June 24, 2013

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POLITICAL PULSE: Legislature Finishes Majority of Work, Will Return to Consider Vetos

The House and Senate worked long days most of last week and finished voting on the bills pending before them, including the ACA Medicaid expansion (L.D. 1066).  The House failed to find the necessary votes to override a gubernatorial veto, meaning Medicaid expansion will not happen by the start of 2014.  The Legislature plans to return to Augusta this Wednesday to consider vetoes of several bills, including the budget.  Depending how much work they complete they may adjourn for the year or may return for one or more additional days.  Last week the Governor did sign into law L.D. 727 regarding truth in advertising regarding health professionals/practitioners which was a priority for the Association.


The bill to expand health coverage to low income Mainers by 2014 fell short of the votes needed in the House to withstand the Governor's veto.  While the vote was 95-52 this did not reach the 2/3 vote necessary.  This means that nearly 25,000 parents and low income adults will lose MaineCare coverage as of January 1, 2014 and nearly 45,000 will not be eligible who would otherwise have full coverage funded with 100% federal dollars. The bill included the following amendments first offered by Senator Roger Katz (R-Kennebec) in the Senate: 

  • Expansion is contingent upon Maine receiving 100% match for all childless adults; 
  • Impose Co-payments for Expansion Population; 
  • Evaluation of Expansion and Report to Legislature; and 
  • Sunset Provision.  This amendment would sunset the expansion coverage on 12/31/2016.  

The MMA continues to work with proponents to plan next steps and ensure as many people as possible in Maine can receive health coverage.  As an immediate next step, we need to hold lawmakers accountable who voted in opposition to the measure and thank our legislators who voted in support of covering more Mainers. Please see how your legislator voted and contact him/her to say thank you or express your disappointment. 

See how your legislator voted. 

Contact your legislator. 


Two weeks ago the House and Senate enacted the unanimous Appropriations Committee report on L.D. 1509, the State Fiscal Year 2014-2015 biennial budget.  The votes on enactment were 102-43 in the House and 25-10 in the Senate.  The Governor has indicated an intention to veto the budget bill, but he also said that he would take the full 10 days to review and consider it.  The Governor held a press event late last week to criticize the tax increases included in the budget and propose a short term budget fix to give the House and Senate time to come up with different ways to balance the budget for the full two year budget cycle.  The Democrats have stated that they have enough votes to override the veto and it is premature to consider other approaches at this point.


The Maine Senate last Wednesday night killed a bill that would allow a new type of dental provider, a dental hygiene therapist. The bill would have established a license for a dental hygiene therapist who would be able to perform some procedures normally performed by dentists, like fillings and tooth extractions.  An amendment in the House had required that 50 percent of patients served by dental hygiene therapists be recipients of MaineCare, and the bill passed in the House 95-45.  It failed in the Senate 14-21. 


Representative Mark Dion's bill,  L.D. 1240, An Act to Promote the Safe Use and Sale of Firearms, requires universal background checks for anyone purchasing a firearm.  The bill passed with votes of 78-71 in the House and 18-17 in the Senate.  The Senate had recently approved a much weaker version of the bill that only created a crime for "knowingly" selling to a person prohibited from owning a firearm however the Legislature ultimately adopted the version supported by the House that would require background checks for all sales. 

MMA Legislative Committee Conference Call, Tuesday, June 25th, 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 25th 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.  

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Loan & Trust Committee Meets Wednesday to Award 2013 Medical Student Loans from MMEF

MMA's Loan and Trust Committee will meet this coming Wednesday, June 26, at 2:00pm at the Frank O. Stred Building in Manchester to consider loan applications from 51 medical students from Maine.  This year there will are 42 applicants from allopathic schools and 9 applicants from osteopathic schools.  Thirty applicants are students at the Tufts Medical School - Maine Medical Center program.  These funds are made available from the Maine Medical Education Foundation which was established in 1960 for the purpose of assisting Maine residents in medical school.

Last year the committee awarded low interest loans to 52 applicants totaling early $300,000.  A small amount of money is set aside each year for late applicants.

The committee is chaired by Mark Bolduc, M.D.,  general surgeon practicing in Waterville. [return to top]

Maine Health Access Foundation Releases Funding Opportunity RFPs

The Maine Health Access Foundation (MeHAF) announces the availability of grants under the Improving Access to Quality Care for Uninsured Individuals (A2QC) program.  Grants under this program will support the advancement of a sustainable system of care that delivers comprehensive, high-quality health care services to improve the health of uninsured, low-income individuals and reduces the time spent in poorly-coordinated, inefficient and costly care.

