April 7, 2014

Subscribe to Maine Medicine eNewsletters
Manage Your Subscriptions
Email our Editor...
Maine Medical Association Home Page
. Search back issues
. Plain Text Version
Printer Friendly

Senate Passes and President Signs Temporary SGR Patch; ICD-10 Delay Included

Last Monday evening, shortly after last week's Update was published, the U.S. Senate passed H.R. 4302, Protecting Access to Medicare Act of 2014, legislation that contains both a one-year delay of scheduled SGR cuts and a one year delay of ICD-10 implementation.  The vote makes the 17th time the Congress has applied a short-term patch to the formula that sets Medicare payment rates for physicians.

Earlier in the day on Monday (March 31) Senator Ron Wyden (D-OR) tried to bring to a vote the permanent SGR repeal legislation paid for with Overseas Contingency Operations funds, but was unsuccessful. Both Senator Susan Collins and Senator Angus King voted for the legislation which was signed into law the following day by President Obama.

CMS is holding claims for the first ten business days of April so as to allow time for the Congressional action to take effect and prevent the negative 24 percent cuts from taking place. While MMA is relieved to avoid the 24% cut, we join the AMA and hundreds of other medical organizations in expressing disappointment that the opportunity to pass legislation permanently repealing the SGR formula was missed. And some of the "pay-fors" in the permanent repeal bill were used for this temporary patch which cost nearly $20 billion, making it more difficult to put together a bill accomplishing a permanent repeal between now and the new deadline of April 1, 2015.

H.R. 4302 also includes a broad array of the usual "extenders" as well as a number of policy changes to offset its cost. Among these provision are the following:

  • The geographic adjustment (GPCI) floor of 1.0 for physician work in the Medicare fee schedule would be extended for 12 months to March, 2015 (this is of assistance to Maine and many rural states),
  • Implementation of the ICD-10 diagnosis coding set would be delayed one year, until Oct. 1, 2015.
  • The HHS Secretary would have discretion to continue suspending RAC post-payment audtis under the "2 Midnight" policy through June 2015.
  • Annual targets of $0.5 billion in savings from misvalued Medicare services would be established from 2017 through 2020 for an estimated savings of $4.0 billion.
  • Revisions to the payment system for diagnostic tests and the laboratory fee schedule, based on market-based private sector rates, would be made for an estimated savings of $2.5 billion.
  • Payments for using CT equipment that does not meet certain dosage standards and implementation of appropriate use criteria for advanced imaging services would save an estimated $0.2 billion.
  • Revisions to the Medicare sequester in 2024 that effectively amplify the sequester's impact on all Medicare providers in that year would save an estimated $4.9 billion. 

George W. Wood III, M.D., 1921-2014; MMA President 1972-73

The Associated was saddened to hear last week of the death of Dr. George Wood, who had been the longest surviving MMA Past President until his death March 27th in Orono where he had lived for many of his retirement years.  Dr. Wood was 92 years of age.

Dr. Wood, an internist and pulmonologist, served as President of MMA in 1972-73 and also served as a delegate to the AMA from the mid-60's to the early 70's, chairing the New England delegation to the AMA in 1970-71.  Dr. Wood was also very active in the Maine Lung Association and served on the American Lung Association Board from 1973 to 1981.  He was a founding member of the Maine Thoracic Society in 1955 and served as President of that society in 1957.

Dr. Wood was also very active politically serving in several positions in the Republican Party and running for the State Senate from Bangor in 1982, losing to a fellow Bangor city councilor, John Baldacci.  Dr. Wood also served as a Trustee of the University of Maine from 1987 to 1998. Following retirement from his private practice, Dr.Wood had worked for several years at the Cutler Health Center at the University of Maine.

"Despite being in his early 80's at the time, Dr. Wood played at active role in MMA's Sesquicentennial in 2003", noted Gordon Smith, MMA EVP.  "It was a real privilege to get to know Dr. Wood through that experience.  He was a physician's physician and had a very profound influence on many organizations and individuals in the state.  He will be greatly missed and our condolences go out to his family and many friends." [return to top]

Results of Latest Member Electronic Poll

Many thanks to the 320 members who took a moment to respond to the recent Survey Monkey poll sent to all members for whom MMA has an e-mail address.  Here are the results:

If Congress fails this month to permanently repeal the Sustainable Growth Rate formula controlling physician payment under Medicare, should MMA oppose another temporary fix, notwithstanding that Medicare payments would be reduced 24% or approximately $50 million dollars in Maine April 1 to Dec. 31?

YES, oppose another temporary patch            36%

NO, try to patch it again                                 64%

Do you support the new law requiring hospitals and all healthcare practitioners to maintain a price list based on charges for an uninsured patient?

YES       71%     NO   29%

Do you support legislation soon to be enacted requiring any health care provider to provide, upon request of an uninsured patient, an estimate of the total price of medical services rendered during a single medical encounter and the identity of any third-party health care providers who may be involved in that single medical encounter and who may bill the patient separately?

