Appropriations Committee Completes Public Hearings on $6.3 Billion Budget

Last Friday, April 5th, the Appropriations Committee completed public hearings on the $6.3 billion budget that had consumed four weeks of testimony.  The items impacting the HHS budget were heard last with the MaineCare reductions in reimbursement to hospitals being the final topic presented Friday afternoon.  MMA EVP Gordon Smith was the final speaker, presenting MMA's testimony in opposition to the hospital cuts that totaled more than $40 million annually. 

MMA's testimony opposed all of the reductions to hospitals, but the testimony highlighted the impact of the reductions to the Critical Access Hospitals.  Mr. Smith noted the considerable pressures on the small hospitals to invest in electronic medical health records systems, to prepare for conversion to ICD-10, and to establish and adequately fund primary care networks consisting of patient centered medical homes and for MaineCare, Health Homes.  "It is not fair to expect these facilities to do more with less," Smith noted.  

Jeff Austin on behalf of the Maine Hospital Association noted the need to retain the critical access hospital funding so that the taxes paid under the "tax and match" scheme adopted years ago were repaid to each facility.  Representatives of critical access hospitals in Pittsfield and on Mt. Desert Island also testified, as did Katie Fullam Harris on behalf of Maine Health and Lisa Harvey-McPherson on behalf of Eastern Maine Healthcare.

The HHS Committee will continue work on the budget this week.

POLITICAL PULSE: Legislative Highlights from the Week

Here are some highlights of what MMA's advocacy team followed at the State House the week of April 1st: 

MMA TESTIFIES ON BUDGET BILL  

The Appropriations and Financial Affairs Committee and Health and Human Services Committee concluded public hearings on the DHHS portions of the 2014-15 Biennial budget last week. MMA testified on the budget last Friday, when the Committee heard testimony on proposed cuts to hospital outpatient services and critical access hospitals.  The Health and Human Services Committee now moves into work session and will decide their positions on DHHS aspects of the budget.  They plan to finish voting on their recommendations by April 19th and report back to the Appropriations Committee the week of April 22nd. 

HHS HEARS TESTIMONY ON BILL TO ACCEPT FEDERAL FUNDS FOR HEALTH CARE 

The Health & Human Services Committee held a public hearing on the bill to accept federal funds to provide more than 69,500 Mainers with health coverage through the MaineCare program this past Tuesday.  Dozens of proponents testified in favor of the bill, including hospitals, business owners, patients, clergy and law enforcement. Dr. Amy Madden, chair of the MMA Legislative Committee, presented the MMA's testimony in favor of the bill.  Dr. Madden stated that Maine will use the funds wisely given the State's current efforts to reform health care through patient centered medical homes, ACOs and other innovative changes in the way care is delivered.  Commissioner of DHHS, Mary Mayhew, testified in opposition, citing concerns over the state of the Federal budget and shortfalls in the current MaineCare program.  The Committee will hold a work session on the bill tomorrow.

GOVERNOR VETOS YOUTH TANNING BILL   

The MMA worked with pediatricians, dermatologists, cancer survivors, public health advocates and others to support LD 272, a bill that would ban minors from using tanning beds.  The MMA sees this is a basic public health measure that protects teens from a known carcinogen. The bill had bipartisan cosponsorship and received a strong 10-4 vote out of the Health and Human Services Committee earlier this session. It received majority votes in both the House and Senate over the past several weeks.  Last Thursday, Governor LePage announced that he was vetoing the bill, citing it as an issue of parental choice.  The next step is for the House and Senate to decide if they are going to attempt to override the veto, which would require a 2/3 majority in both bodies. 

IFS COMMITTEE HOLDS PUBLIC HEARING ON INSURANCE BILLS  

The Insurance and Financial Affairs Committee held a public hearing last week on a number of bills related to health insurance practices, including the ability of the Bureau of Insurance to review premium rates in the individual and small group markets, the size of the premium differential allowed for geographic, age and smoking status and the requirement that Maine's high risk reinsurance program operate publicly.   MMA's Andrew MacLean testified in favor of all 6 bills, LDs 83, 102, 161, 225, 681 and 1176.   The Committee will hold a work session this week on the bills, as well as on LD 1006, An Act To Clarify Transparency of Medical Provider Profiling Programs Used by Insurance Companies and Other Providers of Health Insurance.  

