April 22, 2013

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MMA is 160 Years Old this Week. Help Celebrate on Oct. 5, 2013

The Maine Medical Association was founded on April 28, 1853 when 27 physicians met at the Tontine Hotel in Brunswick for the purpose of promoting medical science and the regulation of the practice of medicine and surgery in the state.  Mark your calenders now to join MMA in recognizing its 160th anniversary year at a Gala celebration in Portland on Oct. 5 as part of the Annual Session.

While there were local medical clubs in Maine as early as 1791, the first statewide organization of Maine physicians, called the Medical Society of Maine, was inaugurated with Dr. Samuel Emerson of Kennebunk as President in 1820.  The Society met several times throughout the next twenty five years but ceased to meet after 1845.  Poor roads and difficult travel were cited as the major reason for the demise of the Society.

But within another decade, leadership again emerged resulting in the foundation of what is now known as the Maine Medical Association.  At the meeting in Brunswick on April 28, 1853, James McKeen, M.D. of Topsham was chosen as chairman and John D. Lincoln, M.D. Secretary. Isaac Lincoln, M.D. was chosen to serve as President until the time of the first Annual Meeting which was held on June 9, 1853 in Augusta.  In its first year, the membership of the Association consisted of 82 physicians.

On April 28, 2003, a commemorative plaque was placed at the location of the former Tontine Hotel in Brunswick recognizing the twenty-seven physicians who had founded the association 150 years before.  Members are encouraged to view the plaque which sits atop a granite marker at in front of what is now known as the Tontine Mall in Brunswick.

Similar to the Sesquicentennial celebration a decade ago, MMA will hold an anniversary gala in Portland as part of the 2013 Annual Session.  A reception will be held at the Portland Museum of Art on Saturday evening, Oct. 5 at 5:45pm followed by dinner and dancing at the Holiday Inn by the Bay. Registration materials for the Annual Session will be included with your next issue of Maine Medicine and formal invitations to the Gala will be sent to each MMA member over the summer.  Registration to both will also be available on the website at www.mainemed.com.

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 15th.  It was a relatively quiet week at the State House due to school vacation week and the House and Senate did not meet for sessions on the Floor.  However, several Committees did keep busy.   


Last week, the Health and Human Services Committee took final votes on their recommendations to the Appropriations committee about funding for DHHS portions of the biennial state budget.  Many of the votes on more controversial items split along party lines.  For example, in a 7-5 vote, the Committee recommended against proposed Critical Access Hospital rate cuts and recommended to "table" a reimbursement cut for outpatient services for the Appropriations Committee to take up.  The minority Republicans voted for an amended version of both cuts. Other items followed by MMA include savings budgeted for MaineCare redesign efforts (supported by the Committee), eliminating the Drugs for the Elderly Program (opposed 7-5) and changes to MaineCare paying for "bed hold" days in nursing homes when residents are hospitalized (opposed unanimously by the Committee).  The Committee is scheduled to report their recommendations to the Appropriations Committee today and the Appropriations Committee will begin their work sessions on budget in earnest this week after all Committees have reported back to them.  The Legislature has until June 30 to pass a budget. To avoid a state-government shutdown, the spending plan would have to garner support from at least two-thirds of the Legislature. 


While many other Committees took the week off, the Labor, Commerce, Research and Economic Development Committee kept up a steady pace and held a number of public hearings of interest to the MMA.  

On Tuesday, they held a hearing on LD 1368, regarding boxing regulations in the state.  The bill proposed to reinstate old regulations governing the practice of boxing in Maine since the newly created Mixed Martial Art Authority has been charged with creating new rules but has not yet finalized them.  MMA was monitoring the bill and had opposed the creation of the Mixed Martial Art Authority several years ago. 

On Thursday, the Committee held several hearing regarding regulating health professionals.  They first took up LD 1196, an MMA bill that will modify the residency training requirements in the laws governing medical licenses to allow certain oral surgeons to now qualify for a medical license.  The license would be limited to the practice of oral and maxillofacial surgery.   The MMA, Maine Dental Association, Mark Jacobsen, DMD, MD, and Greg Sarka, DDS, MD, testified in favor of the measure.  The Board of Licensure in Medicine testified in opposition to the bill but is open to finding a solution that will allow duel-trained oral surgeons to receive a medical license. 

Thursday afternoon the Committee took up bills to require mental health professionals to have training in domestic violence (LD 1238) and license recreational therapists (LD 1281), both bills monitored by MMA, before moving on to a hearing on LD 1310, a bill that would change the composition of the Dental Board.  The bill would reduce the number of dentists on the board and would have positions for two dentists, two dental hygienists, two denturists and three representatives of the public. Much of the work would be done by subcommittees for each profession.  MMA EVP Gordon Smith, Esq., testified on behalf of MMA in opposition to the proposal, stating that it would set a bad precedent for licensing boards and would negatively impact the relationship between the Medical Professionals Health Program and the board. [return to top]

MMA Legislative Committee Conference Call, Tuesday, April 23rd, 8 p.m.

