October 14, 2013

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SIM (State Innovation Model) Steering Committee Update

The SIM Steering Committee met last week and reviewed the role of the Committee which operates under the guidance of the State Leadership Team.  CMS has recently approved the state plan and guaranteed the grant funds required as the project moves from the planning phase to implementation.  The Committee will continue to meet every other week under the chairmanship of Kevin Flanigan, M.D.   Dr. Flanigan is the Medical Director for MaineCare.

In addition to the regular meetings, an annual meeting for the project has also been scheduled for Oct. 31 from 9:00am to noon in Augusta at a location yet to be announced.  Steering Committee reports are expected to be used to help reintroduce the project to the public. October will also be the month in which the various work groups will meet for the first time.  The work groups are under the direction of the Maine Health Management Coalition, Quality Counts and HealthInfoNet, respectively.

At last week's meeting members also discussed the vision and mission statements for the SIM grant.  While a subcommittee has been appointed to review the language and to bring a revised statement back to the Committee, it was agreed that the focus of the grant is to facilitate the necessary data collection and delivery innovations required to support the on-going state transformation including patient centered medical homes (and Health Homes) with the goal of reaching the Triple Aim.  The Triple Aim encompasses the goals of better care for individuals, improved population health and lower health care costs.

The two representatives of health professionals on the Steering Committee are Noah Nesin, M.D. and Rhonda Selvin, APRN.  Both Noah and Rhonda are happy to hear from health professionals regarding the work of the Committee.  They can be reached via e-mail to nnesin@pchcbangor.org and rselvin@msn.com.

A great deal of information on the project can be found on the project website at the following web address:     www.maine.gov/dhhs/oms/sim/index.shtml

Free CME 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

5:30-9:00 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; Clare Desrosiers, MSW, with the Diversion Alert 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]

CMS Extends PQRS Registration Deadline to Oct. 18

As detailed below, several hundred large group practices are in danger of having all Medicare payments cut by 1% in 2015 unless they act now to sign up for GROUP participation in PQRS.  Based on AMA advocacy efforts,  CMS has extended the deadline for large practices to register in Administrative Claims from Oct. 15 to Oct. 18. The AMA is continuing to advocate for a longer extension, but it may not happen due to the government shutdown. 

Reminder for practices of 100 or more: Oct. 18, is the last chance to avoid certain Medicare payment cuts.

In the Affordable Care Act, Congress required CMS to apply a Value-Based Modifier (VBM) to all physicians’ Medicare payments by 2017 and to some physicians’ payment starting in 2015. In response, CMS intends to apply a 1 percent VBM penalty to the Medicare payments of physicians in groups of 100 or more that did not engage in GROUP participation in the Physician Quality Reporting System (PQRS) in 2013. This VBM penalty would be in addition to another 1.5 percent penalty that would apply to all physicians who did not participate in PQRS either as an individual or as part of a group. To avoid these penalties, physicians in groups of 100 or more should ensure that their GROUP is registered for one of the PQRS group participation options. Physicians who are not subject to VBM and are not yet participating in PQRS can still avoid the 2015 payment cut by registering for the CMS-calculated administrative claims reporting mechanism in 2013. 

The PQRS registration system, which will close on Oct. 18, can be accessed at https://portal.cms.gov and as of Oct. 8, data from CMS suggests that several hundred group practices who must register have not done so.  Use of the system requires an Individuals Authorized Access to the CMS Computer Services (IACS) number, which can be acquired at https//applications.cms.hhs.gov.  Additional information regarding registration and obtaining or modifying an IACS account is available at the Self Nomination/Registration web page. Please note that due to the government shutdown, CMS is unable to update the October 15 date listed on their website.

 Additionally, please note the help desk phone number listed in error messages on the PQRS registration portal is incorrect. Users should call the PV-PQRS Help Desk at 1-888-734-6433 Option 3 for questions about registration. They can also contact CMS’ QualityNet help desk at: 1-866-288-8912  (TTY 1-877-715-6222). [return to top]

MMA Offers Legal Resources on Payment Reform; Holding First Payment Reform Committee Meeting

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.

