January 27, 2014

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MMA Board Sets New Direction at President's Retreat

At its annual President's Retreat held this past weekend, the 24 member MMA Board of Directors made some difficult, but strategic, decisions and established a pathway for the association to achieve some critical goals in the next three to five years.  Recognizing that resources are likely to diminish, the Board expressed strong support for allocating resources to those services most highly valued by the members and to eliminate or de-emphasize the low valued products and services.

Responding to the results of a membership survey in which members force ranked twenty services in terms of their value to the member, the Board voted to move resources from the low-value services to the high value services.  For over two years, the Board has reviewed the principles for non-profit governance spelled out in  The Road to Relevance published by the American Society of Association Executives and authored by Harrison Coerver and Mary Byers, CAE.  The authors had previously written a prior book entitled, The Race for Relevance.

The survey results demonstrated that members most valued MMA's advocacy for the profession.  Also receiving high marks were the Medical Professional Health Program, legal services and communications and publications.  Receiving the lowest rating were affinity/royalty arrangements, the corporate affiliate program, the Annual Meeting and the relationship with the AMA.

While some of the decisions made will take some period of time to accomplish, others will be implemented immediately or within the next few months.  For instance, while there will be significant changes at the Annual Session this year in Bar Harbor, Sept. 5-7, the same basic format will take place.  Future Annual Meetings, however, will look very different recognizing that fewer than 3% of the members express any interest in it.  On the Corporate Affiliate issue, MMA also had begun to decrease the number of relationships managed and with only 30 affiliates presently, a decision was made to eliminate the annual Corporate Affiliate breakfast immediately.  Staff will look for other ways to show value to the remaining Corporate Affiliates.

While many of the association's activities were valued and enjoyed by a small number of members, some of these activities were not central to the core mission of the Association: To support Maine physicians, advance the quality of medicine in Maine, and promote the health of all Maine citizens.

In some cases, non-essential activities, such as providing management services to medical specialty societies, will have to do better financially or they will be phased out.  This principle applies to some of the educational activities as well.  In a nutshell, the Association plans to be much more focused on some key areas that the members have indicated are essential and support the mission of the organization. 

POLITICAL PULSE: MMA Emphasizes Need for Compromise to Provide MaineCare Coverage

Last Thursday, the Maine Medical Association led a successful press event emphasizing why physicians support accepting federal funds to cover more individuals through the MaineCare program and the need for legislators to find a compromise to move the legislation forward this session.

Three physicians and an advanced practice nurse practitioner spoke at the press event, which was widely covered by the media.  Speakers included Kenneth Christian, MD, former Board Chair of the Maine Medical Association from Ellsworth; Marguerite Pennoyer, MD, an MMA member and allergist and immunologist with the Maine Medical Center; Rhonda Selvin, NP, President of the Maine Association of Nurse Practitioners and Associate Medical Director of Maine Quality Counts; and Amy Madden, MD, Chair of the MMA Legislative Committee.  Several members of Maine AllCare and other physician volunteers attended the event and helped field questions.  The event was covered by the Bangor Daily NewsChannel 6, the Lewiston Sun Journal and MPBN

Health and Human Services Committee Takes Up Medicaid Expansion, Managed Care

The Health and Human Services Committee held a work session last week on LD 1578, the bill that would allow Maine to accept federal funding to provide health care via MaineCare to more low-income Maine residents.  The session allowed members of the Committee to ask questions of several advocates and members of the Department of Health and Human Services staff.  The Committee tabled further consideration of the bill pending an updated fiscal analysis by the Office of Fiscal and Program Review.  The Committee also continued consideration of LD 1487, Senator Roger Katz's bill to transition Medicaid coverage to managed care.  The Committee heard from AmeriGroup and Martin's Point regarding their views of managed care.  The Committee has asked the Maine Medical Association and other physician and provider groups to share feedback on the proposal this Thursday.  

Legislature Overrides Governor's Veto of Tobacco Cessation Coverage Provision

Last session, the legislature overwhelmingly passed LD 386, a bill to restore coverage of smoking cessation benefits to the MaineCare program.  The Governor vetoed the bill, stating that because beneficiaries would not be charged co-payments for the services, the bill "expands welfare unchecked."   However, since 2011, CMS has recommended to states that they cover smoking cessation services with no copays or deductibles, citing the fact that "several peer reviewed studies have found that reductions in patient out-of-pocket costs increase both the use of cessation services and overall tobacco quit rates."  Last week, the Maine Senate voted 31-4 in support of overriding the Governor’s veto. After a vote two weeks ago in the House of 131-10 in support of the override, this bill will now become law.  Thank you to MMA members who reached out to your legislators to urge them to support the measure. 

