September 3, 2013

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Upcoming Deadlines a Medical Practice Should Keep In Mind

With the traditional summer behind us, here are some upcoming deadlines to keep in mind this Fall:  on Sept. 23, the HIPAA-HITECH omnibus final regs become enforceable by the government; Oct. 9 is the effective date of legislation enacted during the First Regular Session of the 126th Legislature; and on Oct. 25, the processing of Medicare claims in Maine moves from NHIC to NGS. 

See articles below for more details on both the HIPAA regulations and the processing of the Medicare claims.  The effective date of legislation enacted this past session is Oct. 9 (90 days following final adjournment) except for those bills in which a different effective date was specifically set forth in the legislation.  This latter exception would include all the bills that passed as emergencies and became effective upon the Governor's signature.

Each issue of the Weekly Update is featuring an explanation of an enacted bill that would be of particular interest to physicians or medical practices, prepared by Associate General Counsel Jessa Barnard, J.D.

State Sells Liquor Revenue Bond; Governor Signs Bond Package, Riverview Bill

The State of Maine's liquor revenue bond has been sold, according to a press release issued today from Governor Paul LePage. The revenue bond, part of Governor LePage's plan for a new wholesale liquor contract, will be used to repay $183.5 million in debt the state owes to Maine hospitals. This payment will trigger a federal match of $305 million.  The full payment is expected to be paid during the month of September.

The Governor also announced last week that he was signing a package of bond bills totaling $149.5 million for infrastructure projects, college and university improvements and rehabilitation of Maine's National Guard armories, as well as a bill to address safety concerns at the State's psychiatric hospital. The Legislature approved these measures in a special session held last Thursday. 

This past session, the Governor proposed LD 1515, "An Act To Increase the Availability of Mental Health Services", to establish an inpatient-level treatment facility within a correctional institution. The bill - intended in part to address long wait times to admit patients to Riverview - was passed by initial votes in the Legislature, but carried over to the 2014 session due to a $3 million price tag.  In the meantime, the Administration learned that certification of Riverview was in jeopardy for its Medicare deficiencies, which requires compliance with the Centers for Medicare and Medicaid Services.  LD 1515 gained attention in order to address some of the issues raised by the CMS audit, though Legislators and the Administration acknowledget that it does not resolve all of the concerns. 

The Legislature wants to be more involved in understanding the issues raised by the CMS audit and LD 1515 includes a legislative oversight committee that will monitor the changes at Riverview.

The Administration submitted a plan of correction in response to the CMS audit this summer and received a letter last week from the Centers for Medicare and Medicaid Services accepting the state's plan of correction for Riverview.

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Room Block Expires Today for MMA Annual Meeting, Oct. 4-6, in Portland

MMA is excited to be holding its 160th Annual Session in downtown Portland Oct. 4-6.  Most events, including the Saturday evening Anniversary Gala, will be held at the Holiday Inn by the Bay.  The room block expires today, Sept. 3 so make your reservations asap.  There are still rooms available but after today the room rate increases to $256/night. Seven and one-half hours of category one CME are available and the theme of the Session is The Changing Face of Medical Education.

The Association has not held its Annual Meeting in Portland in many years and this Anniversary Meeting is shaping up to be one of the most popular meetings in several years.  Being close to many of Maine's medical education facilities made the topic for this year's meeting relatively simple.  We will be looking at the changes in all aspects of medical education, including undergraduate, graduate and post-graduate.  We will also be offering tours of the Hannaford Center for Safety, Innovation and Simulation at the Brighton Campus of the Maine Medical Center. 

The CME portion of the meeting begins at 1:15pm on Friday afternoon, Oct. 4, with a keynote presentation by Edison Liu, M.D., PhD., President and CEO of Jackson Laboratory.

The Saturday evening Anniversary Gala will begin at the Portland Museum of Act and then move to the Holiday Inn for dinner.  Music for dancing after the dinner will be provided by the popular Bob Charest band.

Registration for the meeting and a full schedule of events is available on MMA's website. Registration materials were also mailed to each member in July.  Room reservations at the Holiday Inn by the Bay can be made by calling 1-800-345-5050.  Call soon, as the room block expires on Sept. 3rd.

