President Signs the Pathways for SGR Reform Act of 2013
On Thursday, Dec. 26, President Obama signed into law the Pathway for SGR Reform Act of 2013. This new law prevents a scheduled payment reduction for physicians and other practitioners who treat Medicare patients from taking effect on Jan. 1, 2014. The new law provides for a 0.5 percent update for such services through March 31, 2014. Chances have never been better for achieving a permanent repeal of the SGR by the end of March.
The new law also extends several provisions of the Middle Class Tax Relief and Job Creation Act of 2012 as well as provisions of the Affordable Care Act. Specifically, the following Medicare fee-for-service policies have been extended:
Section 1101 - Medicare Physician Payment Update - the new law provides for a 0.5 percent update for claims with dates of service on or after Jan. 1, 2014 through March 31, 2014. CMS is currently revising the 2014 Medicare Physician Fee Schedule to reflect the new law's requirements as well as technical corrections identified since publication of the final rule in November. The 2014 conversion factor is $35.8228.
Section 1103 - Extension of Medicare Physician Work Geographic Adjustment Floor - The existing 1.0 floor on the physician work geographic practice cost index is extended through March 31, 2014. As with the physician payment update, this extension will be reflected in the revised 2014 Medicare Payment Fee Schedule. This provision is of particular interest and value to Maine physicians.
Section 1105 - Extension of Medicare Inpatient Hospital Payment Adjustment for Low-Volume Hospitals - The Affordable Care Act allowed qualifying low volume hospitals to receive add-on payments based on the number of Medicare discharges from the hospital. To qualify, the hospital must have less than 1,600 Medicare discharges and be 15 miles or greater from the nearest like hospital. This provision extends the payment adjustment through March 31, 2014, retroactive to Oct. 1, 2013.
Section 1106- Extension of the Medicare-Dependent Hospital Program - The MDH program enhanced payment to support small hospitals for which Medicare patients make up a significant percentage of inpatient days or discharges. This provision extends the MDH program until March 31, 2014 and is retroactive to Oct. 1, 2013.
MMA will be working with the AMA and other medical associations toward the goal of achieving permanent repeal of the SGR prior to the next deadline of April 2014. All of Maine's Congressional delegation are committed to a permanent repeal.
Transparency of Pricing Law Takes Effect on Jan. 1, 2014
Public Law Chapter 332 (L.D. 990) was enacted during the First Regular Session of the 126th Legislature but its effective date was delayed beyond October in order to give medical practices and hospitals an opportunity to come into compliance. The law replaces an earlier statute requiring the posting of prices. The new law, which is expected to be further clarified this coming session, requires all health care practitioners to provide copies of a price list of all services and procedures performed at least 50 times during the preceding calendar year. The prices must be those that the practitioner charges patients directly when there is no insurance coverage. The prices must be accompanied by the applicable standard medical code listed by diagnosis. Practitioners must inform patients about the availability of the price list and provide copies of the list upon request. Practitioners also must inform patients of information that may be obtained from the Maine Health Data Organization web site. The new law was featured in a front page article in the Bangor Daily News this past week on Dec. 26.
The Legislative Council has allowed a bill to be introduced this coming session that is expected to amend Chapter 332. MMA staff is working with the bill's sponsor, State Senator Richard Woodbury (I, Yarmouth) and the Maine Hospital Association to draft amendments that will clarify some of the provisions of the current law. While there are no guarantees in the legislative world, there appears to be wide-spread agreement to remove the reference to diagnosis codes and to eliminate the requirement to furnish the entire list. Other helpful clarifying amendments may be added as well.
MMA staff is available to help member practices comply with the new law. Transparency of pricing is an important component of health system reform and is seen as essential to patients knowing more about the cost of care. For more information, contact firstname.lastname@example.org, email@example.com or firstname.lastname@example.org. [return to top]
HHS Extends EHR Donation Exception/Safe Harbor Rules through 2021
The U.S. Department of Health & Human Services (HHS) Office of the Inspector General (OIG) and the Centers for Medicare and Medicaid Services (CMS) have published companion rules which extend the ability for physicians to accept donations of almost free (must pay at least 15% of the cost of the technology) electronic health records (EHRs) from certain health care entities without violating STARK and Anti-kickback rules. The exception/safe harbor was scheduled to sunset on December 31, 2013. The American Medical Association is pleased to announced that due to the AMA's advocacy, HHS has extended the time physicians can accept donated EHRs under this exception/safe harbor through 2021. They had proposed 2016 as an earlier date but recognized that this was too soon. While the AMA advocated for a permanent exception, the extension of the sunset through 2021 brings welcomed relief for physicians as they continue to adopt EHRs and struggle to with the high cost of implementation. The rules also made several other notable changes:
- Excludes labs from the types of entities that may donate EHRs
- Updates the definition of what type of software is considered interoperable for the purposes of donations
- Clarifies the requirement prohibiting any action that limits or restricts the use, compatibility, or interoperability of donated items or services
- Removes from the exception the requirement related to electronic prescribing capability
HHS accepted the argument made by several others that labs should be removed from those types of entities permitted to donate EHRs to physicians due to concerns that EHR donations are being used to secure inappropriate referrals. The AMA, however, advocated that a preferable approach would be one that focused more on the need for better education around the limits of the safe harbor and exception for EHR donations.
