July 21, 2014

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CMS Announces Award of Medicare Quality Improvement Network to Healthcentric Advisors

On Friday, July 18th, CMS announced that it had awarded the new five-year contract (11th scope of work) for Medicare quality review beginning August 1, 2014 to HealthCentric Advisors of Rhode Island.  The contract was awarded for all six New England states, thus removing Maine, New Hampshire, and Vermont from the previous contractor, Northeast Healthcare Quality Foundation, the current QIO which has held the Medicare contract for several years.

Healthcentric Advisors, formerly known as Quality Partners of Rhode Island, was previously the Medicare QIO for the state of Rhode Island.  The organization is a nationally recognized healthcare quality improvement and patient safety advisory organization providing its clients with effective education, consulting, research, analytical, and project management services.

The Rhode Island organization is the same organization that partnered with Maine Quality Counts to put together a proposal to provide QIO services in Maine.  While that effort was ultimately unsuccessful, MMA is encouraged with this awarding of the contract to the Rhode Island group given that it has committed in its application to have more of a local presence than the previous contractor and to collaborate with local QI initiatives, such as the projects currently led by Quality Counts.

The award of the contract is subject to appeal and it is possible that the Northeast Healthcare Quality Foundation will contest the award.

The grouping of the six New England states is consistent with the announced intention of CMS to have fewer contractors doing the quality review work across the country.

MMA Leadership "Listening Session" Scheduled for July 31st in Bangor

Members of the MMA's Board of Directors and senior staff invite physicians in Penobscot, Piscataquis, and Hancock counties for a "listening session" at a restaurant to be announced in Bangor from 5:30 - 7:30 p.m. on Thursday, July 31st.  Drinks and hors d'oeuvres will be on MMA.  The MMA leadership very much would like the opportunity to mingle with physicians in the Bangor area in an informal, social setting and to hear what's on your mind.  This is a great opportunity for you to speak up about how MMA can better serve you.

 For more information, please contact MMA EVP Gordon Smith at gsmith@mainemed.com or at 622-3374, ext. 214.  [return to top]

Ethical Issues in Contemporary Medicine is next First Friday Program on August 1

The final presenters have been named for the upcoming First Friday presentation entitled, "Ethical Issues in Contemporary Medicine" on August 1, 2014 from 9:00 am to noon.  The program is available live at the Association offices in Manchester or via webex.  The $70 registration fee is the same regardless of location. Two and one half hours of category one CME are available.

Presenters include ethicist Frank Chessa, Ph.D. from the Maine Medical Center, Stephen Johnson, Esq., of the law firm of Kozak & Gayer, P.A., and Melanie Cutler, J.D., M.D., a practicing psychiatrist who is a member of the clinical ethics committee at the Maine Medical Center.  Before receiving her medical training, Dr. Cutler was a practicing attorney in Washington, D. C.  Rounding out the panel will be MMA attorneys Gordon Smith and Andrew MacLean.

Topics being addressed during the program include ethical implications of quality metrics; definitions of medical futility in the context of end of life care, POLST as an additional tool in health care decision making; and the Maine version of the Uniform Health Care Decisions Act.  Dr. Cutler will discuss the operation of clinical ethics committees in an era of declining resources.  AMA officials will discuss the recent rewrite of the Code of Medical Ethics and its annotations.  

Registration is available on the MMA website at www.mainemed.com or by calling 622-3374.

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Harborside Hotel Room Block Closes August 5th for MMA's 161st Annual Session

The MMA's 161st Annual Session will take place at the beautiful Harborside Hotel & Marina in Bar Harbor, Maine from September 5-7, 2014.  Our room block at the hotel will close August 5th and we have been advised that there will be no extensions.  You can find information about the meeting, including registration information, the agenda, and hotel reservation information on the MMA web site here.  The code for the MMA room block is "MMA2014."  We encourage you to take a look at the meeting materials because we have made some changes this year in hopes of providing a better experience for physicians and their families.  The changes include:

  • A shorter time commitment.  The meeting will begin with an opening reception on Friday, September 5th and will close mid-morning on Sunday, September 7th;
  • Child care will be available throughout the meeting;
  • The business part of the meeting, the General Membership meeting, has been shortened from a half a day on Saturday to two hours;
  • Free time.  You will have some opportunities to network with your colleagues from other parts of the state and/or to enjoy Mount Desert Island with your family - MMA will make some group dinner reservations at local restaurants for Friday evening and Saturday afternoon is free time;
  • More relaxed.  Rather than the formal Saturday evening banquet, we will have a casual lobster bake at the Bar Harbor Club on Saturday evening;
  • Relevant CME.  The CME agenda for the meeting includes presentations through MMA's Academic Detailing program, by a national expert on health care economics and payment systems, and by professionals focused on physician health and wellness; and
  • Exercise.  You will have a chance to walk or run in the 34th Edmund Hardy, M.D. Road Race on Sunday morning!
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ACCME® 2013 Annual Report Executive Summary

Accreditation Council for Continuing Medical Education 2013 Annual Report Executive Summary

Each year, accredited providers within the Accreditation Council for Continuing Medical Education (ACCME®) system, submit data describing their overall continuing medical education (CME) programs.  This information includes the numbers and types of CME activities, the hours of instruction, the numbers of physician and non-physician participants, and some financial information.  From this data and information, the ACCME produces annual reports as a service to accredited CME providers and other stakeholders.  To view the report please use the URL: http://www.accme.org/sites/default/files/630_2013_Annual_Report_20140715.pdf.

Three Sections: The 2013 Annual Report includes three sections.  The first section features aggregated state and national statistics, including total numbers of accredited CME providers, activities, hours of instruction, and participants. The second and third sections feature separate information about the CME delivered by ACCME-accredited providers and by state-accredited providers, offering an overview of the CME system at both the national and state levels.

Trend Analysis:   To offer a long-range view of the accreditation system, the 2013 Annual Report includes a year-by-year data analysis, showing trends in CME revenue and expenses, and the numbers of educational activities, hours of instruction, and participants from 2005 through 2013. The report includes trend analysis exploring participation in various activity types.  Information about the percentages of CME activities designed and analyzed for changes in competence, performance, and patient outcomes, is also included.

Key Takeaways

Scope of the Accreditation System:  The ACCME 2013 Annual Report shows a The report shows a robust, stable system with 1,950 accredited CME providers, including ACCME-accredited and state-accredited providers. Accredited providers offered more than 138,000 educational activities in 2013, comprising more than one million hours of instruction.  These CME activities educated more than 24 million earners, including physicians and other healthcare professionals.   (This figure represents aggregate participant total and not the number of unique participant.  Participants attending multiple activities are counted multiple times.)  Although the number of ACCME providers has declined over the years, this has not been accompanied by a reduction in physicians’ and other health care professionals’ access to accredited CME within the ACCME system.  The number of activities and hours of instruction have increased since 2010.  The number of physician participants in CME activities has remained fairly stable.  The number of non-physician participants has grown steadily.

Activity Types:  CME providers offer a diverse range of activity types.  The ACCME’s information on participation in activity types shows the growth of participation in individualized, self -directed CME such as Internet searching and learning.

CME Design and Evaluation:  Accredited CME providers are successfully achieving the ACCME’s expectations.  The ACCME's Accreditation Criteria require providers to produce educational activities that are designed to create change and to analyze the changes that were achieved as a result of the activities.  For the second year in a row, the report includes the percentages of CME designed and analyzed for changes in competence (teaching health care professionals strategies for translating new knowledge into action), performance (changing and improving what health care professionals actually do in practice) and changes in patient outcomes.

Income:  In 2013, income from other sources made up 61% of total income. (Income from other sources represents income other than commercial support and advertising and exhibits income. Examples include participant registration fees, government grants, private donations, and allocations from a CME provider’s parent organization or other internal departments.)  Commercial support accounted for 26%, and advertising and exhibits accounted for 13% of total income.  Income from other sources has increased steadily with an average yearly increase of 6% since 2005.

About the Annual Report

Commercial Support Reporting: Through 2010, accredited providers estimated the monetary value of the in-kind support they received and included that estimate in their total commercial support numbers.   Beginning in 2011, due to a modification in ACCME commercial support reporting requirements, accredited providers no longer included estimates of in-kind support and reported only monetary commercial support.  Therefore, comparisons between 2011–2013 commercial support numbers and previous years will not be valid.

Income and Expense Reporting:  The ACCME asks accredited providers to report the income and expenses for their individual activities and their overall CME programs.  The ACCME does not ask providers to calculate profit. Due to the variety of organizational types and their accounting systems, readers cannot accurately determine or make assumptions about the profitability of CME or cost per participant based on this data.