The MMA is also pleased to announce the first meeting of its new ad hoc Payment Reform Committee. This committee will build on the work of the former Payer Liaison Committee with a special focus on monitoring and providing physician feedback on ongoing payment reform initiatives.  The meeting is scheduled for Tuesday, November 12th from 6-8 pm at the MMA Headquarters.  If you are an MMA member with an interest in payment reform, please consider serving on this committee and joining us on the 12th.  For more information or to RSVP, contact Project Manager Jennifer Reck, MA at jreck@mainemed.com[return to top]

MMA Dues Renewal Is Coming Soon to a Mailbox Near You!

The Maine Medical Association began billing for 2014 membership dues this past week.  The dues amount has not been increased and remains $480 for active membership although a variety of discounts may be available.  If you are not aware of whether you may qualify for a discount, please contact MMA Membership Coordinator Lisa Martin at 622-3374 ext. 221 or via e-mail to lmartin@mainemed.com.  Discounts are available for members working part-time (considered to be twenty or fewer hours a week), osteopathic members so long as they also belong to the Maine Osteopathic Association, members joining for the first time and for group members.

Membership dues are critically important to MMA if the Association is to continue its mission and advocacy for Maine's physicians, patients and public health.  Although non-dues income now makes up more than half of the MMA budget, membership dues represents a strong 40% of revenue.

We hope members will renew their membership and pay their dues promptly.  We need your support.

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Your Story Can Help More Mainers Have Health Security

Earlier this year, the Maine legislature failed to override a veto on legislation to accept federal funds that have already been set aside to provide health insurance coverage to more people through MaineCare.  As a result, 70,000 of our patients, friends, relatives, and neighbors in Maine will not be able to get affordable health care coverage.  Many will not qualify for subsidies in the new health insurance marketplace because the federal health reform law was designed with the expectation that all states would accept the federal funding set aside to provide greater access to health coverage.

The Maine Medical Association is working with the Cover Maine Now! coalition because we believe hard-working, low-income Maine families should have access to lifesaving health screenings and treatment, as well as the security of quality health coverage to get care when they need it, without facing huge medical bills.

Cover Maine Now! is collecting stories from around the state to share with legislators who will soon vote on whether to accept federal funds to provide affordable healthcare to 70,000 more Mainers.  These legislators need to see faces rather than more statistics.  They need to hear your story, or perhaps the story of one of your patients. 

Please follow the link to the Cover Maine Now! website (or call 866-626-7059 ext. 205) to tell your story about why affordable, quality health coverage is important to you and your patients.  If you have patients who would like to tell their story, please encourage them to visit the website or call.  Or email the MMA at jbarnard@mainemed.com for cards to hand out to your patients with the contact information. 

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OMS Releases Call for Accountable Communities and Behavioral Health Homes

Accountable Communities Request for Applications (RFA)

The Department of Health and Human Services has posted the RFA for its MaineCare Accountable Communities Initiative at: http://www.maine.gov/dhhs/oms/vbp/accountable.html

Key dates are listed below:

1.      Optional Notice of Intent/ Interest Survey due - November 15, 2013

2.      Application due - December 9, 2013

3.      Implementation - May 1, 2014

Through Accountable Communities, MaineCare will engage in shared savings arrangements with provider organizations that, as a group, coordinate and/or deliver care to a specified patient population.  Accountable Communities that demonstrate cost savings, as well as the achievement of quality of care standards, share in savings generated under the model.  Accountable Communities will achieve the triple aim of better care for individuals, better population health, and lower cost.  This initiative will be offered statewide as a Medicaid State Plan option.

If you have questions, please contact Michelle Probert.

Behavioral Health Homes Request for Applications (RFA)

The Department of Health and Human Services has posted an RFA for its Behavioral Health Home initiative at: http://www.maine.gov/dhhs/oms/vbp/health-homes/stageb.html

Key dates are listed below:

Informational Sessions:

  • October 21, 2013: Augusta Civic Center, 9:00-10:30
  • October 22, 2013: Webinar, 2:00- 3:00**
  • October 23: Webinar, 11:00- 12:00**
**Due to a limited number of phone lines for webinar participants, please register by 5:00 PM on October 18, 2013 by clicking here.