MMA SUPPORTS SEEKING ASSISTANCE IN OVERDOSE CASES 

Last Wednesday, the Criminal Justice and public safety Committee heard testimony regarding LD 1044, An Act to Amend the Laws Governing Prosecution of Individuals Possessing a Controlled Substance under Certain Circumstances.  The intent of the bill is to provide an incentive for those in the presence of someone who has overdosed to call 911 and stay with the individual by not using evidence derived as a result of seeking medical evidence to prosecute the person who sought help.  MMA's Gordon Smith testified in favor of the bill, along with MaineGeneral, the MCLU, and individuals who have been impacted by friends or family overdosing.  A district attorney opposed the bill and the Criminal Law Advisory Commission testified neither for nor against.  

ENVIRONMENT AND NATURAL RESOURCES COMMITTEE CONSIDERS CLIMATE CHANGE 

The Environment and Natural Resources Committee held a hearing last week on LD 825, a bill that would direct the Department of Environmental Protection to resume its study of climate change and adaptation.  The hearing drew a large number of proponents, including environmental organizations, individuals working with their towns to create climate adaptation plans, and climate experts.  Dr. Lani Graham testified in favor of the bill on behalf of the MMA, stating that the public health implications of climate change justify further study by the DEP. 

MMA OPPOSES BILL TO INVALIDATE AFFORDABLE CARE ACT   

The MMA testified last week in opposition to LD 680, which would ban state or federal officials located in Maine from implementing the Affordable Care Act.  The MMA emphasized that the Supreme Court has already found the ACA to be constitutional so state and federal employees are obligated to uphold the law.  Several citizens testified in favor of the bill and stated that if Maine does not believe the law is constitutional it has the authority to nullify the law. 

LABOR COMMITTEE KILLS BILL ON ALTERNATIVE TREATMENTS 

The Labor, Commerce, Research and Economic Development Committee held work session last week on LD 747, An Act To Protect Doctors Who Prescribe a Complementary Course of Treatment and To Provide Insurance Coverage for That Treatment. The bill provides that the Board of Licensure in Medicine may not bring disciplinary action against a physician who prescribes or provides medicine or treatment that is authorized for a complementary health care provider. The bill also requires such treatment to be covered under health insurance plans.  The Committee voted unanimously that the bill ought not to pass.  MMA opposed the bill.   [return to top]

MMA Legislative Committee Conference Call, Tuesday, April 9th, 8 p.m.

The MMA Legislative Committee weekly phone calls will continue tomorrow, Tuesday, April 2nd at 8 p.m..  They will be held every Tuesday at 8 pm through the session. 

Legislative Committee members and specialty society legislative liaisons are strongly encouraged to participate.  Any physician, practice manager, or other staff member who is interested in the MMA's legislative advocacy also is welcome to participate.  It is not necessary to RSVP for the calls.

NEW EDUCATIONAL SERIES "FREE CME" From Maine Center for Cancer Medicine

Maine Center for Cancer Medicine Presents Educational Lecture Series:  Screening & Treatment

4th Wednesday of Each Month (with exceptions), 6 PM – 7 PM

100 Campus Drive, Conference Room

Scarborough, Maine

Note: To attend the live presentation or join a lecture via Webex, contact Betsy Chase

at 207-396-7634 or chasee@mccm.org.

April 24, 2013:  Prostate, PSA Screening   Dr. Aronson

May 22, 2013:  Prostate, Treatment Update  Dr. Aronson

June 26, 2013:  Lung, Screening & Treatment Update  Dr. Thomas

July 24, 2013:  Breast, Screening Update  Dr. Weisberg

August 28, 2013:  Breast, Treatment Update  Dr. Weisberg

September 18, 2013:  GI Screening Update   Dr. Benton

October 23, 2013:  GI, Treatment Update   Dr. Dugan

November 13, 2013:  Melanoma Review and Update for the PCP   Dr. Aronson

December 18, 2013:  Palliative Care Review  Dr. Keating

January 22, 2014:  Brain, Screening and Treatment Dr. Evans

February 26, 2014:  Clinical Research Overview  Dr. Thomas

March 26, 2014:  Hematologic, Treatment Update  Dr. Ryan

FREE CME Credit Available

  [return to top]

Save the Dates: Prescription Drug Abuse Programs in Millinocket May 8 and Wells June 8

Watch your e-mail and the Weekly Update for two CME programs recently scheduled on the topic of pain management and prescription drug abuse.  With funding from the AMA and the state Office of Substance Abuse and Mental Health Services, MMA has put together an outstanding faculty for three hour programs in Millinocket and Wells.  The Millinocket program will be held May 8 from 6:00 pm to 9:00 pm at Pelletier's restaurant.  Dinner will be available at 5:30 pm.  The southern Maine program will be held at the Coastal House on Rt. 1 in Wells on Saturday morning, June 8 from 9:00 am to noon with a continental breakfast being available at 8:00 am.The cost per attendee is just $20 and three hours of category one CME is available.