The CMS rule can be found here and the OIG rule can be found here. [return to top]
Advisory Committee Maintains Protection for Sentinel Event Reports
At their meeting on Dec. 17 an advisory committee charged with reviewing and making recommendations on Maine's Freedom of Access Laws voted not to weaken Maine's confidentiality protections for sentinel event reporting. The vote capped several years of advocacy by the Maine Medical Association, Maine Hospital Association and Medical Mutual Insurance Company of Maine to maintain the protection, arguing that the protection has increased patient safety and created a culture of no-blame investigation of quality concerns. Maine Statue currently states that sentiel event reports are confidential and privileged although data from the reports that do not identify or permit identification of the health care facility can be shared publically. In 2012, subcommittee of the Right to Know Advisory Committee proposed to abolish the protection. After many meetings of the subcommittee at which they received information on how other states treat such reports, written testimony from advocates and comments of hospital staff and others, the subcommittee voted Dec. 10 not to eliminate the protection and the full committee accepted that recommendation on Dec. 17. [return to top]
MMA Legislative Committee Conference Calls to Begin Jan. 14
In keeping with past practice, the MMA Legislative Committee will hold weekly conference calls every Tuesday at 8:00 p.m. during the session beginning on Tuesday, January 14th. Look for the conference call information each week in the Maine Medicine Weekly Update beginning January 13th.
For more information about the activities of the MMA Legislative Committee, please contact Andrew MacLean, Deputy EVP at email@example.com or 622-3374, ext. 214. [return to top]
Payment Reform Readiness Webinar Series: Connecting to HealthInfoNet, Jan 21
Payment Reform Readiness Webinar Series: Connecting to HealthInfoNet for Better Care Coordination and Outcomes
January 21, 2014, 12-1pm
Shaun Alfreds, MBA, COO, HealthInfoNet
David Hallbert, MD, & Molly Stevens, RN, Martin’s Point Health Care
Data is at the heart of payment reform efforts intended to reward outcomes rather than volume. Practices preparing for payment reform are making improvements to their systems for data collection, exchange and analytics. Within this spectrum, HealthInfoNet is a valuable tool for exchanging data necessary for informed decision-making, care coordination and improved outcomes.
Shaun Alfreds, MBA, COO of HealthInfoNet will give an overview of HealthInfoNet, emphasizing its practical value for primary care.
David Hallbert, MD and Molly Stevens, RN will explain how they put HealthInfoNet into practice at their work site, Evergreen Woods Primary Care in Bangor.
To join this webinar, please email Jennifer Reck at firstname.lastname@example.org. This webinar was made possible through a generous grant from the Maine Health Access Foundation. Other payment reform related resources are available at: http://www.mainemed.com/cme-education-info/payment-reform-resources [return to top]
First Friday's Programs Resume in Feb. and April; New Program on Employment Contracts Announced
MMA's educational programs offered the first Friday of selected months and available at the office in Manchester or via Webex will resume in February. On Friday, Feb. 7, Attorney Ben Townsend of the firm of Kozak & Gayer will lead a program entitled, Payment Reform and the Legal Toolkit. The program will be presented from 9:00 am to noon and will feature a toolkit exploring how physician practices can prepare for payment reform. The program is presented with grant support from the Maine Health Access Foundation (MeHAF).
On Friday, April 4th, the topic has been changed from ICD-10 (which is the subject of a two-day program being held March 25-26) to physician employment contracts. With many residents and physicians already in practice receiving new contracts, the need for education in this area has become clear. A balanced panel of attorneys working on these contracts will present to attendees the common elements in these contracts and the pros and cons of having a contract at all versus being treated as an employee at will.
