MMA members and can be reached at ryanlisa@cmhc.org.



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CMS is Hosting a Medicare Enrollment Provider Call

CMS is hosting a National Provider Call on Wednesday, October 10th from 1 to 2:30 p.m. Eastern time, regarding Medicare enrollment issues.  More specifically, the call will focus on revalidation, billing for physicians who order and refer services for Medicare patients, and recent updates to the Medicare online enrollment system.  Plans have been underway at CMS to begin rejecting claims when the ordering/referring provider is not listed in the Medicare enrollment database known as PECOS.  The AMA has persuaded CMS to delay these edits several times over the past few years, arguing successfully that the edits should not be activated until the vast majority of providers are successfully enrolled in PECOS.  CMS has assured that physicians will be given at least 60 days advance notice before the edits are activated.  In addition, CMS has been revalidating providers' enrollment in Medicare for almost a year, as required by the Affordable Care Act.  This revalidation process is being phased in and scheduled for completion by 2015.  Also as a result of AMA advocacy, CMS has said physicians will be among the last providers asked to revalidate their enrollment information.  You can find registration information for Wednesday's call at:  http://www.eventsvc.com/blhtechnologies. [return to top]

Statement of Northern New England Compounding Pharmacy Regarding Recent Meningitis Outbreak

As you may know, Northern New England Compounding Pharmacy is a compounding pharmacy specializing in customized medications for individual needs.  At NNCEP, we are committed to providing the highest quality products and services to our customers.  Compounding quality and sterility at our facility is paramount. 

We currently provide professional compounding pharmacy services to many customers in New Hampshire, Maine, and Massachusetts.

We have received a number of inquiries regarding a meningitis outbreak linked to a compounded preparation  from a specialty pharmacy in Framingham, Massachusetts.  As a result, we are reaching out to our customers proactively to inform them that our company is NOT affiliated with the Bay State pharmacy at the center of this tragic outbreak, nor has it ever been.  The name of the implicated pharmacy, which has suspended its operations, is similar in name only to our business (For clarification, the implicated pharmacy is called New England Compounding Center (NECC)).

Therefore, we want to ensure there is no customer confusion and/or concern regarding the safety of our operations.  We are a fully accredited compounding pharmacy.  In fact, NNECP was the second pharmacy in New England to earn national accreditation through the Pharmacy Compounding Accreditation Board (PCAB) and the only pharmacy in the State of New Hampshire or Maine to achieve this distinguished certification. 

We employ a great number of quality control practices prior to prescriptions leaving our facility.  For example, we conduct routine sterility testing on sterile preparations compounded at our pharmacy.  In addition, independent certification and inspection of our facilities is conducted on a bi-annual basis.

We are available to help those in need of quality compounding services should you be aware of other individuals requiring immediate prescriptions.  Please know that NNECP is committed to providing these much needed services and our track record evidences our standard of only the highest degree of professionalism. Should you or your patients have any questions regarding our business, please do feel free to call our offices at 800-964-0094 ext. 3 or email david@nnecp.com.


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Division Director for Thoracic Surgery Appointed at Maine Medical Center

Tracey Weigel, M.D., has joined Maine Medical Center as Division Director for Thoracic Surgery and Medical Director for the Comprehensive Thoracic Oncology Program within the Department of Surgery, as of October 1st.

Dr. Weigel will be joining Dr. Mayuko Fukunaga, of Chest Medicine Associates, in leading the Thoracic Oncology Program at Maine Medical Center.  They will direct multidisciplinary lung and esophageal cancer clinics with Dr. Weigel managing program development, growth of the Division of Thoracic Surgery, clinical training, and research programs within the division.

Since 2001, Dr. Weigel has been the Chief of Thoracic Surgery at the University of Wisconsin (UW).  She received her medical degree from the University of Rochester School of Medicine, completed her General Surgery Residency at Brown University, and her Cardiothoracic Surgery Residency at the University of Wisconsin.  Additionally, she completed two clinical fellowships in surgical oncology and thoracic oncology at Memorial Sloan-Kettering Cancer Center and remained on staff prior to moving to Wisconsin.  She is certified by the American Board of Thoracic Surgery and American Board of Surgery and specializes in surgical treatment of lung-related malignancies. 

Dr. Weigel's outstanding professional contributions will enable Maine Medical Center to build a comprehensive Thoracic Surgery Division on par with other leading Thoracic Oncology programs across the country and is complementary to the outstanding colleagues she joins at Maine Medical Partners - Cardiothoracic Surgery, The Department of Surgery, Chest Medicine Associates, Spectrum Medical Group, Maine Center for Cancer Medicine, and Maine Medical Center Cancer Institute.