Faculty for each programs will be announced shortly.

For questions, contact Gail Begin at gbegin@mainemed.com.

  [return to top]

Report on Today's Meeting of Dirigo Health Agency Board of Trustees

At today's regularly scheduled Board of Trustees meeting, members voted unanimously to recommend to the Legislature's Insurance and Financial Services Committee that the Maine Quality Forum be retained following the termination of the Agency in 2014 and that it reside within the Maine Health Data Organization.  The Forum is likely to be the beneficiary of some funds remaining in the DHA after January 1, 2014 and these funds could be used to staff projects of the Forum for a year or more.

The Maine Health Data Organization is expected to submit legislation in January 2014 that would reduce the size of the 21 member MHDO Board and restructure the governance of the Board.  This re-structuring has been discussed for a number of months and was one of the items recommended in the Final Report of the L.D. 1818 Task Force. [return to top]

Update on House SGR Framework

CMS Now Accepting 2014 ePrescribing Hardship Requests to Avoid Penalties

Physicians will receive a 2% penalty in 2014 if they do not meet the requirements of the Medicare ePrescribing (eRx) program this year, meet one of the limited exemption categories, or obtain approval for a hardship exemption.  From March 1st through June 30, 2013, CMS has re-opened the Quality Reporting Communication Support Page to allow physicians to request a hardship exemption for 2014.  Physicians who do not meet one of the exemption or hardship categories must:

Downeast Association of PAs Seeks Award Nominations

The Downeast Association of Physician Assistants is accepting nominations for 2013 awards! 

The three awards presented are:  the Robert J. Lapham Outstanding Service Award, the Outstanding Maine PA Award, & the Outstanding Health Care Professional Award.  

These awards are presented each year in recognition of outstanding service to the PA Profession and to the Downeast Association of Physician Assistants. Nominations are made to the Chair of the Awards Committee, who presents the names to the Board of Directors for final selection. The awards are presented at DEAPA’s Annual Meeting, held in the spring of each year. To make a nomination, visit our website by clicking on the following link:  DEAPA Professional Awards  where you will find descriptions of each award and where you can download a questionnaire/nomination form.  Complete the nomination form and email it to info@deapa.com or fax to 622-3332.

Please direct any questions to info@deapa.com.

DEADLINE: April 14, 2013 [return to top]

AMA Provides Resource on Medicare Sequester

All Medicare services provided by physicians are currently subject to a 2% payment cut under the budget sequestration.  As it stands now, the sequester will be in effect for nine years, unless Congress and the White House are able to reach a significant deficit reduction agreement that replaces it.  The AMA has developed a FAQ document to respond to questions regarding implementation of the sequester cut, as well as some related issues. You can find the AMA FAQ on the web here. [return to top]

Upcoming Events

Job Openings

ACADEMIC FEMALE, NEURO & RECONSTRUCTIVE UROLOGY OPPORTUNITY

University of Vermont - Burlington, Vermont

The Division of Urology at the University of Vermont College of Medicine in alliance with Fletcher Allen Health Care is seeking a board certified/board eligible Urologist to work at our free-standing, fully-equipped Continence Center.  The successful applicant must have completed a board approved Urology residency, be eligible for medical licensure in the State of Vermont and be eligible to work in the United States.  Advanced training in Female Urology, Neuro-Urology and Reconstructive Urology is preferred. Duties will include general urologic patient care opportunities aligned with the teaching of medical students and urology residents.  Candidates should have broad experience in all aspects of Urology.  This is a full-time, 12-month, salaried position with attending staff privileges at Fletcher Allen Health Care and possible leadership opportunity.  The academic appointment at the University of Vermont will be at the Assistant Professor or Associate Professor level (Clinical Scholar Pathway) and will be determined by the candidate’s background and experience.

The University is especially interested in candidates who can contribute to the diversity and excellence of the academic community through their research, teaching, and/or service. Applicants are requested to include in their cover letter information about how they will further this goal.  The University of Vermont is an Affirmative Action/Equal Opportunity Employer.  Applications from women and people of diverse racial, ethnic and cultural backgrounds are encouraged.  Applications will be accepted until the position is filled.

Interested individuals should submit their curriculum vitae with a cover letter and a list of four references electronically to:  Scott Perrapato (Scott.Perrapato@umv.edu) or apply on-line at:  https://www.uvmjobs.com.

