October 7, 2013

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MMA Hosts Successful 160th Annual Meeting; Guy Raymond, MD, New MMA President

The Maine Medical Association hosted a successful annual meeting this past weekend, October 5-7th, at the Holiday Inn by the Bay in Portland.  Over 250 members and guests attended the gala celebration on Saturday evening following a day of CME and association business. Guy Raymond, MD, was installed as the MMA President, Lisa Ryan, DO, began her term as President-Elect, and Brian Pierce, MD, was elected chair of the MMA Board of Directors. 

The Association marked its 160th Anniversary with a reception at the Portland Museum of Art and gala celebration at the Holiday Inn by the Bay, in addition to offering a full complement of CME programming and completing Association business over the weekend.  

The meeting opened on Friday with an inspirational keynote address by Edison Liu, MD, President and CEO of the Jackson Laboratory, who left participants with the impression that the future of medicine is already here.  Peter Bates, MD, Academic Dean of the Maine Medical Center-Tufts University School of Medicine Maine Track program was joined by medical students Michael Neilson and Rebecca Wood to discuss the innovative techniques being used to train physicians in Maine.  The session on Friday was capped by tours of the Hannaford Center for Safety Innovation and Simulation at Maine Medical Center. 

The Association General Membership meeting was held on Saturday morning.  Members considered six policy resolutions and approved five resolutions that now go to the MMA Board for adoption: Endorsement of the ABIM Foundation Choosing Wisely Initiative, Supporting an Evidence-Basis for Public Health Policy, Prohibiting Tobacco Sales in Health Care Settings, Updating the MMA Poll on Physicians' Opinions about Healthcare Reform and Bicycle Safety and Funding.  In addition, attendees recognized those members who graduated from medical school 50 years ago, elected new officers and one additional MMA Board member, Jabbar Fazeli, MD. 

At the business meeting, members also received an update from Dr. Steve Stack, American Medical Association Immediate Past Board Chair, regarding AMA initiatives and examples of how the AMA provides real value to physicians and the public.  Dr. Terrance Sheehan provided his final report prior to retirement on the Medical Mutual Insurance Company and Neal Lane of the AARP National Policy Council addressed the commonalities of interests between Maine physicians and seniors. 

The Saturday evening gala provided an opportunity for mixing and mingling, as well as honoring the past and future of medicine in Maine.   Dieter Kreckel, MD, was recognized for his year of service as MMA President and Alice Haines,MD, was awarded the Mary Cushman, MD, award for humanitarian service for founding the Lewiston-Auburn Free Clinic which serves low income and uninsured patients, including a large number from the immigrant population.  Dr. Terry Sheehan was awarded the MMA President's Award for Distinguished Service for his career as a practicing pediatrician, CMO at Southern Maine Medical Center and President and CEO of Medical Mutual Insurance Company.  Dr. Kreckel and his family, along with a few other hardy individuals, closed down the dance floor at midnight. 

Sunday kicked off with the 33rd Annual Edmond Hardy, MD road race before CME sessions on the history of medicine in Maine and Maine's early female physicians.   Dr. Guy Raymond closed the event by sharing his goals for the year as Association President. 

As you can tell from these highlights, it was an energizing and full weekend.  The Association would like to thank all of the attendees, speakers and  individuals and organizations who sponsored the meeting and gala, supported the publishing of the gala program and exhibited over the weekend.  

New Laws Impacting Your Practice Go Into Effect This Week

There are a number of bills that passed into state law in 2013 that will have a direct impact on your practice. We have highlighted them below.  Unless otherwise specified, these laws go into effect this Wednesday, October 9th.  You can find the full text of all laws on the Legislature's website and enter the LD (legislative document) number in the box provided.  You can also view a summary of laws and explanatory slide presentation on the MMA website.  With questions or for more information contact the MMA at jbarnard@mainemed.com or gsmith@mainemed.com

Practice Management:

  • Changes to Cost of Copying of Medical Records: For paper records you can now charge $5 for first page and .45 for additional page with $250 max. For electronic records, offices can charge for “reasonable actual costs” including staff time and postage. Can’t charge for tech/data fees. Max of $150. (LD 23/ LD 1500)
  • Health Care Practitioner Transparency/ Identification-  Includes full disclosure in advertising of the license the provider holds, wearing identification with name and health care provider license type, and display of license in your office (Note: this section of the law is under review). (LD 727)
  • Price List in Your Office- Requires practitioners to have and make available to patients a list of common procedures that are provided at least 50 times during the year, must include CPT code and descriptor and reference cost information available on the Maine Health Data Organization website (LD 990) Note: Effective date: Jan. 1, 2014.
  •  Disclosure of Health Care Information- New law makes Maine law more consistent with federal law by allowing disclosure of health care information if, in good faith, disclosure is made to avert a serious threat to health or safety (LD 882)