 YES    60%     No 40%

MMA intends to send out a brief electronic poll each quarter of the year and will take some steps to try to increase participation in the polling which only requires a moment of time to complete. It is increasingly important to know the opinions of our members on the many public policy issues facing our state and nation. [return to top]

Physician Employment Contracts Highlighted at First Friday Eudcation Session

The First Friday educational program in April featured the topic of physician employment contracts. Presenters included Donald Quigley, Esq., General Counsel to MaineHealth, Steve Gauthier, Vice President, Contracting and Business Development, Central Maine Healthcare Corp., John Branscombe, Director of Physician Practices at Eastern Maine Medical Center, Michael Duddy, Esq. of Kelly, Remmel & Zimmerman and MMA attorneys Jessa Barnard, Andrew MacLean and Gordon Smith.

Among the many issues discussed during the interactive three hour session were:

  • The current trends in Maine regarding contracting and employment "at will".
  • Restrictive covenants
  • Payment for tail coverage
  • Physician compensation models
  • Indemnification provisions
  • Mandatory arbitration clauses

Copies of the outlines and powerpoint presentations are available from Gordon Smith or Gail Begin and will be placed on the MMA website asap.

The next First Friday presentation is on May 2nd and features the new laws established by the 126th Legislature which is due to adjourn next week.  The June 6th program is the popular Annual HIPAA Update. Registration for both programs is available via the MMA website or by calling Lisa Martin at 622-3374 ext. 221. [return to top]

Senior Section to Meet on April 30 on Public Health Issues

MMA's Senior Section, chaired by Buell Miller, M.D., will meet next on Wednesday, April 30, 2014 from 11:30am to 2:00pm at the Association offices in Manchester.  Lunch will be available at 11:30am with the program beginning at noon.  The topic for the meeting is, Update on Public Health Issues in Maine and presenters are two former Directors of the Bureau of Health, Dora Mills, M.D., MPH and Lani Graham, M.D., MPH and MMA's Associate General Counsel Jessa Barnard, J.D.

Any MMA member interested in attending should communicate with Lisa Martin at 622-3374 ext. 221 or via e-mail to her at lmartin@mainemed.com.  There is no charge at attend. [return to top]

POLITICAL PULSE: Legislature Moves Towards Scheduled Adjournment of April 16

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.

Legislature Overrides Veto of Price Transparency Bill, Will Become Law 

Last week, overwhelming majorities of the House and Senate voted to override the Governor's veto of LD 1642.  LD 1642 was Senator Woodbury's bill that attempted to improve upon the bill that passed last legislative session, LD 990, requiring that health care practitioners provide patients with price information.  The new law clarifies that the prices should be listed by CPT code and that the practice needs to notify patients of the list but does not need to provide the full list to every patient. The law also clarifies that a health care entity that does not routinely render services directly to patients in an office setting may satisfy the requirements by providing information on its publicly accessible website. The full text of the final law can be found here.  It will become effective 90 days after the legislature adjourns, or mid-July.  The Governor had vetoed the bill stating that it did not go far enough to provide price information to patients. The House voted 138-4 and the Senate voted 31-3 in favor of the override. 

Appropriations Committee Hears FY 2015 MaineCare Proposals

As reported in previous issues of the Update, on March 20th, the Appropriations Committee reached unanimous agreement on an initial supplemental state budget focusing mostly on FY 2014 items.  The Committee has now returned to deliberations on the FY 2015 situation and held hearings last week on two proposals related to MaineCare services -  a proposal to modify the timing of MaineCare payments to certain providers and a proposal to to increase surveillance and utilization review of Medicaid payments to providers and consumer users of Medicaid services to determine the extent of fraud and abuse.  MMA is monitoring both proposals.  The full text of both can be found here

Medicaid Coverage Bill Awaits Governor's Action

As previously reported, 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) has been enacted and sent to the Governor.  It is expected that he will veto the bill sometime this week 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. [return to top]

MMA Legislative Committee Weekly Conference Call, Tues., 4/8/14, 8 p.m.

The next MMA Legislative Committee weekly conference call will take place tomorrow night, Tuesday, April 8th 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.

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

Spectrum Medical Group and OA Centers for Orthopaedics (OA) Announce Merger

Spectrum Medical Group and OA Centers for Orthopaedics (OA) announced last week that they have merged operations. Collectively, they are the largest, non-hospital affiliated healthcare provider organization in the state.

The two organizations have a demonstrated track record of successful collaboration. In 2011, Spectrum and OA combined efforts with two other physician practices to form Specialty Solutions, an association of independent specialty physician practices. In addition, Spectrum provides both anesthesiology and radiology services to OA. The experience in prior collaborations was integral in the decision to merge.

OA will continue to operate under its current business name. Each organization will also maintain their respective relationships with key hospital, health system, and community partners. Most day-to-day aspects of patient care will remain the same and patients will begin to experience expanded benefits over time.

