June 3, 2013

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POLITICAL PULSE: Calls Needed on Important Health Care and Public Health Legislation

Please read the article below to get up to speed on what is going on today at the State House.  Issues of critical importance to healthcare in Maine, including payment of the huge hospital debt owed by MaineCare, expansion of MaineCare with ACA dollars, informed consent in treatment of Lyme disease and childhood vaccinations are all being dealt with presently as the First Regular Session heads for its scheduled adjournment date of June 19th.


The bulk of the action at the state house has now moved from committees to the floor of the House and Senate.  Several bills of importance to the MMA were up for debate this week and continue to be in play.  This is the time when it is extremely important for legislators to hear from physicians on these issues.  


As expected, last week, the legislature sustained the Governor's veto of L.D. 1546, An Act to Strengthen Maine's Hospitals, Increase Access to Health Care and Provide for a new Spirits Contract, a bill combining payment of the hospital MaineCare debt and the MaineCare expansion provided for in the Affordable Care Act.  Following this action, the Health and Human Services Committee held a brief work session on LD 1066, the original bill introduced to provide health care through the MaineCare program, and voted 10-4 to pass the bill out of Committee.  The original language of the bill has been updated to reflect changes that were made in the Veteran's and Legal Affairs committee to LD 1546, such as creating study groups to review the fiscal impact of the coverage and making the coverage contingent on the federal government paying Maine the match rate stated in the ACA (100% for three years going down to 90% over time).  Passage of the MaineCare expansion will clear the way for payment of the substantial hospital debt, a critical issue for Maine's hospitals and physicians alike.  After a lengthy debate this morning, the House voted 89-51 in favor of LD 1066.  The majority vote included five Republicans:  Rep. Carol McElwee (R-Caribou), Rep. Jarrod Crockett (R-Bethel), Rep. Thomas Tyler (R-Windham), Rep. Windol Weaver (R-York), and Rep. Sharri MacDonald (R-Old Orchard Beach).

The time has come to communicate with your legislators about the importance of getting these priority items passed.  You can leave a message for your Senator at 287-1540 or toll free at 1-800-423-6900 and for your State Representative at 287-1400 or toll free at 1-800-423-2900.  The priority for Monday is to reach members of the House but the bill will soon be moving to the Senate. 

If you do not know who your Senator or Representative is, contact Maureen Elwell at MMA at 622-3374 ext. 219 or via e-mail to melwell@mainemed.com.  While calls are encouraged to all legislators, if you have questions about the key targets for calls on this bill or the items listed below, contact Jessa Barnard at jbarnard@mainemed.com


LD 597, An Act To Inform Persons of the Options for the Treatment of Lyme Disease, hit the Senate floor this week.  It passed out of Committee with a 12-1 vote and passed the House 122-18 two weeks ago.  However, the bill is very problematic for several reasons.  It would require physicians to inform patients every time they order a laboratory test for the presence of Lyme disease that a negative result for a Lyme disease test does not necessarily mean that Lyme disease is not present.  Further, it requires the Maine CDC to link from their website to the websites of several advocacy organizations that promote long-term antibiotic use for treating "chronic Lyme disease."   Many Senators opposed the requirement that physicians use a scripted disclosure for every Lyme disease test and the MMA and MCLU worked very hard to oppose the bill in the Senate.  Last Thursday night, the Senate approved the bill with a 19-17 vote.  The bill moves back to the House where several legislators are working on amendments to remove the scripting and address the website links.  MMA members are encouraged to reach out to both their Representatives and Senators to urge them to oppose LD 597. 


LD 754 is an anti-vaccine bill that would require physicians to disclose the ingredients in vaccines every time they provide a vaccine, as well as require clinicians to inform parents of their right to opt out of school vaccination requirements.  While a majority of the HHS Committee had voted that the bill ought not to pass, in a surprise vote last week, the House voted 81-62 in favor of the bill.  MMA, AAP, MaineHealth and others worked to educate Senators about the issue and the Senate voted 25-9 against the bill.  However, the bill still faces further votes in the House and the Senate next week.  MMA members are encouraged to reach out to their legislators to urge them to oppose LD 754.  

MMA Legislative Committee Conference Call, Tuesday, June 4th, 8 p.m.

**PLEASE TAKE NOTICE - THE CALL IN NUMBER HAS CHANGED (due to technical difficulties)**

The MMA Legislative Committee weekly phone calls will continue tomorrow, Tuesday, June 4th 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:  1-877-668-4493  NOTE THAT THIS IS A NEW CALL IN NUMBER

Passcode:  23045263

No new bills of interest to MMA were printed last week, but we will update participants on the latest action at the State House.