The MMA Legislative Committee weekly phone calls will continue tomorrow, Tuesday, April 23rd 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.

Please use the following conference call number and passcode.  These will remain the same for every weekly call during the session:

Conference call number:  1-877-669-3239

Passcode:  23045263

The following are bills of interest to the physician community printed last week.  We will discuss the priority bills marked with an asterisk (*) first:

LD 1417, An Act To Amend the Laws Governing Certain Human Services Licensing and Certification Requirements (monitor; pediatricians, psychiatrists)

LD 1423, An Act To Amend the Medical Marijuana Law Regarding Excess Harvested Marijuana (monitor)

LD 1429, An Act To Allow School Administrative Units To Establish Rules, Procedures and Guidelines for Properly Trained Staff To Carry a Concealed Handgun on School Property while Acting in Their Official Capacities (monitor; Public Health Committee)

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Physicians's Day at the Legislature Update

We are sorry to report that we are unable to reschedule Physicians' Day at the Legislature for 2013.  It has not been for lack of effort, but as many of you know, it is very difficult to schedule a date this late in the session.  We will attempt to schedule a date in  February or March 2014, early in the session when there will be a lot of "hot" issues to discuss with legislators.  Thank you for supporting the event and we sincerely hope that you will be able to join us in 2014! 

For those of you wanting to be more involved with legislative activities, there are still dates available for serving as Doctor of the Day at the Legislature in May and June.  Please contact Maureen Elwell at melwell@mainemed.com if you are interested and available. And any interested member is welcome to join the legislative committee on the weekly conference calls at 8:00pm every Tuesday evening. The call in number is available in the adjacent article on this week's legislation. [return to top]

Diversion Alert Program to Debut Statewide

In response to increasing numbers of prescription drug addiction in Maine, the Diversion Alert Program will be made available to all prescribers and pharmacists in Maine in June 2013. 

Diversion Alert is a statewide program for medical professionals that:

  1. alerts health care providers to patients arrested for diverting or abusing prescriptions; 
  2. provides an online, password protected arrest database; and
  3. provides educational resources to assist in responding to patients arrested or charged with illegally diverting prescriptions. 

Diversion Alert is a free program made available through funding from the Maine Attorney General’s Office. Licensed prescribers, pharmacists or their designated representatives can register to receive monthly alerts via mail or email and access a 24/7 online arrest database that provides a six-month historical record of arrests submitted to Diversion Alert by Maine law enforcement agencies. 

Since Diversion Alert was initiated in Aroostook County in 2009, numerous medical providers have been surprised to discover patients they thought they knew very well in a Diversion Alert monthly installment. Patients who are abusing or diverting prescriptions, though in need of professional help, all too often take up a significant portion of a provider’s office time. Diversion Alert data will identify both patients who may be in need of substance abuse treatment and patients who may be drug-seeking for the purpose of diversion. 

To register to receive Diversion Alert, visit diversionalert.org. If you have questions about the program, call Clare at 521-2408 or email clare@diversionalert.org[return to top]

Another Drug Take-Back Day this Saturday, April 27

Local police departments in many communities across the state will participate in another nationwide drug take-back day this Saturday, April 27.  Law enforcement officials will receive unused, unwanted and expired prescription drugs for safe disposal, with no questions asked.  The collection will be held from 10:00am to 2:00pm.  For more information, visit the Department of Justice website. [return to top]

Medicaid Primary Care Payment Increase - Physician Self-Attestation

As reported in previous issues of the Update, the Office MaineCare Services (OMS) is implementing Section 1202 of the Affordable Care Act,  which requires Medicaid programs to pay for select primary care services and vaccine administration at rates equal to Medicare for 2013 and 2014.  

To receive the payment increase, however, physicians must act.  Each qualifying physician must complete and submit a Self Attestation form. By completing the form, providers attest that s/he meets the criteria established by the ACA – specifically, that:

  • they are appropriately Board certified; OR 
  • that 60 percent of their Medicaid claims are for evaluation and management (E&M) and vaccine administration codes as specified in the federal rule.  

The Self-Attestation form can be found here (downloadable Word document) and provides detail on each of the above criteria.

Provider files will be updated once OMS has approved your form, and OMS will send you a confirmation via email. Please note that the increase will not occur until OMS has approved your form, and that payments will be retroactive to 1/01/13. 

If you have any questions, please contact Donna Sutter at OMS at (207) 629-4280.