Potential exhibitors and sponsors should contact Lisa Martin at MMA ( or call 622-3374 ext. 221) [return to top]

WINXNET Offers Free HIPAA Security Audits to 20 MMA Members

Compliance with the HIPAA Security Rule can be daunting. It can be even more difficult when you don’t have a firm grasp on the underlying technology. When you dig deep and try to understand the tasks and procedures you need to protect electronic data, you are likely to encounter technical terms and IT buzzwords that are confusing.

Winxnet, a HIPAA compliant IT consulting and outsourcing firm, has worked with hundreds of healthcare organizations to help them understand and cost-effectively address their technology needs.  The Winxnet Security & Compliance Health Check is designed to help healthcare organizations quickly cut through the confusion by providing answers to the question, “Do I have the correct administrative, physical and technical controls in place to pass an audit?”

How does it work? It’s simple and can be completed in one day.  

A team of Winxnet Certified HIPAA Security and Compliance Professionals will conduct a health check which includes the following steps:

  1. Review a short list of questions with you.  
  2. With your permission, run a secure software program to gather information about the state of your information security.
  3. Conduct a vulnerability scan of your internal network (Internal test). 
  4. Conduct a vulnerability scan of your firewall (External test). 
  5. Review the documented findings with you.  

After gathering the needed information the team will analyze the data, document findings and recommendations, and review them with you with a clear path forward. 

The results of the findings may include steps you need to take towards full compliance with the HIPAA Security Rule.  If you need outside support to address some or all of the recommendation towards full compliance, Winxnet has a team of Certified HIPAA Security and Compliance Professionals ready to assist.

Through the MMA and our strategic partnership, this Health Check valued at $949 is being offered at no cost for the first 20 MMA members.  If interested, send an email to or call 207.780.0497 and reference the MMA.  [return to top]

New Laws Impacting Your Practice: LD 534, Disclosure of Mental Health Information

Each week MMA is running weekly articles highlighting new laws passed by the 126th Legislature that impact the practice of medicine in Maine.  We are also happy to present an overview of new laws to your medical staff, practice or specialty society and have posted a summary of laws and explanatory slide presentation on the MMA website. 

LD 534 changes the way some mental health information can be shared with the goal of increasing coordination of care.  MMA supported the law change. 

Currently, Maine law requires a patient's authorization to disclosure their health information outside of the office or facility where the services were provided if it reflects mental health services provided by a clinical nurse specialist, psychologist, social worker, LCPC or psychiatrist.  

LD 597 allows disclosure of information reflecting mental health services provided by these clinicians without authorization to another health care practitioner, facility or payor for purposes of care management or coordination of care. Disclosure of psychotherapy notes remains governed by HIPAA.  The practice disclosing the information is still required to make a reasonable effort to notify the individual of the disclosure. 

The new law goes into effect on October 9th and the full text can be found here.

With questions or for more information contact the MMA at or[return to top]

Compliance Deadline for New HIPAA Rules Approaching Sept 23

The Sept. 23 compliance deadline for the omnibus rule/HITECH amendments to the Health Insurance Portability and Accountability Act (HIPAA) is just around the corner.  

Your practice will need to ensure compliance with the changes in the Privacy Rule, Breach Notification and Security Rule.  MMA has tools and resources to assist you, incuding a sample Notice of Privacy Practices, Sample Business Associates Agreement and overview slide presentation.  See for more information.  

Here are some key steps you should be taking between now and September 23rd: 

1. Update your Notices of Privacy Practices to comply with the new HITECH requirements. The amended Notice of Privacy Practices should be posted in a prominent location, placed on your website (if you maintain a website), given to new patients, and made available upon request to existing patients who have already received and signed a Notice of Privacy Practices.

2. Update and revise existing business associate agreements to address the final rule provisions and obtain new business associate agreements as needed. (Note that covered entities that have business associate agreements that were effective before Jan.25, 2013 have until Sept. 23, 2014 to update them.)

3. Update your breach response policies. The Final Rule changed the definition of “breach” as well as the risk assessment that must be undertaken to determine if there has been a breach. It is more likely that an impermissible access, use or disclosure of PHI will be a “breach” necessitating notification to the individual, HHS, and possibly the media. Breach response policies should reflect the new standards.

4. Review and update your HIPAA Policies and Procedures Manual. Perform a "gap" analysis to determine what changes are needed to existing HIPAA policies and procedures and update them accordingly. It is important to ensure that the policies and procedures accurately reflect both the new rules and the operations of your practice. 

