October 21, 2013

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NGS to Become Medicare Part B Carrier in Maine Friday, Oct. 25

As previously reported in the Weekly Update and elsewhere, the processing of Medicare Part B claims on behalf of CMS will transition from National Heritage Insurance Company to National Government Services (NGS) this coming Friday, Oct. 25, at 5:00pm.

The transition in Maine is also happening in New Hampshire, Vermont, Massachusetts and Rhode Island and is part of a national strategy by CMS to have fewer administrative contractors.  National Heritage Insurance Company (NHIC), which has had the contract for many years, will remain a subcontractor to NGS which should assist in assuring a smooth transition and cut-over.  The cut-over on the Part A claims has already occurred.

A letter was mailed from NGS on Oct. 10 to the provider community containing the important contact information for the company and a detailed list of the impacted local coverage determinations.

MMA staff has been participating in weekly conference calls with NGS officials in preparation for the transition  Early boarding for electronic submitters continues to improve with progress noted following contacts with the vendor community.  All steps of the transition are completed to date with no unresolved issues identified.

The move from NHIC to MGS will have an impact in the local policies area.  For example, of particular interest to psychiatry, NHIC began paying for Transcranial Magnetic Stimulation Therapy for major depressive disorders in 2011. However NGS does not cover the procedure.  A communication is being sent by the state psychiatric associations to NGS officials requesting that coverage be continued.

For more information, go to www.NGSMedicare.com.

National Government Services, Inc. is a subsidiary of Wellpoint which is also the owner of Anthem Blue Cross and Blue Shield.

Technical Problems Impact Health Care Insurance Marketplace; 476,000 Applications Filed Nationwide

Problems continued last week with the on-line application process at Healthcare.gov including error messages and loading page delays.  However, it was announced by CMS that 476,000 applications for health insurance have been filed through either federal or state exchanges.  Officials would not say how many people have actually enrolled in the insurance market.  It is unclear whether the program is on track to reach the 7 million people projected by the Congressional Budget Office to gain coverage during the 6 month sign-up period. It is important to note that people can still enroll in plans offered on the Marketplace by phone or with paper applications. 

Some of the technical issues with the marketplace entry portal were blamed on a high volume of visitors to the site - 14.6 million in the days following the Oct. 1 start date.   

Today, Oct. 21, the Advisory Committee on the Exchange established by the Maine Legislature will meet for the second time and among other things will hear from Region I HHS Director Christie Hager, J.D., MPH.  Committee members will also review responses DHS has made to questions asked by the Committee.  While the LePage administration has refused to meet with the Committee, HHS and the Bureau of Insurance have agreed to respond in writing to questions submitted in writing by the Committee. 

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Peter Sacchetti, M.D. Appointed to Board of Licensure in Medicine

Peter Sacchetti, M.D. of York has been appointed by Governor Paul LePage to a six-year term on the Board of Licensure in Medicine.  Dr. Sacchetti is a Board Certified internist practicing at Webhanett Internal Medicine.  He is a native of New Hampshire.  He has recently served as President of the Medical Staff at York Hospital.

He takes the position previously held by Gary Hatfield, M.D. who completed two full six-year terms in June.  The Board consists of six physicians, three public members and one physician assistant.  The PA position is not yet filled but the Governor is expected to make an appointment soon. [return to top]

Four Spots Still Available at Thursday's Free CME Program on Preventing Prescription Drug Abuse

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 four slots remaining 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]

MMA Webinar: Payment Reform Readiness for the Independent Physician, Nov 21

Webinar:  Payment Reform Readiness for the Independent Physician

Nov. 21, 12:00-1:00 pm

Ben Townsend, JD, Shareholder, Kozak & Gayer
Beverly Neugebauer, Executive Director, Coastal Women’s Healthcare

Attorney Ben Townsend of Kozak & Gayer will discuss the publication he recently authored for the MMA entitled “Payment Reform Readiness: A Legal Toolkit for Physicians”.  He will provide an overview of current payment reform initiatives as well as the sometimes unexpectedly complicated business, legal and compliance issues that such initiatives may raise, particularly for independent physicians.

Beverly Neugebauer, Executive Director for Coastal Women’s Healthcare in Scarborough, will give a first hand account of how Coastal Women’s Healthcare has navigated many challenges of the changing healthcare payment environment, remaining a viable, independent practice owned by eight physicians.

