June 2, 2014

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Maine Health Insurance Exchange Advisory Committee Resumes Work on Tuesday

The Maine Health Insurance Exchange Advisory Committee will resume its work on Tuesday (June 3).  The meeting will be held in room 228 at the State House from 9:00am to 3:00pm.  The Committee is co-chaired by Senator Margaret Craven (D, Lewiston) and Representative Sharon Treat (D, Hallowell) and is resuming its work after taking a reprieve during the legislative session.  The Committee was established by Joint Order H.P. 1136 in 2013 to advise the Legislature regarding the interests of individuals and employers with respect to any health benefit exchange that might be created by the state pursuant to the ACA.

This will be the first meeting of the Advisory Committee since announcing statistics on the first year enrollment in the federally operated Maine health insurance exchange.  Enrollment in the exchange greatly exceeded expectations with most of the enrollees being entitled to subsidies and with most of them opting to join the new Maine Community Health Options.  The other participant in the exchange in Maine was Anthem Blue Cross Blue Shield of Maine.

On Tuesday, Committee members will receive the following presentations:

  • Legislative Update and information received from state agencies 
  • Federal Update from Christie Hager, Region One Director, U.S. Department of Health and Human Services
  • State Regulatory Update from Eric Cioppa, Maine Bureau of Insurance
  • Health Plan Update by Anthem and Maine Community Health Options
  • Consumer outreach activities and enrollment update.

The Committee will also discuss plans for 2015 (open enrollment begins Nov. 15, 2014)

Audio for the meeting can be streamed over the internet by clicking here.

Physicians and other health care practitioners and providers are represented on the Committee by MMA EVP Gordon Smith.  Dr./Rep. Linda Sanborn, M.D. also serves on the Committee which includes 18 members.  All appointments were made by the President of the Senate or the Speaker of the House.

Registration Now Open: MMA's 23rd Annual Practice Education Seminar, June 18

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.  

The full agenda, speaker list and registration are now available on the MMA website

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

MHMC Healthcare Cost Workgroup Holds Second Meeting

A Healthcare Cost Workgroup established by the Maine Health Management Coalition as part of the State Innovation Model (SIM) grant met for the second time on May 29th.  Facilitated by national expert Michael Bailit, M.D., nearly 40 participants reviewed six possible strategies to address price growth and variation.  The strategies discussed included the following:

  1. Transparency
  2. Reference pricing
  3. Narrow networks
  4. Bundled Payments
  5. Risk-based Contracts with Growth Caps
  6. Regulated prices/Rate setting.

Maine has had some experience with all the strategies except for reference pricing.  Reference pricing works via a health plan setting a maximum amount - reference price - for a procedure, drug or type of stay.  The plan then designates providers that meet the reference price and any quality standards.  Patients are then free to use whichever providers they want, but must pay the difference for any higher priced providers.  In this scenario, typically the out of pocket amount paid by the patient would not count towards any applicable deductible.  Recently, the Obama administration has provided an opinion that reference pricing does not violate the ACA out of pocket limits.

While the discussion was very preliminary, there did not seem to be a lot of interest in reference pricing by the attendees.  MMA will continue to follow the workgroup deliberations closely and report to members and practice managers via the Weekly Update and Maine Medicine.  [return to top]

New Laws Impacting Your Practice: LD 1840, Automatic Enrollment in PMP; Physician Enrollment Tops 90%

Each week MMA will be running articles highlighting new laws passed by the 126th Legislature that impact the practice of medicine in Maine.  We are also happy to present an overview of new laws to your medical staff, practice or specialty society and have posted a slide presentation overview of all health care-related legislation enacted by the 126th Legislature on the MMA website.

LD 1840 directs the Department of Health and Human Services, Controlled Substances Prescription Monitoring Program to streamline the process for enrollment in the Prescription Monitoring Program (PMP).  The PMP is the database of all transactions for schedule II, III and IV controlled substances dispensed in the State of Maine.  Based on the recommendations of the Substance Abuse Services Commission, the new law, which took effect immediately, states that the PMP must implement a mechanism for prescribers of controlled substances to be enrolled automatically as a part of the process of applying for or renewing a professional license.  The change would impact prescribers who are registering with the program for the first time or are renewing registration.  The new law also repeals the section of statute that made registration mandatory as of March 1, 2014, if 90% or more of a class of prescribers had not registered.  