5. Notify business associates of their obligation to comply with the HIPAA Security Rule and certain parts of the HIPAA Privacy Rule. 

6. Train your employees on the new HIPAA requirements.  Document the training.  MMA attorneys are available to come to your practice to train you and your employees on the new requirements. 

Contact Jessa Barnard at for more information.   [return to top]

Employers Required to Notify Employees of Health Insurance Marketplace By Oct 1

Beginning January 1, 2014, individuals and employees of small businesses will have access to health insurance through a new competitive private health insurance market – the Health Insurance Marketplace. Section 18B of the Fair Labor Standards Act, as added by the Affordable Care Act, generally provides that an applicable employer must provide each employee at the time of hiring (or with respect to current employees, not later than October 1, 2013), a written notice about the heath insurance marketplace and health insurance options.  

Employers are required to provide the notice to each new employee at the time of hiring beginning October 1, 2013 or to all current employees no later than October 1, 2013.  The requirement applies to employers to which the FLSA applies.

The notice must include: 

  • Informing the employee of the existence of the Marketplace (referred to in the statute as the Exchange) including a description of the services provided by the Marketplace, and the manner in which the employee may contact the Marketplace to request assistance;
  • If the employer plan's share of the total allowed costs of benefits provided under an employer's health insurance plan is less than 60 percent of such costs, that the employee may be eligible for a premium tax credit if the employee purchases a qualified health plan through the Marketplace; and
  • If the employee purchases a qualified health plan through the Marketplace, the employee may lose the employer contribution (if any) to any health benefits plan offered by the employer and that all or a portion of such contribution may be excludable from income for Federal income tax purposes.

For more information, and sample notices based on whether you currently offer health insurance to your employees, see: [return to top]

MMA Webinars: The Affordable Care Act Marketplace Update, Sept 11 & 25

The Affordable Care Act: Marketplace Update (and more)

September 11th, 12-1:30 pm or 

September 25th, 12-1:30 pm 

Presented by CarePartners - MaineHealth, Consumers for Affordable Health Care, Maine Medical Association/Maine Medical Education Trust, and the Maine Primary Care Association.  

Topics will include: 

  • The ACA Overview: What has happened so far
  • Details on coverage, enrollment and subsidies for the new health insurance marketplace opening Oct 1 
  • Where to send patients for assistance in enrollment and how practices and health systems can help with enrolling the uninsured
  • Implications for practices and health care systems

Free and open to any hospital or medical practice staff, administrators or clinicians. To register, contact Jill Barkley at   Log in information will be emailed after registration.   

Supported with funding from the Maine Health Access Foundation.  

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Processing of Medicare Claims Transitioning to NGS on Oct. 25

On Feb. 22, 2013, CMS made a contract award to National Government Service (NGS) for Jurisdiction K (Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut and New York) for the processing of Medicare claims for both Part A and Part B.  In doing so, CMS consolidated the contracts for what was previously known as Jurisdiction 13 (Ct. and NY) and jurisdiction 14 (remaining New England states).  The effective date of the change from the current NHIC states for Part B claims is Oct. 25, 2013.  NGS will also be responsible for processing Medicare home health and hospice claims in all the New England states.  NGS is a subsidiary of Wellpoint and has extensive experience across the country in administering Medicare claims.  NHIC, which has been the part B carrier in Maine for several years will still have a role in the process, but will provide that service as a contractor to NGS.

This change represents implementation of the plans of CMS to contract with fewer carriers across the country. MMA staff recently met with NGS representatives and discussed this significant change and came away from the meeting believing that NGS is committed to a smooth transition.

National Government Services has been working with NHIC to identify differences between their business practices.

They have identified the following areas where providers may notice a difference in the JK MAC:

  • Local coverage determinations (LCDs) are being standardized throughout the jurisdiction
  • New electronic data interchange (EDI) connectivity front end (M2)
  • New P.O. Box numbers for use with JK MAC
  • New interactive voice response/recognition (IVR) format for use with JK MAC
  • New toll-free customer care telephone numbers for use with JK MAC
  • New business organization telephone numbers for use with JK MAC
  • Fax on demand option (available through IVR)
  • Telephone Reopening Unit (TRU) telephone numbers and process (available for Part B providers)
  • Medical records are not accepted via fax
  • New contractor ID numbers

