November 25, 2013

 
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MMA Looking for Feedback on MaineCare Primary Care Increase

In a meeting this past week with MaineCare officials, MMA staff agreed to ask our primary care members about their experience with the primary care fee increase effective Jan. 1, 2013. Once an attestation form is completed, reimbursements for most primary care codes are paid at 100% of Medicare, with the increase funded by the federal government under the provisions of the ACA.

The increase is available to eligible primary care physicians who are paid off of the MaineCare fee schedule.  It is not available to providers billing under provider-based reimbursement or to practitioners whose services are billed through a federally qualified health center.

Here are the questions MMA is interested in:

  1. Have you completed the attestation statement so that you are receiving the increase?
  2. How much increased reimbursement have you received?
  3. Has your practice been able to see more MaineCare patients or open to new MaineCare patients as a result of the increase?

Please send your answers to Gordon Smith at gsmith@mainemed.com.

The increased payment is funded by the federal government for only two years so it will be a high priority of MMA to work with MaineCare officials to find funds to continue the increase after 2014.

L.D. 388 Work Group Proposes Automatic PMP Registration via Medical Licensing & Renewal

As a result of legislation passed in 2012, registration with the Prescription Monitoring Program (PMP) of prescribers of controlled substances in Maine is required by March 1, 2014 unless 90% of that class of prescribers is registered by Jan. 1, 2014. While there is no enforcement of this requirement in the law, MMA has been working with the legislature and the Substance Abuse Services Commission (SASC) to find an alternative to mandatory registration. At the request of MMA, legislation was introduced into the first regular session of the 126th Legislature (L.D. 388) authorizing the establishment of a work group to determine the cost and feasibility to having PMP registration occur automatically with the issuance or renewal of a license.  The legislation was amended into a Resolve which asked the Substance Abuse Services Commission to convene a work group to complete this evaluation.

The work group was formed and has now reported back to the SASC that such a system is feasible with a one-time cost of about $25,000.  Legislation is now being prepared to repeal the original mandate and substitute the automatic registration which would require the prescribers to do nothing except watch their e-mail for their user ID and password.  In order to accomplish this, we still need to pass amendments to the law and acquire the funding from the general fund or some other source.  Passage of the bill will be a high priority for MMA this session.

MMA encourages all prescribers of controlled substances to register for the PMP.  Do not wait for the automatic registration as the vagaries of the legislative and appropriations processes do not guarantee that we can get the ball over the goal line as the Patriots did so successfully last evening.  But we will certainly try. [return to top]

Dec. 6 First Friday Presentation to Focus on Accountability, Transparency & Public Reporting

The Association's final First Friday educational program of 2013 on Dec. 6 will focus on the topic of practice accountability, transparency and public reporting.  The data from your practice, whether it is claims data, administrative data or clinical data, is becoming increasingly important and will eventually be linked to payment. The program is offered from 9:00 am to noon at the offices of the Association in Manchester, Maine but participation is also available on-line through webex. This particular program is part of MMA's effort to educate physicians on payment reform and is presented with financial support from the Maine Health Access Foundation.

Registration is available on the MMA website or by calling 622-3374.  Flyers will also be sent out to practices once the faculty and topics are finalized.  Among the topics being considered are the following:

  • Carrier's tools for encouraging shopping by their insureds.
  • Provider profiling.
  • Transparency initiatives of the 126th Legislature, including L.D. 990 regarding the posting of prices in the physician office.
  • The difference between claims data, administrative data and clinical data.
  • Clinical data registries offered by various specialties including cardiology, surgery and ophthalmology.
  • State attempts to place data on public websites.
  • Data initiatives included in the State Innovation Model (SIM) grant.
  • Use of data emanating from HealthInfoNet.

The schedule of First Friday presentations offered in 2014 are also now on the Association's website.

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MMA Delegation Advocates SGR Repeal on Capitol Hill During AMA Interim Meeting

The MMA's delegates to the American Medical Association (AMA), Maroulla Gleaton, M.D. and Richard Evans, M.D., attended the 2013 AMA Interim Meeting near Washington, D.C. from November 16-19, 2013.  The AMA House of Delegates enacted policy calling for Congress to repeal the Medicare SGR formula by the end of the year.  The cost of a so-called "permanent fix" to the SGR problem is the lowest in many years, an estimated $138 billion over 10 years.  During the past decade, Congress has spent $146 billion on short-term patches.  On the afternoon of Tuesday, November 19th, the MMA delegation went to Capitol Hill to meet with each member of Maine's Congressional delegation to press the case for the SGR repeal.