Annual Report Preparation: The aggregated information published in this annual report is based upon self-reporting by individual ACCME-accredited provider organizations.  The accuracy and relevance of the responses may vary depending on the accredited providers’ interpretation of questions and categorization of activity types. The ACCME does not provide full verification of the accuracy of all reported information.  The ACCME compares the data to the prior year’s data and investigates significant differences at the individual provider level.  The ACCME also investigates if it appears that providers have reported activity data that does not conform to the ACCME’s definitions and reporting instructions. In some circumstances, accredited providers may submit new data to correct data entry errors.  The information about state-accredited providers included in this annual report is reviewed by ACCME Recognized Accreditors using the same principles as the ACCME.  The ACCME also does a secondary review of data from state-accredited providers.

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Prepare Your Practice for Compliance with New Laws, Effective August 1, 2014

Under the Maine Constitution, most bills enacted by the Legislature and signed into law by the Governor take effect 90 days after adjournment of the Legislature.  This year, adjournment was in late May and the effective date of legislation is August 1st.  Not all the new laws are effective on this date as emergency legislation takes effect immediately upon the Governor's signature and some bills include a different and specific effective date.  

Among the laws taking effect next week which are of most significance to physician practices are the following:

  •  L.D. 1642 and L.D. 1760 advancing health care pricing transparency; and
  • L.D. 388 and 1840 streamlining enrollment for the Prescription Monitoring Program.

Information on all the newly enacted laws can be found on the legislative and regulatory section of the MMA web site.



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CBO Budget Report Estimates Federal Health Spending to be 8% by 2039

The Congressional Budget Office (CBO) released its annual long-term budget outlook on July 15th and in it the CBO estimates that spending on federal health care programs will reach 8% of GDP, the same as the Office estimated in 2013.  The CBO projects that in 2039 4.6% of GDP will be spent on Medicare and 3.4% would be spent on Medicaid, the Children's Health Insurance Program (CHIP), and ACA insurance subsidies.  During the next 25 years, aging will account for 39% of health care spending growth, excess cost growth will account for 33%, and the expansion of federal subsidies will account for 28%.  New technology also will drive health care spending. [return to top]

Protect Against Inaccurate Reporting Under the Sunshine Act

Financial interactions between physicians and manufacturers of drugs and medical devices—including everything from research and ownership interests to reprinted journal articles and meals—soon will be made public under the Physician Payments Sunshine Act (also known as the Open Payments Program).  Doctors need to act quickly to make sure they're protected from inaccurate reporting.

The AMA successfully convinced the Centers for Medicare & Medicaid Services (CMS) that physicians should be able to review and dispute the financial data drug companies have reported about them prior to publication, but the agency has left very little time for physicians to do so.

The MMA would like members to know they have a way to protect themselves and understand the steps to take.

Time is of the essence.  There are three steps physicians must take in order to review and dispute the data reported about them:

  • Step 1: Complete CMS' e-verification process, which opened June 1st and must be finished before physicians can take the next step.
  • Step 2: Register with CMS' Open Payments system, which should be available in a matter of days.
  • Step 3: Review and dispute their data within 45 days.

Disputes that are filed before a yet-to-be-announced August cut-off date will be flagged as such in the initial public release September 30th.  Physicians will have until December 31st to retrospectively file disputes about their data.

Physicians can access the practical information they need to navigate the Sunshine Act data release in a free online toolkit from the AMA. 

Download a package of ready-made communications materials, including sample articles, an infographic and social media postings.  Additional materials will be added as steps 2 and 3 become available.

Possible changes to the continuing medical education (CME) exemption: In the proposed Medicare Physician Fee Schedule for 2015, CMS has proposed revoking the Sunshine Act exemption of financial transfers made to organizations that offer independent CME accredited by the Accreditation Council for Continuing Medical Education or when credit is granted by the AMA, American Academy of Family Physicians, American Osteopathic Association or American Dental Association. 

The agency instead is proposing to exempt third-party financial transfers for CME only when an industry donor is unaware of the recipients or beneficiaries before and after the funds are transferred.  This raises concerns because the industry potentially could learn the identities of speakers and participants through brochures, programs and other publications related to a CME event after the funds have been transferred. 