Collectively, the practices employ more than 200 physicians and provider staff, including physician assistants, nurse practitioners, and physical and occupational therapists. In 2013, the organizations served in excess of 500,000 patients and provided approximately 1.7 million services. More information can be found at www.spectrummedicalgroup.com or www.orthoassociates.com.

[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]

Physician Identity Theft Through Fraudulent Tax Returns Surfaces in Maine

Following a trend identified earlier in Indiana, South Dakota, and Puerto Rico, last week the MMA learned that as many as a dozen Maine physicians have been the victims of identity theft through the fraudulent filing of tax returns using their names, addresses, and social security numbers to obtain a tax refund.  Physicians usually discover the problem when they try to electronically file their tax returns but are rejected because a return already has been filed using their social security number.  The MMA would like to understand the scope of the problem in Maine, so if you have been victimized in this way, please contact Gordon Smith, EVP, at gsmith@mainemed.com or 622-3374, ext. 212. 

Also, the MMA encourages all Maine physicians to be alert to this problem during this tax-filing season.  You’ll find more information about the Internal Revenue Service’s (IRS’) recommendations to address this threat here: http://www.irs.gov/uac/Taxpayer-Guide-to-Identity-Theft. [return to top]

Upcoming Events

Ever Wanted to Take a Harvard Course?

Now you can! Beginning today, April 7, 2014, Harvard University will be launching a new, free online course about health policy in the United States. You'll have the opportunity to experience world class teaching from a world class faculty as you delve into the essentials of U.S. health care policy.

To learn more about the class visit www.getbettermaine.org


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: www.mainehealthworkforceforum.org


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." 

Please join us in an evening celebration to recognize the following Maine-based organizations and individuals for their outstanding achievements assuring equitable care for all Mainers. The honorees include: Marjorie Wither, Maine Migrant Health Program, United Somali Women of Maine & Waldo County Dental Care


MaineCare Provider Advisory Committee Meeting

April 17, 2014


Conference Room 103B

Cross State Office Building, 111 Sewall Street, Augusta, Maine or  via phone:  1-877-455-0244, with passcode 7989253087#

The MaineCare topics for this meeting will be Telemedicine and Physician Assistant prescribing rights. Any provider interested in MaineCare initiatives may attend the meeting.


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


Prescription Assistance Information and Networking Meeting

April 25, 2014

9 a.m. - 12 p.m

Maine Medical Association, Manchester

To register contact MedHelp Maine medhelpmaine@gwi.net or (207) 793-4462

Meeting attendees from organizations with existing medication access programs will learn best practices from their medication access colleagues, and individuals from communities not yet offering such resources will learn how they might do so. 


The Maine Public Health Association (MPHA) Tobacco Webinar Series  

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

May 1, 2014, 2:00 pm 

Register here: https://www1.gotomeeting.com/register/198693440

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

May 15, 2014, 2:00 pm 

Register here: https://www1.gotomeeting.com/register/910761344

Consider the Source: The Intersection Between the Fund for a Healthy Maine and Tobacco Prevention and Control

June 3, 2014, 2:00 pm 

Register here: https://www1.gotomeeting.com/register/553284137

For more information, visit: http://www.mainepublichealth.org/events/event/


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.


AAP Maine Chapter Annual Spring Education Conference

May 9-10, 2014

Harborside Hotel, Bar Harbor

This year we will focus on "The Main Things for Pediatric Practice in Maine," featuring a keynote address by Ross Greene, PhD, author of The Explosive Child. 

Please visit www.maineaap.org/conferences for more information and to register.  Please register and book your hotel room by April 28th. 


Nominations for 16th Annual Schwartz Center Compassionate Caregiver Award

Due May 9, 2014

This prestigious award recognizes healthcare providers in New England (CT, ME, MA, NH, RI, VT) who display extraordinary compassion in caring for patients. The recipient will receive $5,000, and four finalists will receive $1,000 each. Nominations are due May 9, 2014. The Schwartz Center will honor the award recipient and four finalists at its annual Kenneth B. Schwartz Center Compassionate Healthcare Dinner on November 20, 2014, at the Boston Convention Center. For more information, visit http://www.theschwartzcenter.org/supporting-caregivers/cca.aspx or call (617)724-4746.


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: http://www.downeastaidsnetwork.org/mehra-sec/


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, jsalis@aol.com, (207) 577-2018



The Maine Public Health Association’s (MPHA) 30th annual 2014 Fall Conference

October 7, 2014

Augusta Civic Center

MPHA Call for Abstracts for breakout sessions: Abstracts from all areas of public health are welcome.  We encourage abstracts focusing on the theme of building on 30 years of public health progress. All abstracts must be submitted via e-mail no later than Wednesday, May 21 at 5:00 p.m. to MPHAabstracts@gmail.com.

 The Call for Abstract form is available at: http://www.mainepublichealth.org/category/pressroom/


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.

[return to top]

Job Openings

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: providerrecruitment@ushworks.com - Online: www.ushealthworks.com - 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 psychiatry.jobs@dartmouth.edu.  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.



[return to top]

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