Majority of Judiciary Committee Rejects "Religious Freedom" Bill 

The Judiciary Committee held a work session last week on LD 1428, An Act to Protect Religious Freedom.  The bill states that State action may not burden a person’s right to the free exercise of religion, even if the burden results from a rule of general applicability.  MMA testified against the bill from the perspective of the medical community, stating that while the bill may initially sound appealing, it threatens to disrupt access to many medical services.  For example, providers, support staff or institutions could refuse to provide primary care services, prenatal care, treatment for sexually transmitted diseases or any other service if it conflicted with religious views.  After an extensive discussion regarding the pros, cons and unintended consequences of the bill, a majority of the Committee voted that the bill ought not to pass.  

Insurance Committee Considers Mandates, Single Payer Study

Following discussion of two health insurance mandate proposals, the IFS Committee last Thursday voted to send L.D. 1600, An Act to Require Health Insurers to Provide Coverage for Human Leukocyte Antigen Testing to Establish Bone Marrow Donor Transplantation Suitability to the Bureau of Insurance for a so-called "mandate study."  The Committee tabled the other mandate proposal, L.D. 347, An Act to Amend Insurance Coverage for Diagnosis of Autism Spectrum Disorders until receiving more information from the Office of Fiscal & Program Review.  The Committee also engaged in a lengthy discussion of the single-payer progosal, L.D. 1345, and are considering an amendment entitled, Resolve, To Study the Design and Implementation of Options for a Universal Health Care Plan in the State That is in Compliance with the Federal Patient Protection and Affordable Care Act. [return to top]

2014 Medicare Physician Fee Schedule Available

New England's Medicare contractor, National Government Services, has now posted the 2014 Medicare physician fees to its website.  The good news is that many claims have been received in 2014 and NGS has begun to process claims using the new schedules meeting all CMS timeliness requirements.      

www.ngsmedicare.com has a tool available to assist offices in searching for fee schedules using the appropriate state and locality by type of service provided.  All fees were added to the website earlier this month.  Search tools are  available individual code or the entire file.  Many find the individual code search easier to navigate.   

Knowing that the current legislation expires on March 31, 2014, NGS will be sharing updated information as it is received. This link will direct to you to the complete fee schedule file. [return to top]

MMA Legislative Committee Weekly Conference Call, Tuesday, 1/28/14, 8 p.m.

Tthe next MMA Legislative Committee weekly conference call will take place tomorrow, Tuesday, January 28 at 8:00 p.m. 

Legislative Committee members and specialty society legislative liaisons are strongly encouraged to participate.  Any physician, practice manager, or other staff member who is interested in the MMA's legislative advocacy also is welcome to participate.  It is not necessary to RSVP for the calls.

Please use the following conference call number and passcode.  These will remain the same for every weekly call during the session:

Conference call number:  1-619-326-2772 

Passcode:  729-7185

The purpose of the weekly conference calls is to review and finalize the MMA's position on bills printed that week, to hear the views of specialty societies on the new bills or their concerns about any health policy issues, and to discuss the highlights of legislative action that week.  The calls rarely last longer than an hour and usually we can accomplish our business in much less time.  The MMA staff lists a suggested position for each bill and any medical specialty particularly affected by the bill.

If you have an opinion about any of these bills, but cannot participate in the call, please contact Andrew MacLean, Deputy EVP at amaclean@mainemed.com or 622-3374, ext. 214.

The MMA staff has been hard at work scheduling Doctor of the Day volunteers for the second session of the 126th Legislature.  This month, we still have openings for January 28th.

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.

The following are bills of interest to the physician community printed last week.  We will discuss the priority bills marked with an asterisk (*) first.

LD 1738, An Act To Improve Maine's Involuntary Commitment Processes (monitor pending input from MAPP; psychiatrists)*

LD 1739, An Act To Amend the Maine Medical Use of Marijuana Act (monitor)*

LD 1740,  An Act To Amend Laws Relating to Health Care Data (oppose)*

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Support Maine's Pre-litigation Screening Panels by Serving as a Volunteer Panel Member

The primary reason Maine's medical liability premiums are among the lowest ten states in the country is the existence of our very effective, and mandatory, pre-litigation screening panel system.  The legislation authorizing the panel system was effective in 1988 meaning that we have had a 25 year experience withe the system.  Even many trial lawyers now acknowledge its effectiveness.