Public Health:

  • Copy of Lyme Disease Test Results to Patient- Every practitioner that orders a lab test for Lyme Disease must provide written test results to patient and requires Maine CDC to post information on its website regarding Lyme disease & treatment (LD 597)

Children’s Health and Welfare:

  • Screening for Heart Conditions-  Requires hospitals, birthing centers to test newborns by means of appropriate technology for the presence of critical congenital heart disease; rulemaking may require reporting to DHHS. (LD 460)
  • Prenatal Drug Exposure- Amends existing law on reporting to DHHS by a health care provider involved in delivery or care of infant with prenatal exposure to drugs – changes "reports" to "notifications" and repeals the requirement that the department investigate all reports. Defines fetal alcohol syndrome and adds it to the list of conditions that require notification to DHHS; also changes language about withdrawal symptoms (LD 257)
  • Mandated Reporting of Child Abuse and Neglect- DHHS required to make a report to licensing boards of a health care professional who appears to have violated the mandatory reporting laws (LD 1024). A new law also requires reporters to report in any infant under 6 months or otherwise non-ambulatory: fracture of bone, substantial bruising, multiple bruises, subdural hematoma, burns, poisoning, or injury resulting in bleeding, soft tissue swelling or organ impairment (LD 1523)

Scope of Practice/Licensing:

  • Physician Delegation- Physician may now delegate activities to support staff and delegate without being on premise at the time the activities are performed (LD 198)
  • NP as School Health Advisor- Allows NPs to fill the School Physician Role (LD 197)
  • Physician Assistant Licensing-  Creates a joint licensing process for physician assists with the MD and DO Board of Licensure. PAs will now be able to prescribe Schedule IIs under the Osteopathic Board of Licensure so long as it is approved in their plan of supervision. PAs will have delegation authority to other staff, will be able to employ their own supervising physician, and will have a seat on both the MD and DO Boards of Licensure (LD 556)
  • Pharmacist Vaccine Administration- Can administer vaccines licensed by the FDA that are outside the guidelines recommended by CDC/ACIP to an adult with prescription (LD 32)
  • Pharmacist Collaborative Practice-  Allows pharmacist to examine, diagnose and treat under delegation of an authorized practitioner (LD 1134)

Prescribing Related Legislation: 

  • Enrollment in Prescription Monitoring Program (PMP)-  Directs Substance Abuse Services Commission to create a process to increase provider participation in the PMP and work with Licensing Boards to develop auto enrollment with your medical license renewal (LD 388)
  • Qualifying conditions expanded for Medical Marijuana-  Adds PTSD, inflammatory bowel disease and dyskinetic and spastic movement disorders and other diseases causing severe and persistent muscle spasms to the list of qualifying medical conditions (LD 1062)

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MMA Offers New Legal Resources on Payment Reform

The Maine Medical Association is pleased to announce the availability of two new resources it has created for physicians seeking to better understand the scope and implications of payment reform.

  1. Payment Reform Readiness: A Legal Toolkit for Physicians: This hands-on resource introduces providers to various payment reform models as well as a range of strategic responses taken by physicians.  It also includes a thorough review of factors providers must consider to achieve readiness for payment reform with a special focus on legal considerations.
  2. Payment Reform Attorney Directory: As a companion to the legal toolkit, the MMA has also compiled a directory of Maine attorneys who are knowledgeable in the area of payment reform and are willing to advise physicians.

The legal toolkit and the directory are currently featured on the MMA’s Payment Reform webpage and can be accessed by clicking here.   These resources were made possible thanks to generous funding by the “Advancing Payment Reform Strategies in Maine” grant initiative of the Maine Health Access Foundation.  Please send any questions or feedback on these materials to Jennifer Reck at jreck@mainemed.com.

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Medical Associations, AARP Push for Expanding Health Coverage in Maine

The Maine Medical Association (MMA), American Medical Association (AMA) and AARP held a joint press conference on Saturday, October 5th, at the MMA’s 160th annual meeting.  The non-profits discussed the new health insurance marketplace, opportunities for enrollment, and concerns regarding Maine’s failure to accept federal dollars to expand Medicaid under the Affordable Care Act in 2013.  The press event was widely covered by television and print media.  

