April 28, 2014

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Reports of More Breaches of Physician Data Leading to Identity Theft and IRS Scam

Since reporting in last week's Update of the problem that several physicians were having filing their 2013 tax returns because of a previously unknown breach of their social security number and address, MMA has learned of dozens of more cases in Maine and of hundreds of cases in approximately 18 other states.  An investigation by the Secret Service continues.

We have now learned of over 40 Maine physicians and over 115 New Hampshire physicians who have been impacted.  Most of the physicians in Maine are from the Portland area although there have also been reports from physicians in Bangor, Lewiston, Brunswick and Farmington.  The MMA would like to understand the full 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. 

Because of the large number of cases across the country, it is likely that the breach of data was at a national level.  This is a very sophisticated scam and likely global in its scope.  Similar scams have been perpetrated in previous years but most were aimed at employees of large corporations where it was assumed that human resources files were breached and then returns fraudulently filed in the names of many of the employees. The scam this year aimed at physicians and other health professionals is much broader and while some of the physicians are employed by large groups or hospital owned practices, others affected were in small private practices. Therefore, it is the opinion of MMA's attorneys that likely source of the breach was a large national database with physician names, addresses and social security numbers.  Many such databases exist at national pharmacy chains, national health plans, the federal government itself (CMS, IRS) and professional associations.  Because of its sophistication and likely global implications, it may never be known where one or more breaches may have occurred.  It is also likely that the information that was stolen was then sold to criminal elements who then perpetrated the second crime of filing the false returns.

Many of the physicians were not aware that elements of their identity had been stolen for the purpose of filing a tax return and seeking a tax refund in the name of physician.  Most did not know anything was amiss until filing a return and receiving information from the IRS that a return had already been filed.  In some cases, refund checks were received before a return had been filed.  An investigation is underway by the IRS, the Secret Service and other agencies but to date there have been no arrests or charges filed. The Secret Service has asked MMA to furnish the investigating office with the names of physicians who have been impacted and we intend to do so this coming week.

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.  We will be continuing to gather information and making suggestions as the investigations continue.  The consumer protection division of the Maine Attorney General's Office will be weighing in on the matter this week.  That division is responsible for crimes involving identity theft.

Physicians who are concerned that they have been or may be targeted by this scam are encouraged to visit www.experian.com/fraud and place themselves on a 90-day credit fraud alert.  This could potentially slow or halt further attempted identity theft activities. This is recommended as a precaution - at this time we have no reason to believe that every physician is at risk.  We understand that Experian will feed this information and fraud alert to the other two major credit reporting agencies.  If you remain concerned, investigators suggest that you go back to the Experian fraud page after 89 days and initiate a subsequent 90-day credit fraud alert.


We realize that many physicians affected have already taken some or all of the following steps but for those physicians who may be new to this issue but affected, the following are some recommendations based on our conversations with investigators and theft identity experts.

1.  Contact the IRS.  If you are impacted, be sure to follow up directly with the IRS in order to verify your identity and avoid penalties for the fraudulent filing.  Call the IRS Identity Protection Specialized Unit at 1-800-908-4490.  You will need to file a paper copy of your tax return, along with  completed IRS Form 14039, Identity Theft Affidavit, which should be faxed to the IRS at 1-855-807-5720.  Ask your accountant if you need an Identity Protection Personal Identification Number (IP PIN) for the paper return.

The U.S. Secret Service recommends accessing some of the information available on the IRS identity protection information page.  Tax-related identity theft information is also available on the Federal Trade Commission website.

2.  Contact the Social Security Administration.  Call the Social Security Administration's fraud hotline at 800-772-1213 to report fraudulent use of your Social Security number.  

3.  File a report with local police.  Bring all documentation available, including state and federal complaints you filed.  This will likely be necessary if there is financial account fraud as a result of the identity theft.  However, if the only fraud is tax fraud, the police report would only be necessary if requested by the IRS.  There is some risk that once your social security number has been stolen with perhaps other elements of your identity, that criminals will attempt to open up credit card accounts or other accounts in your name.

If you have questions or need additional information, please contact Gordon Smith, Esq., MMA's Executive Vice President at gsmith@mainemed.com or by calling 207-622-3374 ext. 212. 

New Laws Impacting Medical Practice the Subject of May 2 First Friday Presentation

With the 126th Maine Legislature scheduled to adjourn its Second Regular Session this coming week, MMA will present an educational session on the laws passed by the 126th Legislature on Friday morning, May 2 from 9:00am to noon as part of the First Friday educational programming.

New laws from both sessions will be discussed by a distinguished group of faculty including:

Ann Robinson, Esq, of Preti-Flaherty

Dan Morin,  Government Relations staff at MaineHealth

Charles Soltan, Esq. of the Law Offices of Charles Soltan

MMA Attorneys Gordon Smith, Andrew MacLean and Jessa Barnard.