Perhaps because the legislation was passed many years ago, many of our newer licensees are not aware of the panels and the important role they play in keeping premiums down and in moving the process along.  If you are asked to serve on a panel, please step up to the plate and do so.  Should you be a defendant someday, you would want a volunteer physician on your panel.

During the current legislative session, MMA is also supporting legislation that would increase the compensation paid to the panel chairs.  The chairs are part-time and persons with judicial experience.  They are paid approximately $50 per hour and there has not been an increase in the judicial budget for them since the law was enacted.  Quite frankly, the system would not work without the integrity and hard work of the three individuals who currently chair the vast majority of the panels. An increase in their compensation is way overdue. [return to top]

HealthInfoNet Patient Portal HIE Access Request for Information (RFI)

Do you want to be the FIRST in Maine (and perhaps the nation) to provide patient's access to their statewide HIE record? Does your organization value and seek to improve patient engagement? Then keep reading!

About the Project

As part of the State Innovation Model test grant, HealthInfoNet is seeking one pilot partner to link their organizations patient portal or personal health record (PHR) to the health information exchange (HIE). Once linked HealthInfoNet will use "blue button" technology standards to allow patients to download a continuity of care document (CCD) that gives them a summary of their statewide HIE record. To learn more about the SIM project, visit the State's SIM website

Why Participate?

As a pilot site, your organization will be the first in the State of Maine to provide patients access to their statewide HIE record. This pilot will be a great opportunity to build upon your current patient engagement campaigns and make you a national leader in the movement to provide patients access to their medical information. To help develop communications strategies for your patients and community, your organization will receive assistance from the HealthInfoNet Consumer Advisory Committee, which includes consumer advocates and representatives from consumer advocacy and education organizations. This will be an especially valuable tool to help your patients and their caregivers in managing their chronic disease and complex care plans across multiple providers. 

About the Pilot Selection Process

There are operational and technical requirements in order to participate, please fill out the survey linked here  in order to be considered for the project. HealthInfoNet expects to identify the pilot partner by April 1st. The survey will be open until February 14th. For more information or questions please email Katelyn Michaud at kmichaud@hinfonet.org

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PMP Enrollment Becomes Mandatory for all Prescribers in Maine

The Office of Substance Abuse and Mental Health sent a communication last week to all physicians, dentists, physician assistants, podiatrists and advance practice registered nurses licensed in the State of Maine stating that because fewer than 90% of practitioners were participating in the Prescription Monitoring Program (PMP) as of January 1, 2014, all licensed individuals in the above disciplines are now required  by state law to register with the Prescription Monitoring Program by March 1, 2014. See 22 M.R.S. § 7249(5).  In addition, Chapter 21 of the Joint Rules of the Maine Boards recommends the utilization of the PMP (§III.1 Principles of Proper Pain Management: Evaluation of the Patient).

Therefore, if you have not done so already, please take a moment right now to go to the PMP website  for registration  forms and further information.  Any questions or inquiries can be directed to the  Substance Abuse and Mental Health Services/PMP office at  207-287-2595 or  osa.ircosa@maine.gov.   For technical and registration questions please contact the PMP Help Desk  directly at 1-866-792-3149 or email mepmpinfo@hidinc.com.

As shared in prior editions of the Weekly Update, the MMA is also working with the licensing boards to make registration an automatic part of the license renewal process. 

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ICD-1O Informational Series, Part III: ICD-10 Provider Impact

As a result of feedback from MaineCare’s Provider Readiness survey participants, MaineCare has developed an ICD-10 Informational Series for providers in order to share information and to direct you towards preparing for transitioning from ICD-9 to ICD-10.  This is part three in the informational series.

What is Changing?

On October 1, 2014, the health care industry will transition from using ICD-9 to ICD-10 codes for diagnoses and procedures. This change will have a significant impact on provider and MaineCare processes.

How are ICD-10 Codes Different from ICD-9 Codes?

ICD-9 Codes ICD-10 Codes

Three to five characters Up to seven characters

Approx. 14,000 diagnosis codes Approx. 69,000 diagnosis codes

Approx. 4,000 procedure codes Approx. 72,000 procedure codes

Does not include laterality Diagnosis codes include laterality

Has no place holders Diagnosis codes can include place holders

How Will ICD-10 Affect Your Practice?

