March 31, 2014

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U.S. House Passes One-Year Medicare Payment Patch; Senate Vote Scheduled for 5 p.m. Today

The U.S. House of Representatives vote last week averts a 24% cut in physician reimbursement until April 1, 2015 but represents a disappointment to physicians and hundreds of medical organizations that opposed a temporary patch (the 17th patch) in favor of a permanent repeal of the sustainable growth rate formula. The Senate is expected to vote on the House proposal today at 5 p.m., the last day before the April 1st deadline.

The House bill (H.R. 4302) increases payment rates by 0.5% for the remainder of 2014 but includes no increase for the three months in 2015 leading up to the next cliff.

The bill also delays ICD-10 implementation for another year, until October 1, 2015.

The Congressional Budget Office (CBO) estimated the one-year extension  on physician pay rates to cost $11.2 billion through FY 2015 and $15.8 billion over the period FY 2014-2024.  With the cost of the "extenders" and other program modifications added in, the total cost of the package would be $14.4 billion through FY 2015, but would achieve a $1.2 billion savings over the period FY 2014-2024.

Thanks to all MMA members and others who have communicated to the Maine Congressional delegation the urgent need to permanently repeal the SGR formula and replace it with the substantive provisions agreed to on a bipartisan basis by the three major committees with jurisdiction over Medicare.  The likelihood that Congress will fail again to take a long-term view of the flawed SGR and repeal it, once and for all, is a great disappointment and demonstrates the failure of the government to overcome partisan differences for the common good.

April First Friday Educational Program to Focus on Physician Employment Contracts

MMA's popular First Friday's Educational program in April will feature some of Maine's best known health lawyers discussing various elements of physician employment contracts.  The program should be of interest to any physician contemplating signing an employment contract in the near future, physician recruiters, health lawyers and second and third year residents who expect to be reviewing an employment contract as part of an employment offer.

There is a small cost to attend, via webex or in person at the MMA offices in Manchester.  The program will be presented from 9:00am to noon on this coming Friday, April 4, 2014.  Refreshments will be available to those attending at the office.

Lawyers presenting include Donald Quigley, General Counsel to MaineHealth, Glenn Martin, General Counsel to Eastern Maine Healthcare, Michael Duddy, Esq. of Kelly, Remmel and Zimmerman, and MMA lawyers Gordon Smith, Andrew MacLean and Jessa Barnard.  Steve Gauthier from Central Maine Medical Center is also participating.

More details and a registration form is available on the Association's website or a form can be faxed or mailed to you by Lisa Martin at MMA (622-3374 ext. 221 or via e-mail to  [return to top]

PLEASE COMPLETE: The Physicians Foundation's 2014 National Physician Survey

It is a pleasure to announce that The Physicians Foundation a non-profit group of physician and medical society leaders, is conducting its third national survey of America’s physicians.

This landmark survey, which you may have read about in The Wall Street Journal, USA Today and many other publications, is intended to give physicians a voice, and we greatly urge your participation. 

Take the Survey

All participants who include their email address will have the full survey report emailed to them, and will be entered in a drawing for a $10,000 travel voucher, a $2,000 Apple voucher, and multiple iPad Airs.  MMA also has an opportunity to earn a $5000 honorarium if Maine has the highest percent of physicians completing the survey.

Most important, this survey has been instrumental in conveying how physicians feel about the current state of the medical profession, and for that reason we believe it is important that you participate.

Thank you for your consideration and your time. [return to top]

Today, March 31, Last Day to Enroll in Health Insurance Marketplace Plans

ACA Health Insurance Marketplace open enrollment ends today, Monday, March 31, 2014. The next open enrollment period for 2015 is from November 15, 2014 to February 15, 2015. 

If you or your patients don't enroll by the end of the day today, you won't be able to get private health insurance as an individual until 2015 unless you have certain life events that give you a special enrollment period.

However, the Marketplace just announced a new special enrollment opportunity.  If technical problems with the website or other issues prevent you from successfully enrolling by March 31, you will be able to finish your application after the deadline and avoid a penalty.  You must try to enroll by visiting or calling the Call Center to start the process by Monday.  If you are unable to complete your enrollment, you will be able to try again in April and check a blue box on to show that you tried to enroll before the March 31 deadline. 

