November 12, 2012

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Party Control of Maine Legislature Shifts Again; 4 Physicians Among Apparent Winners

Congratulations to Linda F. Sanborn, M.D., Geoffrey M. Gratwick, M.D., Ann E. Dorney, M.D., and Jane P. Pringle, M.D. on their election to the 126th Maine Legislature!  This is the first time in at least a half-century that there will be more than two physicians in the legislature.  All four physicians are active MMA members and each one is expected to have a significant influence on the development of health policy in the state.

Demonstrating just how volatile the electorate continues to be, Maine voters in the 2012 General Election appear to have restored Democratic control of both chambers of the 126th Maine Legislature.  Among the apparent Democratic winners are four physicians:  Representative Linda F. Sanborn, M.D. (District 130, parts of Buxton and Gorham), Senator-elect Geoffrey M. Gratwick, M.D. (District 32, Bangor and Hermon), Representative-elect Ann E. Dorney, M.D. (District 86, Madison, Norridgewock, and Solon), and Representative Jane P. Pringle, M.D. (District 111, part of Windham).  The MMA congratulates these successful physician candidates!  They will bring great credibility to the continuing debate about health care reform and other important health policy matters in the Maine legislature.

With the election now over, the MMA leadership and staff are busy preparing for the First Regular Session of the 126th Legislature.  The new legislature is scheduled to convene on December 6th for swearing in ceremonies and the election of leadership and constitutional officers.  The deadline for legislators to file bill requests is December 21st and the MMA expects hundreds of bills impacting on medical practice and public health to be considered in 2013.  Budget crises continue, both in Augusta and Washington, D.C. with continuing uncertainty about federal approval of 2012 MaineCare cuts and the so-called “fiscal cliff” facing President Obama and the Congress on January 1st.  Among the federal fiscal problems is the 27% Medicare SGR cut that would be devastating to both physicians and patients, but the AMA, MMA, and other medical societies are working hard to achieve another short-term patch during the lame duck session.  The new Congress must, however, work toward a permanent solution to the Medicare SGR problem.

The MMA Legislative Committee, now chaired by Amy Madden, M.D., a family physician practicing in Belgrade, will meet on December 12th from 6-8:30 pm at the MMA offices to review the composition of the new legislature and to finalize the Association’s legislative agenda for 2013-2014.  Dr. Madden invites any interested physician and medical specialty society representative to the meeting to discuss policy priorities for the medical community.  RSVP to Maureen Elwell at

So, please join the MMA leadership and staff in advocating for the interests of your patients, public health, and responsible professional regulation.  Serve as Doctor of the Day, participate in Physicians’ Day at the Legislature on March 19th, and join the weekly Legislative Committee conference calls when you can.  Democracy is a participatory sport and we need your help!

AMA House of Delegates Convenes Interim Meeting

The AMA's 500 plus member House of Delegates convened Saturday (Nov. 10) for its Interim Meeting.  

Representing Maine physicians at the meeting are delegates Richard Evans, M.D. of Dover-Foxcroft and Maroulla Gleaton, M.D. of Augusta.  Also attending the meeting are MMA President Dieter Kreckel, M.D. of Rumford, former MMA and AMA President Robert McAfee and EVP Gordon Smith, Esq. and Deputy EVP Andrew MacLean. The meeting continues through tomorrow.

Among the many items of business, Council on Medical Services Report 5, entitled, "Strengthening Medicare for Current and Future Generations" is attracting the most attention.  The Report calls on the AMA to change its policy on Medicare to support a defined-contribution plan that would provide a fixed sum of money for a Medicare recipient to use to select an appropriate plan from amongst several private and public plans.  The reference committee hearing the report, Reference Committee J, will be making its recommendation to the House of Delegates later today.

Because of the pending 27% reduction in Medicare reimbursement scheduled for Jan 1, 2013 and the other reductions in federal spending due to sequestration, there is a lot of anxiety and pressure being felt at the meeting concerning what needs to be accomplished in Washington in the next two months.

The meeting is expected to conclude tomorrow morning, Nov. 13.

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States Given More Time to Submit Exchange Plans

The Department of Health and Human Services November 9th extended the deadline for states to submit plans for state-based health insurance exchanges until December 14th.

In a letter to all governors, HHS Secretary Kathleen Sebelius said that states still need to notify HHS by Nov. 16—the original deadline—whether they intend to set up their own exchange.

But, in an acknowledgment that many states said they needed more time, Sebelius said HHS will extend the deadline for submitting an actual plan for the exchange, known as a “blueprint,” until Dec. 14.

Sebelius said HHS will approve or conditionally approve the state-based exchanges by the statutory deadline of Jan. 1, 2013.