ICD-9 codes are used by many providers in business processes and technology systems. Providers need to make changes to their processes and technology to support ICD-10 and continue uninterrupted transactions with payers, including MaineCare.

  • Replacement of all ICD-9 codes
    • The ICD-10 code set is a full replacement of the ICD-9 code set.
    • In most cases there is an approximate one-to-one match but not always. One ICD-9 code may correspond to many ICD-10 codes.
    • Centers for Medicaid and Medicare Services (CMS) has provided a tool, called General Equivalence Mappings (GEMs) that can assist providers with determining which ICD-10 codes to use. You can access GEMS on the CMS website.
  • Changes to billing and submitting claims
    • All discharges and services provided on or after October 1, 2014 must use ICD-10 codes. If ICD-9 codes are submitted for dates of service on or after October 1, 2014, claims will deny.
    • Payment amount may be impacted depending on which ICD-10 codes are used for billing.
  • Changes to your operations
    • Whereas ICD-9 codes consist of 3-5 digits, ICD-10 codes consist of 3-7 alpha-numeric characters.
    • Business processes, systems (e.g., practice management and clinical software, billing systems), and paper and electronic forms may need to be modified to accommodate the new, longer codes.

Why Transition to ICD-10?

  • Better reflects current medical practices
  • Provides more specific data from clinical documentation
  • Supports patient care coordination across clinical settings
  • Improves public health reporting and tracking

For more information, go to MaineCare’s ICD-10 webpage or CMS’s ICD-10 Provider Resources’ webpage. Please send questions about ICD-10 to MaineCare’s ICD-10 email box.

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Ken Ginsburg in Maine Feb. 19-20 on Building Resilience

The Maine Chapter of the American Academy of Pediatrics (MAAP) received a “Visiting Professor” grant from the national AAP enabling us to bring Dr. Kenneth Ginsburg to Maine on Wednesday, February 19th (Waterville/Augusta) and Thursday, February 20th (Bangor).  These events have been supported and organized in partnership between the MAAP and the Maine Resilience Building Network (MRBN).  To learn more about Dr. Ginsburg and register for the opportunities in February in Maine, please click on the link below.  You will be able to learn about Dr. Ginsburg's work, his writings and be invited to indicate your interest in attending one of these sessions at this site.  


Registrations will close by Friday, February 7th and registrants will be notified by Monday, February 10th.  Please reserve the desired date(s) in your calendar!  Registrations are limited! You are encouraged to share this invitation with colleagues.  We are certain that this won't be Dr. Ginsburg's last visit to Maine and will develop an interest list from this registration opportunity so that the AAP can keep you in the "loop" for this and future professional development opportunities.

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Last Chance for Survey Responses: Share Your Thoughts on Payment Reform and Single-Payer Health Care

MMA members only please are requested to complete a short, confidential survey on payment reform including a question on single-payer health care by January 29. One randomly drawn member participant will be able to designate a charity to receive a $500 donation in appreciation for your time. Click here to link to the survey. [return to top]

National Drug Take Back Day Scheduled for April 26, 2014

The next National Drug Take Back Day has been scheduled for April 26, 2014.  It is expected that many agencies that participated in 2013 will participate again. In addition, the Department of Justice is hoping that food pantries may participate and accept donated food items while at the same time, old, expired and unused medications can be dropped off to law enforcement representatives.  Watch the Update for further announcements.  [return to top]

Job Openings

ED Provider Jobs

Challenging, Lucrative, ED Provider jobs in central Maine - honoring and serving Veterans.  ED Physicians are needed in Augusta. Must-have an unrestricted medical license (from any U.S. state), and current ACLS certification. This is your opportunity to use and develop your skills of diagnosing, treating, and managing patients according to standard, usual, and acceptable methods and techniques.

B/C or B/E specializing in EM, IM, or FP by the appropriate accrediting agencies (EM preferred).

This is the opportunity for you to receive a competitive salary, a generous leave package, excellent health & life insurance benefits, and retirement benefits. You'd be eligible to participate in a pension program as well as a matching Thrift Savings Plan which is similar to a 401K. If you are a veteran, you may be able to combine accrued military retirement credit with VA pension benefits.