Ready to apply? Applying is easy! Go to to apply online, or call 1-800-318-2596 to apply by phone. [return to top]

Patient Experience Survey Results for 270 Practices Now Available to the Maine Public Online

The results of a patient experience surveys conducted by 270 Maine primary care and specialty care practices in late 2013 and early 2014 are now available online at  The surveys were completed by approximately 40,000 adult patients and parents of pediatric patients.  The voluntary survey asked randomly selected patients about aspects of their health care experience closely linked to quality metrics, from how well doctors explained things to whether office staff was courteous and helpful.  The surveys were completed over a four month period in late 2013 and early 2014.

The expenses associated with the surveys were supported by the Maine Quality Forum in exchange for the results being publicly available.  The publicly reporting of the survey results is one of the first efforts of its kind in the nation.

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MaineCare ICD-10 Regional Forums Follow Up

During the week of March 10th, MaineCare hosted regional forums for providers throughout the State of Maine. The purpose of the forums was to help Maine’s provider community get ready for the ICD-10 transition and answer questions related to its implementation. Topics included an explanation of ICD-10, how it will impact providers, what providers can do to prepare, and a Q&A session.

To access a copy of the presentation and webinar recording, please visit MaineCare’s ICD-10 webpage. This presentation is relevant for all providers, including administrators, billing staff, and clinicians, as well as other members of the health care community seeking information about ICD-10.

MaineCare will be hosting additional forums this summer. Dates will be communicated via the MaineCare Provider Listserv in the coming weeks.

For more information about ICD-10, 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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POLITICAL PULSE: Work Continues on Medicaid Expansion and Budget

As reported last week, the focus of legislative activity has largely moved to the floor of the House and Senate where unanimous bills will make their way through the process and divided reports will accumulate on the calendar as the 126th Maine Legislature aims towards an April 16th adjournment.

Medicaid Coverage Bill Proceeds to Governor's Desk

On Tuesday, March 18th, the Maine House passed the first of three bills seeking to expand Medicaid coverage to an additional 70,000 uninsured Mainers through federal funds made available to states under the ACA (L.D. 1487).  L.D. 1487 includes a proposal to institute a managed care approach to the MaineCare program and other concessions aimed at garnering sufficient Republican support to override a gubernatorial veto.  The roll call vote in the House was 97-49.  The initial vote in the Senate last week was 22-13, short of a veto-proof majority.  Late last week the bill was enacted and sent to the Governor.  It is expected that he will veto the bill and it will return to the Senate first for and override vote.  If your legislators voted in favor of the bill, please take a minute to drop them a note of thanks.  If your legislators voted against the bill, please ask them to reconsider their vote when the opportunity to override the Governor's veto comes about.  You can find your legislators here.  You can find data and talking points on the issue on the Cover Maine Now web site.

Appropriations Committee Reports Out, Legislature Enacts, Initial Supplemental Budget 

As reported last week, on March 20th, the Appropriations Committee reached unanimous agreement on an initial supplemental state budget focusing mostly on FY 2014 items.  The bill was printed as L.D. 1843 and was quickly enacted by both chambers on Friday, March 21st.  The vote was 33-1 in the Senate and 121-6 in the House.  There were few controversial health care proposals in this bill.  The Appropriations Committee scheduled hearings on bills last week and are expected to return to deliberations on the FY 2015 situation.

Criminal Justice Committee Votes out Drug Enforcement Bill 

Last Wednesday, the Criminal Justice & Public Safety Committee held its final work session and vote on L.D. 1811, Governor LePage's bill, To Appropriate and Allocate Funds To Strengthen the State's Efforts To Investigate, Prosecute and Punish Persons Committing Drug Crimes. The Committee held several work sessions on the bill and struggled to find a consensus approach to beefing up law enforcement while providing some drug addiction treatment resources.  In the end, the Committee voted 8-4 on a scaled-back version of the Governor's bill that would cost about $2 million for additional law enforcement resources - two judges, two prosecutors and 10 MDEA agents - plus $750,000 for existing drug addiction treatment programs.  It is largely expected that because of the cost of the proposal it has little chance of enactment. [return to top]

CME Opportunities and Consultations Available on Prescribing for Pain and Appropriate Use of the PMP

MMA has grant funds available through the end of June to assist members and practices with the difficult area of prescribing for acute and chronic pain and including specifically the appropriate use of the state's Prescription Monitoring Program.  These resources can include CME presentations or in-office consultations.  The funding is available through existing grants from the Offices of Substance Abuse and Adult Mental Health Services and the Maine Board of Licensure in Medicine. Contact MMA Executive Vice President Gordon Smith if you or your practice would like to take advantage of these free resources before the two grants expire. Gordon can be reached at 622-3374, ext. 212 or via e-mail to [return to top]

MMA Legislative Committee Weekly Conference Call, Tues., 4/1/14, 8 p.m.; Doc of Day Needed April 8th

The next MMA Legislative Committee weekly conference call will take place tomorrow night, Tuesday, April 1st 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 or 622-3374, ext. 214.