The cost of each First Friday program is $70 per attendee ($60 if attending three or more programs in one calendar year). Registration is available on the MMA website or by calling Lisa Martin at 622-3374 ext. 221. A list of all the First Friday programs for 2014 is included on the website. [return to top]
One Hundred Years Ago Today in the Maine Medical Journal
(Editor's note: In continuing celebration of the Association's 160th anniversary, we will periodically publish in the Update and in Maine Medicine notes of interest from the Maine Medical Journal of 1914).
From Cumberland County: Although the membership of the Cumberland County Medical Society at the beginning of 1913 was 140 physicians, 97 members attended the April county society meeting, which was a record attendance. At the Dec. 19th, 2013 meeting, the speaker was Dr. J. Madison Taylor of Philadelphia who read a paper written by a Dr. Sajous (who was to attend but fell ill). The subject of the paper was "The Various Forms of Goitre and their Treatment."
Also at the meeting, the following resolution was read: Resolved that the Cumberland County Medical Society, with its guests, assembled from all parts of the State, disapprove of any action directed against Dr. Henry Miller, superintendent of the Insane Asylum at Augusta, as detrimental to the interest of the insane of our State." (It is not clear from the minutes whether the Resolution was passed).
More, next week. [return to top]
Medical Practice Insider Features Content from MMA Payment Reform Readiness Webinar Series
Ben Townsend, JD, of Kozak & Gayer and Beverly Neugebauer, Executive Director for Coastal Women’s Healthcare spoke Nov. 21 on “How to Prepare Your Practice for Payment Reform" as part of the MMA’s Payment Reform Readiness webinar series. Their thoughts and expertise were captured in the following article that appeared in Medical Practice Insider on Dec. 19: http://www.medicalpracticeinsider.com/best-practices/how-prepare-your-practice-payment-reform. [return to top]
Assister Regional Roundtables: Marketplace Enrollment in Maine
Starting in January, Consumers for Affordable Health Care will convene Assister Regional Roundtables for navigators, certified application counselors, and others assisting with Marketplace enrollment in seven regions throughout the State: Sagadahoc, Penobscot, Cumberland, Washington/Hancock, Androscoggin, York, and Aroostook counties.
Come to your local roundtable and you will:
- Hear Marketplace updates and enrollment best-practices,
- Troubleshoot problems, and
- Network with other assisters in the area.
There may also be opportunities to be part of public information or enrollment sessions in the afternoon after these sessions. Details about these opportunities will be available in early January.
Who should attend:
- Certified Application Counselors
- Insurance agents and brokers
When and where:
*Details to follow for the Washington/Hancock, Androscoggin, York, and Aroostook regional roundtables in early 2014.
Sagadahoc Regional Roundtable
Midcoast Maine Community Action
34 Wing Farm Pkwy, Bath
9 am- 12:30 pm
Wednesday, January 8th (Snow date: Thursday, January 16th)
Penobscot Regional Roundtable
262 Harlow Street, Bangor
9 am- 12:30 pm
Tuesday, January 21st (Snow date: Tuesday, January 28th)
Cumberland Regional Roundtable
The Opportunity Alliance
50 Lydia Lane, South Portland
9 am- 12:30 pm
Monday, February 3rd (Snow date: Wednesday, February 5th)
Questions? Please contact Kate Ende, Consumers for Affordable Health Care, email@example.com, 207-622-7083. Registration will be available starting January 2, 2014. [return to top]
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Medical Director of Primary Care - Mercy, Portland, Maine
Mercy, a member of the Eastern Maine Healthcare System (EMHS), is
the Greater Portland regional health care system representing the highest
standards of clinical excellence and compassionate care.
The Director has overall responsibility for the
performance, staffing, operations, and programmatic direction for Mercy Primary
Care. Serves as the liaison between the
primary care physicians, specialists and community resources and develops
continuity of care processes across the system. Participates in strategic
planning and provides leadership in the development and implementation of
productivity systems, quality improvement and practice protocols to ensure the
efficient delivery of health care services. Responsible
for the recruitment, selection, retention and continuing education of
physicians and other clinicians.
MD or DO and board certification in Pediatrics,
Family Care or Internal Medicine required. Minimum 5 years progressively
responsible experience in physician group practices, including management
functions. Experience in utilization
review, care management and NCQA insurance plan quality metrics desired. Computer
proficiency, outstanding interpersonal skills, strong analytical and problem
solving skills required. EOE
FMI and to apply, visit www.mercyhospital.com or
contact Alison Salerno, Provider Recruiter firstname.lastname@example.org.