MeHAF is also announcing funding for its new Thriving in Place (TiP) Across the Continuum of Care initiative as part of its strategic priority to Promote Patient-Centered Care.  The TiP inititative will support health care providers and community partners in developing collaborative strategies to meet the health care needs of adults with chronic health conditions (including elders and persons with disabilities) who are at high risk of in-patient or institutional care, so they can remain healthy and thriving in their homes and communities.

For more information about the Improving Access grant click here.  For more information about the Thriving in Place program click here

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AMA Annual House of Delegates Meeting Wraps Up

The Annual Meeting of the American Medical Association convened on Saturday, June 15, 2013 in Chicago with Maine delegates Richard Evans, M.D. and Maroulla Gleaton, M.D. in attendance, along with alternate delegates appointed for this meeting, MMA President Dieter Kreckel, M.D. and Jo Linder, M.D.  Also in attendance from Maine were former MMA President Robert McAfee, M.D., MMA EVP Gordon Smith, Esq., and specialty society delegate Jack McGill, M.D.

The meeting opened with physician leaders talking about the future of health care at the "Innovations in Medicine" speakers series, and ended this past Wednesday with the AMA House  of Delegates adopting policy that will help shape the future of medicine. At the meeting, AMA delegates:

  • Celebrated the announcement to award 11 medical schools $11 million in grants to Accelerate Change in Medical Education.
  • Formally asked the AMA to repeal and replace the flawed sustainable growth rate Medicare formula and to repeal the Independent Payment Advisory Board.
  • Issued a warning against "inappropriate inquiries" from pharmacies to verify the medical rationale behind prescriptions and diagnoses, calling them an unwarranted interference with the practice of medicine.
  • Voted to recognize obesity as a disease state with multiple aspects requiring a range of interventions to advance obesity treatment and prevention.

On Tuesday Ardis Dee Hoven, MD, an internal medicine and infectious disease specialist from Lexington, Ky., was inaugurated as the 168th president of the AMA. Her inaugural address is available here [return to top]

22nd Annual Practice Education Seminar being Held Wednesday, July 24 in Augusta

The Augusta Civic Center will again be the site of MMA's annual Practice Education Seminar.  Being offered for the 22nd year, this program is designed to offer physicians and practice managers the information and tools they need to be successful in their practice setting, whether the physician is in private practice or employed and regardless of specialty.  As the program runs from 8:30am to 4:30pm with three keynote talks and a dozen breakout sessions, there is sufficient time to cover many of the topics that are in front of practices currently, such as:

  • Preparing for ICD 10
  • Using social media to market your practice
  • Accountable Care Organizations
  • State Innovation Model grant (SIM)
  • Preventing Prescription Drug Abuse
  • Board of Licensure in Medicine update
  • E-Prescribing of Controlled Substances
  • Physician Payments Sunshine Act
  • Legislation Impacting on Medical Practice Enacted by the 126th Legislature
  • Affordable Care Act, including Exchanges, Essential Benefits and Mandated Coverage

The keynote presenter is Jack Lewin, M.D., Chairman of the National Coalition on Health Care.  Dr. Lewin is a former CEO of the American College of Cardiology and the California Medical Association.

Watch your mail for the brochure containing registration materials and a full agenda, or register on-line at www.mainemed.com.  Questions can be directed to Lisa Martin at MMA at 622-3374 ext. 221 or via e-mail to lmartin@mainemed.com.  Lisa will also handle any questions from potential exhibitors. [return to top]

New AMA Study: Patients Responsible for Nearly One-quarter of the Medical Bill

Patients are responsible for nearly one-quarter of the medical bill, according to the findings released last week from the AMA’s sixth annual check-up of health insurers and their patterns for processing and paying medical claims.

For the first time, the AMA’s National Health Insurer Report Card examined the portion of health care expenses that patients are responsible for through copays, deductibles and coinsurance. During Feb. and March of this year, patients paid an average 23.6 percent of the amount that health insurers set for paying physicians.

“Physicians want to provide patients with their individual out-of-pocket costs, but must work through a maze of complex insurer rules to find useful information,” said AMA Board Member Barbara L. McAneny, M.D. “The AMA is calling on insurers to provide physicians with better tools that can automatically determine a patient’s payment responsibility prior to treatment.”

The National Health Insurer Report Card is the cornerstone of the AMA’s Heal the Claims Process™ campaign. Launched in June 2008, the campaign’s goal is to lead the charge against administrative waste by improving the health care billing and payment system.

