May 5, 2014

 
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New England State Medical Society Delegation Approves Tax Fraud Resolution to AMA

Delegates and staff compared experiences and expressed concern about the tax fraud problem and the government's response to it.  Hundreds of physicians across New England now have come forward as victims of the fraud. MMA has been contacted by Special Agent Rodney Giguere with the IRS who is seeking to hear from physicians who have been impacted. 

Special Agent Guguere can be reached at rodney.giguere@ci.irs.gov or (207) 253-6479.  He works out of the South Portland Office of the IRS Criminal Investigation Division.  

The New England Delegation to the AMA met last Friday and Saturday, May 2nd and 3rd, at the Inn at Mill Falls in Meredith, NH.  MMA delegates Maroulla Gleaton, M.D. and Richard Evans, M.D. attended along with Deputy EVP Andrew MacLean.  AMA Past President Robert McAfee, M.D. and plastic surgery delegate John McGill, M.D. also participated in the meeting.  

Among resolutions considered for submission to the AMA House of Delegates in June was a resolution from the Vermont delegation on the physician identify theft/tax fraud problem.  The draft resolution passed and would urge action as follows:

RESOLVED:  That our American Medical Association petition the Internal Revenue Service (IRS) to adopt policies to ensure greater security protection for electronically filed federal income tax returns, including the universal use of PINs, or personal identification numbers; and be it further

RESOLVED:  That our AMA petition the IRS and CMS to promulgate regulations to prohibit the use of SSN by insurers, health care vendors, state agencies other than the tax authority, and non-financial businesses.

The delegation also approved for submission to the AMA House of Delegates resolutions addressing firearms violence, E-cigarettes, observation status, and a state medical society dues exemption/adjustment for physicians unable to attain a residency training program.  

In other business, the group received reports from each New England state medical society President and critiqued a speech by Thomas Sullivan, M.D. who is running for a position on the AMA Board of Trustees.  Dr. Gleaton presented the MMA President's report on behalf of Dr. Guy Raymond who could not attend because of a conflicting CME obligation.

The New England delegation will meet next on September 20, 2014 at the headquarters of the Masschusetts Medical Society in Waltham, Massachusetts.

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

Since beginning to report on 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 across the country.  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.

NEXT STEPS FOR AFFECTED PHYSICIANS

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.

You can also contact Special Agent Rodeny Giguere who works out of the IRS Criminal Investigation Division in South Portland.  He is seeking to hear from Maine physicians who have been impacted to assist with an investigation into the issue.  His contact information is (207) 253-6479 or rodney.giguere@ci.irs.gov

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. 

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POLITICAL PULSE: Maine Legislature Returns for Veto Day, Summary of New Laws Available

On May 1st, “Veto Day,” lawmakers overturned at least 15 of the 48 vetoes issued Gov. Paul LePage over the past two weeks.

Top on many healthcare organization’s lists was Medicaid expansion (LD 1578). The House sustained the Governor's veto of the Speaker of the House, Mark Eve’s, Medicaid expansion bill, in a 94 to 53 vote. Essentially, the legislature failed to override the Governor’s veto by just 4 votes. While disappointed, the Cover Maine Now coalition and its many advocates should be proud of the hard work they put into this campaign.

Equally disappointing, we did not have the votes to override the Governor’s veto of LD 1719, a bill that would use money from the tobacco settlement to fund public health and prevention initiatives including tobacco cessation and other substance abuse prevention. LePage proposed late Wednesday to use that money instead to fund Maine’s nursing homes.

Perhaps the most important veto override was when lawmakers rebuked LePage’s veto of their $30 million budget fix for the current biennium. The Governor did not submit a supplemental budget and chose not to participate in the budget conversations. The Governor weighed in only to veto the bill after it won broad bipartisan support in the Legislature. Among the items in the budget that attracted sweeping bipartisan support were provisions for more funding for nursing homes and to reduce waitlists for developmentally disabled people. The bill now becomes law, balancing the state budget, for now.

MMA has now released a slide presentation overview of health care-related legislation enacted by the 126th Legislature and will be highlighting new bills that practices should be aware of in upcoming issues of this newsletter. 

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. You can find the "List of Primary Candidates" for the June 10, 2014 primary election on the web here.

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.    [return to top]

MMA Payment Reform Committee to Meet on Wednesday, May 7

The MMA Payment Reform Committee will meet this Wednesday, May 7 from 6-8:00 p.m. at the MMA offices in Manchester.  Dinner will be available from 5:45 p.m. The Committee will review the agenda for the June 18th Practice Education Seminar and discuss plans for the MMA's payment reform activities for the remainder of the year.  Any MMA member may attend, but please reply by Monday, May 5 to Jennifer Reck, jreck@mainemed.com or 207-274-3793 for meal planning purposes or if you would like call in information or to learn more about the committee.  [return to top]

Report on April 30 MMA Board of Directors Meeting

The MMA Board of Directors held a regularly scheduled meeting on Wednesday, April 30.  The Board welcomed new member Kenneth Lombard, M.D., medical director of Maine Medical Partners and a pediatric gastroenterologist. The Board also welcomed 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 Board reviewed a timeline prepared by staff detailing the goals for implementing the recommendations made by the Board at the President's Retreat in January.  Most of these recommendations involved reviewing the costs and benefits of all MMA services and products to ensure both relevancy and cost-effectiveness.  An additional goal is to better focus the work of the Association in areas most valued by the members. The Board is also working on the issues of Board governance. 

Board members also received a staff update on the final actions of the 126th Legislature.  It was announced that Executive Committee member Charles Pattavina, MD, will chair the Maine Physician Action Fund which is the authorized political action fund of MMA.  Charles McHugh, MD, will serve as Secretary-Treasurer. 