The full text of the law can be found here

The Office of Substance Abuse and Mental Health Services also announced that physician enrollment in the PMP has now topped 90%.  By April 2014, 91% of physicians and 90.8% of all presribers had registered with the program.   In February alone, the PMP program processed 2520 applications for enrollment.  So, while the law mandating registration has been replaced by automatic enrollment, much of the work of enrolling prescribers has already been accomplished. 

With questions or concerns about this law, please contact MMA Attorneys Gordon Smith, Andrew MacLean or Jessa Barnard via email or at 622-3374.   [return to top]

American Medical Association House of Delegates Convenes at Annual Meeting Saturday

The House of Delegates of the American Medical Association will convene in Chicago on Saturday (June 7) for its Annual Meeting.  MMA delegates Richard Evans, M.D. and Maroulla Gleaton, M.D.will be present as will MMA President Guy Raymond, M.D. and MMA EVP Gordon Smith, Esq.

Watch for the Weekly Update next week which will contain some details on the meeting which will adjourn on Wednesday, June 11. [return to top]

MMA Board of Directors to Meet on Wednesday, June 4, 2014

The 23 member MMA Board of Directors will hold a regularly scheduled meeting this coming Wednesday, June 4, at 4:00pm at the offices of the Association in the Frank O. Stred Building in Manchester. All MMA Board meetings and committee meetings are open to any MMA members who wishes to attend.  The Board is currently chaired by Brian Pierce, M.D., a family physician practicing in Rockport.

Wednesday's meeting features a new agenda format with all presentations being sent in writing in advance of the meeting thus providing more opportunity for the Board members to discuss what is happening in their specialties or geographic areas that MMA should know (a modest environmental scan). [return to top]

Attorney General Mills Announces 2013 Drug Death Statistics

Attorney General Janet Mills and the Office of the Chief Medical Examiner disclosed today that 176 drug induced deaths occurred in Maine in 2013, an increase of 13 deaths over 2012. 105 of these deaths were attributable to pharmaceutical opioids and 34 were attributable to heroin. The number of drug induced deaths has been consistently high over the last 13 years and exceeds the number of deaths due to crashes on Maine's highways.

These statistics include all deaths in which one or more drugs are mentioned on the death certificate as a cause of death or as a significant contributing factor. Most of these deaths reportedly are accidental overdoses. 

"Maine medical and law enforcement communities have have made a concerted effort to reduce access to opioids in Maine," said Attorney General Mills. "However, the statistics show there is still a major addiction problem in our state. Law enforcement, prosecutors, the medical community and educators must work in concert to prevent people from becoming addicted in the first place." 

The Attorney General remarked on the astonishing increase in deaths due to heroin use. Heroin use is on the rise partly because of regulations restricting prescriptions for oxycodone and regulations requiring tamper-resistant packaging of prescription opioids. In 2012, 28 people in Maine died as a result of heroin overdose, compared to just seven in 2011. That number continued to climb to 34 deaths in 2013.

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Indoor Tanning Raises Risk of Melanoma: FDA Strengthens Warnings for Sunlamp Products

Using sunlamp products such as tanning beds or tanning booths increases the risk of skin damage, skin cancer and eye injury, according to the Food and Drug Administration (FDA) and numerous other health organizations. A particularly dangerous result is melanoma, the deadliest type of skin cancer.

According to the American Academy of Dermatology and the World Health Organization, indoor tanning heightens the risk of developing melanoma by 59 percent, and the risk goes up with each use. Despite these risks, according to the American Cancer Society (ACS), thousands of Americans will opt for an indoor tan. The ACS estimates that nearly 13,000 people die each year from skin cancers—approximately 9,700 of which are from melanoma. The ACS predicts that in 2014, melanoma will account for 76,100 cases of skin cancer.

To help protect consumers and inform them about the risks of indoor tanning, FDA is changing its regulation of sunlamp products and UV lamps intended for use in sunlamp products. The changes strengthen the oversight of these devices, and require that sunlamp products carry a visible, black-box warning stating that they should not be used on people under the age of 18.

This change is due to concerns that the effects of UV radiation add up over time, and children and teenagers who are exposed to indoor UV radiation are at greater risk for skin and eye damage.