The Centers for Medicare and Medicaid Services (CMS) has also issued a series of Q&As about the payment increase, including which specialties and subspecialties qualify. [return to top]

Accept Federal Funds for Maine’s Health - Action Needed

As a member of the Cover Maine Now! coalition, the Maine Medical Association has been working to bring new federal funds to Maine to cover tens of thousands of uninsured Mainers.  

Accepting these federal dollars, which have already been set aside to cover Maine’s uninsured, will benefit all Maine people and boost Maine’s economy.  

You can help our efforts by signing a petition to your state legislators.  The legislature is considering a plan to accept federal funds, and they need to know that you support it.  

Please send a message to your legislators today. 

Accepting federal funds will save lives and save money.  Please help us keep the momentum going!

Urge your legislators to support accepting the federal money.  

To learn more about our efforts, visit Cover Maine Now. [return to top]

Framework to Repeal SGR Continues to Take Shape

About two weeks ago, the House Ways and Means Committee and the Energy and Commerce Committee majority (Republican) staff circulated a second draft of a joint framework for repealing the SGR.   The American Medical Association (AMA) prepared written comments on that second draft and MMA staff participated in a conference call this past week with the AMA Washington D.C. office to get up to date on this perennial but nonetheless critical topic.

The committees’ proposal continues to be generally consistent with the principles the AMA and over 100 state medical societies and national specialty organizations sent to Congress last Fall.  It promotes a diversity of new payment and delivery reform models, modifies but still preserves fee-for-service, and maintains the medical profession’s leadership role in developing quality measures and data reporting systems.  It would immediately repeal the SGR, provide for several years of payment stability with statutorily set fee schedule updates, and provide options for physicians remaining in fee-for-service.  Physicians who participate in robust new payment and delivery models would be exempt from the quality reporting programs required in fee-for-service.

The written outline provided by the committees omits some important details, however, including specific information about base payment rates and the structure of the quality incentive program.

 Key points made by the AMA in its 20-page comment letter include the following:

  • The stable and predictable payment rates provided in the first phase of the proposal must also provide the foundation for the modified fee-for-service plan that is envisioned.  Resources required to implement redesigns of care are significant, and negative incentives impede the practice investments that are required.
  • Value-based payments should be funded with “new” money and not be calculated on a budget neutral basis within the Medicare physician payment system.
  • Participation burdens for physicians need to be streamlined and simplified.
  • Physicians should be able to choose whether their performance incentive payments are based on a comparison with their own past performance or on their performance relative to peers.  Participation in clinical improvement activities such as specialty-developed data registries in lieu of quality reporting should also qualify for incentive payments.
  • The alternative payment and delivery models that would exempt physicians from meeting the performance requirements imposed on the new fee-for-service system should include new models developed by physicians, including more incremental models that focus on specific conditions and disease management.

At this stage, the House proposal is best viewed as a framework, rather than a detailed plan for eliminating the SGR and transitioning to a new payment system.   Nonetheless, the AMA views the committees’ work as a very positive development.  This is the second document that has been circulated.  This focused attention on the Medicare physician payment system so early in the year, combined with the effort to solicit comments directly from physician groups, is encouraging.  And, conceptually at least, the framework that is offered appears highly consistent with the principles that Federation groups endorsed last fall. [return to top]

Medicare Enrollment Referring/Ordering Deadline, May 1

As you are probably aware, Medicare is preparing to go live on May 1 with the referring / ordering edits that will result in claims denials unless the referring / ordering physician or other health care provider is enrolled in Medicare (or has a valid opt-out affidavit on file with their local Medicare contractor).  To be clear, it is the billing provider’s claim that is at risk of being denied.  The American Medical Association was instrumental in securing a delay in the implementation of this policy (which was originally scheduled to go into effect in 2010) so that physicians had sufficient time to enroll (or file a valid opt-out affidavit).   The AMA, together with MGMA, have prepared a fact sheet / FAQs which you may find helpful.  To find the fact sheet and for more information on Medicare enrollment please visit the AMA website at http://www.ama-assn.org/go/medicareenrollment. [return to top]

Faculty Announced for 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 in Millinocket includes Tamas Peredy, M.D. of the Northern New England Poison Center, Kevin Flanigan, M.D., MaineCare Medical Director, David Dumont, M.D. representing the Maine Board of Licensure in Medicine, Gordon Smith, Esq, from MMA and a representative of the Prescription Monitoring Program.  

Faculty in Wells includes Cyrus Jordan, M.D, MPH, Director, Vermont Medical Society Education and Research Foundation, Kevin Flanigan, M.D., MaineCare Medical Director, Noel Genova, PA-C of the Chronic Pain Project, Gordon Smith, Esq., from MMA and a representative of the Prescription Monitoring Program.

Additional faculty may be added.