In particular, we will continue a discussion from last week on issues regarding L.D. 171An Act To Facilitate the Licensing of International Mail Order Prescription Pharmacies by the Maine Board of Pharmacy.  Look for additional information on this bill attached to the reminder email from Maureen Elwell tomorrow.

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Last Chance to Register for CME Progran on Preventing Prescription Drug Abuse, June 8 in Wells

MMA is presenting a three hour CME program on prescription drug abuse on Saturday morning, June 8, 2013 in Wells.  The program begins at 9:00am and is being held at The Coastal House on Rt. 1 in Wells.  Faculty includes Cyrus Jordan, M.D., Noel Genova, PA-C, MaineCare Medical Director Kevin Flanigan, M.D., Enriko Farmsworth of the Prescription Monitoring Program and Gordon Smith, Esq.  

The cost of the program is just $20 and registration is available on the MMA website at www.mainemed.com or by calling 622-3374.  You may also e-mail your intention to attend to Ashley Bernier at abernier@mainemed.com and simply pay at the door.

Breakfast refreshments will be available prior to the program beginning at 8:30 am.


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Important Announcement from MaineCare on ACA's Enhanced Reimbursement for Primary Care - New Attestation form Required

Included below are important updates related to the 2013/2014 Primary Care payment increase, which was effective January 1, 2013.

The Centers for Medicare and Medicaid Services (CMS) has informed the Office of MaineCare Services (OMS) that the enhanced rates OMS had set are too high, and OMS will need to decrease the rates.

Effective Wednesday, May 29, 2013, claims will pay at these lower, corrected rates. Claims paid from January 1, 2013 through Tuesday, May 28, 2013 will be reprocessed. This reprocessing will begin the first week in June.

Next, CMS has also asked OMS to update the self-attestation form. Providers who have already attested must re-attest using the new form, which is available online at www.maine.gov/dhhs/oms/pdfs_doc/news/2013-14_PCP_Increase.doc, along with instructions.  Please complete and submit the revised form by June 30, 2013.

Please note that, although our previous attestation process permitted PAs and APRNs practicing under the supervision of a qualifying physician to attest on their own behalf, CMS has said that the supervising physician must do the attestation on behalf of any PAs and APRNs that they supervise and are responsible for.

Lastly, CMS has informed OMS that hospitals – specifically provider specialty 062 (Hospital Based Professionals) – are NOT eligible for the increase (due to the fact that MaineCare cost-settles hospital-based physicians), so there is no need for hospital-based providers to attest.  The Department will send a separate communication to hospitals informing them of the timing to reprocess claims that were inappropriately paid at the enhanced rate.

Thank you for your patience and OMS apologizes for any inconvenience this has caused. If you have any questions, please contact Provider Services at: 1-866-690-5585. [return to top]

Coming this Friday - Let MMA Train Your Staff on NEW HIPAA/HITECH Provisions

The June 7 First Friday educational session, offered both on site and through webex features the Annual HIPAA Update.  This year's Update is particularly important as the final HITECH rules are enforceable as of Sept. 23, 2013.  Registration is available at www.mainemed.com.  THE WEBEX SITES ARE NOW FULL (25) BUT SPOTS ARE STILL AVAILABLE FOR PEOPLE TO ATTEND AT THE OFFICE IN MANCHESTER.

The program runs from 9:00 am to noon and the faculty includes Stacey Mondshein Katz, Esq. and MMA attorneys Gordon Smith, Andrew MacLean, and Jessa Barnard.

MMA's updated model forms, including the Notice of Privacy Practices and the Business Associate Agreement will be distributed at the program. [return to top]

Last Day to Register for June 10 ACO Forum for Primary Care Providers

Accountable Care Organizations Educational Forum

June 10, 2013

Guest speaker: John Freedman, MD, MBA

Hilton Garden Inn, Freeport

6:00 buffet dinner, 6:30-8:30 presentation and discussion

With generous support from the Maine Health Access Foundation, the Maine Medical Association is pleased to offer an educational forum with John Freedman, MD, MBA. He will be discussing the emerging role of accountable care organizations (ACOs).  This event will be targeted toward primary care providers, particularly those in independent practice seeking to better understand the potential impacts of payment reform models such as ACOs.          

John Freedman is Principal at Freedman HealthCare in Newton, MA and has 20 years' experience in systems management, managed care, health care quality measurement and quality improvement, clinical laboratory development, health economics, and medical informatics. His experience comes from leadership roles at nationally recognized organizations, such as Kaiser Permanente, Tufts Health Plan, MA Health Quality Partners, Focused Medical Analytics, and the MA Quality and Cost Council. 