To join this webinar, please email Jennifer Reck at jreck@mainemed.com.  The legal toolkit document and other payment reform resources are available at: https://www.mainemed.com/cme-education-info/payment-reform.  The webinars and resources are made possible through a generous grant from the Maine Health Access Foundation. [return to top]

Save the Date: MMA Legislative Committee Meeting, Dec. 9

The MMA Legislative Committee, chaired by Amy Madden, M.D., will hold an organizational meeting in anticipation of the Second Regular Session of the 126th Maine Legislature on Monday, December 9th from 6:00 p.m. to 8:30 p.m. at the MMA office in Manchester.  Dinner will be available at 6:00 p.m.  Any MMA member or practice management staff person who is interested in our advocacy work is welcome to attend.  Medical specialty societies are strongly encouraged to have a representative at the meeting to ensure their members are aware of policy initiatives that may affect their specialty.  For our meal planning, please RSVP to Ashley Bernier (abernier@mainemed.com; 622-3374, ext. 213) if you plan to attend.

MMA is not planning to hold a Physicians' Day at the Legislature this year.  However, the Cover Maine Now! (CMN) Coalition, (www.covermainenow.com), a broad based group of health care and consumer advocacy organizations supporting the acceptance of federal funds to provide health coverage for low income Mainers, plans a rally at the State House in support of that initiative on January 8th, the opening day of the second session.  The MMA is a member of the Steering Committee of the Coalition and encourages physicians to attend on the 8th.  The MMA will publish more information about the CMN rally in the Maine Medicine Weekly Update as it becomes available. 

The MMA is also seeking physicians who are willing to serve as "Doc of the Day" for the Legislature in 2014.  To learn more about the program or sign up, please visit: http://www.mainemed.com/doctor-day. [return to top]

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. [return to top]

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 - please note that these dates have recently changed to reflect expected delays in the Medicaid State Plan Amendment (SPA) approval process as a result of the recent federal shutdown.

Written questions due: October 25, 2013

Informational Sessions:
October 28, 2013: Augusta Civic Center, 9:00-10:30
October 29, 2013: Webinar, 2:00- 3:00**
October 30, 2013: Webinar, 11:00- 12:00**

**Due to a limited number of phone lines for webinar participants, please register by 5:00 PM on October 25, 2013 by clicking here.
Optional Notice of Intent/ Interest Survey due: November 15, 2013
Applications Due: December 6, 2013
Implementation of Behavioral Health Homes Program: April 1, 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.

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

If you have questions, please contact Kitty Purington. [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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MGMA Seminar: Generational Differences in the Workplace & Advanced Excel 2010 Tips and Tricks

Medical Group Management Association of Maine Presents:

Generational Differences in the Workplace & Advanced Excel 2010 Tips and Tricks

Wednesday, November 13, 2013
8:30 - 4:00
Fireside Inn & Suites
81 Riverside Street
Portland, ME

Generational Differences in the Workplace

Today’s workforce is comprised of many different generations of employees. The work ethic and work habits of the Baby Boomers is very different from that of Generation Y. Many Baby Boomers feel that hard work and loyalty is what defines a good employee. Many Generation Ys place importance on work-life balance and instant gratification/recognition in the workplace. Kim will explore generational differences in the workplace and learn how to effectively manage these different
types of employees.

Advanced Excel 2010 Tips and Tricks

Excel, the longstanding powerhouse of spreadsheet software, is one of the most commonly used business applications on the planet. As an Excel user, you know that the software has unlimited capabilities for making your job easier and less stressful. But learning the countless features available to you can be a daunting task. This workshop will teach you the most common advanced features and functions Excel offers — taking your level of proficiency from basic to advanced. After this training you’ll be amazed at how this powerful program can work for you.

Speakers Include:

Kim Brewer, CPA, CMPE
Practice Administrator
Northampton Area Pediatrics, LLP

Pamela Beaulé, MBA, CMPE
Director of Managed Care

For more information or to register, visit:  http://www.memgma.com/site/events-calendar.htm [return to top]

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.


Chief Medical Officer at Portland Community Health Center

The Portland Community Health Center, located in the heart of Portland Maine, is seeking an experienced physician leader/chief medical officer to join our mission driven team.  As a Federally Qualified Health Center, we offer a great opportunity to provide patient centered holistic care to a highly diverse patient population.  An interest in teaching and international medicine is preferred. Position is full time, extended hours, outpatient only and no call.

The Chief Medical Officer is responsible to the CEO.  She/he also makes direct reports to the monthly Board of Directors meeting and the quarterly Board Quality Management Committee. The Chief Medical Officer is accountable for the delivery and quality of all PCHC’s health care clinical services.

Portland Community Health Center, 180 Park Avenue, Portland, ME 04102 http://portlandcommunityhealthcenter.org

Submit resume and letter of intent to: Leslie Brancato, CEO: Lbrancato@portlandchc.org or 207.874.2141 Ext: 5028.


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 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.   [return to top]

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