4/8/13 

DFD Russell Medical Centers seeking NURSE PRACTITIONER / PHYSICIAN ASSISTANT

The DFD Russell Medical Centers (DFDRMC) operates three community health centers in central Maine.  We are looking for a full-time NP or a PA for immediate placement.  A current unencumbered Maine license and proficiency with electronic medical records are required.

Excellent benefits, including medical, dental and life insurance, 403(b) retirement plan, flexible spending accounts, a generous paid time off plan and incentive plan.  Salary is commensurate with experience.

We are an equal opportunity employer committed to diversity in the workplace.  If you want more information about this position, please fax or e-mail your resume to Laurie Kane-Lewis, CEO at Fax 524-2549 or E-mail laurie.kane-lewis@dfdrussell.org.

4/22/13 

PSYCHIATRIST, PSYCHIATRIC NURSE PRACTITIONER and/or PHYSICIAN ASSISTANT 

Assistance Plus is seeking two (2) full time psychiatrists, psychiatric nurse practitioners and/or physician assistants for the Medication Management Program in Benton and Wilton. The professional team is overseen by Robert Gordon, medical director. Our primary focus is to assist those with behavioral health disorders.

Applicant must be a graduate of an accredited degree program and licensed to practice in the State-of-Maine. A minimum of three years experience required.

We offer a generous benefit package of full coverage for health, dental, and 401K along with a sign on bonus of $5,000. This position is Monday through Friday and no on call coverage is required.

Please submit resume and cover letter to Jillian Jolicoeur 453-4708 ext 408 or email jjolicoeur@assistanceplus.com.

4/22/13 

DOCTOR SOUGHT (Full or Part-time)  in Falmouth, ME Practice

A progressive integrative medicine practice located in Falmouth, ME, is now hiring Doctors (MD or DO) for a full or part time position. This is a rare opportunity to break free of the limitations of the conventional medicine paradigm and begin a new, ideal practice. Are you tired of fast, poor quality patient interactions, stressful work environments, lack of autonomy in your practice, too much time dealing with insurance companies or frustrating EMR?  Imagine a practice where you can spend as much time as you want with each patient, establish real therapeutic relationships, work in a healing-oriented, emotionally mature, low-stress environment, learn new healing arts skills that actually help your patients, and customize your practice based on your own interests and strengths.

We offer competitive pay based upon experience level.  Compensation package include: hourly or daily rates, bonuses, health benefits, CME, and paid time off.   We see an exciting variety of conditions in patients that are motivated to heal, open minded, and deeply appreciative. Imagine a level of trust and rapport that reminds you why you chose to be in the medical field. Collaborate with practitioners of osteopathic manipulation, energy medicine, hypnotherapy, and more.  We take the time to learn from each other and from our patients for the mutual benefit of all involved.  Practitioners need to have genuine desire and experience in Integrative Medicine.  Examples would be trained in integrative medicine or other holistic modalities such as reiki, acupuncture, supplementation, hypnotherapy and other modalities.  Primary/Family care experience would be plus. We are growing and need full or part time, MD’s and DO’s statewide.

If you are interested in learning more, please send a cover letter and copy of your curriculum vitae to brad@Integr8Health.com.

4/22/13  

CHIEF OPERATIONS OFFICER Sought - Katahdin Valley Health Center

Katahdin Valley Health Center located in the heart of the Katahdin Region announces our search for a new Chief Operations Officer.  The incumbent will report to the Chief Executive Officer and oversee the day to day operations of this group of Federally Qualified Health Centers.  With an $8 million operating budget, 4 clinics, and a strong commitment of providing access to quality health care, KVHC offers an exceptional opportunity for a seasoned executive.  The KVHC Administrative office is located in Patten, ME.  The Katahdin Region is a recreational paradise with trout fishing, skiing, snowmobiling, and more than 2,000 lakes, streams and ponds.

Successful candidates will have demonstrated experience leading a Health Care management team, working knowledge of a federally qualified health center and experience working with regulatory agencies.  Core competency in financial operations, grant writing/management, provider relations and strategic planning are desired.   Minimum Qualifications:  Bachelor’s Degree or equivalent in years of experience in a health care setting, management experience, provider relations experience, excellent communication skills, working knowledge of Microsoft Office products, experience with an Electronic Medical Records system, and 2 years in an executive leadership position.  

Qualified candidates should submit a CV with cover letter to mlefay@kvhc.org or mail to KVHC, P O Box 500, Patten ME 04765 – Attention: Human Resources.  KVHC is an equal opportunity employer.

5/6/13