Family Medicine Physician - Maine Medical Partners
Maine Medical Partners (MMP) is seeking an experienced BC/BE Family
Medicine physician for one of their well-established
outpatient practices located in Scarborough, Maine, with
opportunities to also participate in hospital care as well as teaching of
medical students and residents.
is a high quality team of more than 370 physicians providing a wide range of
hospital-based, primary, specialty and sub-specialty care delivered through a
network of more than 30 locations in and near Greater Portland. Scarborough Family Medicine is redesigning
care in alignment with the Patient Centered Medical Home care model to provide
more convenient care with patient centered continuity. We are looking for a physician with at least
3-5 years of experience who wants to play an important role in making the care
team of the future a reality for the people of greater Portland.
Maine Medical Center has 637 licensed beds and is
the state’s leading tertiary care hospital, with a full complement of
residencies and fellowships and an integral part of Tufts University Medical
For more information please contact Alison C.
Nathanson, Director, MaineHealth Physician Recruitment Center at (207) 396-8683
Family Medicine Physicians
Northern New England Primary Care, LLC
is seeking board certified or board eligible Family Medicine Physicians to
join our independent, multispecialty group totaling 6.5 providers in
NNEPC specialties include: Family Practice, Internal Medicine, OB/GYN,
Pediatrics, Pain Management, Osteopathic Manipulation and Fluoroscopic
Interventional procedures. The clinic provides an array of ancillary services
including full service lab, MRI, Ultrasound, and Physical Therapy.
Inpatient services are supported by the
local hospitalist group. NNEPC is
interested in recruiting to support the community need for primary care
The Kennebec Valley region has a catchment of
250,000 and is located in the lakes region of central Maine.
For more information, contact Lisa Avery at 207-629-5522 or email email@example.com.
Case Manager - Maine Medical Professionals Health Program
Applications Open: December 3, 2013 to January 10, 2014
We are seeking an experienced full time Case Manager for a quality
healthcare related organization. This position will require discretion
and sensitivity to confidential information. The position of Case Manager
is critical to ensure the ongoing oversight of active participants in the Maine
Medical Professionals Health Program (MPHP). It is the primary responsibility
of the Case Manager to oversee and monitor participants’ compliance with the
care and reporting requirements of their Monitoring contracts. This
position reports to the Director of the Medical Professionals Health Program.
regular communication with MPHP participants.
MPHP participants’ progress in the program.
and assessing participants' recovery monitoring programs.
and documenting compliance issues.
MPHP team informed of any caseload changes and issues.
regulatory boards fully informed regarding mandated participants.
outreach and development work to assure early intervention.
Bachelor’s Degree/Masters preferred. Regular Full
time Position located in Manchester, Maine. Salary commensurate with education
For more information and to apply, visit: http://www.jobsinme.com/seek/resultdetail.aspx?jobnum=923038
Director/Chief Medical Officer
exciting leadership opportunity with a diverse mission-focused community health
center for a family practice or internal medicine MD.
Medical Director/CMO will provide leadership and medical expertise to our
dynamic team of providers, assure system infrastructure and processes that
support our patient centered, holistic approach to a diverse patient
position will be shared between administrative and clinical responsibilities.
Experience in a community health center, teaching and international medicine is
preferred. Part-time will be considered;
full-time is preferred.
Portland Community Health Center is a federally qualified health center located
in the heart of beautiful Portland, Maine. We offer competitive compensation and
a full benefits package.
apply, please email your cover letter, resume, and salary expectations in confidence
by January 16th to: firstname.lastname@example.org
Department of Psychiatry Faculty Position
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
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 email@example.com. 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.
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The Maine Public Health Association (MPHA) will be launching a Tobacco Webinar Series starting in December.
The Raw Numbers:
Tobacco Use and Control Data Review—The Maine Story
January 16, 2014, 2:00 pm
Speakers: MaineHealth and MPHA
The Answers Are Out There: Best Practice Strategies to Reduce Tobacco Use
February 27th, 2014 at 2:00 pm
Speakers: American Cancer Society Cancer Action Network and American Heart Association
Consider the Source: The Intersection Between the
Fund for a Healthy Maine and Tobacco Prevention and Control
March 20, 2014, 2:00 pm
Speakers: Friends of the Fund for a Healthy Maine and MPHA
Sex Sells: the Wild, Wild East—Emerging Tobacco Trends
May 15, 2014, 2:00 pm
Save the Date!
Quality Counts 2014 Annual Conference
Wednesday, April 2, 2014
Registration materials and information will be available in February at www.mainequalitycounts.org or by calling QC at 207.620.8526, ext. 1004.