For the FDA's full statement on their new recommendations, click here

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Surescripts Study Finds Majority of Prescriptions Transmitted Electronically in 2013

In a report released on May 21st, Surescripts has found that efforts to promote electronic prescribing of prescription drugs in the country is producing results.  The report entitled, "National Progress Report on E-prescribing," 58%of all presriptions in 2013 - approximately 1 billion -were transmitted electronically.  In the study, Surescripts used both its own proprietary data and public data.  The company's own database showed a 32% increase in electronic prescribing over the previous year.  The report says that 73% of physicians used e-prescribing in 2013.  Delaware, Minnesota, and Vermont are the top three states for e-prescribing with 81% of physicians in Delaware using such technology.  Wisconsin, North Dakota, and Connecticut also are in the top ten states for e-prescribing.  All states transmitted at least 45% of eligibile prescriptions electronically according to the report.  [return to top]

Upcoming Events

The Maine Public Health Association (MPHA) Tobacco Webinar Series  

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/ 


MaineGeneral's 2014 Spring Coding Conference

Friday, June 13, 2014

Regional Hospital Education Pavilion, Augusta, ME

7:30 am - 4:00pm

Topics include: CPT Combined Coding Changes, Transitional Care Management, Engaging Physician’s in ICD 10 and Next Steps with ICD 10

Contact: Lisa Beeckel, Practice Administrator, 621-9537 or Lisa.Beeckel@MaineGeneral.org


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


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


NAMI Maine Fundraiser: "Our Boy Hubert and the Wolf" Performance

Sunday, June 29, 2014

3:00 pm

Franco Center, Lewiston

Tim Sample’s playful re-imagining of this children’s classic (including three outta-state hunters and a celebrity quacking wolf) is guaranteed to provide laughter and musical fun for your entire family. 

For tickets or more information, click here

5th Annual Patient Safety Academy

Friday, September 5, 2014

 9 am – 4 pm

University of Southern Maine, Portland campus, Abromson Center

Cost: $50, with a discounted rate of $25 for students

Registration is now open. To register, click here or visit the Patient Safety Academy webpage at usm.maine.edu/muskie/psa


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

October 7, 2014

Augusta Civic Center


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.

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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.


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.


ED Provider Jobs

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

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

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

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

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

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


BC/BE Family Practice Physician

We are seeking a BC/BE Family Practice physician to provide medical care one-day-per-week on the day off of the permanent provider.

Rangeley Family Medicine, located in a medically underserved community, serves 1,700 people ranging from newborns to retirees. 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. One of eleven practices of HealthReach Community Health Centers, we are located in the popular Rangeley Lakes Region, which features plentiful lakes and streams, thousands of acres of wild forests, and abundant wildlife. We offer competitive compensation and malpractice coverage. EOE. Contact: HRCHC Recruiter, 10 Water Street, Suite 305, Waterville, ME 04901 ~ (207) 660-9913 ~ Fax: (207) 660-9901 ~ Communications@HealthReach.org ~www.RangeleyCHC.org


Attention BC/BE FP doctors!

Ready for a change?

Bingham Area Health Center offers a one-day-per-week opportunity throughout the year for a physician to provide medical care on the regular provider’s day off. The health center serves 2,500 people of all ages and also offers on-site dental care and behavioral health services. A committed community board provides ongoing support and local feedback. A Level-Three Patient-Centered Medical Home, Bingham is one of eleven practices of HealthReach Community Health Centers. It is located in Somerset County along the Kennebec River. We offer competitive compensation and malpractice coverage. EOE. Contact: HRCHC Recruiter, 10 Water Street, Suite 305, Waterville, ME 04901 ~ 207.660-9913 ~ Fax 207.660-9901 ~ Communications@HealthReach.org  ~www.BinghamCHC.org

Considering retirement, but not quite ready?


Associate Medical Director - Maine Medical Partners Internal Medical Clinic

Maine Medical Partners is seeking an Associate Medical Director for their Internal Medicine Outpatient Clinic at Maine Medical Center. 

The Maine Medical Partners Internal Medicine Clinic is the primary outpatient teaching site for Maine Medical Center’s Internal Medicine Residency Program.  The Clinic, located in Portland, Maine, is the medical home for a culturally diverse population, in addition to providing specialty clinics in cardiology, dermatology and international medicine. 

This fulltime position is an excellent opportunity for motivated Internal Medicine physicians interested in pursuing a career balancing clinical, academic and leadership roles.  The candidate will need to work well in a team environment, relate effectively with culturally diverse patients, and possess strong teaching, clinical and leadership skills.  The clinical portion of the position involves a mix of direct patient care and the precepting of Internal Medicine Residents.  Candidates must be BC/BE in Internal Medicine.

Maine Medical Center has 637 licensed beds and is the state’s leading tertiary care hospital, with a full complement of residencies and fellowships and an integral part of Tufts University Medical School. 

For more information please contact Alison C. Nathanson, Director, MaineHealth Physician Recruitment Center at (207) 396-8683 or nathaa@mainehealth.org.