The next Board meeting is on Wednesday, June 4 at 4:00 pm.  It will be preceded by a meeting of the Executive Committee at 3:00 pm.  Both meetings will be held at the offices of the Association at the Frank O. Stred Building in Manchester.  Board or Executive Committee meetings are open to MMA member who wishes to attend.  [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]

CMS Announces October 1, 2015 as New ICD-10 Implementation Date

As part of the Medicare hospital inpatient prospective payment system (IPPS) rule released April 30th, CMS has set October 1, 2015 as the official implementation date for the ICD-10 code set.  The proposed IPPS rule will be published in the Federal Register on May 15th and comments are due by June 30th.  The proposed rule also requested comments on how the ICD-10 transition will affect the hospital value-based performance (VBP) payment program.   [return to top]

Maine - National Drug Take Back Initiative Final Results

The local representatives of the US Drug Enforcement Agency would like to thank everyone for their participation during the eighth National Drug Take Back Day held on Saturday, April 26, 2014. They completed the incineration process last Monday at Covanta Haverhill Inc. in Haverhill, ME. (Waste to Energy Facility). The statewide collection results have reached yet another new bar:  27,040 pounds. This is the largest amount collected during any collection in Maine to date. 

The total for all eight collections in Maine to date now stands at 133,660 pounds.  This will likely continue Maine's standing as the #1 ranking state for the largest collection per capita in the US. The US DEA is planning an additional drug take back event in the fall. 

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May is Lyme Disease Awareness Month

Lyme disease is the most common vectorborne disease in Maine. Cases have already been reported in 2014, and the number will rise as the weather continues to get warmer.

Lyme disease is a bacterial infection carried by the deer tick.  Cases have been increasing each year in Maine, and occur in all 16 counties. More than 1,375 cases of Lyme disease were reported statewide in 2013, a record high for Maine.  Lyme disease is most common among school age children and adults older than 65. Most infections occur during the summer months.

The most common early symptom of Lyme disease is an expanding red rash that occurs 3-30 days after being bitten. Fever, headache, joint and muscle pains, and fatigue are also common during the first several weeks. Later features of Lyme disease can include arthritis in one or more joints (often the knee), Bell's palsy and other cranial nerve palsies, meningitis, and carditis (AV block). Lyme disease is treatable, and the majority of patients recover after receiving appropriate therapy.

For testing and treatment information, see the health alert here.

Other Tick-borne diseases: 

Other diseases that are carried by ticks in Maine include Anaplasmosis, Babesiosis and Powassan. Symptoms of Anaplasma include: fever, headache, malaise, and body aches. Symptoms of Babesia include: extreme fatigue, aches, fever, chills, sweating, dark urine, and possibly anemia.  Symptoms of Powassan include:  fever, headache, vomiting, weakness, confusion, loss of coordination, speech difficulties, seizures, and encephalitis and meningitis.

In 2013, providers reported 94 cases of Anaplasmosis, 36 cases of Babesiosis, and 1 case of Powassan.  Five anaplasmosis cases and two babesiosis cases have already been reported in 2014. 

For more information:

Lyme disease data are available on Maine CDC's website.  

For more information on tickborne diseases, including Lyme. 

A Physician's Reference Guide is available and describes the most common tickborne diseases in Maine.  This guide can be found on the Maine CDC's website.

For IDSA Lyme disease treatment guidelines.

To order Lyme educational materials. 

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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]

Upcoming Events

Free Colorectal Cancer Webinars

Maine CDC Colorectal Cancer Control Program offers three educational webinars with opportunity for FREE CMEs!

Office Strategies for Increasing Colorectal Cancer Screening Rates in the Primary Care Practice
Evidence-Based Guidelines to Improve Colon Cancer Screening Quantity and Quality in Maine
There is No One "Best" CRC Screening Test: The Proof and the Benefits of Getting FIT

 Viewing each webinar and completing the pre- and post-tests will grant the participant one free CME. Click here to get started.

***

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. 

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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.

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The Affordable Care Act: What’s in it for my Nonprofit?

Tuesday, May 13, 2014

8:15am - 10:15am

Senator Inn, Augusta, ME

The Maine Association of Nonprofits, in partnership with the Maine Health Access Foundation, is holding a free Affordable Care Act (ACA) forum where nonprofits can get the answers they need to make good decisions about Obamacare. 

For more information or to register, click here.  Must register by May 9th. 

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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/

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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 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/

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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.

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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

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Maine Association of Physician Assistants Summer CME Conference

June 20 & 21, 2014 

Portland Marriott at Sable Oaks, So Portland, ME 

Friday June 20 - ED Primer and Potpourri for the PCP 

Saturday June 21 - Commercial Driver Medical Examiner Workshop - open to all medical professionals

For more information and to register, visit http://www.mainepa.com/conference

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Save-the-date! 

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

BC/BE Family Practice Physician

Lovejoy Health Center (Albion, ME) seeks a BC/BE family practice physician to provide primary care including obstetrics (optional) to patients of all ages. As a NCQA-Patient-Centered Medical Home, we offer accessible, high quality healthcare with integrated behavioral health services focused on the patient’s care experience. Founded in 1978, we serve over 4,000 residents and visitors each year. We reside in the peaceful, picturesque, and welcoming central Maine region near four-season recreational opportunities and the Maine coast. We offer competitive compensation, incentive plan and malpractice coverage. Position is eligible for loan repayment. EOE. Contact: Recruiter, HRCHC, 10 Water Street, Suite 305, Waterville, ME  04901 ~ 207.660.9913 ~ Fax 207.660.9901 ~ Communications@HealthReach..org ~ www.LovejoyCHC.org.

6/2/14

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.

6/23/14

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