There are no new bills for review this week, but the MMA staff will brief participants on the latest news from the State House.

The MMA staff has been hard at work scheduling Doctor of the Day volunteers for the second session of the 126th Legislature.  The only remaining day we need to fill to have a Doctor of the Day every day this session is April 8th. Please help us have a 100% success rate. 

If you have any questions regarding the “Doctor of the Day” program, please feel free to contact the MMA at You can submit your registration on line. We hope to see you at the State House. 

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NH Governor Hassan Signs ACA Medicaid Expansion Bill

Following a year long legislative debate about the issue, on March 27th, New Hampshire Governor Maggie Hassan (D) signed a bill (S. 413) expanding Medicaid coverage to approximately 50,000 low income individuals.  The New Hampshire plan depends on obtaining a Medicaid waiver.  With passage of the New Hampshire legislation, 26 states and the District of Columbia are pursuing Medicaid expansion under the ACA, 19 states have declined expansion, and 5 states continue to debate the issue.  The legislature's plan provides a strong private sector role and came about as a result of a bipartisan study commission.  Beginning July 1st, approximately 10,000 low-income employees will be offered subsidies to purchase employer-based health insurance.  Individuals who do not have access to employer-based health insurance will enroll with one of the managed care plans currently available to Medicaid beneficiaries.  Beginning in 2016, Medicaid expansion enrollees will begin purchasing subsidized, private health insurance through the federal health care exchange.  Currently, Anthem Blue Cross Blue Shield is the only carrier offering plans through the exchange.  The bill includes a December 31, 2016 sunset provision and a provision for automatic repeal should the federal match rate fall below 100% before December 31, 2016. [return to top]

Upcoming Events

Transforming Health Care:  Patients as Partners

March 31, 2014

5:30-7:30 pm 

On March 31st, Maine Quality Counts and its partners will present free “Health Care Town Hall Meetings” throughout Maine to discuss how patients and providers can Choose Wisely.  John Santa, MD, MPH will be presenting live at Maine General Medical Center’s Alfond Center for Health, Education Pavilion with live stream webcast out to the following locations:

Brewer - EMHS, Cianchette Auditorium
Lewiston - University of Maine campus
Machias - University of Maine campus
Presque Isle - University of Maine campus
Portland - University of Maine, Wishcamper Center
Waterville -Thayer Center for Health, Dean Auditorium

 For more information on the event and to register, click here.  Or call Judy Ward at 207.620.8526, ext. 106 or email:


Maine Harm Reduction Conference

Wednesday, May 14, 2014

9 am - 4:30 pm 

Kaplan University, Augusta, ME

Keynote Speaker, Jon Zibbell, Medical Anthropologist with the U.S. Centers for Disease Control will explore the intersection of culture, stigma, drug use behaviors and infectious diseases such as HI and hepatitis C. Jon's anthropologcial fieldwork immersed him in the subculture and lives of persons who inject drugs.

For more information, visit:


Maine's Health Workforce:  What Does the Data Tell Us?

Presented by the Maine Health Workforce Forum

April 15, 2014

8:30  – 10:30 am 

MaineGeneral Medical Center, Alfond Center for Health, Augusta,

Pre-registration not required

For more information, visit:


2014 Hanley Center Honors for Leadership in Health Equity & Health Disparities

Wednesday, April 16, 2014

 Reception & Dinner

 Portland Marriott at Sable Oaks, South Portland

The keynote speaker at the recognition dinner will be Dr. Lori Alviso Alvord, the first Navajo Woman Surgeon and author of "The Scalpel and the Silver Bear."


Webinar - E-cigarettes: Challenges for Clinicians

April 23, 2014

1:00 - 2:30 pm 

This free webinar is hosted by the Smoking Cessation Leadership Center (SCLC) and the Association for the Treatment of Tobacco Use and Dependence (ATTUD).  The webinar will: describe the various types and components of electronic cigarettes (e-cigarettes); describe the current evidence for the clinical use of e-cigarettes among tobacco users; explain the potential clinical and health risks and benefits of e-cigarette use and respond to clinical inquiries regarding e-cigarettes from patients and colleagues. 