You can find more coverage of the 2013 AMA Interim Meeting here. [return to top]

Update on SIM Steering Committee Meeting Nov. 13, 2013

The Steering Committee for the Maine State Innovation Model (SIM) Initiative met for its regular bi-weekly meeting on November 13.  The mission of the SIM initiative is to align and accelerate statewide innovations designed to achieve the Triple Aim of improving population health and health care quality, improving patient experience, and reducing health care costs for the people of Maine. Individual health care providers in Maine are represented on the Steering Committee by Noah Nesin, M.D. and Rhonda Selvin, APRN, CNP.  Noah is a family physician now responsible for quality improvement activities at Penobscot Community Health Center and Rhonda is a family nurse practitioner currently serving as President of the Maine Nurse Practitioner Association.

Highlights of the Nov. 13 meeting included the following:

  • The committee reviewed a draft letter to be sent to HHS Secretary Kathleen Sebelius urging continued funding by CMS of the multi-payer Patient Centered Medical Home pilot.
  • Committee members discussed the Accountable Communities Initiative (ACI) being rolled out by the Office of MaineCare Services.  Some concerns were expressed regarding the timing of the concurrent roll out of the Behavioral Health Homes initiative.  These concerns were addressed by Michelle Probert in the absence of Stephanie Nadeau the MaineCare Director.  The ACI will serve as the MaineCare ACO and is intended to facilitate the implementation of the Behavioral Health Homes initiative.
  • Frank Johnson of the Maine Health Management Coalition led a discussion of the Accountable Care Implementation group and Pathways to Excellence (PTE).  PTE reports are provided at the practice level with a high priority toward aligning the quality metrics selected.
  • Sheryl Peavey from HHS reported on efforts to align the SIM grant activity with other DHHS initiatives and noted that time and fiscal constraints have arisen because of the challenging time line.  Costs relative to preparing competitive requests for proposals have been reduced by optimizing the experience of the three primary existing partners:  Maine Quality Counts, HealthInfoNet and the Maine Health Management Coalition.
  • There was discussion regarding the role of the Steering Committee in the SIM budget.  While the budget is the domain of the State Leadership Team, the Steering Committee will be kept informed.
  • Dr. Yoe discussed the goals for metrics and the need for alignment.  The discussion will be on-goingover the next few months.
  • Subcommittee updates and Mission.Vision agenda items were tabled due to lack of time. It was agreed to extend the next meeting to three hours.

SIM initiative materials are available on the maine.gov website.

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Revised CMS 1500 Claim Form Required April 1, 2014

The Centers for Medicare & Medicaid Services (CMS) has completed a revision of the familiar 1500 Claim form that will be required for paper Medicare claims in 2014.  Changes are also expected to be made in the electronic format.

The new form will differentiate between ICD-9-CM and ICD-10-CM diagnosis codes and expand possible diagnosis codes.  Also qualifiers identifying provider roles on item 17 will include ordering, referring and supervising.

You may find instructions for the revised form in Chapter 26 of the Medicare Claims Processing Internet Only Manual (IOM, Pub. 100-04).  Here is the 2014 timeline for implementation:

  • Jan. 6 -Medicare begins accepting paper claims on the revised CMS 1500.
  • Jan. 6 to March 31 - Dual-use period; paper claims accepted on the old form as well as the revised form.
  • April 1 - Paper claims accepted only on the revised CMS 1500 claim form.
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Dirigo Board Considers Extending Insurance Program into 2014

Because of confusion and delays in the implementation of the Affordable Care Act’s Health Insurance Marketplace, the DirigoHealth Board of Directors is considering not ending the program on December 31 as planned.

The board is concerned about the approximately 7,300 people who are still on the Dirigo plan and don’t seem ready for the transition to the Marketplace. 

Adding to the confusion was President Obama’s change of policy to now allow insurance companies to keep the plans they had been cancelling.  Some Dirigo customers assumed that included Dirigo policies.  It does not. 

The program has enough money for an extension, but it’s unclear whether the LePage administration would agree to an extension.  The board will meet again on December 9 to discuss next steps.

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CMS Gives Consumers More Time to Enroll for Jan. 1 Coverage

The deadline for consumers to enroll in health insurance through the Affordable Care Act's marketplaces to have coverage by Jan. 1 has been moved from Dec. 15 to Dec. 23, a Centers for Medicare & Medicaid Services spokeswoman said.

On a call with reporters, the CMS's Julie Bataille said the deadline is being delayed in response to ongoing technical issues with the federal health insurance marketplace website, HealthCare.gov.

Insurers have assured the CMS that they can process insurance applications submitted as late as Dec. 23 for a Jan. 1 start date, she said.

Consumers still must pay their first monthly premium by Dec. 31 to receive coverage on Jan. 1. 