If you are a physician and would like to participate in this event, please reply to Jennifer Reck at jreck@mainemed.com, including notice of any dietary restrictions, by today, June 3.  There is no cost to attend. [return to top]

Energy and Commerce Committee Releases Draft Legislation to Repeal SGR

The Energy and Commerce Committee Republicans unveiled draft legislation on May 28 that would repeal the sustainable growth rate (SGR) formula and replace it with a new system for determining Medicare physician payments. The release of this draft, which is still missing important details, represents the most recent step to ensure a transparent process and seek stakeholder input on how to reform and improve the current Medicare payment system. 

Building off a framework released this spring, the legislation would eliminate the SGR and replace it with a modified fee-for-service system with an emphasis on improving quality and outcomes through performance measures, while also providing means for physicians to participate in alternative payment models. The Committee requested feedback on its legislative draft by June 10. In addition, the committee’s Subcommittee on Health is holding a June 5th hearing on the draft.  [return to top]

BDN on Hospital Consolidations, Costs and Access to Care in Maine

The Bangor Daily News (BDN) recently examined hospital consolidations, health care costs and access to care in Maine.  The BDN’s Jackie Farwell reported that a string of mergers has left 18 of the state’s 38 acute-care and psychiatric hospitals affiliated with the two largest hospital systems, EMHS and MaineHealth.  80% of primary care doctors in Maine are currently affiliated with a hospital system or a federally supported community health centers. Independent providers find themselves at a relative financial disadvantage because Medicare reimbursement rates are higher, sometimes even double, for care performed in hospitals.  Some experts fear consolidation will bring higher costs, while others emphasize large hospital system’s ability to control costs by redesigning how care is delivered and reimbursed.

Click here to read the full text of the article. [return to top]

Maine Attorney General Janet T. Mills Warns of Imposter "Life Alert" Scam Targeting Elders

Maine Attorney General Janet T. Mills is warning Maine elders to be wary of a phone scam in which the callers lead you to believe they are eligible for a free life alert or medical alert device product and then ask for sensitive, personal financial information. Life Alert is well-known for their tag line of "Help, I've fallen and I can't get up."

"Seniors should always be wary of anyone calling them to tell them that they are eligible for free products in exchange for their personal information," said Attorney General Mills. "Legitimate companies do not operate like this. This scam is particularly insidious because it trades on the well-known brand of Life Alert which is intended for very vulnerable senior citizens."

The company that produces the real Life Alert product has filed a lawsuit against those who have been impersonating Life Alert through scam phone calls, and lying and manipulating seniors into providing personal and financial information. The named defendants include LifeWatch Inc. and Connect America. com, LLC (aka Medical Alert), two companies that purport to be legitimate providers of personal emergency response systems.

Attorney General Mills said that the Consumer Protection Division of the Attorney General's Office has received numerous complaints from Maine seniors about the Life Alert product scam. If any Maine Seniors believe they have been a target of this scam, they should call the Consumer Protection Division: 1-800-436-2131 or email: consumer.mediation@Maine.gov. [return to top]

Upcoming Events

AMA Health IT Webinar: Advancing Interoperability through Meaningful Use: A Refresher Course

Thursday, June 6

12:30-1:30 pm

  You can register here.  

Also, the AMA has a website devoted to Meaningful Use which can be found at www.ama-assn.org/go/meaningfuluse


Maine Concussion Management Initiative Concussion Training

Friday, June 14

7:30 a.m. - noon

Colby College

Covers two levels of training: An Introduction to Concussions and Concussion Management or Interpreting Neurocognitive Testing

For more information or to register, click here


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

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


What Health Care Providers Can Do to Address the Needs of Returning Veterans and Their Families 

July 16th, 2013

8:00 am—12:00 pm

Hannaford Lecture Hall, College of Pharmacy. University of New England

Register Online

This training, part of a national educational campaign aimed at civilian healthcare professionals, will enable these community providers to use their current clinical skills to provide culturally appropriate treatment to service members and their families.


Save the Date: 

Maine Public Health Association 29th Annual Meeting 

October 22, 2013 

8:30 am - 4 pm 

Augusta Civic Center 

For more information, click here. 

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Job Openings

Facilitator/Professional Development Trainer 

The Daniel Hanley Center for Health Leadership is seeking a half-time facilitator/professional development trainer to begin work this summer in Portland. Please see below for more details on the position. 