Among the subject matters discussed will be the new price disclosure laws, the truth in advertising laws enacted in 2013 and the laws enacted amending the Medical Practice Act.

Registration is available on the MMA's website or by calling Ashley Bernier at MMA at 622-3374 ext. 213. [return to top]

POLITICAL PULSE: Legislature to Return for Veto Overrides May 1 - Action Needed

The 126th Maine Legislature finished most of the work of its Second Regular Session early on Good Friday morning.  Legislators will return to the State House for a veto session on Thursday, May 1st.  MMA Legislative Committee Chair, Amy Madden, M.D., and the MMA staff thank all physicians and their staffs who assisted with our advocacy activities this session by joining our weekly conference calls, serving as Doctor of the Day, or providing testimony or grassroots communications with members.  We encourage you to get to know the candidates for the 127th Legislature in your House and Senate districts.

ACTION NEEDED on LD 1578 Medicaid Expansion 

Join the MMA and our partners in support of accepting the federal funds to provide health care coverage to 70,000 low-income Maine people through our MaineCare program. The Governor is expected to veto LD 1578 and calls will be needed now until May 1.  All you have to do is ask your representative to support this proposal or leave a brief message if you do not speak with your legislator. You can find your legislators here. FMI and facts, click to Cover Maine Now.  

This bill is not focused on a managed care approach to the MaineCare program, but suggests a "private option" for most new enrollees through the marketplace.  55,000 childless adults would be transitioned from the Medicaid bridge program to the Marketplace Premium Assistance program if CMS approves the 1115 wavier that Maine would be required to submit prior to transitioning people the Marketplace Premium Assistance program.  Having 55,000 of the 70,000 eligible individuals covered under private health insurance would significantly increase providers reimbursement for services.  The remaining 15,000 individuals are parents and they would remain on Medicaid along with their children for continuity of care. The approach of L.D. 1578 is similar to the legislation recently passed in New Hampshire.  

ACTION NEEDED on LD 1719, Fund for a Healthy Maine

This year, the state of Maine will be receiving a one-time disbursement of about $5 million dollars as part of lawsuit challenge by the tobacco industry. That money should be used to fund tobacco related prevention, cessation, and control efforts. Maine lawmakers have passed a bill that would allocate this one-time funding to the Fund for a Healthy Maine to be used in its continued mission of preventing tobacco-related illness. LD1719 also funds obesity, substance abuse and oral health initiatives. Despite landslide votes in the House (110-34) and Senate (25-6) and a unanimous vote out of Appropriations, the Governor took less than 12 hours to veto the bill.  If your legislator supported the bill the first time, we need them to hold their ground. Contact them and ask them to continue their support. 

Legislature Restores ASC Funding, Improves Access to Naloxone 

The MMA was pleased with action on several bills during the final week of the session.  

  • Following two years of hard work, the MMA and Spectrum Medical Group's lobbyist Ann Robinson succeeded in restoring MaineCare coverage of services provided in ambulatory surgical facilities (L.D. 390).  
  • Also, the coalition seeking an expansion of access to the anti-overdose drug, naloxone, finally passed a bill (L.D. 1686) to expand access by family members and law enforcement.  This bill passed unanimously in both chambers, so it would appear to be able to survive a gubernatorial veto, though supporters believe the final Senate amendment addressed the Governor's primary concerns.  
  • The legislature also enacted a bill (L.D. 1840) to implement the recommendations of the Substance Abuse Services Commission and the Health & Human Services Committee on electronic enrollment of prescribers in the Controlled Substances Prescription Monitoring Program (PMP).  
  • LD 1699, supporting HIV prevention education, was also funded as part of an omnibus bill crafted by the Appropriations Committee.  

The 127th Maine Legislature will be seated in December and will begin work in January 2015.  The MMA staff welcomes input from individual members, practices, or specialty societies on the MMA's legislative agenda for the next legislature.  Now is a great time to get to know the candidates or the 2014 campaign season.  You can find the "List of Primary Candidates" for the June 10, 2014 primary election on the web here. [return to top]

Save the Date: MMA's 23rd Annual Practice Education Seminar June 18 in Augusta

The Augusta Civic Center will once again be the site of the Association's 23rd Annual Practice Education Seminar which is intended to present physicians and practice managers with the information and trends in medical practice in Maine and across the country.  The program will be held on Wednesday, June 18 from 8:15am to 4:00pm.

