October 28, 2013

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Nov 1 First Fridays Program - Annual Compliance Seminar: Preventing Allegations of Fraud & Abuse

MMA continues to hear reports of more aggressive enforcement actions by state and federal agencies, partly as a result of additional funds available through the Affordable Care Act. This month's First Friday CME program features practical tips on how to keep your practice compliant with coding and billing practices, presented by an experienced group of health care attorneys.  The other topic featured Friday morning will be the federal Sunshine Act, requiring the reportability of payments or services of value being given to prescribers by industry.

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.
  • RAC audits
  • False Claims Act
  • Fraud issues associated with Electronic Medical Records
  • Responding to Subpoenas. CID and court orders
  • Current enforcement actions against healthcare professionals
Attorneys John P. Doyle, Jr., Charles Dingman, Nathan Fennessy, Katrina Clearwater of the law firm of Preti Flaherty will present the content on Fraud & Abuse.  Mr. Smith will discuss risks associated with the use of electronic medical records.

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. 

SIM Grant Annual Meeting and Subcommittee Kickoff on Thursday (Oct. 31)

The first annual meeting of the State Innovation Model grant will take place this coming Thursday (Oct. 31) and all health care professionals are invited to attend, along with any member of the public who is interested in the work of the project.  The meeting will be held from 9:00am to noon in the North Wing of the Augusta Civic Center.  The meeting will also serve as a kickoff for the various subcommittees organized to assist the project.

The SIM Steering Committee met last Wednesday (Oct 23) and went through a long list of agenda items including:

  • Steering Committee Logistics
  • CMS Payment for Patient Centered Medical Home Practices 
  • SIM Mission and Vision Adoption
  • Accountable Care Implementation and Pathways to Excellence Distinction
  • SIM Objectives
  • SIM Operational Plan
  • Evaluation/Metric Development

All meeting documents are available at: http://www.maine.gov/dhhs/oms/sim/steering/index.shtml

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National Government Services, Inc. Successfully Transitioned Medicare Part B Workload

National Government Services successfully transitioned the Medicare Part B workload on October 25, 2013 for Part B providers in Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont from NHIC, Corp. Medicare to the new National Government Services JK A/B Medicare Administrative Contractor (MAC). 

There was no need for National Government Services to implement a Dark Day and all of NGS's systems are working and are accessible.  [return to top]

Commission to Study the Incidence of and Mortality Related to Cancer Holds First Meeting

LD 1547, Resolve Chapter 77, passed the legislature this past session and established a Commission to Study the Incidence of and Mortality Related to Cancer.  The Commission held its first meeting last Friday at the State House in Augusta.  The charge of the Commission is to: 

  1. Identify or review the State's current priorities and goals to reduce the incidence of and mortality from cancer;
  2. Identify the types of cancer with the highest incidence and mortality in the State, including the types of cancer whose incidence and mortality rates differ the most from national averages;
  3. Identify the risk factors, including preventable lifestyle risk factors such as tobacco use, diet, exercise and obesity, related to high relative rates of the incidence of and mortality from cancer;
  4. Identify the extent to which barriers to health care in the State contribute to cancer mortality;
  5. Make recommendations for legislative strategies to reduce the State's cancer incidence and mortality; and
  6. Make recommendations for how current state programs could further assist citizens through education and cancer prevention programs.
The Commission includes four physician members: Andrew Hertler, MD of the Harold Alfond Center for Cancer Care, Susan Miesfeldt, MD, with Maine Medical Center, Tracey Weisberg, MD, of the Maine Center for Cancer Medicine and Molly Schwenn, MD representing the Maine CDC Maine Cancer Registry.  Other members include five legislators and representatives of the American Lung Association and American Cancer Society. 

At their meeting last week, the Commission began hearing background information on the incidence of cancer in Maine, mortality rates, and risk factors for cancer.  The Commission's next meetings are scheduled for November 8, November 21 and December 6, all at the State House and they are open to the public. 

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Government Shut Down Delays CMS Issuance of Payment Rules

On October 23rd, CMS announced that the government shut down has caused the agency to delay the release of final provider payment rules from November 1st to November 27th.  These rules include:

  • Revision to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2014 Final Rule with Comment Period (CMS-1600-FC);
  • CY 2014 Home Health Prospective Payment System Final Rule (CMS-1450-F);
  • CY 2014 Changes to the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System (CMS-1601-FC); and
  • Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (CMS-1526-F).