Your salary will be determined by local Physician/Dentist Compensation Panel (commensurate with education, experience and qualifications). By law, U.S. Citizens will be given 1st preference but non-citizens will be considered in the absence of qualified citizens. A signing bonus may be available.  Equal Opportunity Employer. Disabled persons and/or veterans are encouraged to apply.

FMI, call John Poulin at (877) 421-8263 x6913, or email him at john.poulin@va.gov

To apply, go to https://www.usajobs.gov/GetJob/ViewDetails/328066200


Psychiatrist, Psychiatric Nurse Practitioner and/or Physician’s Assistant 

Assistance Plus is seeking a full time psychiatrist, psychiatric nurse practitioner and/or physician assistant for the Medication Management Program in Wilton.  The professional team is overseen by Robert Gordon, medical director.  Our primary focus is to assist those with behavioral health disorders. 

Applicant must be a graduate of an accredited degree program and licensed to practice in the State-of-Maine.  A minimum of three years experience required. 

We offer a generous benefit package of full coverage for health, dental, and 401K.  This position is Monday through Friday and no on call coverage is required.

Please submit resume and cover letter to Kelly Negm 453-4708 ext 303 or email knegm@assistanceplus.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.


Seeking Contract Academic Detailer / Prescriber Educator

The Maine Medical Association, on behalf of the Maine Independent Clinical Information Service (MICIS), is seeking a clinical health professional to serve in the role of a contract “academic detailer.”  Academic detailing entails offering independent, scientific evidence on prescription drugs at the request of prescribers working in primary care.

The part-time contract academic detailer will conduct face-to-face educational outreach visits to discuss the current evidence on best clinical prescribing practices.  The candidate will be available to do one-on-one consultations with prescribers and group teaching sessions in practices, hospitals and at conferences, per request, across the state.

Hours required will vary from month to month, based on demand, and may range anywhere from 5 to 35 hours a month. Flexibility is required. One-year contract subject to renewal.


Candidates must be available to attend a two-day training session in Boston on the principles and techniques of academic detailing.  Additional trainings on specific clinical topics to be detailed will take place in Maine or Boston periodically.


  • Clinical background: MD, PA-C, RN, CNP, or PharmD or similar.
  • Two or more years of clinical experience.
  • Therapeutic competency.
  • Strong interpersonal skills including service-orientation.
  • Excellent presentation and public speaking skills.
  • Ability for light lifting when delivering presentation materials to sites.
  • Ability to travel throughout the state including occasional long days driving and overnight stays in Maine and Boston.
  • Ability to attend monthly work group meeting (mornings) and quarterly advisory committee meetings (afternoons) in Manchester.

Pay:  The contractor will be paid on an hourly basis commensurate with the candidate’s background and skills.

Contact:  Please send cover letter and resume by Feb. 28 to Jennifer Reck, MA, MICIS Program Manager, at jreck@mainemed.com.


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Upcoming Events

Medical Group Management Association of Maine

2014 Third Party Payer Seminar

January 28, 2014 (Storm Date January 30, 2014) 

Waterville Elks Club, 76 Industrial Street, Waterville, ME

8:30 am - 4 pm 

Plan to join us for our most popular program of the year, our annual Third Party Payer Seminar.  Payer representatives from the major plans will be speaking at this seminar and providing updates that affect your practice.  Come learn about the new products offered on the Health Care Exchange and how they can help your patients.

For questions or more information, contact Linda Tardif, Education Chair, (207) 783-1449, LTardif@CentralMaineKidneys.com 


The Maine Public Health Association (MPHA) Tobacco Webinar Series  

The Answers Are Out There: Best Practice Strategies to Reduce Tobacco Use

February 27th, 2014 at 2:00 pm 

Register Now 

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 

Register Now 

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 

Register Now  


CODEquest 2014 - Conquering ICD-10

Sponsored by the American Academy of Ophthalmic Executives, a division of the American Academy of Ophthalmology, and the Maine Society of Eye Physicians and Surgeons.

Friday, March 7, 2014

11:00am - 4:15pm

Harraseeket Inn, Freeport, ME

Details and Registration are available at:  http://www.aao.org/aaoe/coding/codequest-maine.cfm or contact Peggy Coakley at pcoakley@aao.org or 415-561-8561.


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. 


Maine Society of Eye Physicians and Surgeons Spring Educational Program and Business Meeting

Friday, May 2, 2014

12:00pm - 4:45pm

Harraseeket Inn, Freeport, ME

For more information, please contact Shirley Goggin at sgoggin@mainemed.com or 207-445-2260.


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