The medical community, along with AARP, is focused on making sure that consumers get the information they need about the new health exchanges.  “The AMA’s support for the health system reform law reflects our long-standing role as a leading voice for covering the uninsured – who all too often live sicker and die younger,” said AMA Immediate Past Chair Steven Stack, M.D. “Americans have been bombarded with conflicting messages about the health care reform law. It’s important for people – especially the uninsured -- to learn the facts.”  

Incoming MMA president, Guy Raymond, MD, stressed the point that in 2013, Maine missed the initial opportunity to accept millions of dollars in federal funds to offer residents health insurance as well as reduce hospital debt and charity care.  “It is imperative that Maine accept federal funds to expand access to health care through Medicaid,” he said on Saturday.  “Having quality health coverage is a key factor in people being able to see their doctor for both preventative care and treatment of illness and disease.”

AARP stated that having access to affordable health care coverage can be especially important for older adults not yet eligible for Medicare.    

 “Thousands of older Mainers have lost their jobs or are struggling in jobs without health insurance,” said Neal Lane of AARP’s National Policy Council. “Leaving vulnerable people without access to primary and preventive care can jeopardize even the most careful preparation for health and financial security in later life.”

AARP Maine Volunteer State President, Rich Livingston, added “Of particular note is the fact that because Maine declined federal funds during the last legislative session, tens of thousands of Mainers, many of whom are 50-64, will fall into a “coverage gap.” They will have no access to health coverage under Medicaid; and, they are too poor to qualify for subsidized coverage under the new health insurance exchanges. On behalf of our 230,000 AARP members and their families, we urge our elected leaders to do the right thing in 2014 and expand health care coverage for all hardworking Mainers.”

MMA EVP Gordon Smith, Esq., fields a question from the press (far right), joined (R to L) by  Neal Lane of AARP’s National Policy Council; incoming MMA President, Guy Raymond, MD; AMA Immediate Past Board Chair Steven Stack, M.D; and AARP Maine Volunteer State President, Rich Livingston. [return to top]

MMA Is Here to Help You and Your Patients Navigate the Marketplace

The Maine Medical Association has FREE materials available to physicians and their patients on health care reform. The health insurance exchanges, also know as the Marketplace, opened last week on October 1st. 

Extremely high volumes of on-line activity and call traffic to Marketplace resources was reported.  Millions of Americans visited the www.healthcare.gov website on October 1st. In Maine, Consumers for Affordable Health Care, just one organization providing assistance to Mainers with navigating the Marketplace, reported they received over 55 calls in about six hours on October 1st. While some expressed frustration that they couldn’t get onto the website, here are some important tips to remember and share with patients:

  1. Enrollment will be open until March 31st, 2014. If your patients could not enroll online earlier this week because of high traffic online, they have plenty of time!
  2. They can mail in an application and don't need to enroll online.
  3. If your patients don't have access to a computer, they can enroll by phone using the toll free number.
  4.  If they don't have all of their documentation ready when they go online – patients can submit the application as is! The Marketplace staff will call them to help finish their application.

Enrollment is a marathon, not a dash! Let's make it to the finish line to get as many Mainers insured as possible!

The Marketplace and Physicians

As a trusted source of health information, your patients may look to YOU for help in navigating the Marketplace.

The Marketplace is a new way to shop for health insurance coverage. A single, on-line source will let consumers get information about their health coverage options in a way that makes it easy to make side-by-side comparisons of private insurance plans’ benefits, quality, and price and find out if they are eligible for assistance with the costs of health coverage.

In Maine, two plans, Anthem and Maine Community Health Options, will be offering plans on the exchange. Open enrollment began October 1st and ends on March 31, 2014. Coverage can begin as soon as January 1, 2014.

Resources are now available:

  • Visit www.healthcare.gov for more information about the Marketplace and upcoming benefits including where patients can get in-person assistance.
  • Call the Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325.
  • In Maine, visit www.Enroll207.com to find Maine specific resources including how to find local, personal help with enrolling in the Marketplace. 
  • If your practice is looking for the latest resources and information on how to help patients sign up on the Marketplace visit www.marketplace.cms.gov
  • Also call the Maine Medical Association at 207-622-3374 x 211 or email jbarnard@mainemed.com you have questions about how to get more information or  want  FREE brochures, and other materials for your waiting rooms/ bulletin boards for your patients.
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Administration Proposes $33,750,000 in Savings

The biennial budget enacted in June included a provision directing the Governor’s Office of Policy and Management to identify already-booked savings over the two-year period of $33,750,00.  Of that, $11,250,000 was to be found in FY14 and $22,500,000 was to be found in FY15. The budget also charged the Office with identifying 100 positions for possible elimination.