The theme of this year's program is "Preparing Your Practice for the Rough Road Ahead."  The focus will be on payment reform and best practices.  Carol Vargo from the American Medical Association will present data from the Rand survey conducted for the AMA which asked physicians questions about their level of satisfaction with their work and also elicited opinion about practice sustainability.  Kevin Flanigan, M.D., Medical Director for MaineCare will present a keynote luncheon talk on the State Innovation Model grant and its role in reforming the payment and delivery system in the state.  Other speakers will be announced shortly and the complete program will be included with the April-May-June issue of Maine Medicine. Registration will also be available on the MMA website at www.mainemed.com after May 1.

This year's program is supported by the Payment Reform grant from the Maine Health Access Foundation (MeHAF). [return to top]

MMA Board of Directors Meets Wednesday, April 30

The 24 member MMA Board of Directors will meet this coming Wednesday at 4:00pm at the offices of the Association in the Frank O. Stred Building in Manchester.  Following the two hour meeting, the Board will hold its annual dinner with the Board of the Maine Osteopathic Association.

The agenda includes as its priority topics a report from staff regarding following up from the January Board Retreat and a review of the nearly completed work of the 126th Legislature.  The Board will also receive a report from the Annual Session Committee on some significant changes to this year's meeting (Sept. 5-7, 2014 in Bar Harbor) and a report from EVP Gordon Smith on the national data breach leading to hundreds of physicians having 2013 tax forms filed fraudulently in their name and the criminals receiving tax refunds in their name.  MMA is cooperating with the Secret Service which is the lead agency investigating breaches in at least 18 states, including Maine.

The Board will welcome new member Kenneth Lombard, M.D., medical director of Maine Medical Partners.  Dr. Lombard practices pediatric gastroenterology and lives in Yarmouth.  Also attending will be two observers from the Maine Hospital Association Board, Charles Therrian, CEO at MaineCoast Memorial Hospital and Steve Diaz, M.D., CMO at MaineGeneral Hospital.  Two MMA Board members recently attended an MHA Board meeting as part of this exchange which is expected to involve two meetings each year.

The MMA Board is chaired by Brian Pierce, M.D., a family physician with an office in Rockport. [return to top]

AMA Issues Grace Period Guide to Assist Physicians

A rule published by Centers for Medicare & Medicaid Services (CMS) provides individuals who purchase subsidized coverage through the health insurance exchanges with a 90-day grace period before their coverage is cancelled for non-payment.  The AMA has released new resources that offer step-by-step help for minimizing risk to physician practices because of this rule. 

Under the CMS rule, insurers in health exchanges are required to pay any claims incurred during the first 30-days of the grace period, but insurers are not required to pay claims incurred during the last 60-days for any patient whose coverage is terminated. Patients are considered to be covered for care during the entire grace period, but insurers are allowed to place all the claims during the last two-thirds of the period in a pending status and retroactively deny them when coverage is terminated at the end of the grace period. 

More information and new AMA resources for physicians are available from the AMA here

View the AMA press release here.  

The American Academy of Family Physicians has also created a resource with frequently asked questions about the 90 day grace period. [return to top]

Patient-Provider Partnership Pilot Applications Released

A Request for Applications has been released by Maine Quality Counts, as part of the Maine State Innovation Model (SIM) Initiative.  This set of Patient-Provider Partnership (P3) Pilots are designed to:    

  • Improve health care quality and reduce avoidable costs by engaging patients more actively in decisions about their health care. 
  • Promote more effective communication between patients and their health care providers to make more informed decisions. 

QC will select and sponsor nine physician practices or provider organizations as pilots for shared decision-making. QC will identify and provide technical support and mini-grants to implement informed decision making tools in a more in-depth, multi-faceted manner.  The project team will work with each pilot site to identify current strengths, opportunities and potential barriers to implementing, through a range of interventions that reflect and leverage multiple drivers of change.

Set 1:  P3 Pilots – Choosing Wisely –  The deadline for applications is April 30, 2014.  This first set of P3 Pilots will test informed decision-making using the established and recognized national tools by the American Board of Internal Medicine (ABIM) Foundation’s “ Choosing Wisely®” Initiative. (The current Choosing Wisely in Maine Initiative, initiated in 2013 and led by QC, involved four provider pilots who have implemented Choosing Wisely tools into their healthcare settings). The P3 Pilots - Choosing Wisely Application is available HERE.

Set 2:  P3 Pilots – Low Back Pain - Shared decision-making decisions using tools available through the Dartmouth-Hitchcock Center for Shared Decision Making,  Ottawa Hospital Research Institute, Health Dialog, and Healthwise®.  The deadline for applications is May 8, 2014.  For more information on these available tools please see the link below. The goal is to promote more productive patient-provider conversations about the overuse of tests and procedures and support physician/health care provider efforts to help patients make smart and effective care choices. The P3 Pilots – Low Back Pain Application is available HERE.