To learn more, please visit the JK Transition Information Website and click on the link for Part B providers.   NGS also encourages providers to subscribe to their Listserv/Email updates program to receive important information about the JK MAC transition and upcoming training opportunities. Register today on the National Government Services Web site:

  • Go to the start page
  • Select your line of business as applicable
  • Accept the site attestation
  • Select Publications > E-mail Updates from the left navigation
  • Select Subscribe  
  • Enter your e-mail account information
  • Create your profile
  • Select the desired E-mail Update categories and select Submit
  • Once registration is complete you will be notified by e-mail to confirm your account information.
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First Friday's Educational Programming Resumes on Sept. 6 with the Annual Risk Management Seminar

On Friday morning, Sept. 6, three senior risk managers from Medical Mutual Insurance Company of Maine will present three current risk management topics at MMA's offices in Manchester (also offered via webex).  

Stacey Doten, Senior Risk Manager for Medical Mutual, will present on the new risk management issues raised by the increased use of electronic medical records systems.  Nancy Brandow, Senior Risk Manager for Medial Mutual will discuss how to improve patient safety through effective medication reconciliation.  And Lou Anne McLeod, Senior Risk Manager at Medical Mutual will give a talk entitled, "Are Your Office Systems Putting Your Practice in Jeopardy." MMA EVP Gordon Smith, Esq., will moderate the morning session.

The last two First Friday programs of 2013 will be held on Friday Nov. 1 (Annual Compliance Seminar) and Friday, Dec. 6 (Accountability, Transparency & Public Reporting).

Registration is available on the MMA website or through calling MMA at 622-3374.

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Job Openings

Full-Time PA-C or FNP Position Available

We are searching for an experienced healthcare provider to join our supportive team-based Family Medicine Practice.  Full Circle Family Medicine is a physician owned private practice in Mid Coast Maine.

We are a full spectrum, well established practice with a focus on preventative, wellness and mindfulness based care.

Please forward CV and references to:  Full Circle Family Medicine, Attn:  Wendy Williams, 68 Chapman Street, Damariscotta, ME  04543 or via email to: Questions: please call 207-563-6623 option 7 to speak with Wendy.

We look forward to hearing from you.


Physician Assistant or Family Nurse Practitioner (Walk-In Care)

Health Access Network, a Federally Qualified Health Center (FQHC) is seeking a full time Physician Assistant or Family Nurse Practitioner to join our community health center team.  Successful candidate will provide walk-in care in our new state of the art facility in Lincoln, Maine.

Experience is preferred.  Providers utilize a fully integrated electronic medical records system and are supported by a medical assistant / nursing assistant.

  • Sign-on bonus
  • Moving allowance
  • Possible NHSC loan repayment
  • 100% paid health insurance
  • 401K
  • Generous paid time off
  • $2,500 annual CME allowance
  • Federal malpractice insurance

We are a multi-disciplinary community health center with sites in Lee, Lincoln, Medway, Millinocket, and W. Enfield serving patients in Northern Penobscot Maine.  Interested candidates may forward a resume and cover letter to Sonia Maxwell, HR Director/Compliance Officer, P.O. Box 99, Lincoln, Maine 04457, 207-794-6700, smaxwell@hanfqhc.orgEqual opportunity employer & program.


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 or visit our website at  KVHC is an equal opportunity employer.


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Upcoming Events

 Attend Commercial Driver Medical Examiner Training - 2 Dates/2Locations

The Maine Academy of Family Physicians is pleased to announce two more opportunities to complete the newly Federally required “Commercial Driver Medical Examiner (ME)” training here in Maine.

Sept. 7th in Portland

Oct. 26th in Bangor. 

This day-long program will be eligible for AMA Cat I CME credits (as well as AAFP Prescribed credits)

For more information or to register, click here.


Maine TB Update 

September 11, 2013

9:00 AM – 3:45 PM

Online and in-person training  

In-person training held at: 

University of Southern Maine

Lewiston-Auburn College - Room 170, 51 Westminster St., Lewiston

Jointly Sponsored By Maine Center for Disease Control and Prevention  and New Jersey Medical School Global Tuberculosis Institute. The purpose of this one-day update course is to provide public health nurses and other health care professionals in Maine with enhanced knowledge and skills in the management of tuberculosis (TB). The format includes lectures, panel discussions, and two breakout sessions.  Please register online at:


Washington and Hancock County Workshops: Safety Net Programs for Maine’s Seniors

September 11, 2013

Machias, The Kay Parker Building, 26 Hadley Lake Road 

9:00 AM—NOON 


Ellsworth, Washington Hancock Community Agency, 248 Bucksport Road

2:00 PM—5:00 PM 

Topics include updates on the Medicare Savings Program, Drugs for the Elderly, MaineCare; the Food Supplement Program – formerly known as Food Stamps; and My Maine Connection.