The Office presented its report to the Appropriations Committee last week.  While physicians were not directly targeted, the Department of Health and Human Services was charged with finding $11.7 million over the two years.  The Office was only able to identify $7.4 million of cuts, including: 

  • $4 million from the management of vacant positions;
  • $1 million from the CDC's Immunization Fund;
  • $500,000 from the consolidation and alignment of the Public Health Nursing program and Maine Families Home Visiting program.  

These proposed reductions, along with cuts to Head Start and the General Assistance Program led to frustrated questions from Democrats on the Committee who stated they had already rejected such changes in the original budget debate. 

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Legislature Releases Preliminary Bill Titles for 2014

The Maine Legislature has released a list of the titles of bills that legislators hope to have introduced in 2014 - the Second Regular Session of the 126th Legislature.  Because this session is the "short" session, all bill requests will have to be reviewed and approved by Legislative Council before they are actually printed and introduced - as only emergency legislation is supposed to be acted on in the second session.  The Legislative Council is made up of the ten elected leaders of the legislature and they will meet on October 30th to review the bill requests.  

MMA has worked with legislators to submit two clarifying provisions.  Senator Gratwick has agreed to sponsor some modifications to LD 727, regarding wearing name tags and posting licenses, and Senator Woodbury has agreed to work with MMA to clarify some of the language in LD 990 regarding posting of prices for health care services. 

In addition, a number of requests that would impact health care have been proposed, including those related to: 

  • Insurance coverage (expanding federally funded health care) 
  • Scope of practice (licensure requirements for advance practice registered nurses) 
  • Health insurance mandates and regulation (related to ephinephrine autoinjectors, provider profiling programs, oral health services) 
  • Public health measures (motorcycle safety, seat belt use, fireworks restrictions, firearm regulation, toxins in children's products) 
  • Mental health services and access (regarding Dorthea Dix, a mental health unit, involuntary medication and commitment) 
  • Long term care 
Other proposals address a wide range of health care issues including breast density, fraud and abuse, mandated reporting, medical marijuana and physician practice accessibility.   MMA will continue to report on the bills that are allowed by Legislative Council to be introduced and the content of the measures moving forward.   [return to top]

Opiate Prescribing Program Offered in Bar Harbor, Oct 24

The Maine Medical Association, in conjunction with the Maine Office of Substance Abuse and Mental Health Services and Mount Desert Island Hospital, is pleased to offer a seminar on best practices in opiate prescribing: 

Thursday, October 24, 2013

5:30-8:30 pm 

Bluenose Inn, Eden Street, Bar Harbor 

Dinner and 3 CME credits provided 

Faculty will include Noah Nesin, MD, Chief Quality Officer with Penobscot Community Health Care; Noel Genova, PA-C of the Chronic Pain Consultation Program; John Lipovsky, the coordinator of the Prescription Monitoring Program; and Gordon Smith, Esq., Executive Vice President of the Maine Medical Association. 

There is no cost to attend for prescribers affiliated with Mount Desert Island Hospital.  There are limited slots available for physicians and other prescribers not part of MDI Hospital and the cost to attend is $50.  For more information or to register, please contact Gail Begin, MMA CME Director, at gbegin@mainemed.com. [return to top]

November 1 First Fridays Program: Annual Compliance Seminar

MMA 2013 First Fridays Educational Programs

November 1, 2013 

Annual Compliance Seminar: Preventing Allegations of Fraud & Abuse

9:00 AM–Noon 

Registration and Breakfast begin at 8:30 am

Topics include: 

  • What you Need to Know about the Sunshine Act, with guest speakers Ann Robinson, Esq. and Jeff Parsons, Esq.
  • OSHA Update 
  • General Billing and Compliance Issues 

TWO WAYS TO ATTEND the program are available: both live at the MMA Offices in Manchester and over the web via Webex. Because of the substantial course materials, the per person $70 fee is the same whether attending in Manchester or participating through Webex. In either case, please register today. Webex capacity is limited to 25 sites, so don’t delay! Click here to register. 

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Input Sought from Physicians on Impact of MaineCare Transportation Contracts

MMA has been asked whether its members and their practices have been impacted by the change in contracted transportation services utilized to provide rides to MaineCare patients to medical appointments.  If you have been impacted by more no-shows or late arrivals, please contact Gordon Smith at MMA via e-mail to gsmith@mainemed.com. [return to top]

Job Openings

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

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 http://www.mainedentalaccess.org/events.php


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


 Attend Commercial Driver Medical Examiner Training

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

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