Another option is for states to work with HHS in setting up a “partnership exchange,” in which HHS will provide key services for the exchange and the state will operate one or more related activities.

Sebelius, in her letter, said HHS will extend until Feb. 15 the final deadline for states to submit a blueprint as well as notify HHS if they intend to partner with the department in setting up and operating an exchange.

Sebelius said HHS will approve the state partnership applications “on a rolling basis.”

Under the Affordable Care Act, health insurance exchanges are supposed to be up and running in all states by January 2014. They will serve as online venues where people without insurance can compare and purchase coverage offered by different insurance plans. To date, some 13 states and the District of Columbia have declared their intention to create an exchange.

In states that decide not to create an exchange, the federal government will step in and establish one.

Sebelius emphasized that the Obama administration “is committed to providing significant flexibility for building a marketplace that best meets your state's needs.” She noted that funding in the form of exchange establishment grants remains available, with Nov. 15 as the next application deadline.

Up until now it was thought that it was too late for Maine to establish a state-based exchange by the deadline. While Democrats have taken control of the House and Senate in the State and may be interested in pursuing a more active model of exchange, it was thought they would have to wait until 2015 to have the components in place.  It us unclear if Maine will move forward under the new deadline. 

The outcome of the election also changes the chances that Maine will expand Medicaid coverage to all low income individuals up to 133% of the Federal Poverty Level as authorized under the Affordable Care Act and not move forward with the cuts to Medicaid coverage passed by the legislature last year.  It is also expected that in the aftermath of the election the Obama administration will release a wave of regulations and guidance for states on the exchange, Medicaid expansion and other ACA topics.  [return to top]

Get Smart about the Use of Antibiotics: MMA Joins Appropriate Antibiotic Use Campaign

What do sinusitis, most sore throats, bronchitis, runny noses and the regular cold have in common? They are upper respiratory tract infections usually caused by viruses that can′t be cured with antibiotics. Yet, each year, health care providers in the U.S. prescribe tens of millions of antibiotics for viral infections.

To bring attention to this increasing problem, the Maine Medical Association, Maine Centers for Disease Control and Prevention (MeCDC), Maine Hospital Association and Maine Public Health Association will be observing Get Smart About Antibiotics Week this November 12-18th. The campaign highlights the coordinated efforts of the U.S. CDC, states, non-profit partners, and for-profit partners to educate clinicians and the public about antibiotic resistance and the importance of appropriate antibiotic use.

Over-prescribing antibiotics, using a broad-spectrum therapy when a more specific drug would be better, starting and stopping medications, giving leftover medications to a friend who appears to have the same ailment you had, all contribute to the problem of antibiotic drug resistance, according to the US CDC.  As we enter this year′s cold and flu season, the CDC asks parents to not insist on getting antibiotics when a health care provider says they are not needed.

Health care providers are asked to take the time to educate their patients about antibiotic resistance and the possibility of having serious side effects. For example, allergic reactions to antibiotics, such as rash and anaphylaxis, send thousands of patients to the emergency room each year, according to a study published in the Clinical Infectious Diseases Journal.

Health care providers can also prevent antimicrobial resistance by ensuring prompt diagnosis and treatment of infections, prescribing antibiotics appropriately, and following infection prevention techniques to prevent the spread of drug-resistant infections in health care facilities. Doctors cite diagnostic uncertainty, time pressure, and patient demand as the primary reasons for their tendency to over-prescribe antibiotics. Appropriate use of existing antibiotics can limit the spread of antibiotic resistance, preserving antibiotics for the future.

For treatment guidelines for Upper Respiratory Tract Infections, see:

For more information about antimicrobial resistance, including background articles, patient materials and continuing education programs, see [return to top]

December First Friday Program & Webinar - Preparing Your Practice for Health Care Reform

MMA December First Fridays 

DECEMBER 7, 2012 • 9:00 AM - 12:00 PM

The Affordable Care Act (ACA) Post-Election:  What your practice needs to know in the aftermath of the election, including a segment on the role of the medical practice as a purchaser of health care for its employees.

8:30am Registration and breakfast for those in the office

9:00 Welcome and Introductions

9:10 The Affordable Care Act Post-Election.  What’s Hot, What’s Not, Benjamin Townsend, Esq.

10:15 BREAK

10:30 Small businesses as purchasers of health care under the ACA provisions, Ellen McPherson and Rick Morrone, Holden Agency. 

11:30  Discussion and Q & A

Click here to register online or click here to download a program and registration form. 