For patient-friendly materials regarding the Marketplace, please contact the MMA at jbarnard@mainemed.com[return to top]

Sign up to be Doctor of the Day

During the 1996 legislative session, the Maine Legislature asked the Maine Medical Association and the Maine Osteopathic Association to furnish a physician for each day of the legislative session to assist in the event of a medical emergency.  Now the “Doctor of the Day” program is well established and respected, and legislators are enthusiastic about it.  This is a unique opportunity to observe the legislative process in action and to interact with the lawmakers.  We need your help to continue our presence and to ensure the continued success of this program.

The scheduling of volunteers for the second year of the 126th Legislative Session has already begun.  We would like to invite you to participate in the upcoming session that is scheduled to convene in January and is expected to run through April.

Upon receipt of your registration, MMA staff will contact you to arrange and/or confirm the most convenient date for you to serve.  The House Clerk’s office staff then will mail you a packet with a legislative parking pass and confirmation letter informing you about your scheduled date.  On the day of your participation, a Maine Medical Association or Maine Osteopathic Association staff representative will meet you at the State House and will be available to guide you throughout the State House. 

This is an effective grassroots contact program for organized medicine in Maine and it has established substantial "good will" for organized medicine at the State House.  The “Doctor of the Day” program gives you the unique opportunity to observe the process in which your legislators make decisions affecting you as a physician and as a citizen of the State of Maine. 

If you have any questions regarding the “Doctor of the Day” program, please feel free to contact the MMA at docoftheday@mainemed.com. You can submit your registration on line. We hope to see you at the State House for what is expected to be a very interesting session for the medical community. [return to top]

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.

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Job Openings

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.

11/25/13

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.

11/25/13

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.

12/2/13

Nurse Practitioner

Maine School Administration District No. 75 seeks a Nurse Practitioner for our School Based Health Center at Mt. Ararat High School.  The position is a Part time (.5 FTE) salaried position with a flexible schedule.

The Nurse Practitioner will provide administrative and supervisory oversight of our School Based Health Center and administration of the funding grant. Responsibilities include providing comprehensive primary health care services to enrolled High School students and coordination of care with their Primary Care Clinicians. This position works collaboratively with the School Nurses, Medical Director and SBHC Advisory Committee.

Must have State of Maine Nurse Practitioner license and be certified in Family Practice of Pediatrics. At least two years Nurse Practitioner and Supervisory experience preferred.

Please forward a MSAD # 75 Professional employment application, cover letter, resume and copy of license to: Human Resources, M.S.A.D. No. 75, 50 Republic Avenue, Topsham, Maine 04086. Applications can be found at: www.link75.org. (Departments/Human Resources/Employment applications).

12/2/13 

MaineHealth Director of Government Affairs

The Director of Government Affairs reports directly to the Senior Vice President of Government and Employer Relations; and under the supervision of the SVP, will research and coordinate MaineHealth’s position on state and federal legislation and communicate with policymakers on behalf of MaineHealth..

We seek candidates with excellent written and verbal communication skills; strong analytic capacity; and  background in legislative process. The position requires the ability to accommodate a flexible work schedule (some nights and weekends). Working knowledge of health care policy preferred.

The position requires a thoughtful and keen individual to execute the following:

  • Research, monitor and analyze federal and state legislation and regulation;
  • Work with internal advocacy and clinical advocacy committees to coordinate development of positions on proposed legislation;
  • Attend committee hearings and work sessions and maintain written summaries;
  • Maintain files for bills, including handouts and testimony;
  • Draft testimony and supporting materials. Occasionally testify on legislation;
  • Develop and maintain strong relationships with legislators and their staff;
  • Work collaboratively with other organizations to promote MaineHealth’s interests;
  • Participate in Maine Hospital Association’s advocacy calls;
  • Work with contract lobbyists to ensure the effective coordination of legislative activities;
  • Distribute regular internal communications on legislative activities and issues of concern.

To apply, please contact Shawn-Elise Lapomarda, Executive Recruiter, at lapoms@mainehealth.org or 207-662-5936.

Additional information regarding MaineHealth and its members can be found at: www.careersatmainehealth.org or www.mainehealth.org

Equal opportunity employer.

12/9/13

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Upcoming Events

MaineGeneral Medical Center 

2013 Fall Coding & Compliance Conference:  Precision and Quality with Surgical and E & M Coding 

Waterville Elks Banquet & Conference Center 

Friday, December 6, 2013

7:30 a.m. – 3:00 p.m.

Cost: $75  (includes continental breakfast, lunch and breaks)  CEUS: 6 

For more information or to register, contact Cindy Sturtevant, Physician Office Relations Liaison,  (207) 872-4058 or cynthia.sturtevant@mainegeneral.org  [return to top]

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