The AMA is concerned that the proposal will have a chilling impact on accredited CME.  The proposed fee schedule rule also includes two other options that address CMS' concerns about the current structure of the CME exemption.  The AMA is evaluating these options and will be in communication with the Federation as it prepares comments.

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Health Insurance Marketplace Update; Special Enrollment Opportunities Beyond Open Enrollment

Open Enrollment

The next Open Enrollment Period to sign up for insurance through the Health Insurance Marketplace is November 15, 2014 through February 15, 2015.  


Special Enrollment Periods

Outside of Open Enrollment, some people can sign up for health insurance through the Marketplace if they have a life change – known as a “qualifying life event” – that makes them eligible for a Special Enrollment Period.  These changes include marriage, birth, adoption or taking in a foster child, or permanently moving to an area with different health plan options.   Most Special Enrollment Periods last 60 days from the date of the qualifying life event.  Be sure to apply during the special enrollment period as soon as possible after the qualifying life event occurs.   


Do you know your local Navigator or Certified Application Counselor (CAC)? 

Susan Kring, MMA ACA Outreach Coordinator can connect you with Navigators or CACs in your area so you can refer patients who want to learn more about the Health Insurance Marketplace and enrollment assistance.  Contact Sue at 662-2364 or skring@mainemed.com

 For information online: go to www.healthcare.gov to find out about enrollment and eligibility for financial assistance and to apply online. 

 For information by phone: call the Health Insurance Marketplace Call Center at 1-800-318-2596 with questions or to apply by phone.

 Find local assistance in Maine: search for a local Navigator or Certified Application Counselor (CAC) at www.enroll207.com.

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Job Openings

Join the Health Team or Professional Space Available

We are a dynamic Bone Health Team in South Portland Maine, looking for providers to join us to help promote and manage overall health, bone strength, nutrition, fitness and related lifestyle enhancement.  We offer high quality DXA testing and comprehensive osteoporosis management skills.  We created and continue to run the Southern Maine Osteoporosis Support and Education Group - since 1996.  If you really want to help patients to improve their health and their lives - this is the place.   Ann Babbitt MD and Staff

We also offer the opportunity for Office Sharing or Rental:   1) ~ 1500- 4800 sq. ft.  -several offices and exam rooms 9 +, open space for meetings/activities, full kitchen and storage area, 3 bathrooms, lots of parking; all is on ground level. The spaces and possibilities are flexible and options are available.  

Call 207-233-4266 or email ababbitt@maine.rr.com.


Full time Emergency Department Position Available

A full time Emergency Department position is available at Sebasticook Valley Hospital (SVH). Join a hospital employed team of 5 physicians providing 24-hour coverage. ED volume is 13,000 annually. Schedule options include 12 and 24 hr. shifts. SVH is part of the Eastern Maine Healthcare System. Ground transportation and Lifeflight services are available at SVH. The position comes with generous pay rate, vacation, malpractice, relocation expenses, and assistance with medical education debt. Qualifications: Board Certified in Emergency Medicine, or Family Practice with ED/urgent care experience. Contact: Sherry Tardy, 207-487-4085.

Sebasticook Valley Health (SVH) is a progressive 25-bed Critical Access Hospital in Pittsfield, Maine. We are an integral member of the communities it serves. SVH takes a proactive approach in helping people in the Sebasticook Valley region improve the quality of their lives. The hospital works with local businesses, schools, area organizations, and private individuals to make the Valley a healthy place to live. SVH serves an area of approximately 16,500 people and has a wide range of outpatient services, including many specialty services. An expansion and total renovation of the inpatient unit was completed in 2013, offering attractive spacious private patient rooms, state of the art communication’s system.


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


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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Upcoming Events

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 atusm.maine.edu/muskie/psa



The Maine Public Health Association’s (MPHA) 

30th Annual Fall Conference

October 7, 2014

Augusta Civic Center

Keynote speakers include: Erik N. Steele, D.O., FAAFP, Senior Vice President, Chief Medical Officer, Summa Health System and Paul Kuehnert, DNP, RN Team Director for the Bridging Health and Health Care Portfolio, Robert Wood Johnson Foundation

For more information or to register, click here.


Maine Concussion Management Initiative Training

October 21, 2014 in Portland in conjunction with the Maine Brain Injury Conference

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