For questions, contact Gail Begin at gbegin@mainemed.com. [return to top]

Webinar to Help Doctors Prepare for Sunshine Act, April 24

An AMA webinar April 24 will help physicians get ready for a forthcoming database that will report payments and other "transfers of value" physicians receive from drug and medical device manufacturers to the public. Register today.

Under the Physician Payment Sunshine Act, manufacturers of drugs, devices and biologicals covered by federal health care programs are required to report any payments and transfers of value they make to physicians and teaching hospitals beginning Aug. 1.

In addition, any ownership or investment interests physicians or their family members have in the manufacturers or group purchasing organizations must be disclosed to the Centers for Medicare & Medicaid Services (CMS). Most of the information will be posted in a public online database to be launched by Sept. 30, 2014.

Participants in the AMA webinar, offered at 7 p.m. Eastern time April 24, will learn which financial exchanges and ownership interests must be reported, steps they can take now to prepare for public disclosure of this information, and ways they will be able to challenge false, inaccurate or misleading reports.

Presenters also will discuss which types of information are excluded from reporting, such as certified and accredited continuing medical education activities funded by manufacturers and product samples intended for patient use.

Given the importance of this topic to all physicians, the AMA is offering this webinar free of charge to both AMA members and non-members.

Visit the AMA's Sunshine Act Web page to learn more about the requirements of the new law, key dates and answers to frequently asked questions. [return to top]

Upcoming Events

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

FREE CME Credit Available

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


You are cordially invited to attend a MedImmune Speaker Program on: 

FluMist Quadrivalent (Influenza Vaccine Line, Intranasal) 

Tuesday, April 30, 2013 

6:00 pm 

DiMillo's Floating Restaurant, 25 Long Wharf, Portland 

Speaker: Michael Marcus, MD, Dir. of Allergy/Immunology and Ped. Pulmonology, Maimonides Medical CEnter, Staten Island, NY 

Please rsvp by April 25 to demersL@medimmune.com or 508-341-2709. 


AMDA Maine State Chapter 2013 Medication Safety Conference 

May 17, 2013

11:30 am - 3 pm 

DiMillo’s Floating Restaurant

25 Long Warf Portland, ME 

No cost to Healthcare Professionals

Topics include reducing adverse drug events related to Coumadin and practical approaches to reducing antipsychotic use in dementia. 

Attendees may registration online at www.mainemda.com or by contacting Tammy Wing directly at (207) 780-6565 or email thewitt@mainegeriatrics.com


Advancing Change:  Healthcare System Transformation in Northern New England 

Keynote Speaker:  Jay Want, MD, Center for Improving Value in Health Care

May 21, 2013

8:00 am - 5:00 pm

University of New Hampshire, 75 Main Street, Durham, NH

For more information or to register, click here


Save the Date: Enhancing Healthcare for Persons with Intellectual Disabilities

June 11, 2013

Holiday Inn by the Bay, Portland

This one-day program will provide information valuable for improving clinical and systemic capabilities for the effective delivery of healthcare to persons with intellectual disabilities.

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Job Openings


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.



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.


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.


FAMILY PRACTICE PHYSICIANS Sought - Katahdin Valley Health Center

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 Patten 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.


INTERNIST - Coastal Maine

Seeking a BC/BE Internist to join a Mid Coast Medical Group practice of seven internists in Bath, Maine.  Mid Coast Medical Group is a department of Mid Coast Hospital and is a NCQA-qualified Patient Centered Medical Home.  It practices high quality internal medicine supported by an excellent EMR.  Our "outpatient only” call is 1 in 7.

Bath is a beautiful, small, historic city on the coast of Maine.  Nearby Mid Coast Hospital, built in 2001, is the newest full-service, stand-alone hospital in New England.  Mid Coast Hospital combines the newest medical technology with skilled medical professionals and Maine’s natural beauty, to meet the psychological as well as the physiological  healing needs of their patients.

This 92-bed hospital has an active medical staff of 160 physicians serving a population of 90,000 area residents.

Mid Coast offers a competitive benefits and compensation package and an excellent work environment.

Contact Jill Rose, Physician Recruiter, at jrose@midcoasthealth.com or call (207) 373-6888.


Emergency Department PA

Full time summer position, mid-May to mid-October.  Emergency Department practitioner.  Primary duties are direct patient care in the emergency room setting; diagnosis and treatment; meeting with physician supervisor in a timely manner.  Graduate of approved Physician Assistant's program.  Certification in BLS, ACLS, PALS, and ATLS or equivalent.   Current Maine licensure.  Medical Practice maturity as evidenced by at least two years of mid-level practitioner experience within an emergency department setting or by completion of an ER specific residency training program.

For more information or to apply please visit us at http://www.mdihospital.org or contact Charlotte Skiff at 207-288-5081, ext. 1165 or Charlotte.Skiff@mdihospital.org


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