The AMA today also unveiled its new Administrative Burden Index (ABI) to rank commercial health insurers according to the level of unnecessary cost they contribute to the billing and payment of medical claims. The AMA found that administrative tasks associated with avoidable errors, inefficiency and waste in the medical claims process resulted in an average ABI cost per claim of $2.36 for physicians and insurers. Cigna (CI) had the best ABI cost per claim of $1.25, or 47 percent below the commercial insurer average. HCSC had the worst ABI cost per claim of $3.32, or 41 percent above the commercial insurer average.

The AMA estimates that $12 billion a year could be saved if insurers eliminated unnecessary administrative tasks with automated systems for processing and paying medical claims. This savings represents 21 percent of total administrative costs that physicians spend to ensure accurate payments from insurers.

To learn more about Heal the Claims Process™ campaign, including the National Health Insurer Report Card and the new Administrative Burden Index, please visit the AMA website at www.ama-assn.org/go/reportcard. [return to top]

HHS Announces Consumer Savings Under Health Care Reform

Consumers will receive $500 million in rebates as a result of the Affordable Care Act's medical loss ratio (MLR) requirement, the Department of Health and Human Services said June 20.

Some 8.5 million people are due to receive the rebates, averaging about $100 per family, HHS said in a release. The rebates will be sent Aug. 1 and are based on health plan data for 2012.

In addition, HHS said for 2012, some 77.8 million people saved $3.4 billion “upfront on their premiums because of the [MLR rule] and other Affordable Care Act programs.”

The MLR rule, also known as the 80/20 rule, requires individual and small group health insurers to spend at least 80 percent of premiums on medical claims or quality improvements; large group insurers must spend at least 85 percent. Insurers that do not reach those thresholds must refund the difference to consumers.

For more information, click here

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AMA Payment Reform Webinar, July 18
AMA Innovators Committee Hosting Webinar on Designing New Payment Models

The AMA Innovators Committee will hold a webinar on July 18, at 7 p.m. EDT, titled, “Building new payment models and getting paid.”The sixth in a series of seven webinars on delivery and payment reform, this 60-minute webinar has been approved for continuing medical education credit in the form of AMA PRA Category 1 CreditTM. In addition to describing how practices can measure their performance in preparation for value-based payments, this webinar will help physicians:
  • Describe the difference between episode-based bundles and global bundles.
  • Identify the technology and analytic tools necessary to build and maintain these payment models.
  • Recognize the challenges associated with each model and identify solutions.
Click here to register for the July 18 webinar.
Listen to recordings of past Innovators webinars (also for CME) and learn about future webinars at www. ama-assn.org/go/paymentpathways. These webinars are free for AMA members. 
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Next Prescription Drug Abuse Education Program Being Offered July 8 in Machias

The Maine Medical Association will offer a three hour CME program on the subject of preventing prescription drug abuse in Machias on Monday evening, July 8, from 5:00 to 8:00pm.  Dinner will be available.  The program will be held in the Science Building (Room 102) at the University of Maine in Machias with videoconferencing to the Washington County Community College in Calais. The program is being presented at the request of the Washington County coalition working on preventing prescription drug abuse in the county.  The program is funded by the Maine Office of Substance Abuse and Mental Health Services and the Board of Licensure in Medicine.  Faculty announced to date include Tamass Peredy, M.D., State Senator David Burns (R, Whiting), John Lipovsky of the Prescription Monitoring Program and Gordon Smith, Esq., from MMA.  Other faculty will be announced in a few days.

There is a $20 charge, payable to the Maine Medical Association.  Watch your e-mail for opportunities to register or you may register through Ashley Bernier at MMA by calling 622-3374 ext. 213 or via e-mail to abernier@mainemed.com. [return to top]

Job Openings

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.


Emergency Department PA

Full time position.  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.  DEA Certificate.

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


Seeking two (2) full time psychiatrists, psychiatric nurse practitioners and/or physician assistants 

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


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 Houlton locations.  KVHC is a fully electronic medical record site and offers a competitive salary ($170,000 to $190,000 annual) and benefit package which includes: a 10% of first year salary sign on bonus, generous amounts of paid time off, $2500 annually toward CME as well as a completely outpatient site.  The call schedule is 1 in 8 with additional coverage from the Open Access Clinic.  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 10 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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Upcoming Events

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.


Breath Easy Coalition Annual Meeting 

August 15, 2013

10 am - 2:30 pm 

Augusta, Maine 

Click here to register 

Join us for for this FREE event! Featuring presentations and discussions around how smoke-free policies are impacted by medical marijuana and electronic cigarettes, celebration of 10 years of addressing smoke-free housing, networking, and roundtable peer-to-peer discussions around addressing tobacco-use and secondhand smoke exposure in Maine.


Maine Public Health Association 29th Annual Meeting 

October 22, 2013 

8:30 am - 4 pm 

Augusta Civic Center 

For more information, 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

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