Transparency of Pricing Law in Effect as of January 1, 2014
Seeking more price transparency and hoping to encourage consumers to pay more attention to prices and costs, the 126th Legislature in 2013 enacted legislation requiring 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 effective date of the legislation was January 1 2014.
Public Law 2013, 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 December 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. The MMA is interested in physicians' opinions on this law, so please participate in this month's poll question on the topic. See the MMA web site here. For more information, contact firstname.lastname@example.org, email@example.com or firstname.lastname@example.org.
POLITICAL PULSE: Legislature to Convene this Week; Medicaid Debate Expected Early
The second session of the 126th Maine Legislature will open this Wednesday. As per tradition, the Maine Medical Association President - currently, Guy Raymond, MD, of Fort Kent - will serve as the Doctor of the Day, along with an officer of the Maine Osteopathic Association. Because this is the second session, legislative committees will jump right to work, with a number of public hearings and work sessions already scheduled for this week on topics ranging from moving Maine to a single payer health care system to allowing a mid-level dental provider.
LD 1578, the bill that would allow Maine to accept federal funding to provide health care via MaineCare to more low-income Maine residents, has also been scheduled for a hearing next week, Wednesday, January 15th. MMA will be testifying in favor of the bill. The Medical Association has also planned a press event in favor of the MaineCare proposal for Thursday, January 23rd from 10 am - 12 pm at the Welcome Center of the State House. Please contact Jessa Barnard at email@example.com for more information or if you are interested in participating in the event. [return to top]
90-day Premium Grace Periods Under ACA Require Close Eye for Physician Offices
Beginning with marketplace health policies active on January 1, 2014, federal regulations allow patients participating in the exchange plans a 90-day grace period for missed premium payments; health plans are then allowed to deny or later recoup payments from doctors for services provided if those patients end up delinquent on their plan payments. Encourage your patients to remain current on their premium payments to retain their insurance coverage. Additionally, while participating in an exchange may be voluntary, physicians may not be certain what plans they are participating in, and should review their contracts or directly contact insurance companies to determine what marketplace plans include them as part of the network. More information is available in the following two articles: Docs Need Info on 'Grace Period,' AMA Says and Docs May See Pay Delay Under ACA Exchanges. [return to top]
MMA Legislative Committee Conference Calls to Begin January 14th
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 firstname.lastname@example.org or 622-3374, ext. 214. [return to top]
Doctors of the Day Still Needed for January
The MMA staff has been hard at work scheduling Doctor of the Day volunteers for the second session of the 126th Legislature. We still have openings for the following dates in January: 14th, 21st, 23rd, & 28th.
If you have any questions regarding the “Doctor of the Day” program, please feel free to contact the MMA at email@example.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.
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.
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. [return to top]
Five Top Federal Issues That Will Affect Physicians in 2014
An AMA Viewpoints post by AMA President Ardis Dee Hoven, MD
The new year is only just beginning, but it’s safe to say it will be another eventful one. On the schedule are weighty issues that could have a significant impact on physicians and patients in 2014 and years to come.
1. Repeal of Medicare’s failed SGR formula. Congress will continue its work on repeal legislation following the winter recess. In addition to eliminating the tremendous instability that comes with the SGR formula, the bills under consideration offer other significant improvements over current law.
2. Full implementation of the Affordable Care Act, beginning Jan. 1. While aspects of this roll-out have been rocky, we must not lose sight of the ultimate goal of health care reform: Millions of previously uninsured Americans will gain access to care, and millions more no longer will be at risk of losing their coverage when they need it most. This is a chief goal for us as physicians—helping patients become healthy and stay healthy.
The AMA will provide resources to help make the transition as smooth as possible, and we will monitor closely the effect on practices so we can focus our advocacy efforts on areas that will be most effective for physicians and patients.
3. Implementation of the ICD-10 code set, scheduled for Oct. 1. Under the new code set, physicians will have to contend with about 68,000 outpatient diagnostic codes—a five-fold increase over the 13,000 ICD-9 codes we currently use. The AMA has been working for years to prevent the roll-out of ICD-10. Two bills were introduced in 2013 to this end, and we continue to stress to the Centers for Medicare & Medicaid Services (CMS) that the new code set will place an immense burden on physicians.
4. Meaningful use of electronic health records (EHR), to which physicians must attest by Sept. 30. Physicians who don’t attest to fulfilling the meaningful use requirements by the deadline will be subject to Medicare penalties in 2015. While we have been successful in delaying Stage 3 for a year, we continue to urge CMS to make Stage 2 requirements more reasonable, address usability issues and break down barriers preventing communication among EHR systems rather than placing the responsibility on physicians to achieve the impractical.
5. Physician data will be published by Sept. 30 under the Sunshine Act. Financial interactions with drug and medical device manufacturers will be publicly reported in an online database for the first time later this year. Physicians will have an opportunity to review and challenge data before it is posted. In addition to pressing for modifications in how the law is carried out, we offer resources to help you prepare.
2014 promises to be a busy year. The AMA will continue to advocate for federal improvements on behalf of physicians and their patients to improve the health of America. [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 February 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, February 7th, 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]
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)
Register for Sagadahoc Roundtable now! Preregistration is required.
Penobscot Regional Roundtable
262 Harlow Street, Bangor
9 am- 12:30 pm
Tuesday, January 21st (Snow date: Tuesday, January 28th)
Register for Penobscot Roundtable now! Preregistration is required.
Cumberland Regional Roundtable
The Opportunity Alliance
50 Lydia Lane, South Portland
9 am- 12:30 pm
Monday, February 3rd (Snow date: Wednesday, February 5th)
Register for Cumberland Roundtable now! Preregistration is required.
Questions? Please contact Kate Ende, Consumers for Affordable Health Care, email@example.com, 207-622-7083. [return to top]
Member Survey Starts This Week: Let us Know Your Thoughts on Payment Reform
Watch your email this week for a survey the Maine Medical Association is conducting to better understand its members’ attitudes toward, readiness for and needs associated with payment reform. The survey should take about 5 minutes to complete. One randomly drawn participant will be able to designate a charity to receive a $500 donation in appreciation for your time.
The survey is part of the MMA’s ongoing work on engaging physicians with payment reform with funding from the Maine Health Access Foundation. Responses will guide upcoming educational offerings related to payment reform. The survey also provides a chance for you to have your voice heard on this important topic. Please participate! [return to top]
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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 firstname.lastname@example.org.
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: email@example.com
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 firstname.lastname@example.org. 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.