State Epidemiologist Opening 

Job Duties

As State Epidemiologist in the Division of Infectious Disease, you will provide guidance and support to approximately 12-15 epidemiologists in the Infectious Disease Epidemiology Program for disease investigations and outbreak control, surveillance activities, and planned epidemiologic studies. Additionally, you will provide medical guidance, as needed, to all other programs within the Division; the Maine Immunization Program and the HIV, STD and Viral Hepatitis Program. You will be involved in formulation of statewide public health policy including providing legislative testimony by request for the Department. You will participate in the development of disease investigation protocols and the review of case investigations. You will consult with physicians and other health care professionals on disease prevention and control measures. You will respond to inquiries from the public and will coordinate response to media inquiries as directed by the Director of Maine CDC. You will interact with staff in the Division of Public Health System's, Public Health Emergency Preparedness Program, and the Health and Environmental Testing Laboratory, as well as the Division of Environmental Health's Health Inspections Program and other programs as requested. You will be part of the on-call rotation for nights and weekends (for telephone consultation, not on-site work) and provide technical support to other staff as needed when they are on call. As State Epidemiologist, you will supervise the medical epidemiology team which includes the Deputy State Epidemiologist and the Healthcare Associated Infections Coordinator. You will also provide medical guidance and oversight to the Tuberculosis Control Coordinator. You will serve as a liaison between federal CDC and Maine CDC on issues related to infectious disease. The State Epidemiologist will report to the Director, Division of Infectious Disease.


Graduation from an accredited school of medicine or osteopathy with board certification in an appropriate medical specialty. A twelve year combination of training and experience in medicine and public health, to include a minimum of four years experience as an epidemiologist, OR a Masters Degree in Public Health or a related field and six years experience in the field of medicine and public health, to include a minimum of four years of experience as an epidemiologist.  SPECIAL REQUIREMENT: Current license to practice medicine in the State of Maine. 

Agency Information

The Department of Health and Human Services (DHHS) is driven by its vision of Maine people living safe, healthy and productive lives. Its goal is to assist the people of Maine in meeting their own needs, as well as the developmental, health and safety needs of their children. It serves the public in an environment that reflects a caring, responsive and well-managed organization. The Maine Center for Disease Control & Prevention, Infectious Disease Division, is charged with decreasing morbidity and mortality through the prevention and control of infectious disease. Program areas within the Division include Infectious Disease Epidemiology, the Maine Immunization Program and the HIV/STD/Viral Hepatitis program. 

More information: http://www.maine.gov/tools/whatsnew/index.php?topic=dhhs_direct_hire_jobs&id=620082&v=dhhs

For questions, contact: 

Lori Wolanski, MPH
Director Division of Infectious Disease
Maine Center for Disease Control and Prevention
286 Water Street- 8th floor
Augusta, ME 04330
office: 207-287-6448
cell:     207-592-3758


Executive Director, Maine Chapter American Academy of Pediatrics

Seeking a 28-40 hour ED to manage the organization and report to the Board of Directors

The Maine Chapter of the American Academy of Pediatrics is a membership organization of approximately 200 pediatricians and pediatric subspecialists who are dedicated to fulfilling the Chapter’s mission: To improve the lives of children and adolescents in Maine.

We are a small Chapter of the American Academy of Pediatrics that has become nationally recognized for our work, particularly in healthcare quality programs, education and advocacy. 

The Chapter supports the achievement of our mission through providing continuing medical education opportunities for pediatricians in Maine, collaborating with other organizations interested in the health and well-being of children, maintaining a significant presence in legislative advocacy and policy development and working with funding streams (grants, foundations, National AAP). 

Qualifications: Bachelors degree required, advanced degree preferred. Strong written and oral communication skills required. Two years experience in health care or association management field preferred. Must be a consensus builder, have the ability to work independently and with multiple demands. Must have strong leadership skills and be flexible. Grant writing and financial management experience preferred. Technical proficiency working with QuickBooks and with spreadsheets as well as a basic ability to manage a website are preferred. Must be willing to travel in-state as well as attend out of state national and district meetings two times per year. 

Salary and Benefits:  Commensurate with experience. Benefits include health, dental, disability insurance and paid time off. Other benefits: Flexible schedule, ability to work from home. Ability to grow the position/salary based on skill set and funding brought into Chapter. Cost sharing for internet use and phone. Use of Chapter equipment. Knowledge that you are working to improve the health of all children and adolescents in our state. 

Anticipated Start Date: Immediate

To Express Interest or Apply: Please send resume and contact information for three references to Kate Stabile at kstabileaap@gmail.com

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