Click here to register.

Participants who join the live session on April 23, 2014 can claim CME/CEU credit for $35 per certificate


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 or 207-445-2260.


The Maine Public Health Association (MPHA) Tobacco Webinar Series  

Sex Sells: the Wild, Wild East—Emerging Tobacco Trends

May 15, 2014, 2:00 pm 

Register Now  


Inter Professional Collaborative Practice Summit 

May 28, 2014

University of New England Harold Alfond Forum, Biddeford, Maine

Funded by the Josiah Macy, Jr. Foundation and the Maine AHEC network, the summit will host national experts to address the relationship between health professions education, clinical practice, and national healthcare reform. 4.25 hours CME credit expected.

Click here for more information.


Maine Concussion Management Initiative Trainings 

June 13, 2014 in Waterville at Colby College (Date tentative)
October 21, 2014 in Portland in conjunction with the Maine Brain Injury Conference

All sessions 7:30 a.m. - 12:00 p.m. 

Includes An Introduction to Concussions and Concussion Management & Interpreting Neurocognitive Testing (including using ImPACT)

$100 for Health Care Professionals  (CEUs/CME available); $40 for school personnel and all other attendees

For more information or to register, contact Jan Salis,, (207) 577-2018


Free On Demand CME: Motivational Interviewing 

Basic Skills and Clinical Applications of Motivational Interviewing

This online activity consists of two-30 minute modules on using motivational interviewing techniques to help patients change health behaviors. Specifically, the program addresses four different problems that negatively affect health: non-adherence to treatment guidelines, poor eating habits, lack of exercise, and smoking. The activity also provides scenarios that demonstrate how MI is used in clinical settings.

Faculty: Michael Bierer, MD, MPH

Provided by Lunder Dineen Health Education Alliance of Maine - In Collaboration with Massachusetts General Hospital

Click here for more information or to take the course.

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Job Openings

Physician - Wound Care, part time

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.  We are seeking a Physician to join our Wound Healing Center. This is a part-time, 20 hour per week benefited position.

Mercy's Wound Healing Center provides advanced wound healing techniques, two hyperbaric oxygen therapy chambers and state-of-the-art assessment, testing and treatment for people suffering from acute and chronic wounds. The successful candidate must be an MD, DO or DPM, eligible to be licensed in the State of Maine and board certified or eligible in the physician’s specialty. Broad and in-depth technical knowledge and skills related to the practice of medicine and wound care and relevant training and experience in hyperbaric medicine is desirable. 

Mercy offers a competitive salary and benefits package. The beautiful Greater Portland area is a community rich in cultural resources with an active, working waterfront, in a region that abounds in year-round outdoor recreation from the ocean to the mountains.  E.O.E.

FMI, and to apply for this position, please visit our website at or contact Alison Salerno, Provider Recruiter at , or 207-879-3804.


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

To apply, go to


Medical Director - Scarborough, ME

We are seeking an experienced Medical Director with interest in occupational medicine for our clinic in Scarborough, ME. The Medical Director will be able to practice medicine in a supportive environment while providing oversight to mid-level practitioners.

The successful candidate must be board certified or board eligible MDs or DOs in Maine. Previous experience in Occupational, Emergency, Internal or General Practice Medicine is preferred.

About U.S. HealthWorks:

U.S. HealthWorks Medical Group is a leading national provider of occupational medicine and urgent care services. Operating close to 200 medical centers in 19 states with nearly 2,000 employees, including approximately 350 affiliated physicians; U.S. HealthWorks serves thousands of patients each day. At U.S. HealthWorks Medical Group, we offer programs and services that can help prevent illness, maintain health and provide early intervention and rehabilitation whenever injuries or health problems occur.

In addition to competitive salaries we offer: 

Occupational Medicine Focus

Incentive plans

Opportunity to grow and learn with an industry-leading healthcare organization

Flexible hours and excellent work environment

Benefits including, health, dental, vision, 401(k)

Apply Today!

Email: - Online: - Call: 1.888.770.8749 ext. 2659



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 psychiatrists 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  Please reference search number PS0314D.

Dartmouth College/Dartmouth Hitchcock Clinic/Geisel School of Medicine is an equal opportunity/ affirmative action employer with a strong commitment to diversity. In that spirit, we are particularly interested in receiving applications from a broad spectrum of people, including women, persons of color, persons with disabilities, veterans or any other legally protected group.



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