Set 3:  P3 Pilots – Shared Decision-Making:  Behavioral Health DecisionsApplications will be available on May 19, 2014.  This third set of P3 Pilots will use formal shared decision-making tools to aid patient-provider conversations.

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Applications for Rural Medical Access Program Funds Due by May 2

For over twenty years, eligible obstetricians and family physicians doing OB have received reimbursement for a significant portion of their professional liability premiums through the Maine Rural Medical Access Program that MMA established through the legislature in the early 1990s.  The Program is jointly administered by the Maine CDC Rural Health and Primary Care Office and the Bureau of Insurance.  It is intended to promote obstetrical and prenatal care in federally Medically Underserved Area/Populations and Primary Care Health Professional Shortage Areas of Maine through assistance with insurance premiums.  To be considered eligible, physicians must be practicing in Maine, have performed deliveries and/or provided prenatal care and have malpractice insurance for prenatal care and/or OB services for the period of July 1, 2013 through Dec. 31, 2013.


1.  Physicians whose practices are located in federally designated Medically Underserved Area/Populations or Primary Care Health Professional Shortage Areas, who practice at least 50% of the time in underserved areas, and whose practice includes at least 10% MaineCare patient visits.

2.  Physicians whose practices are not located in federally designated Medically Underserved Area/Populations or Primary Care Health Professional Shortage Areas but are located in Primary Care Analysis Areas of under 20,000 population and at least 50% of the visits are patients from federally designated areas and/or MaineCare.

To find out if your site qualifies, you may refer to a map on the following website:


Applications for 2014 can be obtained from Cari Balbo, Rural Health Manager at 287-5524.  Applications must be completed and returned to the Maine CDC Office of Rural Health and Primary Care by Friday, May 2.  Late applications can not be accepted. Cari is also available to answer any questions about the program. [return to top]

Announcing Single Sign-On Access from HealthInfoNet (HIN) to the PMP

To promote use of the Maine PMP and HIN, effective Thursday, April 10th, the PMP is accessible directly from the HIN clinical portal through a single sign-on process. This will provide health care providers throughout Maine easier access to comprehensive patient data and assist them in providing effective patient treatment.
This single sign-on process will allow HIN users to bypass the whole PMP login process and launch directly from the HIN clinical portal to the PMP Practitioner/Pharmacist query portal patient look up site. All prescribers, dispensers and their delegates who are interested in using this feature must be registered to use both the PMP and HIN.

Important: If you want this service, you must request it.
You can sign up for single sign-on one of two ways.

  1. Request access through the HIN portal using the “Request PMP Access” link on the Links Menu.
  2. Contact HealthInfoNet at customercare@hinfonet.org or 207-541-9250. Please include your PMP user name, first name, last name and date of birth in your message.

Need to register with the PMP?
If you are not registered with the PMP, please submit a completed and signed registration request form to the Office of Substance Abuse and Mental Health Services (SAMHS), Prescription Monitoring Program. Registrations forms can be found on www.maine.gov/pmp. For any PMP technical issues, contact the Help Desk at mepmp-info@hidinc.com or 1-866-792-3149.
Need a HIN user account?

If you do not have a HealthInfoNet user account and your organization is connected, contact your organization’s IT Help Desk. If your organization is not connected to HealthInfoNet, please visit the website at www.hinfonet.org or call 207-541-9250 to learn more.

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New Funding Opportunity: Improving Access to Quality Care for Uninsured Individuals

The Maine Health Access Foundation (MeHAF) announces the availability of grants under round two of the Improving Access to Quality Care for Uninsured Individuals (A2QC) program.  Grants under this program will support the advancement of a sustainable system of care that delivers comprehensive, high-quality health care services to improve the health of uninsured, low-income individuals, and reduces the time spent in poorly-coordinated, inefficient and costly care.

The A2QC program is an effort to support and work with health systems, health care and social services providers to minimize disruptions in established provider relationships as patients cycle on and off public or private coverage, and advance collaborative, community-based systems of care.

This second round of A2QC planning grants will provide an opportunity for communities in areas of the state where no round one A2QC award was made to apply. Eligible areas: Northern, Eastern, Western, and Central Public Health Districts, Piscataquis County and Northern Penobscot County. Each project's service area may vary from County-wide to individual communities.

Up to three one-year planning grants of up to $50,000 will be available. In 2015, A2QC planning grantees will be eligible to compete for three-year implementation grants.

For more information on the A2QC program, informational sessions and application schedule, go to the A2QC New Funding Opportunity page on the MeHAF website, or contact Program Officer Charles Dwyer.
Deadline for online applications is May 21, 2014 by 4:00 p.m. (EDT).

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Upcoming Events

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/

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Job Openings

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.


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