Optional Notice of Intent/ Interest Survey due - November 1, 2013

Applications Due: Friday, November 22, 2013

Implementation of Behavioral Health Homes Program: January 2014

Behavioral Health Home (BHH) services will be delivered by a Behavioral Health Home Organization (BHHO) that partners with a Health Home primary care practice to deliver comprehensive care management and care coordination services.  BHHOs are licensed community mental health providers who meet other criteria as detailed in this RFA.  A separate application will be issued for primary care practices that are not currently approved to provide Health Home services and that are interested in partnering with a BHHO to deliver BHH services.

If you have questions, please contact Kitty Purington.

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MMA Senior Section to Meet Wednesday, Oct. 23
MMA's Senior Section will hold its next regularly scheduled meeting Wednesday, Oct 23rd beginning at 11:30am at the Frank O. Stred Building in Manchester.  The presentation will involve the recruitment and retention of physicians in Maine and the speaker is Jeremy Robinson of Merritt Hawkins.  Lunch will be served.  

Any member interested in attending who has not previously responded to Lisa Martin may simply call Lisa at 622-3374 ext. 221 or vi e-mail to lmartin@mainemed.com.  Buell Miller, M.D. continues to chair the Section.
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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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Webinar: Employees with Injury, Illness and Disability

The Maine State Bar Association Presents: 

Employees with Injury, Illness and Disability 

Live Webinar 

Wednesday, October 23, 2013

9:30 a.m. - 11:30 a.m.

Physician practices are encouraged to participate. 

Click here to view the program information and registration.

Workplace issues raised in the case of employees with injury, illness and disability can be challenging in the employment law context because at least three, and sometimes more, separate and distinct statutory regimes often apply simultaneously. In this session, we will explore the extent to which these independent legal frameworks overlap and, in some instances, conflict.

The panel will address practical applications of the laws in a number of different scenarios with both employee and employer perspectives.  We encourage you to submit questions in advance, so that the panel can address specific issues.  Questions can be submitted to clewebcast@mainebar.org.

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Job Openings

Ambulatory Surgery Center Manager

Central Maine Orthopaedics (CMO) is recruiting for a full-time Manager for our ASC. The foremost duty of this position is to ensure the day-to-day operations and management of the ASC run smoothly and efficiently.  This position requires a professional with strong leadership characteristics with an associated broad skill set who will serve as role model, mentor, and coach/facilitator.

This position is responsible for delivery on the organization's strategic plans, benchmarks, and critical success factors and therefore must demonstrate accountability and responsibility for own work and expected outcomes for those supervised. This position is responsible for maintaining requirements for State licensure, Medicare certification, and accreditation by the Accreditation Association for Ambulatory Health Care (AAAHC).                                                                            

AAAHC/JCAHO experience in an ASC or hospital free-standing outpatient surgery setting, required.

Please see the full listing for this opportunity on the Careers section of our website www.cmogroup.org.

Interested candidates, please send cover letter, résumé, and salary requirements to:  Janine Valliere, HR Manager, Central Maine Orthopaedics, 690 Minot Ave, Auburn, ME  04210 or e-mail to jvalliere@cmogroup.org.


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 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 & Maine Medical Association Proudly Present

Public Health Policy & Advocacy: What You Really Want to Know but Are Afraid to Ask

October 21, 2013

 Noon to 4:30 p.m. 

State House, Augusta, ME

The event will be held at the State House and will include a tour a Noon, with the session beginning at 1pm. This is a fabulous opportunity to hear directly from legislators and volunteer advocates, become clear on the line between advocacy and lobbying and learn more about Maine's legislative committees and process. 

The event is free and open to the first 60 people who respond. 

Click Here for more information or to register. 


Maine Public Health Association 29th Annual Meeting 

October 22, 2013 

8:30 am - 4 pm 

Augusta Civic Center 

For more information, click here


athenahealth Webinar: 

Webinar: Staying Profitable Through Payment Reform

Wednesday, October 23

12:00 p.m. ET

The government has already launched initiatives like Shared Savings Programs, Accountable Care models and Pay-for-Performance (P4P) programs. Private payers are also trying a variety of new reimbursement approaches and there are only more changes to come. Register for our webinar today for an in-depth look at payment reform strategies for success.

Click here for more information or to register. 


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