The delay means that providers will have half the usual 60 days to comply with the new rules which may be a challenge for some organizations.  For physicians, it just adds to the uncertainty of Medicare payments, given the scheduled 25% cut mandated by the SGR unless Congress acts. [return to top]

HealthInfoNet Receives $300,000 Grant to Connect VA Health System

On October 15th, HealthInfoNet announced that it has received a $300,000 grant from the Health Research and Services Administration (HRSA) to connect the state's Veterans' Administration (VA) health system with the health information exchange.  The grant award is for 3 years and HealthInfoNet expects to receive similar amounts in the following years.  According to the U.S. DHHS Office of E-Health Standards and Services, Maine, Ohio, and Kentucky are the leading states in the development of a health information exchange.  HealthInfoNet currently includes 34 of 38 acute care hospitals and 376 ambulatory care providers in the state.  Among the states, Maine has the 5th highest per capita veteran population at 12.8%. [return to top]

CMS Paid $6.3B in Medicare EHR Incentive Payments in 2012

On October 24th, the Government Accountability Office (GAO) issued a report stating that the Medicare program paid hospitals and health care professionals $6.3 billion in meaningful use incentive payments in 2012, more than twice the amount paid in 2011.  CMS paid almost 2300 hospitals $3.5 billion and paid almost 184,000 eligible professionals $2.8 billion.  These figures represent 48% of eligible hospitals.  The hospital incentive payments ranged from $4827 to $4.7 million and the median payment amount was $1.4 million.  Fewer than a third of eligible professionals received Medicare EHR incentive payments in 2012. [return to top]

MICIS Can Help Physicians Save Time and Practice More Effectively

The Maine Independent Clinical Information Service (MICIS), the academic detailing program of the Maine Medical Association, has been helping busy physicians keep up with medical literature since 2009.  MICIS provides high-quality, rigorous and independent modules on a range of topics that are offered to you by trained clinicians at your convenience, at your work site, at no cost. CME is available.  

Currently available topics are:

  • Obesity Management (NEW!)
  • Antipsychotics

 Upcoming topics are:

  • Antibiotic Stewardship (Nov. 2013)
  • COPD (Jan. 2014)
Contact Program Manager Jennifer Reck today at jreck@mainemed.com for more information or to schedule a visit. [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]

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]

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]

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.


Practice Administrator at Maine Nephrology Associates in Portland, Maine

Maine Nephrology Associates (MNA), an independent physician practice located in Portland, Maine, is seeking a Practice Administrator.  MNA is comprised of eleven nephrologists and two physician extenders supported by approximately 25 employed staff. We provide specialist care for kidney disease and hypertension in a single private office location that includes its own laboratory, in four area hospitals and in five dialysis centers.  MNA Physicians hold Tufts University School of Medicine faculty positions to teach trainees at Maine Medical Center.  MNA physicians also serve as principal investigators on numerous research grants.

The Practice Administrator’s oversight responsibilities include all aspects of practice management: planning, implementing, controlling, contracting, financial, legal and regulatory compliance, administrative services, physician credentialing, human resource policies and benefits, organizational design, supervising, training, billing, scheduling and medical records functions.

The Practice Administrator reports to the Managing Partner and this pair in turn works with the Physician Steering Committee to implement the strategic goals of the group.  The ideal candidate is an experienced healthcare management professional with competence to lead this medical practice through organizational change to ensure efficient, effective and safe operations of all aspects of clinical and administrative operations.

Interested candidates are invited to forward a resume or CV along with a cover letter detailing how your experience meets the expectations of this position along with salary requirements to mnamgr@maine.rr.com.


Department of Psychiatry Faculty Position

The Geisel School of Medicine at Dartmouth, Department of Psychiatry, in a productive collaboration with the State of Maine, is seeking a psychiatrist to join our faculty for inpatient responsibilities at the Riverview Psychiatric Center.

Riverview Psychiatric Center is a 92-bed acute psychiatric facility located in Augusta, ME and is the flagship inpatient treatment center for Maine’s public mental health system.  Psychiatrists with expertise in general inpatient psychiatry or forensic psychiatry are encouraged to apply.

Academic duties can include teaching and supervision of medical students and residents. Research opportunities available and encouraged.

Candidates should be board certified or eligible in Psychiatry. This position will include a faculty appointment at The Geisel School of Medicine at Dartmouth at a rank and salary commensurate with experience. Curriculum vitae and three letters of reference, addressed to Dr. William Torrey, Search Chair, should be e-mailed to psychiatry.jobs@dartmouth.edu.  Please reference search number PS1013D.

The Geisel School of Medicine at Dartmouth is an Equal Opportunity/Affirmative Action Employer and encourages applications from women and members of minority groups.


Family Medicine Physicians

Katahdin Valley Health Center is recruiting dedicated Family Medicine 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 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.  


Medical Group Management Association of Maine Presents:

MGMA Seminar: 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

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

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