Overview: Facilitation & Training Professional is a half-time position, reporting to the Associate Executive Director, responsible for provision of facilitation, professional development training programs in Hanley programs and other activities, and participating in evaluation of existing and potential programs.

Position Responsibilities:

  • Physician Executive Leadership Institute Foundational Program On-Site Facilitation - Serve as site facilitator, including planning and preparation, on site facilitation, debriefs, executive coaching during the on-site day, project oversight with On-site physician leader, and follow up.
  • Training of other PELI Foundational Program On-Site Facilitators- Advise and support for other designated Site Facilitators as they work with their respective sites.
  • Design, revise, update curriculum, and participate in evaluation of PELI Program Foundational Curricula to ensure that course content continues to supports overall learning objectives, in conjunction with the Executive Director and Associate Executive Director and other identified stakeholders.
  •  Health Leadership Development Program Facilitation – Collaborate in the facilitation, including planning, preparation, and follow up, for Health Leadership Development program.
  • Serve as a facilitation resource for Hanley Stakeholder Engagement activities as needed.
  •  Plan, design, and develop new programs and curriculum to meet emerging health leadership needs, in conjunction with the Executive Director and Associate Executive Director.Design, develop curricula, and provide professional development skills training as needed for various Hanley programs.
  • Provide consulting services as requested for healthcare organizations and providers.


  • Advanced degree in organizational development, human relations, organizational psychology, professional development education/training, business, or related field
  • At least five years of extensive experience in facilitation and curriculum development of professional development programming required; experience with physician and/or health care providers and business preferred
  •  Proficient spoken and written English, outstanding verbal, written, and presentation skills
  • Highly adaptable and flexible
  • Punctual, meticulous, and reliable
  • Strong interpersonal skills
  • Proven ability to lead by example and foster productive, effective professional relationships
  • Certified or willing to become certified to deliver Myers Briggs Type Instrument required, proficiency & certification as appropriate in delivery of other personality/type/ assessment tools
  •  Experience in executive coaching required; Certification in executive coaching preferred
  • Strong Professional references (at least two)

Position is half-time with the potential to become full time. Overnight travel is required up to 3 times monthly. Ability to work a flexible schedule including evenings and periodic weekends is required. Brief cover letter, resume and contact information for 2-3 references should be emailed no later than 5 p.m. Monday, June 3, 2013 to jobs@hanleyleadership.org.


Behavioral Health Consultant

Sacopee Valley Health Center is seeking a full time LCSW to join our Medical Team as the Behavioral Health Consultant.  This position involves working with patients in a busy integrated primary care setting to more effectively manage the behavioral aspects of their physical/mental illnesses and/or chronic medical conditions.

Applicant must possess valid State of Maine license or be license eligible.  Experience in a health care setting preferred.  Anticipated start date for this position:  June 3, 2013.

Send resume to info@svhc.org or mail to:  Human Resources Coordinator, Sacopee Valley Health Center, P.O. Box 777, Parsonsfield, ME 04047.  Sacopee Valley Health Center is an equal opportunity provider and employer.


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.  


Physician Needed – Portland, Maine

Do you want to work in a fun office?  Do you want to help people positively change their lives?  Would you like to treat only grateful patients?  Tired of the hassles of running a practice? Dealing with insurance?  Non-compliant patients?

We are an active, growing practice of Obesity Medicine in Portland. Since 2009, we have had tremendous success in helping people regain control over their health, getting off of anti-hypertensives and reigning in their metabolic problems.  We practice according to the guidelines of the American Society of Bariatric Medicine, using scientifically validated principles.  Our team is seeking a physician with a positive personality and attitude to ideally work full time (though part time is an option), starting immediately.  We work cooperatively with the patients' primary cares.  We will train you in Obesity Medicine practice.  We have a star team to support you.  If this sounds like you, please email us at jobs.drverne@gmail.com.  Include your contact information, and we will call you.


Practice Opportunity for Psychiatrist – Augusta, Maine

Liberty Healthcare anticipates an opening for a full-time attending Psychiatrist at the Riverview Psychiatric Center in Augusta, Maine. This position offers a small case load, competitive compensation package, regular 40-hour workweeks, minimal on-call, 7+ weeks off annually, liability insurance, onsite CME, relocation assistance and a collegial work environment. Psychiatrists who have an interest in providing inpatient services to adults who have serious and persistent mental illness and/or forensic patients are encouraged to apply.  Details available online at www.libertyhealthcare.com/upload/303.pdf.  Contact Ian Castronuovo at (610) 389-7430 or ianc@libertyhealth.com.


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 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.


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