These workshops are designed for Community Service Providers and provided at no charge.  RSVP to Jennifer Sanborn at Maine Equal Justice Partners (MEJP) with your name, organization, phone number, and email address:  626-7058 x 200 or


4th Annual Patient Safety Academy

Friday, September 13th

9:00am – 4:00pm

University of Southern Maine, Portland Campus, Abromson Center

Cost: $50, with a discounted rate of $25 for students

12 workshops, including the USM School of Nursing Simulation Lab! The Patient Safety Academy is returning for its fourth year! Last year over 150 health care professionals representing Maine hospitals, physician practices, pharmacies, long-term care facilities, agencies, organizations and advocacy groups participated in knowledge and skill building workshops. Any individual interested or engaged in patient safety activity is invited to attend.

To learn more or register, click here


12th Annual Downeast Ophthalmology Symposium

Presented by the Maine Society of Eye Physicians and Surgeons

September 20-22, 2013

Harborside Hotel & Marina - Bar Harbor, ME

This Symposium offering 15 hours of CME is open to ophthalmologists across the country!

For more information, visit

Additional Questions?  Call  Shirley Goggin at 207-445-2260 or


Maine Health Management Coalition’s 20th Anniversary Symposium

Getting Health Care Right: Past Successes and Future Imperatives

October 10, 2013

8:30 am – 3:30 pm

 Abromson Center (USM) in Portland

The Coalition’s annual symposium brings together employers, providers, payors and patients from across Maine’s health care market to hear from nationally recognized speakers about current trends in health care payment and delivery.  This year’s keynote is world famous geneticist, author, and professor Dr. William Haseltine.

For more information or to register, click here.  Maine Medical Association members are eligible for discounted tickets.


Maine Dental Access Coalition Fall Conference

Friday, October 18, 2013

8:00 am - 4:00 pm

Morgan Hill Event Center, Hermon, Maine

 All One Body:  Creating Optimal Health Outcomes A Symposium for Medical and Dental Health Providers

Keynote: Medical Dental Collaboration:  Why it Matters and How It Works by Dr. John R. Luther, DDS, Senior Vice President of Dental Management and Chief Dental Officer at DentaQuest

Registration information to follow.  Visit


Maine Public Health Association 29th Annual Meeting 

October 22, 2013 

8:30 am - 4 pm 

Augusta Civic Center 

For more information, click here


2013 Maine Primary Care Association Annual Conference

October 23 - October 24, 2013

Bar Harbor Club, Bar Harbor, Maine

This year's conference, "Health Care Reform: Putting the Promise into Practice" will highlight emerging trends and opportunities in the face of health reform—with specific emphasis on how Maine’s health centers can play a pivotal role in delivering on the promise of health care reform. 

For more information, or to register, click here


Maine Cardiovascular Health Council's 2013 Cardiovascular Summit

Stroke - The First 3 Hours: Bridging the Health System and the Community

   Thursday, November 7, 2013

8:00 am - 4:00 pm

Samoset Resort, Rockport, Maine

In this one day event, we are combining scientific sessions with population health.  As we move into a more collaborative healthcare environment, this is the ideal conference to learn about the newest information regarding stroke care, along with resources available through our state and local programs.

For more information or to register, click here


2013 Division of Infectious Disease Annual Conference

November 13, 2013 

Augusta Civic Center

 Sponsored by the Maine Center for Disease Control & Prevention

Since 1983, the Maine Center for Disease Control and Prevention, Division of Infectious Disease, Department of Health and Human Services has organized an annual infectious disease conference targeting public health issues of emerging concern to medical practitioners throughout the State. Presentation topics will focus on a range of infectious diseases and immunizations. This year’s conference includes aspects from the Division of Infectious Disease’s Epidemiology, Immunization, HIV, STD and Viral Hepatitis Programs. 

For more information or to register, click here


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