MMA Special Webinar: Implementing the Annual Wellness Visit in your Practice: Tips from the Field 

DECEMBER 11th, 12-1 pm 

Join the Maine Medical Association and Maine Primary Care Association for a webinar sharing tools and best practices for implementing the Medicare Annual Wellness Visit in your practice.  Dr. Roger Renfrew of Redington Medical Primary Care and Dr. Laura Jett with Norway Family Medicine will address why they find the visits useful, how they describe the visit to their patients, workflow issues and how they integrate the visit into their practice.  Certified Professional Coder Laurie Desjardins from Baker Newman Noyes will answer your billing and coding questions.   We will also share checklists, sample patient letters and other tools to use in your practice.  

Register today by sending your name, email and practice name to Ashley Bernier, or 207-622-3374.   There is no cost to participate. 

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MaineCare Provider Relations Division Update

The MaineCare Provider Relations Unit has added several new staff members and work has been assigned according to MaineCare sections of policy.  These changes are effective immediately.  Once all staff are fully trained, periodically work may be reassigned by policy section to ensure appropriate work distribution and especially to enhance our ability to serve you.  As a result, the State county assignments are no longer valid. 

Please remember to call the Molina Call Center at 1-866-690-5585 for your routine claims questions, to check eligibility, and for general assistance.  Please contact the Provider Relations Specialist (PRS) assigned to the policy section pertaining to your questions, training needs, or if you are advised to contact your PRS for assistance with enrollment or resolving a difficult issue. 

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DHA Patient Experience Survey Registration Extended to Nov. 16

The Dirigo Health Agency (DHA) is pleased to announce that registration for its patient experience survey initiative has been extended to Friday, November 16. This will be the final extension and is open to all practices.

The DHA and its partners are committed to supporting a statewide effort using Designated Vendors and a standardized tool to collect and publicly report patient experience survey data. Survey data include information that only patients can provide to help improve patient-centeredness and care quality in Maine.

To participate in this initiative, practice sites (or medical groups or health systems on their behalf) must contract with a Designated Vendor that has been selected to administer a CG-CAHPS experience survey to patients served by primary care and specialty practices in Maine. Practice sites wanting to participate in this voluntary initiative and receive subsidies up to $8.60 per completed survey must contract with a designated vendor and agree to have survey results publicly reported.

For the list of designated vendors and more information about the program, click here or contact: Alexander Dragatsi, Dirigo Health Agency’s Maine Quality Forum, 207.287.9965, [return to top]

CMS Extends Time for Filing for ePrescribing Hardship to Avoid 2013 Penalty

As a result of persistent AMA advocacy, CMS has decided to re-open the Communications Support Webpage to allow physicians who missed the June 30th deadline to file for a Medicare ePrescribing hardship in order to avoid a 1.5% penalty in 2013.  The AMA has been urging CMS to take such a step.  Please note that this is for the 2013 eRx payment adjustment only.  Hardship exemption requests for the 2014 payment adjustment will be accepted during a separate timeframe later in calendar year 2013.

Physicians who would like to file a hardship but did not file one before June 30, 2012 will now be able to do so between November 1st and January 31, 2013.  The current hardship exemptions include: 

  • Has an inability to ePrescribe because of state, federal, or local law;
  • Had fewer than 100 prescriptions during the period from January 1, 2012 to June 30, 2012;
  • Practices in a rural area without sufficient high-speed internet access; or
  • Practices in an area without enough pharmacies available to do e-prescribing.

To avoid errors that could result in receiving the 2013 penalty, physicians must use their individual Type 1 National Provider Identifier in their exemption filing.  This is the number used in Box 24(J) of the CMS 1500 paper form or in the Rendering Provider Name or Billing Provider loop of electronic claims.  Physicians also must use the Taxpayer Identification Number (TIN) they use for billing when filing for the hardship.  For physicians who bill using their Employer Identification Number, this is the number that should be used when filing for a hardship exemption.  For those who bill using their Social Security number, the SSN should be used when filing.  

For additional information and resources, please visit  If you have questions regarding the ePrescribing Program or need assistance submitting a hardship exemption request, please contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or via  They are available Monday through Friday from 7 a.m. to 7 p.m. CST.  Physicians who are Mac users may still experience trouble filing for a hardship, therefore, if this occurs, they should contact the Help Desk as well since CMS is working to resolve these issues. [return to top]

Great American Smoke Out Nov 15.

The American Cancer Society is marking the 37th Great American Smokeout on November 15 by encouraging smokers to use the date to make a plan to quit, or to plan in advance and quit smoking that day. By quitting — even for one day — smokers will be taking an important step towards a healthier life – one that can lead to reducing cancer risk.

Tobacco use remains the single largest preventable cause of disease and premature death in the US, yet more than 45 million Americans still smoke cigarettes. However, more than half of these smokers have attempted to quit for at least one day in the past year. As of 2010, there were also 13.2 million cigar smokers in the US, and 2.2 million who smoke tobacco in pipes.