Please join us in welcoming Dr. Weigel to Maine Medical Center. [return to top]

MMA Seeking Practices Implementing Medicare Annual Wellness Visit

The Maine Medical Association has grant funding to provide outreach and education to practices about the Affordable Care Act.  As part of this work, the MMA has worked with MaineHealth and the Maine Primary Care Association to create a toolkit on implementing the new Medicare Annual Wellness Visit (AWV).   Our organizations are planning to host a webinar this fall presenting the tools and answering questions about the AWV and are seeking practice managers or other practice staff who are willing to speak about your experiences beginning to provide the visit to your Medicare patients.  While we know many practices are still struggling to effectively and efficiently provide this visit, we know there are others we can learn from.  If interested, please contact Jessa Barnard at jbarnard@mainemed.com or call 622-3374  x 211.   [return to top]

Two-Thirds of Health Care Workers Received Flu Shots Last Season; Federal Goal Not Met

The percentage of health care workers receiving influenza vaccinations during the 2011-2012 flu season remained roughly the same as prior seasons—about two out of every three workers vaccinated, far below the government's 2020 goal of a 90 percent vaccination rate, according to a new survey by the Centers for Disease Control and Prevention (CDC).

However, for one subgroup—workers employed at long-term health care facilities other than doctors and nurses—the vaccination rate fell to an estimated 50.2 percent.

The low vaccination rate for workers at long-term care facilities caught the attention of Howard Koh, assistant secretary for health at the Department of Health and Human Services.

“This is particularly worrisome because these professions typically care for people at high risk from complications in the long-term health care setting,” Koh told a September 27th press conference in Washington, held by vaccination advocates.

Condition of Employment

At the same conference, the American Medical Association's director of medicine and public health, Litjen Tan, said employers could go beyond encouraging workers to be vaccinated.

“Every medical facility needs to have an influenza prevention program in place, and that influenza prevention program should have vaccinations as a significant component of it,” Tan said.  “But, significantly, the National Vaccine Advisory Committee [report] goes on to say if you have all these prevention programs in place and you can still not successfully immunize 90 percent of your health care workers … they strongly recommend you look at other methods to get to that rate, which includes conditions of employment.”

The advisory's committee's recommendations were issued in February, despite opposition from the Occupational Safety and Health Administration and unions.

Physicians Had Highest Rate

The survey, “Influenza Vaccination Coverage Among Health-Care Personnel—2011-12 Influenza Season, United States,” was published in the Sept. 28 issue of Morbidity and Mortality Weekly Report.

Across all health care positions, CDC researchers estimated 66.9 percent of workers were vaccinated. In 2010-2011, the rate was 63.5 percent, and in 2009-2010, 63.4 percent.

Among all adults, regardless of occupation, the vaccination rate for the last flu season was 39 percent.

Physicians continued to be the staff members most likely to be vaccinated, at a rate of 88.5 percent, an increase of 1.4 percent from the previous survey.  Nurses reported a rate of 77.9 percent, an 8.1 percent boost from the prior survey.  For both professions, the vaccination rates were within a few points of each other whether or not people worked in a hospital, doctor's office, or long-term care facility.

Large Variances

However, large variances were found among other workers—from dentists to cleaning staff—based on where they worked. The overall rate for these workers was 62.8 percent, compared with 61 percent the prior flu season.  The vaccination rate for workers in hospitals was 75.5 percent; the prior year's rate was 71.1 percent. In doctor's offices, the rate was 62.1 percent, up from 54.6 percent the year before.

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Aroostook County Practitioners: MICIS Offering CME on Evidence-based Prescribing, Oct. 15-18

MICIS, the Maine Independent Clinical Information Service, a program of the Maine Medical Association, offers high quality, no cost CME on the evidence-based use of prescription drugs. Our academic detailers visit practice sites throughout the state to speak with individuals, small or large groups. Though any practitioner can request a visit from one of our academic detailers at any time, MICIS is currently scheduling its first-ever “County Tour” to reach out to Aroostook County practitioners. To that end, MICIS academic detailers will be present throughout the county October 15-18, offering educational modules on the following topics:

  1. Antipsychotic medications
  2. Management of chronic pain
  3. Management of atrial fibrillation 

Please contact Jennifer Reck, MICIS Program Manager, at jreck@mainemed.com or 632-5806 if you would like further information or to request a visit on a specific topic.  Not in Aroostook County but still interested? Please contact Jennifer Reck with any questions or to schedule a visit at your practice site.

Maine Independent Clinical Information Service (MICIS)

Academic Detailers:

Erika Pierce, MMC, PA-C

Elisabeth Fowlie Mock, MD, MPH, FAAFP

Advisory Committee Chairperson:

Noah Nesin, MD

More information can be found at: http://www.mainemed.com/academic/index.php

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Physician Compensation and Contracts Seminar by Attorneys Duddy, MacLean, & Smith on October 19th

To accommodate conflicting schedules, the October CME program on the topic of Physician Compensation and Employment Contracts has been moved to Friday, October 19th.  Attorneys Michael Duddy, Gordon Smith, and Andrew MacLean will present the latest information on physician compensation in Maine and include a discussion of productivity incentives and other aspects of employment agreements.  The programs costs $65 and will be held from 9:00 a.m. to noon at the offices of the association in Manchester, Maine.  The program is also available via webex. 

With many physician employers now moving to new contracts, this program would be of particular interest to employed physicians and their employers.

Register now at www.mainemed.com or call 622-3374 ext. 221.