Physicians in Maine can refer patients to the Tobacco Helpline at 800-207-1230 or [return to top]

MMA Announces 2013 First Fridays Seminars; Mark Your Calendar!

MMA 2013 First Fridays Education Sessions

8:30 AM – Registration and Breakfast; All sessions 9:00 – Noon with breakfast included

TWO WAYS TO ATTEND These programs are available 9:00 am - noon, both live in Manchester and over the web via Webex. Because of the substantial course materials, the per person $70 fee is the same whether attending in Manchester or participating through Webex.  Webex capacity is limited to 25 sites, so don’t delay!

Click here to register online or download a program and registration form here

FEBRUARY 1 Preventing Prescription Drug Abuse While Treating Chronic Pain

MARCH 1 Protecting Professional Reputation in an Age of Social Media

APRIL 5 Annual Coding Seminar

presented by the Learning Center at Baker Newman & Noyes

MAY 3 Update on the Affordable Care Act

JUNE 7 Annual HIPAA Update

SEPTEMBER 6 Risk Management Seminar

- presented by Medical Mutual Insurance Company of Maine

NOVEMBER 1 Annual Compliance Seminar: Preventing Allegations of Fraud & Abuse

DECEMBER 6 Accountability, Transparency & Public Reporting: The Importance of Your Data

For questions or more information, please contact Lisa Martin at or 207-622-3374 x 221. 

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Job Openings

CLINIC MANAGER - Orthopaedics

Central Maine Orthopaedics (CMO) is a successful orthopaedic practice in Central Maine and we are currently recruiting for a full-time Clinic Manager for our Ambulatory Clinic. The foremost duty of this position is to ensure that the day-to-day operations and management of the clinic run smoothly and efficiently.  This position requires a professional with strong leadership characteristics with an associated broad skill set who will serve as role model, mentor, and coach/facilitator. This is a CMO senior manager role responsible for both organizational and operational outcomes.  This position ensures CMO's continuing compliance with our organizational standards and policies in the areas of human resources, fiscal management, purchasing, medical records, facilities management, and clinical operations.  This position is responsible for delivery on the organization's strategic plans, benchmarks, and critical success factors  and therefore must demonstrate accountability and responsibility for own work and expected outcomes for those supervised.  Central Maine Orthopaedics is an Equal Opportunity Employer.

For additional information regarding this position, please view the full posting on our web site at or contact Janine Valliere at 207-783-1328 or


NURSE PRACTITIONER Position Available in Dexter, Maine

Sebasticook Family Doctors is a Federally Qualified Health Care Center currently accepting applications for a Full Time Nurse Practioner for our  Dexter location.  Ideal candidate will have two or more years experience with exceptional clinical, interpersonal and EMR skills.    Maine License and DEA registration required.  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,  


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


Psychiatric Nurse Practitioner Position Available in Dexter, Maine

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 at


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Upcoming Events & Conferences

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


A Moderated Public Discussion: What If Everyone Had Health Care in Maine?

Sponsored by Maine AllCare

November 15, 2012 6:30 PM

Think Tank, 533 Congress St., Portland

This forum will cover the problems, the progress, and ideas on how to make health care really work for everyone.

For more information, contact Beth Franklin at 650-3177 or


Maine General Medical Center Fall Coding & Compliance Conference 

Achieving New Heights in Health Care Reform 

November 16, 2012

Waterville Elks Banquet & Conference Center, Waterville 

6.5 AAPC CEUs Covering: The Road to ICD 10, Vascular & Thoracic Procedural and Terminology Overview, Introduction to APC and more 

For more information or to register, contact Cindy Sturtevant, 872-4058


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. 


 Graceful Synergy: Defining the Partnership between Public Health and Accountable Care

December 6, 2012, 5 pm 

Grace Restaurant, Portland

Support the Maine Public Health Association while hearing from Lisa Harvey McPherson, RN, MBA, MPPM, Vice President of Continuum of Care and Chief Advocacy Officer of Eastern Maine Health Systems and Barbara Crowley, MD, Executive Vice President and MaineGeneral Health pediatrician, who will deliver a presentation examining the relationship between public health and accountable care.     

 For more information or to register, click here


Maine HIV, STD & Viral Hepatitis Program HIV & Primary Care Conference 

December 7, 2012

Maine Principals' Association, Augusta 

For more information or to register, click here


Save the Date: 2013 Quality Counts Conference 

April 3, 2012

Augusta Civic Center, Augusta 

QC 2013 will feature Dr. Donald Berwick, former CMS Administrator, as keynote speaker highlighting the theme of reaching the Triple Aim of improvement.  Registration materials and detailed agenda will be available January 2013.


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]

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