Watch your next issue of Maine Medicine for a list of First Friday programs for 2013.

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Planned MIHMS Disaster Recovery Testing Rescheduled to November 10 12

Maine DHHS recently announced Disaster Recovery Testing on MIHMS, scheduled for October 11-13.

MaineCare will NOT perform the Disaster Recovery Test at the time previously scheduled. The Health PAS online portal will be available for normal activity during that time.

MaineCare has rescheduled the Disaster Recovery Test on MIHMS to 3:00 AM on Saturday, November 10, 2012 through 3:00 AM on Monday, November 12, 2012. The MIHMS Health PAS Online Portal will be unavailable during this time. [return to top]

Key Dates for the 126th Maine Legislature: MMA Legislative Committee Meeting, Convening Date, & Cloture Deadline

The details for the organizational meeting of the MMA Legislative Committee for the 126th Maine Legislature follow:

Date:  Wednesday, December 12, 2012

Time:  Dinner available at 6:00 p.m.; meeting will take place from approximately 6:15 to 8 or 8:30 p.m.

Place:  MMA Headquarters, Frank O. Stred Building, Manchester, Maine

Agenda:  Will include a review of election results, preview of legislation anticipated in the First Regular Session of the 126th Legislature, and development of the MMA's legislative agenda; the Committee also will decide the day and time of the weekly conference calls during the session

RSVP:  All are welcome, but please contact Maureen Elwell, Legislative Assistant, if you will attend the meeting, so we can plan for the meal, at melwell@mainemed.com or 622-3374, ext. 219

If you would like to discuss a bill proposal with the MMA advocacy staff prior to the meeting please contact one of the following individuals: 

Also, the MMA understands that the 126th Maine Legislature will convene on December 6th and that the cloture deadline for submission of bill requests for the 2013 session will be December 21st.

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Upcoming Events & Conferences

Webinar: Colorectal Cancer Screening in Primary Care

October 16, 2012, 12-1 pm 

The Maine Primary Care Association and the American Cancer Society are pleased to host national expert, Durado Brooks, to discuss the latest research on colorectal cancer, screening recommendations and actions you can take in your primary care practice to prevent the disease or find it early. 

To join the online meeting on 10/16, click here.  

Call-in Number: 1-866-469-3239 

Access code:804 979 716 


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


Maine Cardiovascular Summit 

Best Practice: Cardiovascular Care in the Field, in the Clinical Practice, and in the Community

November 8, 2012

Samoset Resort, Rockport 

National  and local cardiovascular health experts will come together to discuss best practice in cardiovascular care. 

For more information, or to register, click here


Maine CDC Infectious Disease Conference 

November 13, 12012

Augusta Civic Center, Augusta

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


Free Aging Advocacy Conference 

November 14, 2012

Augusta Civic Center, Augusta

Maine’s Aging Network is hosting a FREE Aging Advocacy Summit to prepare volunteers, staff and advocates to effectively participate in Maine’s health care redesign efforts at the local, state and national level.

For more information or to register, click here


Women's Health 2012: Strengthening Partnerships to Improve Health Equity 

November 16, 2012

Senator Inn, Augusta

The Maine Women’s Health Campaign invites you to attend a day-long conference dedicated to women’s health. We will hear from distinguished national and state health policy leaders and experts on women’s health, health equity, health policy, and public health, including Paula A. Johnson, MD, a women’s health specialist and pioneer in the treatment and prevention of cardiovascular disease.

For more information or to register, click here. 


Save the Date: First Annual Conference of the Medical Professional Health Program 

Health, Wellbeing and Awareness 

April 5, 2013

Holiday Inn By the Bay, Portland

This will be the first Medical Professionals Health Program Health Conference focusing on addiction, recovery and wellness. The conference is open to all licensed professionals.  [return to top]

Job Openings

MD/DO Position Available in Dexter, Maine

Sebasticook Family Doctors is accepting applications for a MD/DO at our busy Dexter location.  Ideal candidate will have two or more years experience in a busy community health outpatient setting delivering high quality care.  Exceptional clinical, interpersonal and EMR skills are required.   SFD offers  excellent compensation, benefits and working environment.   Join our growing team!  

Interested applicants should send resume and cover letter to:  Melanie Knowles, Human Resources, Sebasticook Family Doctors, 18 Moosehead Trail, Suite 5, Newport, ME 04953 or at mknowles@sfdchc.org


Family Practice Physicians

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, Patten 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.


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.


Psychiatric Nurse Practitioner

Sebasticook Family Doctors is a Federally Qualified Health Care Center currently accepting applications for a Full Time Psychiatric Nurse Practioner for our  Dexter location.  Position includes assessment, medical management, therapy and group work.  Ideal candidtate will have 3 or more years experience in a busy community health outpatient setting delivering high quality care.   Excellent compensation, benefits and working environment.

Send resume and cover letter to:  Melanie  Knowles, Human Resources,  Sebasticook Family Doctors,
18 Moosehead Trail, Suite 5, Newport, ME 04953  or by email at mknowles@sfdchc.org.

10/8/12 [return to top]

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